Posted 71 days ago

The World's Women Need Our Help!

by Christine Sine, Mustard Seed Associates

“The church’s challenge for the 20th century was the equality of women,” proclaimed the speaker at a conference I attended recently. “Now that this battle has been won, we need to move on to new issues facing the church in the 21st century.” I was stunned as I thought of my many women friends around the world who still struggle to find acceptance and feel valued within their society and their churches. This statement has revolved in my mind ever since. What have women gained in the last few decades, and as we look to the future what are they still seeking?

I have benefited tremendously from the battles that women fought and won in the past. My husband’s mother would have loved to become a doctor, but that was an impossible dream for most women in the 1930s. For me, entering medical school in 1968 was an easy decision—almost half of my medical colleagues were women.

Life as a woman wasn’t always easy. After I graduated from medical school, I moved to New Zealand and entered family practice. My medical colleagues treated me as equals, but ironically, in the country that was one of the first in the world to give women the right to vote, I felt more discriminated against in the church than ever. “It’s wrong for a single woman to earn more than a married man,” I was told. “God only calls women into ministry when men don’t respond,” was another oft-repeated statement. In spite of a very successful medical practice, I felt like a misfit. Not only did society not approve of who I was, but God didn’t seem to either. I was scared to look at what the bible said about women because I was afraid this would only confirm my worst fears.

Then I joined the Mercy Ship Anastasis and it was as though a whole new world opened up for me. Building a hospital on board to perform cleft lip and palate and eye surgeries was an enriching and fulfilling experience. The unique privilege of my life has been the opportunity to use my medical skills in Africa, Asia, Central America, the Caribbean and the South Pacific to bring health and healing to thousands of people. In the process I have not only found my own healing, but have also grown into the person that God intends me to be. Encouraged by the affirmation of my friends and colleagues, I recognized that God does approve of me. “This is why God made me the way I am,” I realized. “I am not a misfit but a unique human being created in God’s image and specially equipped to perform the service that God has called me to.”

Women and Reproductive Health
I am still haunted by the women I have met around the world who have no hope of finding the respect and equality that I enjoy. I vividly remember my first short term medical outreach: working at a clinic in the Dominican Republic. As the only woman doctor on the team, it was decided that I should see all the female patients with reproductive health problems. I was soon overwhelmed; most of the patients who came to see us were suffering from reproductive health conditions. Tragically, it soon became obvious that no one had considered medications for women’s problems to be an important priority in their acquisition of supplies.

Reproductive health conditions—including HIV/AIDS—are still the leading cause of death and illness in women aged 15 to 44 worldwide and the second leading cause of death and illness when both men and women of reproductive age are taken into account. Because there are glaring disparities in access to reproductive health care between rich and poor, the poor disproportionately bear the consequences of poor reproductive health. Complications during pregnancy and childbirth are a leading cause of death and disability among women of reproductive age in developing countries. An estimated 529,000 women died from complications of pregnancy and childbirth in 2000.¹ For every woman who dies, roughly 20 more suffer serious injury or disability—between 8 million and 20 million a year. Virtually all these women were in developing countries. Vulnerable groups—such as indigenous, ethnic or other minority groups—often have significantly higher rates of maternal mortality.

Tragically, most of these deaths are preventable, but limited progress has been made over the past two decades because of the low value placed on saving women’s lives and the limited voice women have in setting health priorities. The cost of not addressing this problem is considerable. Up to 95% of infants will die within the first year of life without their mother. For older children, especially girls, a mother’s death often means reduced resources, income and nurturing. It is not unusual for girls as young as eight or nine to be taken out of school to look after younger siblings.

Fortunately, progress has been made in some countries with high poverty levels and provides an example for others to follow. Success in Malaysia, Sri Lanka and Thailand is credited to significant investments in training of midwives, which began in the 1950s, expanding access to skilled attendance at birth. Maternal deaths halved in these countries every 7 to 10 years.

Women and Sexually Transmitted Diseases
In many parts of the world, women who are infertile are abused, divorced and even murdered. Around 70% of female infertility in developing nations is caused by sexually transmitted diseases that can be traced back to the husband. In a vicious circle, men become infected through visits to prostitutes, they transmit the disease to their wives, who become infected and infertile, and then they divorce them. In some cases, the ex-wife herself turns to prostitution to survive if no other economic alternatives exist for her. Sexually transmitted diseases (STDs) cause more death and illness in women than AIDS does in men, women and children combined. They also cause a large share of preventable infant deaths and disability each year. They reduce individual economic productivity, hamper efforts to slow population growth, and burden already poor healthcare systems. And worse yet, many STDs facilitate transmission of the AIDS virus.

Nearly half of those living with HIV are female, but the share of infected women and girls is growing. Of the 17 million women between age 15 and 49 living with HIV, 98% live in developing countries.² Of all regions, sub-Saharan Africa continues to be the most devastated. No other region in the world approaches its HIV prevalence rates or displays such a disproportionate impact on women and girls. More than three–quarters (77%) of all women with HIV live in sub-Saharan Africa.³ Women and girls make up almost 57% (over 13 million) of all people infected with HIV in the region. Among girls aged 15–24, the difference is even more pronounced: in the worst-affected African countries, as many as three young women live with HIV for every young man.⁴

Women are more vulnerable biologically, socially and culturally to HIV infection than men. In many cultures, men expect sex with any woman receiving their economic support and it is difficult for women to protect themselves from HIV/AIDS. Cultural, legal, religious and economic factors also limit the control women have over their lives, their sexual relationships, and their ability to protect themselves from infection.

The UN Task Force on Women, Girls and HIV/AIDS in South Africa found several particularly effective strategies against AIDS and STDs. The first is to challenge the social norms that contribute to the lower social status of women and girls and condone violence against them. This can be achieved through the use of drama and community-based education. The second is increasing the self-esteem and self-confidence of girls through education and life-skill training. The third is to strengthen legal and policy frameworks that support women’s right to independence, including the right to own and inherit land. The fourth is to ensure access to health services. And the fifth is to empower women economically by providing access to credit with business and marketing skills.⁵

Women and Poverty
Women are disproportionately represented among those who are poor, and the challenge of reproductive health is just one of many problems they face. Though more people have been lifted out of poverty in the last 50 years than in the previous 500, 1.2 billion people still subsist on less than $1 per day. Seven out of ten of the world’s hungry are women and girls, according to the UN World Food Program. Their poverty is often more intractable than that of men because of their low socio-economic status and poor education. This discrimination has dire consequences not just for the woman herself but for her family, her community and even for the environment. Women play critical roles in providing for their families through household and agricultural work, healthcare and economic provision. They often have greater influence than men on rates of population growth and infant and child mortality, on health and nutrition, children’s education, and natural resource management.

In some countries, inheritance laws and land rights discriminate against women. Worldwide women grow about half the world’s food, but own only 1% of the world’s property and receive only 10% of the world’s income. When a husband dies, a woman may be forced off her land. Sometimes she turns to prostitution—the only economic avenue open to her to provide for her children. Paying jobs for women are concentrated in the lowest paid occupations, and if they work outside the home, most work a double day, bearing total responsibility for childcare and household chores, regardless of their contribution to family income. According to the World Bank, women in the developing world earn 73 cents for every $1 earned by men.⁶ In the US, the gap can be even worse. African-American women earn only 63 cents and Hispanic women only 53 cents for every $1 earned by men. In spite of this, assistance projects are usually focused on men and their empowerment, and often ignore women even if the areas they address are traditionally women’s responsibility, like the gathering of water and firewood.

One of the most successful development organizations in the world is now the Grameen Bank, which has extended small loans for self-employment to more than two million woman villagers in Bangladesh and helped to lift hundreds of thousands out of poverty. Its “trickle up” approach has inspired the creation of hundreds of other “micro-credit” programs around the world and helped to reshape international development policy so that it focuses more on women.

Women and the Environment
One of my vivid memories of Africa is of a day I spent with women in a small Ghanaian village. They were hard at work long before I arrived, having risen at dawn to sweep the house, light the fire and prepare the day’s food. Smoke from the fire filled the huts, making me reluctant to stay indoors. We walked to the local stream for water, a thirty minute trek, the return journey made with the precious water balanced on their heads. Five- and six-year-old girls balanced tin cans on their heads to share the load. The older ones carried babies on their backs as well.

What dismayed me most was that the women did laundry in the same stream, and beside them the cattle drank and defecated. There was once a closer and cleaner water source, but it was diverted to irrigate cash crops. I didn’t go to collect firewood. That involved a three-hour trek two or three times a week. On top of that the women worked in the fields, and in the evening spent hours pounding the plantains into fufu, part of the staple diet. It was all backbreaking work and my heart ached as I watched them struggle in an environment that was increasing stressed by growing populations and decreasing resources. The struggle to find basic resources occupied more and more of their time and drained more and more from their already malnourished bodies.

For this village, there was some hope on the horizon. A Swiss relief organization was building a water line to the fresh water supply, and another aid organization was developing a biomethane plant that would eventually provide cooking gas for all households in the community.

This story shows the paradox of development for these women. Water pollution, soil erosion, and destruction of firewood resources is contributed to greatly by the expansion of cash cropping. Women, particularly poor women, rarely receive the economic advantages of this changing use of land resources. When land, water and timber become commodities to be sold, these resources on which family subsistence depended impacts women in devastating ways. They are the ones responsible for providing food, water and firewood for cooking and heating, and expend more and more of their energy on the provision of these basic necessities. In addition, the huge loads they carry on their heads cause curvature of the spine and other back problems.

In order to cope, women reduce the number of cooked meals to one every other day, resulting in lower family nutrition. They also replace firewood with agricultural residues such as cassava stalks and dried dung traditionally used to improve fertility and soil structure. Also, the traditional women’s income-earning activities of fish smoking, pottery making and beer brewing depend on adequate supplies of firewood, and forests supply other raw materials and food products important to women for household consumption.

One of the most successful approaches to environmental degradation was that begun in Kenya by Professor Wangari Maathai in 1977. She developed The Green Belt Movement, which has now planted more than 40 million trees across Africa. Her connectedness to women in rural areas and their struggles to provide for their families, made her recognize that experts who saw the solution to rising poverty as the need for more cash cropping and more fertilizers were wrong. Much of Kenya had been cleared of trees and the soil had degraded and eroded to a serious extent. Rural Kenyans could not find firewood and depended on agricultural residues and dung for cooking and heating. Thousands moved to cities in search of work and money. Women have taken the initiative in the program, showing each other how to collect seeds of nearby indigenous trees and how to plant and tend them. Slowly, devastating effects of soil erosion are being reversed.

Women and Violence
Violence against women takes a dismaying variety of forms, from domestic abuse and rape to child marriages and female circumcision. Rape is still being used as a weapon of war, a strategy used to subjugate and terrify entire communities. Yet the alarming global dimensions of female-targeted violence were not explicitly acknowledged by the international community until December 1993, when the United Nations General Assembly adopted the Declaration on the Elimination of Violence against Women.

Some females fall prey to violence before they are born, when expectant parents abort their unborn daughters, hoping for sons instead. In India and China, it is estimated that there are 60 million fewer women than there should be.⁷ These infants are victims of female feticide, selective malnourishment and neglect.

In other societies, girls are subjected to the traditional practice of circumcision, which leave them maimed and traumatized. Each year about 1 million girls worldwide will suffer female genital mutilation—a crude surgical and suturing exercise done to insure males a virgin bride. An estimated 90 million women and girls living today have suffered this procedure.⁸ It is most widely practiced in Africa, but also occurs in societies in Asia and among migrant populations in developed countries. In recent years, there have been a number of highly publicized cases of women granted asylum to avoid the circumcision of their infant daughters.

The process itself may damage the urinary tract and other surrounding organs, cause shock, hemorrhaging, tetanus and other infections. In Sudan, where infibulation is practiced, 10 to 30% of young girls die from the operation. Later in life, the vaginal opening must be forcibly opened again, extensive scar tissue causes increased complications, pain and sometimes death from childbirth. These women are also more likely to suffer pelvic inflammatory disease and resultant infertility. Unfortunately this is not an easy practice to control because it is rooted in deep-seeded traditions. However, sensitive education for both men and women particularly by traditional birth attendants is making a difference in some African countries. In Kenya, a UN Trust Fund grant has supported women’s groups to develop alternative, nonviolent rites of passage to replace the tradition of female genital mutilation.

There are approximately 50 million uprooted people around the world, both refugees who have sought safety in another country and people displaced within their own country. Between 75-80% of them are women and children fleeing their homes because of war. The proportion of civilian war victims leaped in recent decades from 5% to over 90% of casualties. Eighty percent of casualties from small arms are women and children, who now far outnumber military casualties. Women and children suffer most because they are defenseless and vulnerable. The women suffer repeated and brutal rapes. They are often raped before they leave their homes as a deliberate act of war, but are still vulnerable during their escape and even in refugee camps, especially when they have no male family members to protect them. Not only that but many are maimed as they try to gather meager food and water supplies, by land mines and other detonator devices.

Domestic violence is the most widespread form of abuse against women and crosses all ethnic, social, religious and economic boundaries. Worldwide, at least one woman in three has been beaten, coerced into sex, or otherwise abused in her lifetime.⁹ Most often the abuser is a family member. In some countries, domestic violence is as high as 90%. Often this abuse is systematic and devastating. Societal tolerance contributes to the existence of abuse. In many societies, wife abuse is acceptable behavior and justified as a routine part of married life. The absence of credible support systems for women victims helps perpetuate escalating violence.

In the United States, wife abuse is the leading cause of injury among women of reproductive age. Between 22% and 35% of women who visit U.S. emergency clinics are there for symptoms related to ongoing abuse. Wife abuse also provides the context for many other health problems. Battered women are four to five times more likely to require psychiatric treatment and five times more likely to attempt suicide than non-battered women. They are at increased risk of alcohol abuse, drug dependence, chronic pain and depression.

One particularly vicious and violent form of discrimination and abuse in India and other parts of Asia is “bride burning” or dowry deaths. The tradition of bride gifts—once an act of parental love has combined with greed and materialism. Increasingly, the dowry is seen as a get rich quick scheme by prospective husbands, and young brides are abused if ongoing demands for money are not met. Dowry deaths are notoriously undercounted, estimates vary from 1,200 to 15,000 a year. Often the victim is doused with kerosene and set alight, and then it is claimed she died in a kitchen accident.¹⁰

Healthcare providers can do much in all these situations to help overcome the problem of violence against women. First, they must learn how to ask clients about violence and become better aware of signs that can identify victims of domestic violence or sexual abuse. They can also help women protect themselves by developing a personal safety plan and making them aware of community resources that can provide protection.

Women and Aging
The fastest growing segment of the world’s population are the over-65s with more women in this age group than men. Most of the elderly are presently in industrialized nations, but by 2050, their number will be just as high in developing nations where life expectancy for women is going up despite heavy workloads, multiple pregnancies, chronic anemia, and inadequate medical services. Developing countries generally ascribe less value to women who can no longer bear children and yet often midlife and older women still care for grandchildren and elderly parents, trends which will be more marked in the future. These women frequently suffer from chronic malnutrition and osteoporosis and are often depressed and anxious because of low self-esteem.

In developing countries, few women are covered by pension systems, which often depend on the jobs their husbands held. Most elderly women rely on traditional support systems, namely their children and extended families. This means the number of older women living alone is much lower than in developed countries, but those without close kin are especially vulnerable, because they have little access to other means of support. Unfortunately traditional support systems for the elderly also face severe challenges due to the rising numbers of elderly, declining fertility rates, urbanization and a breakdown in traditional family patterns.

There are many ways to improve conditions for elderly women. Educating healthcare providers to recognize and address the specific needs of elderly women, providing access to in-home assistance services to older women suffering from chronic illnesses in lieu of institutionalization, and encouraging older women to form their own support groups and networks are all ways to improve the situation for the growing elderly population. Recording oral history that reflects the contributions of older women to society is also an important way to improve their self-esteem.

Women and the Bible
Today I am more concerned than ever about the problems women face and the need for Christians to be involved in providing answers. Proverbs 31: 8 reminds us that we are called to be a voice for the voiceless, and in many societies women are still the voiceless ones. They need not only other women to speak up for them but also men.

Jesus often went out of his way to help women who were marginalized by both society and religious institutions. The Samaritan woman drawing water when no one else was around, the woman with a discharge who would never have been allowed into the synagogue, another woman caught in adultery and threatened with stoning are all examples of the marginalized and abandoned women of Jesus day. Jesus not only treated women with respect and dignity, he also affirmed the equality of women in ways that were radical and revolutionary for his society. He healed male and female alike, raised them both from the dead and often illustrated his parables with both male and female examples.

The Old Testament also affirms that women have God-given dignity and worth, equal to that of men. As Genesis 1:28 explains both men and women were created in God’s image. It was the Fall that resulted in the subservient position of women. The redemptive work of Christ reversed the effects of the Fall validating women’s equal status with men. In Galatians 3:26-28, Paul affirms that “in Christ there is neither Jew nor Greek, slave nor free, male nor female, for you are all one in Christ.” The early church recognized the right and necessity of women to participate in the work of the church on an equal plain with men. At times they are cited as leaders of others, and they are always spoken of with respect.

God’s affirmation of the equality and freedom of women through Jewish spiritual practices actually goes back much further than Jesus’ day, as I discovered while researching Sabbath practices for my book Godspace: Time for Peace in the Rhythms of Life. The Sabbath celebration traditionally begins with the women presiding over the prayers of blessing for the family. Honoring women as well as men was always meant to be an important aspect of this celebration that formed the pivotal point for Jewish life.

Hope For the Future
I will never forget Bu, a young Cambodian refugee who worked as a medical assistant with me in the refugee camps in Thailand. “My hope for the future is that one day my daughters will have the same kind of freedom you do,” she told me.

That is my hope for the future too. I pray that one day women everywhere—in churches here in North America, and around the world—will be able to experience the same freedoms that I have discovered through my relationship with Christ: the freedom to be all that God has created them to be, without oppression, discrimination or poverty, and the freedom to develop and use their gifts as God intends them to.

Notes
1. Department of Reproductive Health and Research, Maternal Mortality in 2000: Estimates developed by WHO, UNICEF and UNFPA, World Health Organization, Geneva 2004, accessed June 11, 2008, here.
2. UNAIDS, UNFPA and UNIFEM, Women and HIV/AIDS: Confronting the Crisis, 2004, accessed June 11, 2008, here.
3. Ibid.
4. Statistics Division, Progress Towards the Millennium Development Goals: 1990-2005, Department of Economic and Social Affairs, 2005, accessed June 11, 2008, here.
5. UNAIDS, Women and HIV/AIDS, 14, 15.
6. Institute for Women’s Policy Research, “New Report: Women Get Paid 68 Cents for Every Dollar White Men Get” (news release), April 20, 2004, accessed June 11, 2008, here.
7. United Nations High Commissioner for Refugees, Sexual and Gender-Based Violence Against Refugees, Returnees and Internally Displaced Persons: Guidelines for Prevention and Response, May 2003, accessed June 11, 2008, here
8. United Nations Development Fund for Women, Facts and Figures on Violence Against Women, November 2007, accessed June 11, 2008, here, p. 4.
9. Ibid., p. 2.
10. “Lisa Ling Investigates Bride Burning,” The Oprah Winfrey Show, aired January 16, 2004, accessed June 11, 2008, view here.