Health Response Paper

Carly James

Women in the Developing World

April 1, 2011

Response Paper – Health – Weeks 7-9

The past several weeks of class have introduced me to several new topics of which I had previously been completely unaware. For instance, the issue of obstetric fistula is a major problem of dire need in many parts of the developing world, but goes largely unattended. Why? We discussed some of these reasons in class. Fistula is a problem that affects women directly (men indirectly), so perhaps the gendered nature of the problem contributes to how much attention it gets from policy-makers, NGOs, etc. We discussed how the issue has to do with reproduction and maternity, a somewhat commonplace phenomenon. That is, it is not an epidemic which has cropped up only recently—something like HIV/AIDS, for example, which is more tended to. Reproduction and child-bearing happens everyday and affects so many women. We discussed the barriers women face in terms of support during childbirth, and the issue of access seemed to be the common thread. Reproduction involves much more than the act of giving birth. In order for a woman to be properly taken care of before, during, and after pregnancy, she needs access to quality healthcare, family planning services, knowledge/education on the health concerns associated with childbearing, etc. Gaining access to these services means incurring transportation costs, healthcare costs, and many other service costs. It is undeniable in reading about obstetric fistula and other pregnancy complications that maternal healthcare, as mundane as it may seem, is a pocket of need that seems to have gone largely untouched for too long.

In addition to the topic of obstetric fistula, we discussed HIV/AIDS, female genital mutilation, pollution, and many other issues that affect women’s health. While our discussion of specific health issues was very enlightening for me, I also really enjoyed talking about women’s health in more of a macro sense. For instance, should policy be gender-blind? What are the positive and negative effects of looking at social injustices as gendered phenomena? Also, how far does cultural relativism reach? How do we change cultural norms as outsiders? And is that appropriate? Many of us want to argue that respecting cultural practices is always of the utmost importance, but when human rights abuses enter the equation, does the same argument still hold true? It seems almost impossible in this class to discuss issues affecting women’s health in the developing world and not want to understand the longstanding ignorance associated with them. Furthermore, it is difficult to read about the conditions women face and not want to question why solutions have not yet been found. This is partially due to the nature of the conditions themselves. Over the past several weeks, we have read about prostitutes being affected by HIV/AIDS because their clients prefer to not use a condom. We have read about young girls who are forced to have their genitals cut in order to reduce sexual pleasure. We have seen the women who spend much of their day squatting over rudimentary ovens or open fires burning biomass, causing them health complications. In all of these instances, we see common practices burdening women, sometimes exclusively, with serious health-related issues. The next question, then, is when do women’s health issues cross gender lines and become the concerns of both men and women? That is, when do these become societal problems? I would argue that they are always the burden of the society. For example, if a woman is unable to bear a child in a safe, healthy way, then the society’s population, the husband’s reputation (which may rest on having a child), and the future of the woman’s family are all severely threatened. Issues like this impact both genders, and should therefore be taken much more seriously among policy-makers. One of the questions we dissected over the course of these past few weeks has to do with this: why are women’s health issues not seen as a problem of the society at-large?

Senegalese women face a number of the health problems we discussed in class over the past several weeks, with a specific emphasis on maternal mortality and obstetric care. In Senegal, the lifetime average number of children per woman is five. Only about 12% of women of reproductive age use or have used contraceptives. Female genital mutilation has been known to be a common cultural practice in areas of Senegal, as well. Women’s health is of particular interest in Senegal, because these social concerns are contextualized in an environment where women’s rights are not in abundance and a Muslim-dominated culture disallows people to be open about issues related to their sexuality. In Senegal, clans and families take precedence over individuals, so individual rights are often glossed over in favor of family or clan-oriented rights. For instance, self-determination, bodily integrity, ownership of one’s body, and overall agency can be limited—particularly among women and girls. It is clear that Islam can play a role in thwarting women’s reproductive and sexual rights. Thus, women’s health issues in Senegal are not simply about quality and cost, but also about equality and empowerment.