quick gripe

I realize that a big part of the reason I’m often unhappy with what I do is that, in many ways, my job is incredibly negative. Unfortunately, our project is at a stage where we’re (and by we, I mostly mean I, as I’m the only one working on health projects full-time) struggling to keep our (my) heads above water. We do what we can for the people we’ve already “taken” as patients, try to treat the most urgent needs of those we haven’t “taken”, and pretty much turn away the rest. So it’s become that at least half of my interactions with people in the centre and in the street are them asking me for things that I just don’t think I can do (or don’t want to deal with, or there’s not even a difference, I don’t know).

And there are basically two ways to look at that: either me turning them away isn’t really going to affect there health much, as they’ll just go pay for it themselves somewhere; or me turning them away is pretty much the end of the line, and they go back home and wait out (or don’t) whatever their malady is. Neither of those is particularly palatable, from my point of view. If the former is true, then my job isn’t really necessary, and I’m risking imperialism/perpetuating the current oppressive societal structures for no good reason. If it’s the latter, I’m no longer acting as an agent of change and have turned into just another health access point that is blocked. In which case, my job isn’t really necessary and I’m risking imperialism/perpetuating the current oppressive societal structures for no good reason.

It’s not like both of those are true all the time, and I’m sure often enough it’s not even that me turning them away is really going to negatively affect their health in any major way (it’s not like we normally give out basic pain medication or decongestants anyways). But I can’t always help the sneaking suspicion that every time I tell someone I’m too busy, or I don’t go up to their home because they missed a BSL, or I wait until they come to me for meds when I know they need a refill, I’m not quite doing the very thing that I explicitly came to do.

And fine. My excuses are in general legitimate. I’m stretched beyond thin, doing the majority of the health stuff on my own. I can’t just indiscriminately take everyone that comes in off the street, take them at their word for where they live, what their need is, how much of our time they need. If I did that, AIC would be broke and I would be crazy. But there’s the nagging thought that I could do more, I could rest less, I don’t need a day off every week. Still...

Still, where does the line come where I’m just another barrier to healthcare? I mean, fine, there’s a fair amount of “maybe if I’m super inefficient then you’ll just give up and go away” in the bureaucracy in pretty much every institution we’ve dealt with here, but in general, I think people are doing the best work they can under the circumstances.

It comes down to the fact that in a lot of ways I identify a lot more closely with people working at the hospitals that with the people I take to the hospital.

no, really, abortion does affect your daily life

i sit reading (and now writing about) Said's Orientalism in this coffee shop, mocha, in pune, india. i realize the irony here (or maybe that's an alanis morisette definition, i honestly don't remember anymore): this cafe is ostensibly a hookah bar, and the menu is full of fun things like the word "sheesha" written to look like ةاي ققاي, some crazy take on arabic. and, of course, the fact that i'm probably, in some way, engaging in orientalism myself by just being here, categorizing, judging and working to improve the "other" (the poor, poor indians) by witnessing their ills, feeling moderately outraged, and helping them to use free services already in existence. andi've been struggling a lot (see my other posts) with both the quality of work i'm doing and the premise behind it. but that's neither here nor there. i'm here to Blog For Choice, apparently.

so obviously, abortion exists here in india. and not always in the good, "it's a woman's right to her body" kind of way, but a lot of time sin the "it's my right as a man to have sons" kind of way. the at-birth sex ratio is something ridiculous like 1.2:1 males:females, and sex-linked abortions, though illegal (it's illegal to tell the sex of a fetus), are certainly not uncommon. so yeah, ilet's not pretend that even the right to end an unwanted pregnancy is always and necessarily an empowering thing for a woman. but don't worry, i don't think anyone was. so abortion is also sometimes a tool of the patriarchy. brilliant.

but i wanted to really write about how i see personal control of fertility (of which abortion is certainly a part) as necessarily empowering. india is, by many standards, a very conservative place (bla bla generalizing reducing essentializing ok fine). tubal ligation (TL) and abortion can only be done with the consent of both husband and wife (god only knows what would happen outside of marriage), though i suspect a vasectomy only requires one signature. sterilization is actually highly promoted around here, and there are some pretty good incentives in place (everything free at the hospital, and they hand you cash at the end). but dozens of women have approached s in the past month telling us that they want us to help them out with their TL's, rather than they doing it on their own.

well, generally government services aren't of the highest standard (though i do believe that in almost all cases they are completely acceptable at least). the sassoon general hospital is more akin to a bus station than an american hospital, honestly. but we've found this gem of a public hospital about 8km away (so transport is a bit of a hassle), but in general it's quiet, clean has a good patient to attendant ratio and is served by some of th e best doctors in the city. so we've been taking patients there, especially for gynaecological surgeries. it requires a lot of effort and time on our part (and a fair bit of money for rickshaws), but the women are generally quite happy with the lebvel of services they get there. so there's one barrier overcome, mostly: the goverment services near us ar crappy (and our patients haven't had good experiences there), but the good government services are too far away to be realistically accessible.

so the next barrier to free reproductive choice (and this is not in order of importance or in what order they affect people, just in the order that i happen to be writing) has in general been a pervasive and rigid patriarchy that prevents women from exvercising free agency over their reproductive system. though this varies pretty drastically and is expressed differently in the three communities in which we work, there's a definite pressure on women to produce a large number of children, male children in particular. we've got one woman who cried when she saw her fetus on the sonogram, because "it looks too big, they'll never take that out" (she already has three young boys). another woman is younger than me and has eight (!!!!!!!!) children, but her husband would "never agree to an operation [for her]". a third has three girls, had an abortion last year (you can guess why) and is constantly asking us to put her on fertility medications, as she hasn't had her period in months. the first's husband didn't agree to an abortion (there's still plenty of time), but said she can get a TL when she delivers. the second finally got her TL after her husband was to embarrassed to discuss the matter with us. the third has no known reason for her current amennorhea, so there's not even a discussion about what we're doing there.

so yeah, wtf. i hope that the three quick sketches above illustrate pretty well (without much commentary) why i'm pro-choice, in all matters. banning or unnecessarily restricting abortion (for any reason) is just another step into treating women as walking incubators/baby factories. women (and men, of course) should have complete control of what goes in and out of their bodies, and when. i don't care who helped put it there, or wants to see it once it's out, if it's in you or there is the prospect of it going into you, it's your choice, period.