A peacock at Poa Place. Why don't all men work so hard to impress? Apparently the bride price for a female doctor in Kenya is 20 cows. At least now I know what I'm worth...
Towards the end of a talk about family planning I was giving to the parents of pediatric inpatients a woman raised her hand and said, "My husband got mad at me when he found out I was using Depo-Provera without telling him. He does not want me to use any type of family planning. What should I do?" Several other women in the audience related similar stories and turned to me for advice. While I was prepared to talk about the benefits and drawbacks of different forms of birth control and which types are best to use in certain situations, I was not sure how far I wanted to venture into thorny issues of gender politics (I think I had already alienated most of the men in the audience just by mentioning the possibility of vasectomy). However, the issue of who gets to make these decisions is truly at the heart of the battle for better family planning. Many of the women were already very well informed about the different contraception options and knew how to acquire them. The more pressing problem was how to get everyone to see the worth of family planning in a country that so highly values fecundity.
I weakly answered that ideally partners decide together what type of family planning best meets their needs but ultimately a woman should decide what happens to her own body. What I wanted to add but didn’t is that you should not have to put up with a mzee who dictates everything you do. Of course, many women are without other viable options. Kenyan women are hardly alone in their need to operate in a male dominated world, but many of them have limited access to the education and the resources that could make a difference. Trying to change cultural beliefs in a one hour talk in a country where a man can still have two wives may be out of the question, but I hope that in some way I planted a seed that an alternative is possible. Providing birth control, colposcopies, and anti-retroviral medications is essential for women’s health, but it is also important as a demonstration of solidarity and a sign that they do matter and their well-being is a priority.
I have seen many strong women during my time in Kenya, the doctors and nurses who stand up for their patients’ best interests and gradually push their male counterparts towards change. However, I will take back with me even more stories of women who have been left in unconscionable positions. The woman with nine children who just survived severe post-partum hemorrhage due to uterine atony but is afraid to even consider family planning. The HIV negative woman who has three children but just got re-married to an HIV positive man and is desperate to give him children for fear he will leave her. The woman with a tumor destroying her brainstem whose husband got her pregnant within two weeks of her discharge from the hospital and then abandoned her three months ago when she slipped into a coma. All of these stories could happen in the United States, but here they sometimes seem more the rule than the exception. If only changing the systematic ways in which women are undermined were as simple as treating gonorrhea. Hopefully by giving women more control over their bodies through family planning and offering them a reprieve from the constant demands of child bearing, women can gain the footing they need to start working towards improving their position in society in other meaningful ways.
Dr. Washington thinks we need a revolution...and I don't disagree. But how to start?
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