This is a feeling I have heard expressed by a number of other women. We often avoid certain places and situations, not only because of a general fear of crime, but in many cases, because of a specific fear of rape. Rape affects both men and women, as sexual violence can be directed at anyone, regardless of their sex. Despite this, however, women are disproportionately the victims of rape. In this way, rape becomes an undeniably gendered issue, in which concepts such as ‘masculinity,' ‘femininity' and ‘power' often come together to endanger female bodies.
That the threat of rape so greatly shapes the experiences of so many women, both those who have survived it, as well as many who have not been personally affected by it, speaks to the pandemic nature of sexual violence against women.
In a report entitled "Against Her Will," released in 2006 by PANOS Caribbean, which undertook a situational analysis of rape in Jamaica, links are drawn between high levels of violence in poverty-stricken inner city communities, and the use of rape as a weapon in war.
It can be argued that the high levels of violent crimes cannot in and of itself qualify Jamaica as a war-torn country. However, in a number of select communities, gunplay between warring factions has become commonplace, with young, black males featuring as the main victims and perpetrators of this violence. However, among those who have been directly affected by the violence is a growing number of females, with sexual violence being used as a weapon of war.
Despite assertions by local police officials that "reprisal rapes" are infrequent, gender specialists and activists have challenged that view, noting the persistence of strong links between community-based violence and rape. In the drive to instill fear into communities the bodies of females are sometimes caught in the middle, and "gang rape and rape-as-terrorism... is used on women and young girls in these troubled communities as a form of revenge and also to render the occupants powerless. It sends a message to the people in the community about ‘who run things'. In one such case, two teen-aged sisters were repeatedly and brutally gang-raped by a group of eleven men (who originated from a community other than theirs), who threatened them that they would die because of the area in which they lived.
What emerges is an ugly side to the increasing crime situation in Jamaica, one that disproportionately affects the lives of many working-class, black women in war-torn communities. The need to examine the gendered impact of crime in these communities is succinctly expressed by Jamaican gender specialist Dr. Glenda Simms, who notes: "As long as there are Jamaican communities which are militarized, the figure for rape and other sexual offences will continue to increase. Women pay the price for war."
]]>Amidst evidence of rising rates of domestic violence in Jamaica, there is absolutely no place for "humor" of this sort. It is, however, very useful in highlighting the ways in which we speak of, and don't speak of, domestic violence as a society. It speaks to a cultural environment of complicit acceptance of gender-based violence (GBV); with women accounting for the vast majority of reported cases.
According to recent reports, there has been an upward turn in the rates of domestic violence in Jamaica, with domestic-related murders jumping 20 per cent between 2005 and 2006. The statistics, released by the Jamaica Constabulary Statistics Department, point to steadily increasing reports of domestic wounding and assault, with 49 of the 1,674 murders in 2005 being domestic-related. According to police reports, 17 per cent of all murders in the island between 2001 and 2006 were committed within the home, and the victims of these crimes were predominantly female. It goes without saying that, while these figures highlight increases in acute cases of GBV - resulting in death - they do not paint a thorough picture of the issue, as most cases will still undeniably go unreported.
Domestic violence is typically enforced by a cultural code of silence, which masks the true nature of inter-personal relationships between and amongst women and men. These statistics paint a troublesome picture of violent crimes against women, pointing to the violation of women's human rights generally, and their sexual and reproductive health in particular. The presence of violence - be it emotional, physical or sexual - diminishes the ability of healthy individuals to demand and enforce healthy sexual relationships, and by extension a healthy sense of self.
]]>In typical fashion, the key issue that has arisen in the debate is one regarding the rights of the woman versus the rights of the unborn foetus; with religious and moralistic values heavily influencing the cited reasons why the act of abortion should remain illegal. Ultimately the debate raises the issue of women's control over their bodies and their sexual and reproductive health; a debate that raises key sexual health concerns and nuances.
The act of abortion, as with many gendered acts that shape women's lives, typically remains clouded in a veil of secrecy. The clandestine environment in which abortion is situated is reflected in the legal and policy approaches to the issue. While abortions are legally governed by a 150-year old body of legislation which criminalizes the procedure, common law has allowed for the procedure to be done in specific circumstances. As such, common law allows for the termination of pregnancy in cases of: (i) significant fetal abnormality; (ii) where pregnancy would represent a threat to the welfare or health of the mother and (iii) in cases where pregnancy is an outcome of rape or incest.
This approach to the termination of pregnancy brings with it some major health care challenges.
One of the more evident flaws in the common law which governs the actions of local medical practitioners is its' subjectivity. In instances that are not as clear cut as fetal abnormality or pregnancy as a result of rape, the physician becomes the main holder of power, determining whether or not women who fall outside of these predetermined categories can in fact terminate their pregnancies. What then, happens to those women whose conceptions may not meet the criteria for "rape"; but whose relationships may in actuality be fraught with power imbalances such as the perceived inability to enforce protected sexual intercourse?
An associated health care challenge also arises regarding the ambiguity in the existing legislation and the common law itself. Common law, which develops over an extended period of time on the basis of widespread practices is seen to sharply contrast with the laws on the books in Jamaica. As such, despite the mentioned criteria which allows for abortions in the specified circumstances, the fact remains that legislation takes priority over common law. This places not only the affected women in jeopardy of prosecution, but also the participating physicians themselves. Such an approach potentially impacts women's sexual health, as it could discourage trained specialists from performing the procedure, thereby reducing women's options for safe health care.
The effects of curtailing women's choices for safe reproductive health care are potentially fatal. According to the World Health Organisation (WHO), some 22, 000 abortions are performed in Jamaica each year, collectively representing a significant section of the Jamaican population. This number is cause for concern when taken in tandem with evidence suggesting that complications from unsafe abortions are among the ten leading causes of maternal mortality in Jamaica, particularly amongst pregnant teenagers.
What this means is that for a large number of women, unsafe abortions performed by untrained and/or unspecialized physicians and practitioners are amongst the most accessible options for the termination of pregnancies. This fact is particularly dangerous for those women who may not be able to afford the high cost of having their pregnancies terminated by private and well-trained physicians.
This undeniably places working class women at particular risk. The cost of an abortion by a private physician can fall within the range of JMD 40, 000 (approximately USD 570.00), a cost which is inaccessible for the vast majority of working class Jamaican women. These women, without the alternative option of accessing the procedure within the public health care system - unless they meet the specified guidelines governing abortion - are often forced to access cheaper and potentially far more dangerous options.
The existing policies on abortion therefore privilege women of financial means, and in contrast, work to unfairly curtail the health care rights of working class Jamaican women.
Jamaica, as a signatory to the UN Millenium Development Goals, has undertaken to reduce maternal mortality by 2015, a goal that cannot be achieved if women are denied access to safe and legal abortion services.
While moral values and the right of the foetus are important considerations in the abortion debate, they should not supersede the right of the woman to determine how and when and if she will give birth.
State emphasis must therefore be placed on providing women with the information and support needed to make wise sexual health decisions, one of which could include the decision about whether or not to terminate their pregnancies.
]]>In response to the report, a variety of possible explanations for the practice have been given by advocates and practitioners in the field, including: a lack of father figures; peer pressure; low self esteem and marriage as a means of economic survival. There is indeed merit in all of these contributing factors, and there are undeniably strong links that can be made between the incidence of poverty and the entry of adolescent girls into relationships with older men who are able to assist them and their families financially.
Importantly, one key discussion that also comes to the fore is the persistence of cultural values that often offer covert protection to both the young girls and the older men in such relationships; thereby obscuring the potential danger for the under-aged females in the unions. Responding to the report, child advocate Mary Clarke, pointed to the cultural silence that surrounds such illegal unions, stressing that the wide-scale failure to report such unions is a cause for concern.
The cultural silence surrounding this issue is indicative of wider patterns of silence with regard to sexual and reproductive health issues. Although ideas regarding men's right to ownership over ‘their' women in intimate relationships can be found across communities, the practice of cohabitation between under-aged females and older men is predominantly found in communities marked by poverty. In many instances, young girls become bargaining tools for economic improvement, placing them in relationships in which the power imbalances often affect them negatively.
Factors such as age, economic dependence and a lack of decision-making power often come together to place the young girls in these unions at particular risk for domestic abuse, unwanted pregnancies, and HIV and other STDs. Based on the lack of power that these girls are often able to tap into, there is also evidence that they are particularly likely to suffer emotionally and mentally, resulting in low self esteem which further compromises their ability to demand and protect their sexual health rights.
Amidst calls for increased vigilance in reporting and penalizing the men involved in these unions, we must also be mindful that based on the economic reality of many of the affected girls and their families, such unions may in fact seem like the best available option. Inadequate education opportunities, cultural norms and values and limited support systems (both emotional and financial) inevitably play a role in shaping the environment in which these practices exist.
Any attempts to address, and ultimately eradicate this practice must be grounded on an understanding of this dynamic, or they may in fact put in place systems that do little to actually improve the girls' lives. An exploration of the complex nature of these relationships must lie at the center of these efforts so as to provide these girls and their families with viable options for their survival needs. Failure to do so will inevitably leave in place values and practices that will inevitably undermine any anticipated change for the better.
]]>In a number of communities across the Caribbean, we have come to place an extremely high value on youth, moving away from traditions that elevated our elders to a place of respect, and in essence obscuring their faces, silencing their voices and by extension, increasing their vulnerability. Given the dimension of gender, which often places women at a disadvantage in the allocation of, and access to power, the vulnerability of aged communities becomes an even more pressing issue for numbers of elderly women. Even within most organizations and education programs whose work is dedicated to social advancement, issues related to the elderly often go unaddressed.
In the 2001 text, Health Issues in the Caribbean, mention is made of the growing life expectancy across the English-speaking Caribbean, with a current life expectancy rate of approximately 75 years. This means that, thanks to social advances such as increased access to health care, larger numbers of our population are living longer. What then are we doing to protect the lives and interests of this section of our societies?
The vulnerability of elderly women recently came sharply into focus in Jamaica with charges being made by female residents of an ‘old age home' in a financially depressed community that they are often verbally, and in one case sexually assaulted by members of the surrounding community. One of the most shocking elements of the newspaper article was not, however, the allegations of abuse, but rather the dismissive manner in which authorities responded to the allegations. The elderly women were charged with unnecessarily seeking to stir up trouble, with a key authority stating that the charges were untrue because she would have known about these violations if they were indeed taking place.
Such a response does not take into account one of the key characteristics of abuse: it usually goes unseen, and by extension, unreported. The hidden nature of abuse is exacerbated in cases where factors such as age, poverty, and inadequate social support systems are at play. Many elderly persons virtually live in obscurity, put aside by their families and communities. The invisibility of this group puts them at particular risk.
While a number of goodwill organizations typically intervene in providing assistance and company for the elderly, we as a society are yet to fully integrate the issue of the abuse of the elderly into discussions of sexual and reproductive health. Our inability to view the elderly as sexual beings therefore has the spill-over effect of blinding us to many cases in which their sexuality is being violated.
Any truly successful society is one in which all members are valued, irregardless of their age, gender or social status. Issues such as the sexual health of the elderly must necessarily be integrated into discussions of HIV/AIDS as well as broader sexual health discussions if we are to truly meet the goals of development.
]]>In the global fight to manage and eventually eradicate HIV/AIDS, emphasis has continually been placed on the role of public education in general, and more specifically, on changing sexual and social behaviour that may place individuals at risk for contracting HIV.
By emphasizing the social dynamics that often contribute to the transmission of HIV, policy planners and practitioners are better able to zero in their efforts on issues that may not automatically be seen to be related to HIV. As such, issues such as poverty, gender dynamics (for example, the different understandings of masculinity and femininity), access to education, and community development must be included if we are to create and sustain balanced, effective and sustainable programs and projects. This allows us to broaden our focus on HIV beyond seeing it solely as a health issue, but rather as a social and development issue.
Despite the undeniable need for this broader approach to HIV management, public officials often fail to make the connection between the transmission of HIV and social and cultural behavior.
In celebration of World Aids Day on December 1, Jamaican Prime Minister Bruce Golding publicly announced that the Global Fund grant - a program which covers the cost of HIV/AIDS programs, including antiretroviral drugs for persons living with the virus - will be sustained over the next five years. The grant, which takes effect in 2008, will provide US$44 million (J$3.1 billion) to carry out HIV prevention, treatment and care programmes.
The Prime Minister also expressed concern about the island's need for an additional US$200 million (J$14.2 billion) to deal with HIV initiatives and programs over the next five years; noting that the government would only be able to provide one-third of that amount. He further stated that despite the importance of the fight against HIV/AIDS, the government must also tend to other national priorities such as crime and education. To this end, the Prime Minister has called on the private sector to step up their role in contributing to HIV causes.
In theory, the Prime Minister is right. With a steadily growing crime rate and particular challenges in the area of education, these are key priorities for national development. However, what is missing from his analysis are the linkages between and amongst these areas. Issues such as education cannot be dealt with in isolation from HIV/AIDS, as over time, the links in these areas will become increasingly apparent. The same can be said for most development issues, yet in public forums, public officials often fail to recognize or underline the interconnectedness between these areas.
Another major oversight made by the Prime Minister is his sole focus on the need for increased private sector involvement, with no specific mention being made of the role of civil society organizations in managing HIV. The empowerment of civil society groups must be a core component of any national policies designed to tackle HIV/AIDS-related issues. Failure to recognise, and beyond that to publicly support the work being done by these organisations leaves many stones unturned. These are the people who are actively working to uncover the linkages between social and cultural development issues and HIV, often with little financial or public support.
A key component of any well thought out policy or program must necessarily be the inclusion of civil society organisations. The focus on public education and meeting the needs of those infected with HIV can take us only so far towards managing it. In order to manage HIV, we must first contextualize it. As necessary as funding and private sector support are, they will only take us so far without the input of key players on the field.
]]>In Jamaica, as of January 2007, 5,125 children under the age of 15 were estimated to have been orphaned by AIDS. In 2006, 73 children aged zero to nine years old were diagnosed with HIV.
In the Rapid Assessment of the Situation of Orphans and Other Children living in Households Affected by HIV/AIDS in Jamaica (2002), the unique circumstances of this group of children was outlined. Issues such as access to poverty, effective public health care, stigmatization, insufficient psycho-social support and inadequate network systems all come together to negatively impact the lives of children affected by HIV. Negative cultural attitudes towards the illness negatively impact the level of support - both emotional and financial - that many children receive from their families and immediate support groups following the death of their parents or caregivers. This is further complicated in smaller communities, thereby increasing the stigmatization that is endured during an already troublesome period of their lives.
In recognition of these dynamics, there have been ongoing efforts to centralize the experiences of these children. In 2006, twenty-five young persons that are either infected with, or affected by HIV came together, with the guidance of Panos Caribbean to produce a series of public service announcements entitled "Our Own Voices: Youth Fighting HIV." Providing the young participants with basic journalistic training, as well as training on basic sexual and reproductive health issues and child rights, the program has not only sought to create an avenue for this group to cope with the realities of their lives by giving voice to their concerns, but also to use their experiences as vehicles for change.
In the last week, another powerful initiative has been launched by affected and infected youths, Panos and a local media house, the Gleaner Company. In an initiative entitled "Special Delivery," children living with, and/or affected by HIV will deliver a number of letters to influential persons in the society, advocating positive change on issues that they have identified as being key to their lives. What is of special significance is that the issues that are addressed are those that the children and adolescents themselves have identified, based on the belief that they themselves are most intimately aware of their needs and concerns. In this manner, there are two key outcomes: one, the development of a people-centered approach which can better inform policy and, two, a shift in the lives of the children themselves, whereby, through advocacy they are better able to play active roles in their own lives.
The letters, which are published in the Jamaica Gleaner, have thus far addressed issues such as the need for parenting seminars and the inclusion of parenting components to HIV projects, which would better enable their parents and caregivers to cope not only with their own status, but with the impact on their children.
The two mentioned initiatives illustrate not only the powerful potential of the media for affecting change, but also the importance of privileging the experiences of affected groups, in this case children infected with, and affected by HIV. In so doing, we are able to affect change on two key levels: individual empowerment and social consciousness.
By highlighting the stories of children, as told by children themselves, the "Special Delivery" initiative clearly takes a step towards challenging cultural attitudes towards HIV and those infected with it.
]]>As a non-Jamaican, albeit one who has lived here for years, this has been a grey area for me, because the issues of sexuality in general, and homosexuality in Jamaica in particular, are very complex ones. In Jamaica, attitudes towards homosexuality seem to more visibly relate to relationships between men, and are typically placed in opposition to cultural ideas about masculinity and what it means "to be a man." Even in reference to same-sex relationships between women, the term "sodomite" is often used, again drawing the parallel between "aberration" and male homosexuality.
This strong adherence to gendered ideas about appropriate behaviors and relationships between women and men is further deepened by the overt and covert presence of a strong fundamentalist Christian base, which has resulted in cultural attitudes that call for fire and brimstone to be brought down on those who challenge - through their sexuality and sexual practices - these ideas of appropriateness.
What has clearly emerged is an environment marked by an unwillingness to change, despite the obvious impact that Western (in particular American) society has had on Jamaica. Coming out of this has been a strong sense of "Jamaican-ness,"
i.e. what it means to be Jamaican and "of Jamaica." Homosexuality is positioned in direct opposition to this "Jamaican-ness," and is taken to be a result of external influences on the island.
This "Jamaican-ness" came sharply into focus for me in the past week. A textbook that was allegedly proposed by the Ministry of Education for inclusion in the home economics school curriculum came under fire due to its mention of same-sex unions and families. The home economics textbook in question includes a section stating, "When two women or two men live together in a relationship as lesbians or gays, they may be considered as a family. They may adopt children or have them through artificial insemination."
In response to the public outcry about the proposed inclusion of the text, Minister of Education, Andrew Holness, made reference to the "offensive clause" in the text, denying that it had ever been ministry-recommended, and further stating: "We want to make it absolutely clear that the Ministry of Education does not endorse or support the teaching of homosexual relationships as the accepted standard of family. We don't teach it and we don't recommend it."
This position has been supported by the Jamaica Teacher's Association (JTA), whose president Ena Barclay stated: "It [homosexual relationships] is not something that we embrace in Jamaica, and we can't ask our teachers to teach such a matter to students."
To put such a text in a public forum specifically for the use of children has been taken as an assault on the way things are done in Jamaica, resulting in a response that has unified many Jamaicans, rich and poor, who have been able to transcend social boundaries to condemn the text in unison.
Crime and murder rates in Jamaica are persistently high. Domestic and child abuse have continuously been cited as serious issues compromising the rights and lives of large numbers of women and children. There are serious social issues that warrant attention in this island, and it just seems to me that the collective energy that was brought to bear in the past week could be so much better used by focussing on issues such as those just mentioned.
In the meantime, "Jamaican-ness" reigns supreme, resulting in a climate in which an issue such as homosexuality are so taboo that it only seems to warrant wide-scale discussion when there is a collective move to clamp down on it, and ultimately, to eradicate it. This past week held the potential for serious discussions about the rights of human beings, regardless of their sexual orientation. There was the opportunity for us to really begin to talk openly and honestly about the lives and realities of members of this society.
Instead, Jamaican-ness has prevailed...and the gay textbook is out.
]]>I want to share some stories. They are the stories of teenaged girls that I know. These girls are not estimates. They are not samples of the population. They are just three teenaged girls that I know.
The reason I am sharing these stories is because a young friend of mine recently lost her virginity. Thinking about her...her innocence; the purity of her Spirit; the way she smiles and looks like ten again...thinking about her made me mourn for the loss of a certain part of her life, and pray that she will make the right decisions to protect her life. Thinking of her made me think of other young girls that I know who are just like her: struggling to define and come to terms with their sexuality. As much as we speak about the politics behind sexuality, my friend made me remember that at the center of policy lie young women and men with real stories.
This is a decision that this teenager has been contemplating for a while now. She has a teenaged boyfriend whom she loves. She has the love and friendship of a mother with whom she is able to share her thoughts and feelings about sex. Her mother has made her aware of, and they have discussed the variety of choices open to her: (preferably) to abstain; to protect herself; to not "go all the way." She has chosen to become sexually active.
The second girl that I know is fifteen years old. A couple of weeks ago she believed that she was pregnant. She was scared about this possibility. She is in a relationship with a man many years her senior. They live together. She left her mother's house to avoid being sexually abused by her step-father. This older man has taken her in and provides for her financially. She wants to find a way out, but she really feels like she nowhere to go for assistance. She feels that she no choice but to be sexually active.
At fourteen years of age and five months pregnant, the third girl is well aware of her choices to prevent her from "repeat pregnancies." She attends a Jamaican organization that allows teenaged mothers to complete their education and to receive developmental counselling, with one of the core areas of concern being "delaying unwanted pregnancies." Despite this, she tells me that she doubts she would use a condom with her partner. She tells me he won't use them and that she wouldn't push him to, because he might think she has another "man." She says that she suspects he is sexually active with other people.
These girls are real people. They are real young women who are grappling with the feelings and consequences of their entry into sexual relationships. They have all of the fears, strengths, insecurities, and challenges that make up many of our lives. They each have had a different experience with sex, and they each deserve a health care system that is responsive to their needs and challenges.
Statistics have highlighted the particular risks for sexually active female adolescents, particularly those involved in relationships with older men. In response to these and other red flags that define the sexual lives of many teenagers, the Government of Jamaica has implemented programs such as JA-STYLE aimed at helping adolescents to make wise sexual decisions. All of these are wise and necessary efforts, but I want more.
I want these stories to be heard. I want the young women and men who these policies seek to help to become the ‘experts' on adolescent sexuality who are informing us about it, instead of us informing them. I want an interactive approach that does not berate teenagers for feelings the ways they do. I want my young friend and the other young girls who may be like her, or vastly different to have options, and to have a platform on which they can speak about their fears, concerns and challenges. In which they can make wise decisions and have a number of options that show them how to protect their lives.
The stakes are high. We need to protect our children. No matter how we feel about adolescent sexuality, the fact remains: real girls and boys are choosing to, or being forced to, enter into sexual relationships every day. The stories are numerous. We need to listen. Lives depend on it.
]]>Focusing on morality in discussions regarding sexual and reproductive health care is potentially dangerous. The issue of what is considered to be right and wrong and/or appropriate versus inappropriate is a highly subjective one, influenced by variables such as class, race, philosophical beliefs, and gender. In the Caribbean, where our belief system has been so forcibly shaped by Christianity, a culture has emerged in which women who choose to terminate their pregnancies are typically seen to have committed a punishable act against God.
In Jamaica, there is a saying that women who are “barren” are being punished for having “dash ‘way babies” (had abortions). Such views are not limited to Jamaica and can be found throughout the region, and they do have potentially adverse effects on women’s access to safe sexual care. Women, and adolescent females, may opt out of safer alternatives for terminating their pregnancies for fear of being judged, choosing instead to utilize unsafe alternatives that may endanger their lives. More importantly, such attitudes help to foster a climate of fear and secrecy, thereby compromising women’s sexual health.
By linking abortion with sin, women who take this route are cast in the role of the sinner. Despite steps taken by many Caribbean nations towards ensuring women’s right to safely terminate their pregnancies, cultural debates which pit abortion against God omit two key factors from the debate: (i) women’s right to choose, and (ii) the psychological, social and emotional impacts of their choices – whatever they may be.
The provision of access to abortions is not the same as encouraging people to terminate their pregnancies. There are a number of reasons why people choose not to give birth. It is simplistic to say that the issue can easily be solved by the use of condoms, abstinence or other forms of birth control. The complexity of gender often leaves many women feeling that these are not choices that they can make, so to negate their experiences, while chastising them for their choices leaves a large number of women twice marginalized.
In a cultural context in which women’s value is so greatly tied to their fulfillment of the maternal role, females who for one reason or another choose not to become mothers are seen to be abhorrent, and morality is often a key factor in this designation.
The decision to terminate pregnancy is a serious one, not to be taken lightly. Without doubt there must be a heavy focus on counselling alongside the provision of safe services, with emphasis being placed on the social, psychological and spiritual health of the mother. A rights-based approach centralizes women’s needs, while helping them to explore all of their options, and helping them to make the decision that is best, not only for their children, but for themselves.
]]>A useful phrase which highlights the depth of sexual violence defines rape as the "completed act of sexual violence forcefully performed against the will of another person." What works with this definition is that it places "rape" along a continuum of sexual violence. This definition expands traditional notions of sexual violence, taking account of the diverse ways in which violation occurs. It also leaves room for us to discuss the sexual commoditization of female bodies, often in ways that reinforce social and cultural messages about male domination and female submissiveness.
One of the key players in institutionalized sexual violence is the media, which typically portrays both men and women in sexually stereotyped roles, which are shaped by but also shape social values. In a controversial advertisement that was released earlier this year by fashion house Dolce & Gabbana, a partially naked man is shown holding down a scantily clad woman while a group of men stand by. The advertisement was pulled from the Spanish market following protest by feminist groups, but in response to the uproar fashion designers Domenico Dolce and Stefano Gabbana made the statement: "What does an artistic photo have to do with the real world?" In advertisements such as this one, which not only portray men as rapists, but perhaps more frighteningly women as willing acceptors of rape, this question becomes a very pressing one.
It has been said that art imitates life, so what is to be said of imagery that plays on the sexual violation of women, men and/or children? In societies in which a significant number of women and girls are raped and assaulted, do we have the luxury of putting out messages that reinforce an already strong culture of sexual violence?
In the Caribbean context, this dilemma is particularly evident in popular music forms. A Barbadian calypso a few years back spoke of the adult male's love for riding on the minivan and watching the schoolgirls bouncing up and down. Dancehall songs such as that by Jamaican artiste Spragga Benz often use sexually violent lyrics in his description of sex: "Cock it up, Jack it up, dig out the red...rev out the hole." An Amnesty report found that according to official reports 0.18 per cent of Jamaican women are sexually assaulted each year; and further estimates suggest that these official reports account for only 25% of all cases.
The media's use and manipulation of sexual violence therefore has everything to do with the real world. Although sexually violent images do not automatically lead to sexual violence, they do help to shape cultural values that teach us that it is okay to see women and men in these harmful ways. We become increasingly tolerant of violators and less sympathetic to those who have been violated.
In the highly publicized incarceration of Jamaican reggae singer Jah Cure - who was jailed in 1999 for the brutal rape of a young girl - artists, radio personalities and popular local figures came out in support of the artist with the cry of "Free Jah Cure". What was lost in the rhetoric was the story of the victim, while the man convicted of her assault has been elevated to the level of a wrongfully imprisoned political prisoner, with callers on call-in programs even drawing parallels between Jah Cure and Nelson Mandela.
What are the repercussions when we see the sexual violation of women and girls as "normal?" How does this compromise the sexual health of this significant section of our population? And in reverse, what messages are we teaching young men when we let them off the hook for being sexual aggressors all in the name of "culture?"
Sexual violence is a weapon. Our sexuality becomes a tool to be used against us. How can we even begin to talk about sexual and reproductive health in a culture in which sexually violent art is acceptable? One in which we still sing along and dance to explicit, degrading and violent music? One in which we fail to acknowledge that not only does art imitate life, but quite often, life also imitates art?
]]>Historically, many of the more notable achievements in the gender equity in Jamaica have come under the PNP government. Issues such as HIV/AIDS, adolescent sexuality and gender-based violence have more forcibly come into the global policy arena during the PNP's almost twenty year rule, thereby shaping national policies which have had to speak - even if only in passing - to those and other related areas. The fact is that the Jamaican Labor Party does not have such a history and it is therefore up to the new governing party to determine how, and if, they will move forward with these and other sexual and reproductive health issues.
Real and urgent issues face the incoming government, most of which have not been given the same airtime in political debates as have issues such as economic growth and political mismanagement. One such issue is adolescent sexuality. The policy focus on adolescent sexuality typically revolves around teenage pregnancy and rates of HIV infection amongst this group. In Jamaica, teenage pregnancy has rightfully been identified as a core area for concern, with links being made between adolescent pregnancy rates and the "feminization" of poverty. According to a 2006 UNICEF report, adolescent mothers account for approximately 20% of all births in Jamaica, with only 34% of them returning to school after giving birth to complete their education. This accounts for a significant section of the potential labor force that remains uneducated, impacting not only the cycle of poverty, but related areas such as sexual health, as many women enter into unhealthy sexual relationships in order to provide for themselves and their families.
Interestingly, despite its focus on the economic empowerment of the population and, by extension, Jamaica, the JLP in its' Manifesto makes no mention of adolescent sexuality, thereby missing a significant link between adolescent sexual health and the economic and social development of the country.
It therefore remains to be seen whether the newly elected government will sustain or improve upon previously implemented projects such as the Improved Reproductive Health of Youth Project, which was developed in an effort to create youth-friendly adolescent health care services.
In the meantime, activists and interest groups in Jamaica will need to remain watchful and increasingly vigilant to pressure the government to explore the link between economic growth and social development, underlining the fact that the sexual and reproductive health of Jamaican women and men is not solely a health care issue, but a development issue.
Some in Jamaica would likely suggest that it is the dawn of a new day for the country, it remains to be seen therefore if it will look anything like yesterday did...or if it will be worse.
]]>What I’ve recently begun to question are the ways in which governments, policy planners and experts in the field also share this “afterthought” approach to men’s sexual health. What has been and will be the impact of such oversights on the sexual and reproductive lives of both men and women? And how do we ensure that we don’t lose sight of the multiple ways in which the two areas are linked? What is men’s sexual and reproductive health anyway?
I asked a physician friend of mine this question and received vague and uncertain replies, which came into sharp contrast with his grasp of women’s sexual and reproductive health needs. Given the culture of masculinity often associated characteristics of strength, control, promiscuity, how do planners and practitioners effectively target men to meet their needs?
In Jamaica, with national elections around the corner, politicians are busily promoting their stated future agendas, with the necessary rhetoric being spun around their plans for the reproductive health of the society. In the manifesto of the now ruling party, reproductive health is briefly addressed, promising increased “access to reproductive health information and services to men and women.”
It is important that the manifesto does not collapse men’s sexual health into that of women’s, specifically including men in their focus. It is however insufficient, even in a bulleted point such as this one, to do so without giving even passing mention to how such efforts will take into account the specific, different and multiple needs of women and of men.
I grew up hearing promiscuous men being described as “village rams” or “hard men,” men that you should stay clear of, but who were nonetheless desirable because of their elusive nature. I grew up hearing that men should not cry, that boys and men will sleep around, that men should not show weakness (physical or otherwise). I grew up hearing that “normal” men only slept with women. In the Caribbean (and beyond I am sure), many of these cultural values still exist, and are passed unquestioningly from generation to generation.
Research suggests that young men in Jamaica are more likely than young women to be sexually active with multiple partners and to engage in “outside” sexual relationships (with persons other than their committed partner). Despite the fact that women often bear the brunt of the associated risk as a result of these behaviors (for example, increased susceptibility to the transmission of HIV/AIDS and other STIs), it does however point to an urgent need to incorporate re-definitions of male sexuality and behaviors. It points to the need to examine the power dynamic which helps to shape men’s (and women’s) use of contraceptives. It points to the need to interrogate masculinity and its associated ideas of strength, if we wish to encourage men’s interest in, and responsibility for their sexual health.
Policies also need to urgently take account of the fact that men do not only have sex with women. In a cultural climate that still challenges the “normalcy” and acceptability of homosexuality and bisexuality, how do planners and practitioners provide care for what is often a hidden or hard-to-access group of men? Research is a key step towards building a knowledge base on the lives of men who sleep with men (MSMs), and must in all ways seek to build on the knowledge and experience of MSMs, and importantly, to work towards the elimination of discrimination on the basis of sexual preference.
Men’s sexual and reproductive health is a largely under-explored territory. It is however important territory, not only for the benefit of men themselves, but also because healthier, more knowledgeable and involved men also make more cooperative and open sexual partners. Co-operative partners make wiser sexual decisions, and wiser sexual decisions save lives.
]]>My decision was met by many with skepticism and sometimes even with outright hostility or ridicule. After a while I stopped caring, but it did begin to open my eyes to the politics of giving birth. For the first time I began to question the birth practices that I had come to see as normal: hospitalization; the use of drugs; Caesarean sections; episiotomies...all of these are the terms that I could have come to associate with childbirth. I had come to see midwifery and home birth as irresponsible, dangerous and archaic; and the use of technology as the most efficient guarantee of a safe birth.
Globally, a climate of health care is emerging in which the management of birth through technology has resulted in medical intervention at all stages of even the most "normal" pregnancies. Societies have moved away from birthing practices that focused on the delivery of a healthy infant, but importantly, also privileged the spiritual, physical and emotional wellbeing of the mother. With the increased use of technology at every stage of the delivery, along with increased state intervention into childbirth, an important element has been compromised: women's experiences in becoming mothers.
Giving the seeming naturalness of birth, how does this become a political issue? In short, states benefit from women's maternal "labor" (pun intended). With every healthy baby that is born, states receive future members of society that will predominantly contribute to its economic and social development. Women's bodies - and in particular women's reproductive roles - are therefore central to the functioning of our societies.
Childbirth is usually addressed solely in the capacity of maternal health care, which is generally concerned with indicators such as infant and maternal mortality. While these are key areas of concern the sole focus on these indicators potentially silence women's voices, as countries with low maternal and child mortality rates can unquestioningly assume that their approach to childbirth is a successful one without taking into consideration women's experiences with becoming mothers. This becomes particularly problematic in smaller, developing countries with limited financial and human resources, who may be even more unwilling (or unable) to expand notions of maternal health beyond the current indicators.
By politicizing childbirth we can center women's bodies and female experience. If we call for policies that privilege the importance of women's experiences - of our desires, fears and challenges - then we can move towards integrative approaches to childbirth, approaches that focus not only on mortality rates, but also look at the harder-to-measure indicators such as "satisfaction" and "empowerment."
Given the key role that women play in the reproduction of society, governments - the main beneficiaries of our maternal activities - not only have a responsibility but also a vested interest in ensuring that women experience childbirth as a source of power. A sole focus on the delivery of a healthy baby by a healthy mother stops short of a holistic view of what we mean when we speak of health.
We need to politicize our own understandings of and expectations for our bodies and then to demand birthing practices - whatever they may be - that honor our right to give birth in ways that affirm our senses of self.
]]>He came to mind recently when I read an article in the Trinidadian newspaper The Sunday Guardian (June 17th, 2007), entitled "Assassins on the loose". The article, written by Dr. Ray Noel, HIV Specialist for the Tobago Health Promotion Clinic, makes reference to a "subset of HIV infected people who for diverse reasons react [to their infection] by developing a culpable state of mind, which consists of deceit in hiding their HIV status from their multiple sexual partners". Making reference to the HIV/AIDS epidemic in Tobago, he notes that while health care practitioners may know the identity of these "assassins" victims, "confidentiality rules and the lack of legal options prevent any form of intervention being initiated". Calling for the criminalization and prosecution for "deliberate and malicious sexual exposure and transmission of HIV", Dr. Noel notes that this would be a form of HIV prevention as it would eliminate "a potential source of infection".
The current legal situation which governs the activities of the Tobago Health promotion Clinic protects the client, ensuring that all information remains confidential, and therefore forbidding the discussion or disclosure of any information by employees with any third persons. This law also extends to persons who have been alleged to be HIV positive. While I know first-hand the pain and turmoil that my friend went through, I can't see the wide scale benefit of amending this law in the ways suggested by Dr. Noel.
Personally, I find the term "AIDS Assassins" very unsettling. It sensationalizes a very serious issue. It does not capture the fear, the identity crises, the cultural nuances, nor the social upheaval that may cause many people to remain silent in the face of a positive diagnosis. AIDS does not just happen on a physical level ... it does not just happen to an individual. Defining this as maliciousness becomes extremely problematic, especially when we throw into the mix issues such as poverty, cultural and gender values, and societal discrimination, which may further influence infected persons' decision to keep their diagnosis secret.
In the face of a legal framework that would prosecute infected persons for knowingly exposing others to the disease, other negative outcomes would likely occur. For one, those who may suspect that they are infected may be unwilling to get tested, and importantly, many who do test positive, may resist informing their partners for fear of prosecution, and the inevitable publicity that would come with it.
If the main goal of such a law is the prevention of HIV transmission, we should consider how much could be gained by such a law, and weigh it with what could be lost. Undeniably there are those people who maliciously seek to infect others. However, with stigma and discrimination still among the main challenges in the fight against HIV/AIDS, criminalization laws may compromise the health of the wider population, while attacking a minority in the infected population.
It raises another big issue, that of personal responsibility. My friend can now accept that not only did his former partner "expose him" to HIV, but also that he exposed himself. At no point did they get tested; at no point did they practice safe sex; and after the loss of his child, he remained in the relationship because he did not seek to educate himself about what had happened. Criminalization laws reinforce the idea of a victim and a perpetrator, and can potentially compromise our responsibility to protect ourselves.
Although Dr. Noel's article does have a sidebar of "Criminalisation Problems", which range from increased discrimination to reduced testing, the fact remains that those are not sidebar issues. They are major reasons why criminalization laws are not the best answer.
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