Global Health Reproductive Rights

Day Three: Live-Blogging Women Deliver!

It’s Day 3 of the three-day international conference Women Deliver 2010 in Washington, D.C., and Ms. Bloggers are still on the scene. The conference intends to hammer home the point that maternal and reproductive health is a global priority.

Want to do something to help? You can click here to urge President Obama to keep the U.S.’s promise to ensure women everywhere universal access to reproductive-health services, family planning, and basic education by 2015.

Advocacy and Activism

A session put together by the Merlin Group, an international medical nonprofit organization, focused on how to train health workers and increase the number of skilled birth attendants in fragile, conflict-stricken states. The desired outcome: meeting Millennium Development Goal (MDG)5, which aims to cut world maternal mortality deaths by three-quarters.

Where exactly are women, specifically mothers, dying? According to Merlin, almost 50 percent of maternal deaths occur in fragile states. Merlin reports that, with the exception of Afghanistan, more women die in sub-Saharan Africa than anywhere else in the world.

Afghanistan has the second highest rate of maternal-related deaths in the world: One in eight Afghan women will die from complications during pregnancy or childbirth. Compare this to one in 4,800 in the United States and one in 17,400 in Sweden. War-torn Afghanistan has been left with a poorly functioning health care system and a drastic shortage of doctors, nurses and midwives. Only 14 percent of Afghan women receive skilled medical attention during pregnancy or childbirth, so death by hemorrhaging and prolonged or obstructed labor is a very real threat. Most women have never seen a doctor, and few have access to contraception.

Merlin’s two community midwife training schools, in the Takhar and Kunduz provinces of Afghanistan, have so far trained 155 students to go out and work in their communities. “With more skilled health workers, more mothers will be saved,” Merlin states. “If change can happen in Afghanistan, then it can happen anywhere.”

The Feminist Majority Foundation has long advocated for the health and rights of Afghan women and girls, and its health initiative for Afghan women  works to increase the number of midwives in order to reduce the maternal mortality rate. You can join the campaign and help save Afghan women’s lives: Find out more about the Afghan’s Women’s Women’s Health Initiative here [PDF].

Anushay Hossain

Cervical Cancer is a Problem of Inequity

1 p.m. I spoke with Dr. Lynette Denny, principal specialist and professor of obstetrics and gynecology at the University of Cape Town, South Africa. For the past 15 years, Dr. Denny’s research has focused on cervical cancer prevention in low-resource settings.

Ms. magazine Blog/Danielle Roderick: Yesterday you mentioned that cervical cancer is as much a tragedy as maternal mortality. How so?

Dr. Lynette Denny: In some areas, more women die from cervical cancer than they do from maternal mortality, particularly in Eastern Europe. Certainly in Africa, maternal mortality has been a much bigger problem, But if you think about who dies … in pregnancy-related deaths it tends to be younger women, where with cervical cancer it’s older women who have a very important role to play, particularly in poor communities. In parts of my country in South Africa, 70 percent of households are headed by women, and they’re the sole breadwinners.

Ms.: The winter Issue of Ms. looked at how men’s health is a feminist issue, especially regarding HPV. How does that come into play here?

LD: Involving men is very important. It’s a resource issue. If you have no resource constraints, it makes sense to vaccinate boys and girls, but where you have resource constraints it’s more cost effective to vaccinate women first, and then as your resources increase you include men.

Ms.: Is it easier to address HPV as a women’s issue, like cervical cancer, rather than as an STI?

LD: Certainly in most developing countries we are not interested in putting this as a prevention of an STI. We talk about this as a cancer vaccine. There are two problems with the word STI–one is the perception that you’re dirty, promiscuous, all that language. The other is that HPV is a very different STI  because … whether you manifest an HPV-related disease or not, it’s a manifestation of your own immune system.

Many of the women I treat have only had one partner in their lives, have never been promiscuous … but acquire HPV through [that] partner. She lives life, she’s a poor woman, she has TB, she might have a compromised immune system–so she develops cervical cancer because her system was unable to get rid of the virus. But that only happens 30 years later.

Ms.: What do people need to know about cervical cancer?

LD: It is a common killer and preventable.  We’ve known for over 100 years how to prevent this disease, yet we’ve not brought the technology to women in poor countries. It’s a disease of inequity. It’s highly political.

If you’re a poor black woman born in Africa and you get HPV infection, you’ll die of cervical cancer. You won’t even have access to treatment. If you are a woman infected with HPV in New York, either your immune system will be so strong (because you’re well-nourished, etc. ) you won’t manifest, or if you get cervical cancer you’ll survive it, or it will be prevented because you will get a pap smear every year. It is really a disease of inequity of access to healthcare.

Danielle Roderick

Ghana Seeks Greater Progress Against Maternal Mortality

11:02 a.m. I interviewed Dorothy Onny, one of several African leaders participating in Women Deliver. As deputy director for Ghana’s Ministry of Women and Children Affairs, she is hesitant to rate Ghana’s progress on reducing maternal mortality. In fact, Onny says that all of Africa is facing the same problem: keeping women from dying from pregnancy-related complications. According to Onny, Ghana is intensifying its efforts to make greater progress, including initiating public education campaigns to get more women to seek prenatal and postnatal care, and to encourage them to get help earlier before they experience complications. She says delaying medical care is one of the major causes of maternal mortality. And she says that Ghana–like many other African nations–needs financial support to sustain any progress in saving women’s lives.

Belle Taylor-McGhee

CEDAW–Pushing Ahead for Ratification

11 a.m. During a panel, Ellie Smeal, president of the Feminist Majority Foundation and publisher of Ms., says there is growing support to ratify the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW.) But politicians are standing in the way of history.

The U.S. is one of the last holdouts to ratify the international treaty, which supports women’s basic human rights, including access to basic healthcare (which could improve maternal health), pay equity for women, prevention of violence and women’s right to property and other basic human rights. Sixty-seven votes are needed to pass CEDAW in the Senate and, according to supporters; they are only eight votes shy of a victory.

Belle Taylor-McGhee

Joan Walsh: Words Matter

11:00 a.m. I sat in the front row as Salon Editor-in-Chief Joan Walsh opened the “chairman’s” session by asking the audience: Are there ways that language can help us broaden our reach to a larger audience? To policymakers, to women, to faith-based organizations? “We always need to be checking our language,” Walsh says to a scattered audience in the Plenary Hall, which has taken on the air of a college lecture hall.

Walsh continued,

As effective as this language [at Women Deliver] is, we are still treating women primarily as mothers. Should we be talking more about her innate human rights?… A lot of people still think that this movement is all about abortion, and to a degree our movement has compromised on abortion as a result.

Walsh was joined on stage by panelists Katja Iversen, media specialist and campaign coordinator for UNFPA (United Nations Population Fund); Ana Amuchastegui from Mexico; Kathy Bushkin Calvin, CEO of the United Nations Foundation (UNF) and Ethel Klein of EDK Associates USA. All agreed that language is incredibly important in messaging and cultivating a base of support.

Walsh asked panelists what’s been successful about Women Deliver’s messages, to which Iversen answered:

I love the slogan “Invest in women, it pays.” The Women Deliver title itself is great. This kind of messaging speaks to people outside the movement.

But then Walsh brought up the issue of the wording “maternal mortality” and how it reinforces women as caretakers and does not focus enough on women’s contribution to society. And is the issue of “rights” going away from the messaging of Women Deliver?

Iversen said it’s about cultural context:

What does a woman delivering mean in this culture versus another? Yes, it reinforces women as mothers, but also puts women as investors in the economy of their country.

Calvin of UNF pointed out that a …

“… shift to a rights-based discussion is important, but not everyone responds to that as they do to an individual-rights- based discussion–i.e., having a child is my right my choice.”

This is when the conversation took a very interesting turn about how words mean different things in different cultures, and how some words do not translate at all. As Mexico’s Amuchastegui put it:

[A] rights-based discussion in [the U.S.] is very different than how it is in Latin America, for example, where we are still trying to solidify our democracies. Our people’s rights have not always been respected; we’ve suffered under long dictatorships. So while the language of rights is crucial, it does not just mean sexual rights in our countries–where we are still trying to get our individual rights, our human rights recognized. So there is a huge difference on how the concept of rights are perceived in U.S. vs globally. “Empowerment,” the word, does not even exist in Spanish.

Who knew?! This discussion exposed how the Global North still dictates not only a large part of of development policies implemented in the Global South (these are newly accepted terms for “developed” vs. “developing world”–which I cannot stand, but I will save that for another post!), but how the Global North even dictates the language that we use.

Said Iversen of UNFPA:

Yes, many people around the world are still trying to figure out what their rights are. Do you know what your human rights and are you able to access them? The American approach is “It’s your right so go get it,” and not everyone is able to do that.

Countered Walsh:

Yes, it is true, but it is a fact that some of our messaging is just not going to translate. For example, in some places contraception means empowerment, but in other cultures it doesn’t mean that and is more about reproduction. It is important to talk about these differences.

The discussion then turned back to how we create powerful messages, and Walsh made an interesting case about how the “maternal mortality world portrays women as victims, and they are really not empowering women or reaching women as actors.”

Ethel Klein added how the “victim stuff is getting old”:

When people see a problem, they want to fix it, but if it seems too big they feel hopeless. People think they are just giving charity. We have to think about the long-term; it’s very important.

Anushay Hossain

Conversation with Jill Sheffield

11:30 a.m. I was able to speak with Jill Sheffield, founder and President of Women and Deliver, to take a look at the conference on its last day.

Ms. magazine Blog/Danielle Roderick: The conference has made a great effort to include youth. Why the decision to include youth as a key focus of Women Deliver?

Jill Sheffield: If youth is half the world, youth may not be quite  50 percent of the conference, but it’s much more than a third, it’s getting up to half … and the energy and the focus and the stories and the sheer power of it is going to move us through this. [Sheffield mentioned that there were over 6000 pplicants for the 600 scholarships the conference provides to advocates under 30.]

Ms.: What has been the biggest surprise of Women Deliver for you?

JS: We didn’t have much opposition… The blogs and so on led us to believe there might be. [Sheffield mentioned earlier that protesters had been expected.] And I think it’s because of the approach we have. [Maternal health care is] a domestic issue, it’s a global issue, and it’s broad. Women don’t deliver just babies; that’s the point. When we started this, everybody said “Oh, sure, women deliver babies…”.  We’ve grown out of that; we’ve grown up and we’ve grown beyond that. We now know women can deliver, and do deliver, almost everything.

Ms.: How does bringing together all of these advocates who agree on the importance of maternal healthcare change the conversation? What is different from June 5th when the conference started?

JS: They’re not isolated anymore, they know their resources. All kinds of information, media and money. But it’s bigger than any one person. It always makes you feel better to be part of a positive movement, and that’s what this has become. [In an earlier conversation, Sheffield noted that collaboration  had already taken place–for example, a texting service for pregnant women that was previously only used in the U.S. is now used in eight countries because of conversations at the conference.

Ms.: What do you hope attendees are thinking as they leave the conference tonight?

JS: That they can do it.  That they have to do it, and they’re going to do it.

Danielle Roderick

Young People Deliver

8:30 a.m. Youth is the word this morning, as Ashley Judd introduces the day’s opening plenary “Young Women Deliver.”  Bemoaning the early hour, she promises this might be “the best panel  yet” and introduces the group as all “8-o’clockable” people.  I love this term, and Women Deliver, every day, has proved to be very 8-o’clockable.

The panel of young speakers does indeed deliver on inspiration, hope and all the things that we want youth to be.  Every speaker has an amazing story–the kind of amazing that makes you want to spend less time watching television and more time saving the world because it is actually possible.

There was Maihan Wali of Afghanistan, who started a girls basketball team league across her country and watched a friend die because of her involvement. There was Josh Nesbit of the U.S., who developed a text messaging service to help with heath communications, radically changing care. There was Sarah Nkhoma of Malawi, who attends a university where 1 out of 3 students is HIV-positive, including her own sister.

Each spoke of courage, innovation and the emotion that fueled their projects. A key theme seemed to be that these young people decided to act when statistics became real to them. As Nkhoma said, “You can’t afford to ignore something that happens all around you.”

Danielle Roderick

Above photo courtesy of Women Deliver.

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