Sunday, February 13, 2011

Sexism, Health Care, and the Role of the Church

    The role that women have played throughout the age has largely been in the background. The old adage, “Children are to be seen and not heard” can easily apply to most women throughout the centuries. The treatment of woman as second-class citizens can clearly be seen in many of the stories in the Hebrew Scriptures. The accounts of Sarah, Hagar, and the rape of Dinah in the Book of Genesis, as well as the story of Jephthah’s daughter (Judges 12:7) give us some insight into the way that women were portrayed. Jacob had twelve sons and one daughter, Dinah, and the only time that she is ever mentioned is when she is raped by Shechem, son of King Hamor. If we examine the story of Abraham, Isaac, and Jacob from the standpoint of their wives, we see that it was Sarah and Rebekah who were the major players in terms of remaining faithful to God’s word. Hagar, through no fault of her own, was banished by Sarah, with Abraham’s permission. In fact, after giving birth to Abraham’s first son, Ishmael, he never spoke to Hagar until Sarah was having difficulty in childbirth and then Abraham begged Hagar to help her.

    Another story is the account of David and Bathsheba. David becomes completely infatuated with Bathsheba as he watches her bathe on a nearby rooftop. He has his men bring Bathsheba to him and, for all intents and purposes, he rapes her and she becomes pregnant. While there is no mention of her being raped in the account given in the Second Book of Samuel, the fact is that it was a completely unequal relationship and he used his position of power in order to take advantage of this married woman.

    What does all of this have to do with the issue of women and health care? In her article entitled, “Philosophy and Religion: Do Activists for Women’s Health Care Need Them?”1 Linda Cahill discusses the fact that addressing health equity for women involves exposing, analyzing, and challenging cultural norms that assign women to places of inferior social influence and privilege. The stories I mentioned from the Book of Genesis, Judges, and the Second Book of Samuel are part of our culture and have played a part in the way that woman have been treated.

   Cahill speaks about the importance of empowering women in order to help them receive what they are actually entitled to by virtue of the fact that they are made in the image and likeness of God, but have been denied because of social, cultural, and religious constructs which have served to keep women in a subservient role.

   She also speaks of those who work out of the Catholic common good tradition which has attempted to embody the teachings of Church, particularly Rerum Novarum, Pope Leo XIII’s 1891 encyclical addressing the issue of human labor which defines justice in terms of the participation of all members of society in the common good, with mutual rights and duties, and having to do with social and material goods.

    Labor is a major component of a person’s dignity. While there are careers and jobs that are more glamorous than others, the ability of one to contribute to his or her well-being and the well-being of their family has a direct impact on their self-worth. Being completely dependant upon someone else robs a person of their dignity and limits their ability to make use of the social and material goods that they are entitled to, such as proper health care.

   This point is emphasized in the Cahill’s account of the Muslim women in Bangladesh who were be aided by a group of Catholic sisters. These women were eventually given the material to be able to make macramé plant hangers and sell them after Sister Bruno received funds from Caritas International in order to purchase the materials. The sale of these plant hangers, which might seem insignificant in our society, allowed these women to provide their family with a small amount of money which was used to purchase rice seed to benefit their families.

   In an effort to assist these women, Sister Bruno and the other sisters, reinterpreted Catholic patriarchy as referred to the mission as “father’s household” so that the Muslim men would be more open to allowing their wives to become involved in the collection center since it appeared to be under male protection. Allowing these women to attend the collection center gave the sisters an opportunity to educate these women in health care classes. These classes taught natural family planning, a culturally accepted method which elicited cooperation from the men and helped build up their marital relationship. While such efforts may appear, to some, to be rather minimal it can be quite effective in helping to break down cultural and religious barriers which deny women access to basic health care and other goods that they are entitled to.

   Another positive aspect of religion in regard to health care is that religious traditions place human practices and projects against the horizon of transcendent meaning and value. Cahill gives the example of how Jesus’ passion as an act of solidarity with His people is relived among the militant, protesting Filipino women who have taken up the struggle on behalf of their sisters and the rest of the suffering poor. She also mentions how many feminist theologians in the Third World find in the spirituality and sufferings of Christ a divine identification with women’s suffering and an inspiration to take an active role in changing human conditions so that they more accurately reflect the in-breaking “reign of God.”

While Kelly Brown Douglas does not describe herself as a feminist, she also has a very strong feeling of solidarity with Jesus which is why she is able to remain a Christian in spite of the way that African-Americans have been treated in the United States by those professing to be Christians. Based upon her book, What’s Faith Got To Do with It? 2 it appears that Douglas would agree with Cahill regarding the important of uniting one’s struggles with the sufferings of Jesus.

   At no time does Douglas either discount or dismiss the actions of white Christians in terms of the way they treated their black neighbors; however, she does not condemn Christianity, as a whole, and thereby reject it, but chooses to observe a Christianity which is devoid of Platonic influence and does not see certain people as being inferior simply because of the color of their skin.

   The events recalled in the Gospels are events based upon human history and the experiences of the human heart as it searches for a meaning and purpose greater than itself. These are not black or white experiences, but human experiences. The human heart’s desire for belonging and purpose in life is a deeply felt desire even if it cannot be properly articulated.

    Another aspect of Christianity, which is central to its teachings, is the incarnation. The fact that Jesus became one like us, in all things but sin, means that He truly does understand what we are going through. This is not a disinterested deity, but a God who loves us so much that He was willing to enter into our experience so that His disciples may come to know Him, love Him, and serve Him in this life and be happy with Him forever in the next.

    It is also true that women, particularly African-Americans, those with low incomes and immigrants have a very difficult time accessing to health care. Women tend to be covered as dependants on health insurance policies more often than men and because of the fact that they are more likely to be in and out of the workforce due to pregnancy and child rearing they are much less likely to be able to depend upon employer-provided health care coverage. These are not, of necessity, racial issues, but rather issues of justice which religious organizations can address from a social justice and/or social ethics standpoint. The Catholic Church, for example, is, arguably, the largest social services agency in the world. Through education and other means the Catholic Church has the ability to be of service to those women who need assistance.

   In her article entitled “Health and Human Rights” 3, Maura A. Ryan addresses the issue of women’s health issues particularly in Africa and looks at them through the lens of human rights issues. She borrows from Paul Farmer’s 2003 book Pathologies of Power which makes connections between bioethics and liberation theology. Farmer, a physician, states that the only way to love the poor is to work for their liberation, which he refers to as “pragmatic solidarity”. Ryan presents an example of how this is actually put into effect in Uganda. Some of the most successful HIV/AIDS prevention and treatment programs are based on this understanding of “pragmatic solidarity.” Reach Out Mbuya Parish HIV/AIDS Initiative, located outside of Kampala, Uganda, provides free counseling, testing, and antiretroviral therapy (ARV) to all eligible patients at no cost, along with social, nutritional, and economic support. Reach Out Mbuya began in 2001 with 14 clients as an outreach program of a Roman Catholic parish; today more than 2500 patients are served. Reach Out has four medical doctors on staff, but uses a network of community-based support (in the form of trained CATTS: Community ARV TB Treatment Supporters) to monitor health status and treatment regimes outside of the clinic. Two satellite sites (again building on existing religious community initiatives) increase the area they can serve. According to the most recent report, 52.2 percent of Reach Out’s clients were on antiretroviral therapy. Rates of adherence to therapy average 92 percent. Pregnant women are followed closely to lower the risk of maternal-fetal transmission of HIV; each is assigned a companion to accompany the birth and to lend support in case of family interference or the threat of domestic violence.

   Reach Out Mbuya attributes its success in getting people to come for testing and to stick with treatment plans to its “empowerment” approach. More than 65 percent of their clients are women. Aware of the distinct multilayer vulnerability of girls and women to HIV/AIDS, Reach Out Mbuya offers a micro-finance program, a grandmother’s organization for community-building, a workshop where clients can learn either sewing or bead-making, a school fees program to make it possible for the children of clients to attend primary and secondary school, a food program for all patients on ARV, and educational outreach to raise awareness and combat stigma using drama and the arts. More than 60 percent of Reach Out’s staff are clients, although program directors acknowledge that, as the scale of the program enlarges, employing clients is growing more difficult as most lack the skills to manage more complex budgets and other administrative tasks.

   This is only one example, but it does offer us some insight in terms of what can be done to assist people at their point of need. Following this example, hopefully other such measures can be taken to assist women in their struggle for human rights.

End Notes

1. Kickbusch, Ilona, Karl A. Hartwig, and Justin M. List (ed.) Globalization, Women, and Health in the 21st Century (NY: Palgrave/MacMillan, 2005) pp. 29-47
2. Douglas, Kelly Brown What’s Faith Got to Do with It? Black Bodies/Christian Souls NY: Orbis Books, 2005
3. Ryan, Maura A. “Health and Human Rights” Theological Studies, 69, 2008, pp. 144-163

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