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IPS Writers in the Blogosphere » reproductive health https://www.ips.org/blog/ips Turning the World Downside Up Tue, 26 May 2020 22:12:16 +0000 en-US hourly 1 http://wordpress.org/?v=3.5.1 Famous and infamous births https://www.ips.org/blog/ips/famous-and-infamous-births/ https://www.ips.org/blog/ips/famous-and-infamous-births/#comments Mon, 21 Dec 2009 07:38:21 +0000 Gender Masala http://www.ips.org/blog/mdg3/?p=1141 When is a photo of a woman giving birth considered pornographic? Take your pick:

A. When it is shown in a pornographic magazine, film or website.
B. Never.
C. When it is emailed to government officials urging action to improve public health.

One could argue about A and B but this blog is [...]]]> By Paula Modersohn Becker

By Paula Modersohn Becker

When is a photo of a woman giving birth considered pornographic? Take your pick:

A. When it is shown in a pornographic magazine, film or website.
B. Never.
C. When it is emailed to government officials urging action to improve public health.

One could argue about A and B but this blog is about C.

Earlier this year, in Zambia, Chansa Kabwela, news editor at the feisty opposition newspaper The Post, was charged with circulating pornography with intent to corrupt public morals. What was her crime? During a nationwide strike by Zambia’s miserably paid doctors, a woman allegedly gave birth without medical assistance in a hospital car park. The baby was in a breech position and later died.

Her family sent Kabwela the photos but she found them too graphic for publication. Instead, she emailed them to the vice-president and other government officials and women’s groups, urging a negotiated end to the strike to avoid more deaths.

President Rupiyah Banda found the photos “morbid and peculiar” and Kabwela, a 29-year-old mother of two, was charged with the porn offence, which carries a five-year jail sentence. The state argued that giving birth is sacred in Zambia and the photos were disrespectful.

If giving birth is so sacred, why was the woman delivering in a car park?

Good sense prevailed and in November a judge acquitted Kabwela.

The Post has long been harassed by government for exposing corruption. This court case is one more instance, using birth, women and tradition as a cover to erode press freedom.

A very famous Christmas birth

This being the season of a famous birth, on the other side of the world, in New Zealand, a mischievous billboard about the immaculate conception has angered Catholics.                christmas-advertising-cam-001

It shows Joseph and Mary in bed. She looks blissful; he looks dejected. The kicker: “Poor Joseph. God is a hard act to follow.”

The twist is that the originator is an Anglican archdeacon who commissioned an ad agency to produce a Christmas poster. The archdeacon argues, somewhat confusedly, that the purpose was to highlight that Christmas is about love, not about Mary’s impregnation by God.

Within hours the billboard  was defaced with brown paint. Well, at least this is better than rioting over caricatures of the Prophet or charging an editor with pornography.

Giving birth is charged with cultural meaning: it can be sacred, pornographic, joyful, “eculiar” or offensive.  For half a million women, every year, it is deadly.

Yet these deaths do not spark the same outrage as a billboard or photographs.

My wish this Christmas is quite simple: safe delivery for women everywhere, not in a car park and not in a manger, neither holy nor unholy, whether through sex, artificial insemination or immaculate conception. Just safe.

***

Read about why maternal mortality remains so intractable here and about midwives in India.

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HAPPY BIRTHDAY, CEDAW! https://www.ips.org/blog/ips/happy-birthday-cedaw-2/ https://www.ips.org/blog/ips/happy-birthday-cedaw-2/#comments Fri, 18 Dec 2009 00:00:35 +0000 Gender Masala http://www.ips.org/blog/mdg3/?p=1091 Ask the woman sitting next to you in the bus, train, plane, taxi-brousse or donkey cart what is CEDAW, and most probably you will draw a blank look. C’est quoi?

Yet CEDAW – Convention of the Elimination of All Forms of Discrimination Against Women – has likely impacted on her life and her daughters, if [...]]]> Ask the woman sitting next to you in the bus, train, plane, taxi-brousse or donkey cart what is CEDAW, and most probably you will draw a blank look. C’est quoi?

Yet CEDAW – Convention of the Elimination of All Forms of Discrimination Against Women – has likely impacted on her life and her daughters, if she has any, in many ways, from pension and inheritance rights to the passport they hold.

Quilt made by women of Kyrgztan. (Unifem)

Quilt made by women of Kyrgztan. (Unifem)

CEDAW, which was adopted by the United Nations General Assembly 30 years ago today, is the global Bill of Rights for Women, the first international human rights treaty devoted to gender equality.

Through its 30 articles, CEDAW has boosted women’s rights worldwide in many ways.

Some examples:  new constitutional guarantees for women in Thailand; land- owning rights for women in Kyrgyzstan and Tajikistan; changes to the law of evidence to benefit women in the Solomon Islands; and reproductive health rights in Colombia.

India outlawed sexual harassment in the workplace, Mexico tightened its domestic violence laws and Morocco passed a new family code in 2004.  Read more here.

Today CEDAW turns 30 and is the world’s most widely ratified treaty, with 186 signatory countries.

But there is no time to rest on laurels.

Attempts by conservative forces – from Washington to Jerusalem, from Riyadh to Jakarta – to erode CEDAW are underway, primarily in the field of women’s reproductive rights, nationality, family rights and relationships.

Several countries have failed to ratify the treaty – Iran, Nauru, Palau, Somalia, Sudan, Tonga and the United States, although the Obama administration has indicated it will.

Twenty-two countries have signed and ratified but reserve the right not to implement certain provisions.

Some are minor: Australia does not want to send women soldiers into combat.

Others are more threatening: the United Arab Emirates wants to keep its unequal inheritance laws based on Shariah, and Algeria, its Family Law.

Worldwide, the treaty’s implementation is uneven. In the Occupied Palestinian Territories, Palestinian women suffer abuse and denial of basic human rights at the hands of Israeli settlers and soldiers. The right to family reunification is particularly ignored.

Nevertheless, in three decades, CEDAW has truly changed the world for women, for those who fly on planes and for those who ride donkey carts alike. Equality is our right.

HAPPY ANNIVERSARY!


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Living a woman’s life https://www.ips.org/blog/ips/living-a-woman%e2%80%99s-life/ https://www.ips.org/blog/ips/living-a-woman%e2%80%99s-life/#comments Fri, 04 Dec 2009 08:03:40 +0000 Gender Masala http://www.ips.org/blog/mdg3/?p=1075 Today at noon my daughter graduated from high school. In the afternoon, the email brought news about very dear friends.

In Paris, the Chilean researcher, novelist and feminist Ana (Nicha) Vazquez Bronfman had died, aged 71. She was a beacon for a generation of Latin American women for her insights on identity  and gender. One [...]]]> Today at noon my daughter graduated from high school. In the afternoon, the email brought news about very dear friends.

Motherhood, sisterhood, friendship.

Motherhood, sisterhood, friendship.

In Paris, the Chilean researcher, novelist and feminist Ana (Nicha) Vazquez Bronfman had died, aged 71. She was a beacon for a generation of Latin American women for her insights on identity  and gender. One concept she elaborated specially was “transculturation” – the permanent construction of identities in this world of global migration. In 2006 she wrote superbly about sexuality among the elderly – transgressions and secrets, she called it.

In Rome, my friend and fellow journalist Paola Rolletta underwent the next to last chemotherapy session against breast cancer. She was jubilant to see the end of the chemical bombardment. Like antiretrovirals, chemo saves lives but is no picnic.  

So, in three hours, youth, disease, health and death touched me. Motherhood and friendship.  Joy and sorrow.

Email has made this vertigo possible. News travel quickly and straight to our screens, to our hearts and minds.

News from friends

These days, breast cancer appears more frequently in news from friends.

One in the Dominican Republic and another in Mozambique finished their chemo last year. Paola is finishing hers in February. In Pretoria, where I live, another friend had her second chemo last Friday.

We had lunch together today and wondered if there is more breast cancer among women now than 50 years ago, or better detection. If the rates are higher, why? Lifestyle, fast food, stress, radiation from microwaves, cellphones and all the gadgets that crowd our life?

The Harvard School of Public Health estimates that the poor will account for more than 55 percent of breast cancer deaths this year. Read a very informative story on growing cancer rates among women in the developing world here.

A recent article in  the New England Journal of Medicine argues  that “western” influences such as changes in diet, less exercise, delayed childbirth, families with fewer children, less breast feeding, and hormone replacement therapy are all thought to increase the risk of breast cancer for women in low-income countries.

The good news is that breast cancer, like AIDS, is becoming less and less lethal, if detected and treated early.

I am so proud of my cancer-survivor friends. They have worn their baldness as a badge of courage and have acquired new wisdom.

And while we age and think about breast cancer, a younger generation moves closer to adulthood.

I wondered how to name and save this rambling text in my laptop.  And I wrote – BLOG: LIFE.

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A spiritual gift https://www.ips.org/blog/ips/a-room-of-her-own/ https://www.ips.org/blog/ips/a-room-of-her-own/#comments Mon, 23 Nov 2009 08:00:51 +0000 Gender Masala http://www.ips.org/blog/mdg3/?p=1020 What drives a 17-year-old girl to enter a monastery? Today she is 30, and still happy about her choice. Her eyes sparkle and her laughter comes easy. She exudes peace.

I will call her Gabra (gift, in Amharic), for our conversation was private. I met her at a monastery near Lalibela, the mystical city of [...]]]> Patriarchal in all senses. By M. Sayagues

Patriarchal in all senses. By M. Sayagues

What drives a 17-year-old girl to enter a monastery? Today she is 30, and still happy about her choice. Her eyes sparkle and her laughter comes easy. She exudes peace.

I will call her Gabra (gift, in Amharic), for our conversation was private. I met her at a monastery near Lalibela, the mystical city of rock-hewn churches in northern Ethiopia.

Monastic life has a long tradition and prestige in the Ethiopian Orthodox Church. The oldest monastery dates from the 6th century. A monastic renaissance between the 13th and 16th century brought great moral and political authority to clergy.

Custodians of tradition

Custodians of tradition

Gabra’s rock-hewn monastery dates from the 12th century. Her room is excavated in the pink tufa rock. Two built-in-the-rock platforms, covered with a thin mattress, do as couch and bed. An old cupboard holds a few plates and cooking utensils, three of the long green robes worn by Ethiopian peasants, the white headscarves that nuns wear, and two pairs of sandals.

For income, she and her fellow nuns weave cotton and silk into diaphanous shawls, sold at the monastery. She rises before dawn to pray – the first of daily seven prayers. Her ambition is to study theology in Addis Ababa or in Lalibela.

Gabra is not completely cut off from the world. She has a cellphone and a radio. On Sundays, relatives and friends visit.
Choices

I ask her if marriage and children ever interested her.

“It is a privilege to be single and not to have children,” she says softly, smiling but firmly. She sounds relieved.

Unmarried myself, I agree that motherhood and marriage are just one option. I understand the spiritual call, the peace of contemplation and withdrawal, of a simple lifestyle unencumbered by material things.

Yet I wonder if female genital mutilation had to do with her decision.

In Ethiopia’s eastern region, a girl might suffer genital cutting between the age of 15-17, before marriage. Her clitoris would be cut, sometimes the labia.

ethio-girl-long

She has a right to her bodily integrity.

In Somali region, she would have infibulation at a younger age: the complete removal of her genitalia and, to preserve virginity, being stitched shut with an acacia thorn, leaving only a hole to urinate.

About three-quarters of women in Ethiopia between 15-49 have suffered some form of genital mutilation, said a government survey of 2005. The practice is fading – but too slowly, say activists.

It is not called mutilation for nothing. Sex and childbirth will be extremely painful and dangerous.

If finding a husband means suffering genital cutting, a hard mattress in a rock-hewn room is a much better place than a king-size wedding bed.

Gabra did not speak English, my male guide spoke little, and sex topics are taboo in Ethiopia, so the conversation went in another direction. Gabra was curious about my life, my work, and my daughter.                                          ethio-girl-close

“Would you want to live like me?” she asked. “I don’t think I could,” I said. “But I feel the beauty of this simplicity.” She smiled.

Ethiopia looks and feels ancient and spiritual.  Social cohesion is remarkable. But the same lifestyle that makes ferenji (foreigner, in Amharic) wax lyrical about the “biblical landscape and people” binds women to painful and dangerous traditions.

Some traditions are simply annoying. Women cannot join the rites if they are menstruating, ergo unclean. At no time of the month can women, local or foreign, enter the most sacred chapel of the Lalibela complex, Bete Mikael, where King Lalibela is buried. We are only allowed a glimpse from the door. In some monasteries, no females, including of the animal kingdom, are allowed.

Monastery visitors take leave at 5 PM (international time; in Ethiopian time, 11 in the night). I make my way down the stony path, the tufa rock glowing pink and gold in the sunset.

I am thinking that the monastery – the spiritual world – may be a blessed refuge from the hardship of being born female in a deeply patriarchal world.

Read  recent IPS stories about genital cutting in Uganda, Sierra Leone and cross-border in West Africa.

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HILARIOUS CONDOM ADS https://www.ips.org/blog/ips/hilarious-condom-ads/ https://www.ips.org/blog/ips/hilarious-condom-ads/#comments Mon, 21 Sep 2009 07:59:45 +0000 Gender Masala http://www.ips.org/blog/mdg3/?p=742 Gender Masala has been dealing with serious topics seriously …it’s time for a fun break!  Check out these hilarious condom ads from several continents. They make safe sex fun.

Ranging  from sassy dialogue to black humour, these are one-minute comedies with a smart punchline. The Mother from Hell and the Spoiled Brat skits have [...]]]> Gender Masala has been dealing with serious topics seriously …it’s time for a fun break!  Check out these hilarious condom ads from several continents. They make safe sex fun.

Make safe sex fun. By M. Sayagues

Make safe sex fun. By M. Sayagues

Ranging  from sassy dialogue to black humour, these are one-minute comedies with a smart punchline. The Mother from Hell and the Spoiled Brat skits have a Borat-like humour.  And who would have thought a condom ad from India would depict anal sex?

Click on the ad from Argentina even if you don’t speak Spanish.  Everybody who has been a teenager will chuckle about these teens, their parents and their predicament. (Watch it here)

Laughing got me thinking about how seldom one sees humorous ads about condoms in English-speaking Southern Africa. I have seen some cool ads in Mozambique, though – I think there were Brazilian advisors involved. Where is the fun?

Most ads about condoms in Southern Africa are earnest, even boring, stressing safe sex, HIV prevention, responsibility. Few treat sex as an activity filled with desire, romance, anticipation, indecision, ambiguity, and pleasure.

Yes, for man, sex may be forced, violent, unwanted, unpleasant, too quick, too slow, or too risky.

A pretty condom-carying box. By M. Sayagues

A pretty condom carrying box. By M. Sayagues

But for many others, it is not. Ads should target different segments. If we want to attract the attention of the young instead of totally turning them off, ads must be cool.

It is a fine balancing act. About three years ago, the South African anti-AIDS campaign LoveLife published a monthly insert in major newspapers, called Uncut that tried so hard to be blasé it was borderline pornographic.

There is a distance from acknowledging that young people have sex to portraying teens dressed like hookers in positions suggesting group oral sex.  Many parents threw Uncut straight away. My daughter, aged 14 then and no prude, thought it cheapened girls.

After many complaints and public debate, Uncut changed. It went overboard. Now it reads like a church teen newsletter, wholesome and boring.

It may be that the terrifying scale of the AIDS pandemic in Southern Africa inhibits ad campaign planners and donors from portraying safe sex as fun. Maybe it is fear of offending churches, politicians and parents. And talking about sex has traditionally been taboo.

Yet, to get young people to practice safe sex, condoms must become part of their sexual paraphernalia and discourse. A bit of humour helps.

So have a laugh and tell us which is your favourite!

Ad selection courtesy of Chris Well, a designer and sexual rights activist at Conversations for a Better World. Check out  his website for teens and reproductive health:  www.15andcounting

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Breakthrough for Women at the UN https://www.ips.org/blog/ips/breakthrough-for-women-at-the-un/ https://www.ips.org/blog/ips/breakthrough-for-women-at-the-un/#comments Fri, 18 Sep 2009 17:03:33 +0000 Gender Masala http://www.ips.org/blog/mdg3/?p=819 Guest blogger:  Ann Ninan, IPS Gender Editor

The UN has finally decided to stand up for women!  A decision to create a new agency for women was taken by the General Assembly on September14.

Our colleague Thalif Deen, IPS bureau chief in New York, was the first and only journalist to report it for the [...]]]> Guest blogger:  Ann Ninan, IPS Gender Editor

Is there room for us as well? M. Sayagues

A breakthrough for us as well? M. Sayagues

The UN has finally decided to stand up for women!  A decision to create a new agency for women was taken by the General Assembly on September14.

Our colleague Thalif Deen, IPS bureau chief in New York, was the first and only journalist to report it for the first several hours.

But this blog is not to crow about our scoop.

I’m quite excited by the prospect of a new women’s agency with money and political power. No longer will the world’s feminists have to lobby from the outside to put their views on the table. They have now won admission to the high table.

Any one of those bright, articulate, activist women can emerge to lead the agency. The reality is likely to be less rosy. But chances are that, because it’s new, it will be less under the thumb of the old boy network.

You think I’m a romantic? What the hell, there is no harm in dreaming, is there?  I like to think that there was no way that the General Assembly could have once again shelved the plan for a new women’s agency.

It’s 14 years since Beijing. All the small and big things that governments were forced to accept around women’s rights (CEDAW, MDG, etc.) made it impossible for any country to block the efforts of myriad initiatives (from small grassroots groups to reforms in government policies even if they started as mere tokenism) and to politicise the cause of gender equality.

I do see great hope in the increasing presence of women in politics – Liberia, Japan, India, wherever you look, even Iran (new ministers) and the Gulf (Saudi Arabia has made a few small concessions to women!).

Of course, there is a backlash too – more violence against women worldwide.

As IPS gender editor,  I am sure we will keep track of the new agency as it will be a key player achieving the MDG3 goal – gender equality.

Well, hope springs eternal!

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Missing the Point? A critical review of MDG https://www.ips.org/blog/ips/missing-the-point-a-critical-review-of-mdg/ https://www.ips.org/blog/ips/missing-the-point-a-critical-review-of-mdg/#comments Mon, 14 Sep 2009 07:00:03 +0000 Gender Masala http://www.ips.org/blog/mdg3/?p=708 Next time you read a story or a press release moaning about how country X will not reach the Millennium Development Goals, think twice – whose goal and whose target is it? We know the deadline but do we know the baseline?

Instead of striking a balance between ambition and realism, the MDGs have become [...]]]> Next time you read a story or a press release moaning about how country X will not reach the Millennium Development Goals, think twice – whose goal and whose target is it? We know the deadline but do we know the baseline?

Instead of striking a balance between ambition and realism, the MDGs have become “money-metric and donor-centric”, “meaningless catch-all phrases.”

So says Jan Vandemoortele, a Belgian national, a United Nations senior official and one of the architects of the MDGs, in a thought-provoking article in the July issue of  Development Policy Review of the Overseas Development Institute. (read it here)

Unrealistic? A crowded classrom in Guinea Bissau...

Unrealistic goal? A crowded classroom in Guinea Bissau...

The author recalls that the MDGs were set up in 2000 as collective targets based on extrapolations of global trends.  They are vague by definition; they are not one-size-fits-all.

Instead, one should look at countries’ historical backgrounds, natural endowments and specific problems, then adapt the Goals to each circumstance, as Mozambique, Cambodia and Ethiopia have done.

Otherwise, this puts undue pressure on the poorest countries and, given that most of these are in Africa, nurtures Afro-pessimism.

For example, the global target for education “is not realistic” for countries in conflict, he says.                             

True, targets do change. For example, water for all in 2015 morphed into the more feasible goal of halving the number of people without clean water.

Magic numbers

A mantra has evolved: if only there were more money and higher economic growth, the MDGs would be achieved. Who is fond of these “magic numbers”? Staff at global headquarters of aid organisations, says the author, because of their “excessive reliance on abstract concepts.” (he should know, with his long career as a top UN official).

..and their teacher. By M. Sayagues

..and their teacher. By M. Sayagues

Vandemoortele sees the MDG canon being usurped by interest groups to push their agendas or devalued “as a repackaged call for more foreign aid.”

Rather, the MDG should be a tool to examine disparities and inequities within countries. In his view, the poorest people continue to be excluded. Many of these are women. Without better sex-disaggregated data, the gender dimension of hunger, illiteracy, disease and poverty remains unexposed.

Most progress takes place among the better off, and inequality and inequity keep rising, says the author.

“The targets are often presented as a universal good that will not demand tough policy choices and hard trade-offs among social groups within a country,” he says.

The MDGs should usher in new thinking about inequalities if they are not to miss the point

What do you think? Send us your views.

Read recent IPS stories on MDG here and here

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HAPPY BIRTH-DAY TO ALL MOTHERS https://www.ips.org/blog/ips/happy-birth-day-to-all-mothers/ https://www.ips.org/blog/ips/happy-birth-day-to-all-mothers/#comments Mon, 07 Sep 2009 07:02:02 +0000 Gender Masala http://www.ips.org/blog/mdg3/?p=718 My daughter Esmeralda turns 18 today. Like all parents, I am amazed at how time flies. Like all mothers, I get reminiscent about those days, 18 years ago.

I was very pregnant and very happy. I lived in Rome, Italy, and I wanted a home birth.

I wanted music, soft light, friends, baby on my [...]]]> Safe motherhood for all. By F. Beaumont.

Safe motherhood for all. By F. Beaumont.

My daughter Esmeralda turns 18 today. Like all parents, I am amazed at how time flies. Like all mothers, I get reminiscent about those days, 18 years ago.

I was very pregnant and very happy. I lived in Rome, Italy, and I wanted a home birth.

I wanted music, soft light, friends, baby on my stomach still attached by umbilical cord, no drugs, and no epidural. A birth by my own rules, not by a cold hospital’s.

I found a group specialized in home births – Il Melograno. Their package included ob-gyn and midwife, courses, support and, more importantly, a woman-friendly feel. A photographer from Marie Claire magazine would do a photo reportage on my happy home birth.

Our premise: pregnancy is neither a disease nor a disability. Pregnancy and birth have become over-medicalized; women should reclaim it from doctors overly fond of control and caesareans. My family, my colleagues and the baby’s father thought I was crazy. Home births are more common now but women still battle to extricate pregnancy and birth out of the hospital realm.

In Brazil, we recently lost a battle for a  centre for natural birth in Rio de Janeiro.

Clueless mommy

In my case, at midnight, after 30 hours of labour, I was stuck at 6 cms dilatation – and exhausted. A home birth must be 100 percent natural, so the few drops of oxitocyn to trigger full dilation had to be administered in hospital, three blocks away. There I went. At 2am my daughter was born – and promptly taken away to the nursery.

At 5:30am a nurse literally dumped my baby girl in my arms and left. No instructions on how to feed, nothing. My midwife and friends were coming at 8 am. What to do?  I had never been around a newborn. I was like Carrie Bradshaw in Season 2 of Sex and The City – domesticity and motherhood were not part of my landscape.

So there I was, baby on one hand, baby book on the other, trying to figure it out. This is the most ridiculous and pathetic image of modern motherhood, I thought. How did we end here, from birth as a group event to 6 AM loneliness in hospital?

Less than 24 hours later, against hospital rules, I signed waivers absolving doctors of any responsibility and checked myself out.

I went home and turned on the CD player. My daughter’s godmother had been listening to the Rolling Stones: “You can’t always get what you want”. I chuckled.

Two close friends, one in Windhoek and one in London, recently tried a home birth but ended in hospital, just like me. Still, we were happy to go through labour at home.

Meanwhile, many women struggle to have a safe birth – anywhere. About half a million women die in childbirth very year. There are not enough trained midwives to ensure a safe labour, whether at home or at a clinic,

Photo:

Art by Nelly Romeo Alves, photo by E. Zimbres

from Mexico to Uganda.

At a conference on reproductive health in Berlin last week, the World Health Organisation reported that one woman dies every minute for lack of adequate pregnancy and birth services.

A cruel paradox: the world proffers to revere motherhood but does not make it safe and comfortable for mothers to give birth.

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Whose pleasure? Notes about male circumcision and female sexuality https://www.ips.org/blog/ips/whose-pleasure-notes-about-male-circumcision-and-female-sexuality/ https://www.ips.org/blog/ips/whose-pleasure-notes-about-male-circumcision-and-female-sexuality/#comments Mon, 24 Aug 2009 09:38:30 +0000 Gender Masala http://www.ips.org/blog/mdg3/?p=595 Guest blogger: Pierre Brouard, Deputy Director, Centre for the Study of Aids, University of Pretoria, South Africa

So what headlines have grabbed you lately about male circumcision in South Africa? These caught my eye:

“The death toll in the Eastern Cape’s winter circumcision season has risen to 31”
“Circumcision ‘scam’ probed”
“Two [...]]]> Guest blogger: Pierre Brouard, Deputy Director, Centre for the Study of Aids, University of Pretoria, South Africa

Permanent erection, permanent pleasure?

Hard task: defining sexual pleasure. Photo: M. Sayagues

So what headlines have grabbed you lately about male circumcision in South Africa? These caught my eye:

“The death toll in the Eastern Cape’s winter circumcision season has risen to 31”
“Circumcision ‘scam’ probed”
“Two on run after initiate dies”

As alarming and distressing as these headlines are – and the sad, desperate and greedy subtexts embedded in them – they don’t say much about the other big debate that is raging across southern Africa: the value of male circumcision to prevent HIV acquisition in heterosexual men, and what’s in it for women.

Well what’s in it for women is the topic du jour: Since observational studies had reported an association between male circumcision and reduced risk of HIV infection in female sexual partners, researchers in Uganda conducted an unblinded, randomised control trial to investigate this (Lancet July 2009) by circumcising some HIV positive men and not others. They found that circumcision did not reduce the risk of transmission to their female partners. So no luck there.

But what’s really getting gender activists of all genders to rise up from their sofas and comment on websites and chat rooms is the matter of sexual pleasure, and more specifically, the sexual pleasure of women.

What is sexual pleasure?

Now as a gay man I have to confess this is a topic that I have no personal experience of, but I am as interested in the notion of pleasure for my sisters of any sexual orientation as I am in mine.

I believe sexual pleasure should be a human right advanced to all, though for some of us this may be a progressive realisation of rights as we work through all the baggage of our socialisation!

I’m raising this issue because one of the many studies emerging as a companion to the now famous three circumcision trials, which showed the partial protective efficacy of male circumcision, suggests that “women whose male sexual partners were circumcised report an improvement in their sex life.”

Nearly 40% said sex was more satisfying afterward. About 57% reported no change in sexual satisfaction, and only 3% said sex was less satisfying after their partner was circumcised.

Ancient Egyptians get the snip

Ancient Egyptians get the snip.

Top reasons cited by women for their better sex life: improved hygiene, longer time for their partner to achieve orgasm, and their partner wanting more frequent sex, said Godfrey Kigozi at the Fifth International AIDS Society Conference on Pathogenesis, Treatment and Prevention of HIV in Cape Town recently.

Firstly, if you look at the data above, while 40% did say the sex was more satisfying, the majority in fact said there was either no change or it was less satisfying. Is the headline summary of the research accurate? Why do we need to spin this data?

Fluid and enigmatic

But really what’s vexed me, and others, is this notion of pleasure and how we define it. Those of us who come from a “social” as opposed to “biomedical” or “public health” paradigm would argue that sexuality is fluid, it changes over our lifetimes, it may be context or relationship dependent, it is informed not only by our gender but our class and orientation.

So “pleasure” in a sexual encounter may be shaped by mood, the time of life, the way a woman is relating to her partner that day, whether she was exhausted from chores, her beliefs about female agency in a sexual encounter, whether she was menstruating or in menopause, whether foreplay had occurred.

Pleasure, surely, is variable, contextual, dynamic, changing, unpredictable. Even enigmatic sometimes: a woman may have a good orgasm but still feel angry with her husband or partner. She may never have had an orgasm but feel happy that he does. She may secretly masturbate after he falls asleep and feel fantastic after that.

A biomedical or public health perspective, I would argue, reduces men and women and their practice to simple categories and distinct binaries: gay vs straight; masculine vs feminine; satisfied vs unsatisfied; safe vs dangerous.

This is necessary if you want a simplified view of the world and if you want “proof” that most women will be happy to have their male partners circumcised.

Who needs long and complicated qualitative research when a checklist with a choice of three options tells us all we need to know to placate those pesky social scientists with their doubts and ifs, buts and maybes? But how do you capture the nuances of satisfaction in a questionnaire?

You don’t. I think pleasure is much more complicated than that – and we need better and more interesting research to tease it out (as it were). What do you think?

Read more on controversial issues around male circumcision, sexual pleasure human rights, viagra and condoms.

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Rubbing it the wrong way: condom-grabbing tourists https://www.ips.org/blog/ips/rubbing-it-the-wrong-way-condom-grabbing-tourists/ https://www.ips.org/blog/ips/rubbing-it-the-wrong-way-condom-grabbing-tourists/#comments Thu, 20 Aug 2009 11:43:17 +0000 Gender Masala http://www.ips.org/blog/mdg3/?p=574 In a contest for irresponsible tourism, taking the last two female condoms at a Botswana border post as a souvenir would run neck-and-neck with littering the Central Kalahari Game Reserve with soda cans. Hey, spare a thought for a sister: a local woman might need them. I mean the condoms, not the soda cans.

Journalist [...]]]> A Femidom demo

A Femidom demo. Photo: M. Sayagues/Irin

In a contest for irresponsible tourism, taking the last two female condoms at a Botswana border post as a souvenir would run neck-and-neck with littering the Central Kalahari Game Reserve with soda cans. Hey, spare a thought for a sister: a local woman might need them. I mean the condoms, not the soda cans.

Journalist Bridget Hilton-Barber writes, in the South African weekly Mail & Guardian, about the female condom’s popularity among Batswana women. (Femidoms rub the right way, 14 August). Then she plucked the last ones at the border post, as a souvenir, to lie  in her office drawer.

Well, their popularity is a very good reason to leave the condoms in the box for someone who wants to use them.

Correction:  Someone who needs to use them.

An average of three out of ten pregnant women at public antenatal clinics in Botswana are HIV-positive. This is an improvement over ten years ago, when four or five out of ten pregnant women were HIV-positive. Condoms helped achieve this drop. (Read about AIDS in Botswana hereComes with a price

Condoms have a cost and female condoms are the most expensive, even when subsidized by donors. A male condom costs US$0,4; a female condom, US$2.50.

fem-condom-closeup

Photo: M. Sayagues/Irin

In March, its sole manufacturer, Female Health Company, announced a cheaper version in synthetic rubber instead of polyurethane that will cost around US$0,60 but is not yet available.

Looks cheap? Remember, many Africans live on less than one dollar a day.

Besides price, supply is a problem. Logistics bottlenecks plague the delivery of goods in Africa, from life-saving antiretrovirals to malaria pills, from sanitary pads to birth control pills, from car spares to school books, from snail mail to email.

There is no difference between a female condom in Botswana, South Africa or Holland, I can assure you. The difference is that a consumer in Holland can buy one or get a free one anytime she wants. In Africa, it ain’t that easy.

So control your grabbing impulse, dear tourist. Have you heard of sustainable fishing and harvesting – or condom plucking? You will be doing a sister a favour by leaving those condoms  in the box if you don’t need them.

If you want to see a Femidom, buy one at a drugstore back home.

Responsible tourism  is more than eschewing python boots and turtle soup or using the  towels at the luxury safari camp more than once.

And tell the tour operator not to allow his Dutch clients to pluck condoms for keepsake either. Would they take the KLM airplane life jackets as souvenirs?

This is SO not rubbing it the right way.

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