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Health
Time to Take Charge Again
by Malvika Kaul
October 30, 2005
"In the
Chittagong Hills (in Bangladesh), giving birth to babies is like
ensuring one's death. Women wait and wait for a doctor to arrive and
eventually they die while delivering the child," declared a woman health
worker at the 10th International Women's Health Meet (IWHM)
recently. The health worker was describing what women in some parts of
South Asia go through while delivering a child.
The Bangladeshi health worker was speaking at a special consultative
meet organised by the Malaysia-based advocacy group Arrow. Arrow's meet
aimed to share the various strategies deployed by the Women's Health and
Rights Advocacy Partnership (WHRAP) in strengthening the women's health
movement.
"In a house, if a man and woman are both suffering from an illness, it's
the former who is rushed to the hospital. Women's health needs are
rarely addressed. Why are women suffering, despite so much advancement
in health, and so many leaders pushing for women's health rights," the
health worker asked a group of experts at the Arrow meet. Her questions
grew sharper: "There are over a 1,000 women leaders in the IWHM, yet
even as the meet is on, several women are dying in the process of just
giving birth."
In some ways, her posers were like a reality check on the women's health
rights movement: What has been achieved and what still needs to be
achieved? How far have we come and how far do we still need to go? The
IWHM's broad theme: 'Health Rights, Women's Lives: Challenges &
Strategies for Movement Building' included discussions on how
globalisation is impacting women's health; gender politics of GATS; how
violence against women is becoming a huge risk to their health and well
being; and how women's perspectives need to be integrated in various
policymaking processes.
Worldwide, post-globalisation, women are socially and personally more
vulnerable and financially more insecure. Besides, new age medical
technologies have, in some countries, have threatened the very existence
of a female child.
The 10th IWHM had not only activists, grassroots workers and doctors
debating about women's health, but also economists, poets and
filmmakers, discussing how to take the movement forward.
A recurrent theme at the meet was inequity - why some people (women) are
more vulnerable to diseases and death. As Pakistani activist Kausar Khan
said during one of the meetings: "The role of inequity is so very
relevant today."
The meet also had some 'old enemies' of the movement - resistance to
women's right to sexual and reproductive health (SRH) - being discussed
in the current context. For almost five years now, women's groups and
health experts have been grieving over how and why the SRH issue got
excluded not only from the agenda of the Millennium Development Goals (MDGs)
but also from the priority list of most governments.
In a way, all the gains of the International Conference on Population
and Development held in Cairo in 1994, and the UN Fourth World
Conference on Women in Beijing in 1995, seem to have been lost, with SRH
hardly a focus for governments and planners. The Bangladeshi health
worker's example of the conditions prevailing in Chittagong was just one
of the many illustrations of SRH not being a priority any longer.
Although, in the last two decades, feminists and activists have enlarged
the entire concept of health and well being, not restricting women's
health to just their maternal roles and reproductive rights, the ground
reality demands that we revisit some of these core rights all over
again.
In five South Asian countries - India, Nepal, Bangladesh, Pakistan and
Sri Lanka - high maternal mortality rates (MMR) rates suggest that
reproductive health is really not a goal for the policymakers. The media
regularly reports shocking stories of negligence and of women suffering
because basic health care is still unavailable to most.
Even the recently released 'State of World Population 2005' report by
UNFPA says that every year over 500,000 women die due to
pregnancy-related causes across the world. Lack of access to
contraceptives in the developing world results in 76 million unwanted
pregnancies and an estimated 19 million unsafe abortions worldwide every
year. Ninety nine per cent of the maternal deaths occur in developing
countries.
In recent years, most of the resistance to SRH has centred around
abortion. According to the UNFPA report, unsafe abortions are a leading
cause of maternal mortality and can result in permanent injuries. "Many
women who seek abortions are married. They are usually poor and
struggling to provide for children they already have. Research suggests
that one in 10 pregnancies will end in an unsafe abortion, with Asia,
Africa and Latin America accounting for the highest numbers," says the
report.
Even though the UN recognises SRH as essential step to reduce MMR,
infant mortality rates and the risk of acquiring HIV/AIDS, SRH has been
excluded from the MDGs.
So how can SRH become the centre of the policymaking process? How can
governments be held accountable to ensuring basic health services to
women? How can women's groups and health rights workers ensure that
there is no delay in treatment even in the most remote areas?
The WHRAP partners shared some wonderful experiences of how they have
tried to push the SRH agenda in their respective countries. India
partners, Sahayog (based in Uttar Pradesh) and Chetna (based in
Gujarat), described how research-based advocacy had helped influence
policymakers on SRH issues. In fact, advocacy based on grassroots
research, conducted by local women themselves, made a deeper impact on
the government planners.
Jashodhara Dasgupta from Sahayog said that the process of studying the
system of service providers and producing evidence of negligence has
itself been an empowering process for women in the villages. The women
have now learnt how to access their rights.
A question from one of the participants in the Arrow meet - how personal
issues like sexual and reproductive health needs can be discussed with
village women - suggested how several biases about village women still
need to be challenged. All WHRAP partners agreed that compared to urban
women, village women were less inhibited when it came to talking about
their reproductive concerns. Their experience showed that once women
became aware of their rights, they became more determined to access it.
A gentle but firm appeal was made by some participants to see how men
can be involved as partners. Their role, some felt, may give the
movement that extra push it so badly needs.
The key to successfully push the SRH agenda lies in linking grassroots
experiences with policy issues. Simultaneously, activists and pressure
groups need to use every existing law and legal or representative body
to demand for more SRH-related reforms and for more accountability
within the government.
While the 10th IWHM may not have thrown up answers to all fundamental
questions and concerns about the future of the women's health movement,
it did help in indicating that the struggle for women's health rights
will not only be a long one, but be full of new challenges and old
obstacles.
It's time to take charge, all over again.
By arrangement with
Women's Feature Service
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| Health
The Week of October 30, 2005
The
Quake Opened a Window by Rajinder Puri
United States' "Democracy Thrust" in South Asia is Selective by
Dr. Subhash
Kapila
Lord Curzon and The Partition of Bengal by
Kumud Biswas
Third Child Trick by J. Ajithkumar
Inner City Schools, Affirmative Action and A Child
Left Behind by Gaurang Bhatt, MD
The Art of Happiness: Keep Your Pleasures Mild
by Vikram Karve
Choice of Children's Careers and Parental Aspirations
by Meera Chowdhry
Silver, Silver Shining Bright by Alipta Jena
Speaking for Her Security by Deepti Priya
Mehrotra
Victory for VAWA by Elayne Clift
A Moral Victory is Not What we Want by Gautam
Bhan
Power to the Village
Time to Take
Charge Again by Malvika Kaul
Very Rewarding Scheme by Vipin Agnihotri
Our trip to Cologne (Germany) Durga Puja 2005… by
Jayati Chowdhury
Visiting Ladakh by Anamika Banerjee
Wild Flowers of Chhialekh A Photo
Essay by Kana Talukder
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