While reading the much acclaimed Half the Sky in order to brush up on the principles of current human rights work, I was presented with a number of statistics regarding misogyny and the toll it takes globally. One of the topics that particularly struck me was childbirth in the developing countries. One woman every minute dies in childbirth. For even ten women who give birth, one is seriously injured and these often include rectovaginal fistulas. Since I don't know that rectovaginal fistulas qualify as general knowledge, I'll go into gruesome detail for you. Essentially this occurs in poorer countries when women giving birth don't have proper healthcare and they have trouble pushing the baby through the birth canal, resulting in internal tearing that leaves the affected women leaking both urine and feces as part of their vaginal discharge. Often neighbors and family are so disgusted with the scent and waste that the women are ostracized, sometimes to the extreme of being left to die in the wilderness or sent to live in a hut alone at the edge of the village.
The causes as well as repercussions of this atrocity are largely to do with the medical and overall social neglect women in particular get in developing countries, but a shortage of doctors in these places is also a huge issue. There are many doctors from these countries, but when given the chance, they leave for places with higher standards of living. The authors of Half the Sky say that maybe the export of health workers should be regulated more so that it will be harder for doctors to leave, but such an approach seems a harsh imposition on personal freedom. Reading Chimamanda Adichie's Americanah, a realistic fiction book that largely focuses on the African diaspora, I was drawn into the sympathies of the elite Nigerians who left their campuses for American and England because of the incessant strikes and lack of governmental support for education. A particularly cutting passage in Americanah shows the clash in perspective:
"Speaking of which, I have just got involved with this fantastic charity that's trying to stop the UK from hiring so many African health workers," Alexa said. "There are simply no doctors and nurses left on that continent. It's an absolute tragedy! African doctors should stay in Africa."
"Why shouldn't they want to practice where there is regular electricity and regular pay?" Mark asked, his tone flat. Obinze sensed that he did not like Alexa at all. "I'm from Grimsby and I certainly don't want to work in a district hospital there."
"But it isn't the same thing, is it? We're speaking of some of the wold's poorest people. The doctors have a responsibility as Africans," Alexa said. "Life isn't fair, really. If they have the privilege of that medical degree then it comes with a responsibility to help their people."
Although doctors leaving developing countries can be a strain on the people in need of healthcare, forcing doctors to say home with such methods from Half the Sky as making their medical degrees less reputable so that they are not accepted in the West would not necessarily be effective considering the number of students who leave their country even before medical school in order to get most of their higher education abroad.
Not all poor countries seem to be having the problem of a shortage of doctors showing that there are plausible ways to ensure healthcare.One such case is Cuba. With a GDP per capita of around $10,200 and an economy badly suffering from the US embargo put in place since 1961, Cuba has nonetheless managed to have universal healthcare which is probably the best way to motivate doctors to stay rather than leave. Although Cuba still has doctors who choose to practice elsewhere, there is less pressure to feel the need to do so.
A system of universal healthcare can ensure governmental backing of hospitals so that they will be properly equipped and paid in a timely manner, a specific concern in developing countries where private companies are overwrought with corruption. However many times governments in developing countries are just as plagued with corruption, so to ensure that this would work, more stability would have to be instated.
The writers of Half the Sky also propose the alternative of having people with little to no education be trained in simple surgeries since a great number of deaths in developing countries are caused by problems that would be easily fixable in the West. One example relates back to rectovaginal fistulas.
Rectovaginal fistulas often occur in the Democratic Republic of Congo by such sexual acts of violence as being gang-raped and then having a stick shoved deeply inside them. One such victim stayed at the hospital after recovery and learned how to stitch up such injuries even though she had never even finished primary school.
This shows that more health work can be done in the meantime while resources for major changes in infrastructure are being hoarded by a corrupt elite. Hopefully in the near future such injustices will be resolved but a more manageable and readily affordable goal for the time being might be to train the locals with basic nursing and healthcare skills.
