No Grazing

While having coffee after church today, I met a fascinating woman who does work with women's and children's health in South Africa. She's Swedish and moved to South Africa because she married a South African. Her work in Capetown started off focusing on children's health, but lead her to women's health - because unless the mothers are healthy it's unlikely that the children are. Interestingly, she said that working on women's health leads inevitably to programs to increase the economic self-sufficiency of women.

The starkest example is the AIDs crisis in Africa. One of the highest risk factors for women in Africa is whether they are married. Married women are at an extraordinary risk of contracting HIV because their husbands are using prostitutes or sleeping with other women outside of the marriage and then bringing back sexually transmitted diseases to their wives (and children). Where women are not economically self-sufficient - which is most places in the world - they are trapped. They're dependent on their husbands and feel that they have to stay, even if there's abuse or adultery.

While I was in Cambodia, I saw the same thing. Women from different social classes are separated from one another. The men move between the different classes of women, sleeping with one class outside of marriage, and the other inside of marriage, and passing diseases between them. It's incredible that prostitutes continue to be blamed for the spread of diseases, because it's not them that are spreading it to the wives of the men who buy them. Prostitutes, like wives (and of course they're often both), have limited power over the men that they sleep with. Often times, for example, they are not in a position to insist that a client wears a condom.

Apparently the only country in Africa which has seen a drop in the rate of HIV transmission is Uganda (hopefully Pas, who has done work there, will chime in). My new friend told me that this was because Uganda started a massive public health campaign aimed at curbing concurrent sexual relationships - something which my friend said was more common in Africa than the West (in the West you have lots of sexual partners but their more often one after another, instead of all at the same time). The issue with having multiple concurrent sexual relationships is that if one person in that chain contracts HIV, suddenly you have 4, or 6, or 10 others who contract it almost at the same time. It makes sense that it would spread rapidly under those conditions.

I honestly don't know if this is true, and if you're interested this theory is discussed in depth in a new book called The Invisible Cure, which I plan to get. The slogan of the Ugandan campaign was "No Grazing," as in, if you're eating one dish, don't nibble from others. It was successful because it resonated with both the health workers in Uganda and the population at large.

It's just so shocking that becoming a wife could be the most dangerous thing you could do in terms of your health. But on the other hand, it's not at all surprising that becoming a wife in an unequal partnership could be risky. I think it was Abigail Adams who said that all men would be tyrants if they could. Women have to come together and support one another in becoming economically independent. As the AIDs epidemic demonstrates, women's rights are quite literally a life or death matter.