Showing posts with label maternal health. Show all posts
Showing posts with label maternal health. Show all posts

Sunday, 30 March 2014

Breaking the Culture of Silence in India

“I was a girl, now I am a woman, I came alone, I die alone.
People cried when I was born, when I die none will mourn.”
_________

Antim, 13 years old had not eaten properly since years. After all, she was a girl.  When she was born, the whole community had cried. Not tears of joy but of pain. After the torturous nine months that her mother had gone through, all everyone was expecting was to see the baby that would carry the family name ahead, bring joy to the community where having a baby girl was a sin. And when she came in, not only did the family-friends cried, the mother who had borne her in her uterus cried, from both her heart and her body. She was that’s why named Antim, which meant, the last one.

Her mother conceived almost as soon as she could again. And when her brother was born, that was the end of any happiness she could have seen in this world where patriarchy was the only rule that prevailed. While the whole crowd around her danced in joy, the pain she will have to go through was right in front of her, waiting to grab her like a demon. As she grew, she remained aloof of the basic joys of life: freedom, food and family. At 13, when she started menstruating for the first time, as confused as she was of the changes that were happening to her, she was unaware of the fact that now, the burden of being a woman had grabbed her, a burden she would have to deal with a smile on her face. No proper nutrition, thousand rules to abide by, and unaware of what she could have been, she was being trained to become a woman, a woman who her mother was, her grandmother was and may be her baby girl will be later.

Menstruation is a phenomenon that changes everything for a girl. As she dwindles with the body and emotional changes that happen to her, she is forced to take it as a curse instead of a blessing. On one hand where she can see her body change, on the other she sees how her curious mind is shut forever. Neither does her mother tell her what to do, nor does anybody else. Hygiene, nutrition, puberty, sex education are topics that are dusted under the carpet. As she grows, she realizes that she must have done sins to be born a woman.
______________

Suman, 23 years old sits beside me as we discuss the issues women face in the community. A look at her is enough to understand that though she smiles, she is empty inside. A mother to three girls, she has recently gone through her third abortion. In her six years of marriage, she has been pregnant almost always. With an expressionless face, she explains that somewhere women are born to live a life this way. The purpose of a woman coming on this earth is only to reproduce and so what she was going through seemed to her like a duty. Desires somewhere had died long ago, or maybe never existed at all.

She was married when she was 17 years old. A case of child marriage as she was, she had never seen her husband’s face, and so marriage was just another duty. In a small yet rich town of the most prosperous state of India, she came to her in-laws knowing the duties she was entitled to do. One of which was satisfying her husband in bed, another one being giving the family the heir, male heir. On one hand while she dwindled with expectations of the family growing every day for her to produce a baby boy, she was being cursed every day for failing to deliver. And so, one abortion after another she was loosing faith in her being able to fulfill her duty, failing to be the ideal woman she was defined to be since childhood. Droopy eyes with dark circles around, she was pregnant this time too and scared because soon she had to go through an ultrasound examination to know the sex of the baby. Little she know, its not she who defined the sex of the baby, biologically.  Suman as she was proudly named, which means a flower, had no meaning in her life because she wasn’t aware what blooming was all about.

Issues of Family Planning go way beyond the number of babies. It encompasses the awareness of contraception, rights to make that choice on using one, it entails the issues of Maternal and childcare, it entails patriarchy and control over bodies, involves issues of infection, HIV and Violence Against Women. It’s much more than contraception and incentives to get vasectomy or birth control.  The fact that even today women simply fail to say NO to their husbands and family pressures go beyond any government scheme or incentives given. The issue remains, of dialogue to move beyond ego issues of males related to condoms, of asking instead of forcing to have sex and reproduce.
_____________

Banwari, 55 years sat next to her granddaughter telling her how to cook as her mother went on the farm. She is greeted by the Nurse from the nearby Local health Clinic set up by the government asking her about the injection schedule for the baby boy just born. During the few minutes of conversation, she is tempted to ask her about the changes that she has been undergoing. She had been trying to ask her since months and so, after a lot of courage she shares her troubles. She goes on and describes a series of symptoms that she has been going through. Her knees have started to pain, she is having uneven periods.. the nurse tells her about Menopause but tries to explain to her how she should get herself tested for once. She shuns the idea, takes it as normal and shows her the door.

After two more months of pain and trouble, she wonders if she should have got those tests done. The local ayurveda doctor medicines didn’t work, neither did the priests prayers. The local community radio channel playing on the radio beside her grandson who lies there playing on the cot has the reporter discussing a similar problem. She is hesitant to discuss the issue with anyone, but after a lot of thinking she finally gathers the courage to call the doctor on the call-in show, happy that she isn’t sitting face to face with him. Being retold to get herself examined, she wonders if it was time to see a doctor.. silently, she gets back to her work. She looks at her grand daughter, maybe she sees in her a reflection of her own past. Named after Lord Krishna himself, she must show courage to handle all her pains.

While Menopause is a natural phenomenon, cervical cancers have been on a rise in the country of India. The fact that a woman would think a hundred times before she sees a doctor for a ‘personal’ problem that should not be spoken about to anyone, makes it evident that screening is slower even after awareness. Even today, when it comes to issues related to Maternal Health, Personal hygiene and Feminine care, women in rural India are just not ready to voice out their concerns, their fears. The will live in pain, as they have been trained to but never speak out, thereby remain voiceless.

_____________

These Three stories connect to the Culture of silence in India. Keep aside men. Keep aside social rituals. The fact that even a woman cannot easily talk to a woman about her troubles and get empathy in return makes it evident that even after 65 years of independence, women are crippled by social customs and age-old traditions to a level where they wont speak their desires out. Though systems of support outside family exist, the fact that the first connection should happen at home leaves them helpless. The culture of silence on issues of Menstruation, Maternal Health and Menopause have been there since ever, especially in Northern part of India. These three make women feel burdened of living and while she had faced the same in her childhood, she doesn’t easily take a step to fight for her daughter or daughter-in-law.

Privacy is good. But sometimes issues like these that are of common good, women good, need to be spoken out loud. “We tell ourselves stories in order to live” was a strong statement that Joan Didion had given long time ago. Such stories of pain and sorrow need to be spoken out loud in order to motivate women not to face troubles with a smile, but to voice out the issues they face, the pains they go through, the fears they live with.

What is the starting point?

“Starting a dialogue, maybe”

Friday, 14 February 2014

Women, Contraception & Issues of Access-Usage-Rights

She was all of 22 year old. Four daughters already, two abortions done, I thought I should ask her how it felt to have been pregnant literally all the time since she had been married off. But before I could, her tear-filled eyes looked at me, her lips tried to (fake a) smile, and she said, “This is what women are born for after all. Isn’t it?” I had no answer.
It wasn’t literally that I had none. Somehow I could have used all my textbook based knowledge and my dose of empathy to make her understand that she was worth more than that. That she was powerful. That she was more than a baby-producing machine. That she had rights. But suddenly at that moment, I was completely numb. I had nothing to say. I realized how every system, every policy, every initiative, every organization had failed at that very moment for me.
Do I sound a little hopeless? I had to be. I had no other choice that moment. This issue was more complicated than it looked. What were the problems? Was it Patriarchy and Women’s Status? Or was it access to contraception? Decision making? Or Maternal Health Care? Male-heir desperation? What was it?
On my way back, her strong words kept on resonating in my mind and all I could feel was a sudden rush, an uncontrollable feeling of hatred towards society. People call me emotional with respect to my work. They say I should be more practical. But wasn’t the first reason I joined such a work force that I wanted my emotions to become a passion? I had a hundred thoughts and as the sun started setting, the cold breeze seemed to hit me harder than it usually did.
Issues of Family Planning go way beyond the number of babies. It encompasses the awareness of contraception, rights to make that choice on using one, it entails the issues of maternal and child care, it entails patriarchy and control over bodies, it involves issues of infection, HIV and Violence Against Women. It’s much more than contraception and incentives to get vasectomy or birth control. While the whole system in the country is working towards making people have  control over the production of babies, the lack of empathy has resulted in a flawed policy system where what we have reached today is a point on which we as citizens and humans are better off killing female fetuses and ignoring maternal health.
The fact remains that while an educated strong working urban woman is moving towards using contraception for her own sake, in an average Indian household (let’s not even discuss rural here) a woman still struggles to discuss contraceptive measures to be used by males. She will pop an i-pill or hormonal contraceptive pill rather than ask her husband to use condoms. Condoms have male ego attached to them.
So, when I asked that woman from a very economically progressive yet patriarchal town of a very rich state in India about her view on condoms and birth control, the blank look on her face made me wonder where we are all going wrong, in our struggle to make the country control the over-production of babies.
Questions remain: Will a woman show that she knows her contraceptives well? Will she tell her male counterparts that she is bothered about her health and so should he be? Will she go ahead and buy condoms for him to use? Will she be respected for her interest in use of condoms for birth control and also infections? Will a man value his partner’s opinion on contraception, let her choose what she wants rather than ego-stabbing his opinions on her? Will Contraception become more than a man’s decision and a choice that both take together? The point is that while men on the one hand expect to rule the woman, force her to do what he wants in bed, expecting an average Indian man to make balanced choices keeping his female counterpart in mind is going a little too far right now.
All this takes me back to my Physiology lessons where we did a project on Contraception in my B.Sc days and we explored the various methods and means, did we understand the theory and practicality to use them? The issues of negotiating, of decision making and of rights vs access are something that still remain untaught to women and men out there. Indians don’t appreciate talking about bedrooms publicly but somewhere the urgent need of the hour is to start talking about things as crucial as contraception, sex educationmenstruation and pregnancy-childbirth-menopause.
Her eyes still haunt me when I see women like her around. And till date, I don’t have any answer to give to any woman who comes and asks me what to do to stop her husband from asking her to pull out baby boys from her uterus. I can never forget those eyes. Not until I find an answer, a solution.
This Post was originally published at Women's Web: http://www.womensweb.in/2014/01/women-contraception-usage-rights-india/