EASA2012: Uncertainty and disquiet
Nanterre University, France, 10/07/2012 – 13/07/2012
Uncertainties in rights discourse: addressing health inequalities and development agendas (EN)
Date and Start Time 13 Jul, 2012 at 11:30
Focusing on rights language, ideas and practices in the field of health, the panel will address questions regarding the kinds of anxieties generated for development actors and institutions as well as the uncertainties in health outcomes entailed by the shift to rights based approaches.
A universal, legal language of rights and a 'rights based approach' have come to dominate development discourse. Especially in countries of the global South, but not confined to them, the turn to rights has led states to focus on the agency and mobilisation of the poor and powerless to claim entitlements to food, livelihoods, education and healthcare. But how are rights understood and used by state and non-state actors in development programmes? Focusing on ideas such as accountability, 'choice', 'participation' and 'voice' in the framing of entitlements to health, the panel will seek to address questions regarding i) the kinds of uncertainties generated for development practice, actors and institutions by the shift to rights based approaches; ii) whether rights based approaches are successful in empowering locally disadvantaged groups or whether they actually serve to further disempower the poor and marginalised from gaining better health outcomes; iii) what alternative, localised languages of health and human rights are drawn upon when social actors believe their healthcare needs are not met by the services available, and legal redress is regarded as ineffective? iv) the extent to which the discourse on human rights is exclusionary in terms of its focus on particular categories (poor, women) or conceptual paradigms (northern rather than southern theories of rights).
Discussant: Hayley Macgregor
This workshop is closed to new paper proposals.
Modernity in tradition in the Bajenu Gox program: a new challenge to the Senegalese maternal health system
My paper will focus on the Bajenu Gox program, a project carried out in Senegal in order to promote maternal health, which connects in an original manner global development policies and local traditions.
The universal access to healthcare systems plays a central role in human rights discourse. In this direction, the idea of global health as a human right appears strictly intertwined with the conception of "community health" as a preliminary condition for local development.
Within this glocal approach to health, my paper will focus on the Bajenu Gox ("The community aunt") program carried out by the Senegalese government in order to promote maternal health and reduce mortality rates. As we will show, its distinguishing feature is the attempt to transfer, to a community level (gox), the "pedagogical role" usually played out in the family by the aunt (bajenu). The choice to refer to local traditions, in order to obtain a greater access to biomedical services, will be the starting point to consider the limits and the challenges of such (bio)political project.
In particular, referring to the results of anthropological fieldwork conducted in Senegal, we will focus on two specific outcomes of the Bajenu Gox institutionalized action. First of all, within the project's aims, their role was to widen the reach of biomedical approach to mothering, that is to increase women presence in a modernized healthcare system. Secondly, their efforts also resulted in offering women the possibility to rely on other therapeutic systems - such as religious and traditional ones - which Senegalese women believe equally necessary to deal with uncertainties related to mothering. As a consequence, we may witness the growing relevance of the Bajenu Gox function in Senegalese society as a professional, able to connect universal human rights with structural health inequalities; global health policies with local needs; modern development with women's traditions.
Puerto Rican women, sterilization, and the reproductive rights discourse
This paper evaluates the concept of reproductive rights in the context of Puerto Rican women’s notions of reproductive freedom and their experiences with sterilization. It analyzes how women make fertility decisions and their individual, social, cultural, and historical constraints.
In the twenty first century Puerto Rican women have the dubious distinction of having one of the highest rates of tubal ligation in the world. La operación, as Puerto Rican women colloquially refer to sterilization, is an integral part of Puerto Rico's colonial political history and cultural beliefs. This paper traces how sterilization, a method of population control, was transformed into a popular method of fertility control over four decades. Drawing upon twenty-five years of research on sterilized Puerto Rican women from five different households in Brooklyn, New York (15 families), I explore the interplay between Puerto Rican women's agency and constraints. This framework transcends the traditional binary framework that classifies Puerto Rican women either as victims or agents who exercise complete reproductive freedom. Instead it explores la operación within the broader context of an integral model of reproductive freedom. This model critically evaluates the concepts of reproductive rights and "choice" for their individualistic cultural ideology and examines Puerto Rican women's notions of reproductive freedom based on their individual, cultural, social, and historical experiences. Rather than just engaging in a rights discourse, the women's voices centered on their family's and community's needs and relationships as well as their own. This has implications for how rights are understood and used by such women and calls for a more expansive framework for addressing health inequalities with respect to women's reproduction as well as for promoting development.
Rights based approaches and Santali systems of governance: contradictory or complementary?
This paper discusses rights based approaches from the perspective of a Santali community in India. Based on ethnographic research, I draw on examples of state development policies pushed by the Orissa government, and the impact of these policies at the local level from a gendered perspective.
This paper discusses rights based approaches from the perspective of a Santali community in Orissa, India, focusing in particular on policies to increase women's participation in local level government. As India increases its reservation for women in local level politics to 50%, the relationship between state level policies and indigenous governance becomes more complex. The Santali Majhi system and the decentralised system of state governance - the Panchayati Raj Institution (PRI), work in parallel to each other, yet the power vested in the locally elected women representatives interlinks and overlaps with the Santali system at numerous levels. This paper seeks to analyse the manner in which politics and 'rights based approaches' plays out at the local level, demonstrating how the PRI and the Santali system can both simultaneously complement and contradict each other. Based on ethnographic research, I draw on examples of (failed/challenged) state development policies pushed by the Orissa government, national and international organisations, and the impact of these policies at the local level from a gendered perspective. Through this process I highlight the opportunities created for Santali women through state structures, while demonstrating the importance they continue to place on the Santali system of governance.
Realising reproductive rights in Indian law: the work of legal NGOs in promoting maternal health
This paper engages with anthropological approaches to the study of global human rights discourses around reproductive and maternal health in India. In particular, we examine the way in which activists draw upon reproductive rights as a legal construct: both as a means of promoting women's access to health more broadly as well as furthering a feminist agenda premised on a woman’s right over her body, fertility and sexuality.
This paper engages with anthropological approaches to the study of global human rights discourses around reproductive and maternal health in India. In particular, we examine the way in which activists draw upon reproductive rights as a legal construct: both as a means of promoting women's access to health more broadly as well as furthering a feminist agenda premised on a woman's right over her body, fertility and sexuality. Through an analysis of the work and the language used of both national and region-specific legal actors and organizations, we illustrate the way in which reproductive rights discourse is framed in relation to both national policy and case law and, at another level, ideas around claims and entitlements at the local level. The paper will explore the extent to which paradigms around reproductive rights actually improve the ability of women (particularly those from poor and marginalized communities) to challenge structural inequality and obtain greater access to healthcare.
How is it going to ended? Pregnancy in a context of high maternal mortality
Based on two qualitative studies conducted in urban areas in Senegal and in Benin, this communication intends to report popular, "traditional" and biomedical practices which the women develop in front of the uncertainty of their pregnancy and their delivery in these contexts.
Based on two qualitative studies (interviews, observations) conducted in urban areas in Senegal (Pikine) and in Benin (Cotonou) with pregnant women or having given birth recently, this communication intends to report popular, "traditional" and biomedical practices which the women develop in front of the uncertainty of their pregnancy and their delivery in these contexts. It could be about the respect for dietary restrictions or concerning certain activities, as well as the respect of biomedical recommendations or of those made by traditional healers or religious people, these perceptions and practices highlight in Benin and in Senegal the anxiety which the women develop in front of their delivery and of the birth of their child. The social and health inequalities that these events underline worldwide are just incredible.
Nevertheless, certain differences appear between these two societies of western Africa. While in Senegal, appears clearly a duality between a biomedical health offer and a "traditional" one, in Benin the privatization of the biomedecine and the commoditization of pregnancy is at stake.
In both countries however, a possible bad outcome of the pregnancy (more or less important complications at the time of the delivery) is linked inevitably to the responsibility of the women. It could be by their social background, by professionals of the biomedecine whom they consulted or still by themselves. The biomedicalization of the pregnancy widely accepted and wished by the urban women of these two countries is far from offering this day a satisfactory answer to these very justifiable fears.
This workshop is closed to new paper proposals.