Showing posts with label global health. Show all posts
Showing posts with label global health. Show all posts

Sunday, April 3, 2011

The Rosaries in the Ovaries

In spite of the Catholic Church's continued and unwavering stance against birth control, it turns out that most American Catholics are, not surprisingly, hypocrites.  According to the National Survey of Family Growth, about 98% have used a form of contraception banned by the Vatican at some point in their lives, and 40% identify as pro-choice.  No word yet on whether these sins come up during Confession.



Yet in the developing world, particularly in Latin America and Africa, the Pope's anti-birth control, anti-condom opinions are taken more seriously.  In Catholic nations such as the DR Congo, Peru, and Haiti, rates of birth control use are negligible, and are inversely correlated with rates of HIV infection and unwanted pregnancy.  In Kenya, there have even been widely-reported instances of condom-burnings at the behest of Catholic bishops.

Now, even Pope Paul VI, composer of the treatise Humanae Vitae, acknowledged that couples might "decide not to have additional children" after giving due consideration to "physical, economic, psychological, and social conditions."  And so, to "keep up with the times," ta-da! - thus was born the Catholic institution of Natural Family Planning.  NFP is a complicated system of tracking fertility by taking one's temperature, recording daily levels of cervical mucus secretions, and filling out charts.  This enables a Catholic couple to attempt to avoid pregnancy by abstaining from sex on likely fertile days, while not "perverting the purpose of the marital act."


First, let's be honest:  NFP is birth control.  It's just complicated and ineffective birth control.  Second, Catholicism seems to be very arbitrary with its endorsement of all things "natural:" naturalness is something to be embraced in contraception, but to be shunned when keeping PVS patients alive for decades via ventilators and feeding tubes.

Third, I don't see how this birth control method stands up even to Catholic logic.  The line of reasoning seems to go:  "Sex that isn't open to procreation is wrong.  If I use a condom then God will be displeased, because I'm trying to prevent pregnancy.  But if I have sex according to an intricately-designed calendar, God won't be able to see through my intention.  God wants me to have babies whenever he chooses.  God can do anything.  But he can't surmount a latex barrier even when he really, really wants to."


Sure gets me all hot and bothered.

Anyway.  Couples hoping to marry in a Catholic church are now required to attend four-month classes in Natural Family Planning, to learn the ins and outs of cervical mucus charting and the evils of secular methods of birth control.  For those unable to attend a class, the marriage requirement can be fulfilled with a "home study" class for just $161.  Nevertheless, NFP use is not very common in the developed world, even among Catholic women.  In fact, only about 3.6% of Catholics practice NFP.  Still, for the very high and holy, Natural Family Planning is the one and only way to go.

Given that the Catholic stance against birth control is so often criticized for the plight of starving, HIV-ravaged third world countries, I was curious to see whether NFP had made its way to Latin America and Africa.  Surely, since the Church acknowledges that everyone might not want to procreate constantly, and since it is so concerned with preserving human life, it would try to promote its one approved method of birth control in the third world.  I discovered, however, that NFP courses are available - in English and Spanish only - in all of fifteen nations worldwide.  The majority of these nations (the US, Canada, Great Britain, Ireland, Argentina, Spain, South Africa, and inexplicably, China) are already highly developed.  NFP classes are taught in just six countries total in Africa and Latin America.  Furthermore, according to Natural Family Planning International, current efforts are focused on bringing NFP to the Czech Republic, a country with a fertility rate of 1.24 births per woman, whose people have suffered from "secularism and immorality."  In third-world majority Catholic nations, however, I suppose that the "suffering" has not been so great.

One rare instance I could find of Catholics promoting NFP in the third world comes from my very own Jesuit Georgetown.  A cohort of Jesuits affiliated with the Institute for Reproductive Health is attempting to dispense "cycle beads," rosaries for counting days of the menstrual cycle instead of Hail Marys, in Rwanda, Guatamala, and the DR Congo.  The sad fact is, though, that in the DR Congo, the so-called "rape capital of the world," where girls are often married off at puberty, even a woman's husband is unlikely to respect her wishes to abstain from intercourse during a fertile period.

If Catholic couples truly want to practice Natural Family Planning, then of course that is their right and their choice.  What I'd like to see, however, is some admission that this form of birth control is an elitist luxury, akin to buying organic food or running in Nike Nakeds.  For reasons logistical, economic, and societal, NFP is available almost exclusively in the developed world, while those without easy access are still told that condoms and other forms of "artificial" contraception will drag them down into the depths of Hell.  Yet even faced with these criticisms, the Vatican is as determined as ever not to waver in its resolve.  Pope Benedict XVI, speaking in 2008 on the 40th anniversary of Humanae Vitae, firmly supported his predecessor's treatise, and reminded the world's one billion Catholics that the Church's stance against birth control is "so crucial for humanity's future."

And I would have to agree with him there.

Tuesday, March 8, 2011

International Women's Day

For a few years now, I've been hearing about the 8th of March's celebration of "International Women's Day" from my very Bulgarian boyfriend.  This very Socialist holiday is Valentine's Day and Mother's Day rolled into one, but I'd never heard of it from anyone besides Nikolay. Today, however, while walking in the streets of Madrid, I saw Spanish women carrying roses, and signs and banners commemorating the 100th annual Women's Day.  Turns out the Bulgars didn't make it up.

In honor of this festive and feminist occasion (and given that my sojourn in Spain doesn't give me much time to write a blog post!), I wanted to post an extremely relevant film.  It runs almost an hour, but it is well worth the time.



This award-winning documentary focuses on five Ethiopian women living with obstetric fistula, a devastating yet reversible injury incurred during childbirth.  If you have never heard of obstetric fistula, I am not going to describe it here - just be aware that there are complications of pregnancy far worse than going into labor in a taxi or elevator, as per sitcom convention.  

According to the UNFPA, approximately 2 million girls and women worldwide currently suffer from this condition.  Obstetric fistula almost exclusively affects women from impoverished regions who give birth before the age of 18.  Married off before puberty and impregnated through what would most tactfully be called statutory rape, the girls unlucky enough to develop a fistula endure their condition along with the disgust of their husbands and the rejection of their communities.

The documentary is poignant but not preachy, powerful, yet not overdone.  The disclaimer at the beginning of the film warns the viewer that the subject material is "mature."  Unfortunately, there are some aspects of pregnancy too unpleasant for baby shower games, and not cute enough for a TLC special.  In a nation that loves to raise its voice about choice vs. life, Roe vs. Wade, we so rarely discuss the victims who suffer most at this crossroads of culture, politics, and religion:  young, impoverished girls who have never had a "choice" about anything.

Sunday, February 27, 2011

Globally Pro-Choice

Last week, I was walking across Georgetown's campus when I was stopped by an acquaintance and asked if I would give a minute for "Global Health Day."  Behind her, a large banner proclaimed "Half the world lives on less than $3 a day... that is what we spend on a cup of coffee."  After filling me in on several additional depressing statistics regarding starvation, malaria, and infant mortality, this well-meaning girl asked if I would help global health awareness by writing down something that I believed everyone in the world deserved.  Without pausing, I wrote "access to birth control."

My response was met at first with a smirk, then with irritation, as she suggested that I write something else. "Please take this seriously," she pleaded, implying that my answer had deliberately mocked the plight of millions of starving children worldwide.  It was as if I had suggested sending vibrating cock rings and flavored lube to the war-torn Congo.




Poverty and global health are issues that we love to talk about.  Starving children in China/Africa/Southeast Asia are eternally the subjects of guilt-tripping rhetoric.  Droves of celebrities and well-meaning high schoolers descend on developing nations each year, all seeking to "combat hunger" and "fight AIDS" in fairly non-specific ways.  Images of barefoot toddlers crying in the muddy streets of Delhi and Lima rouse us to donate to a myriad of international charities.  Yet in all of this discussion of child poverty, there is no mention of the children themselves being a compounding factor.

The correlation between high fertility rates, poverty, and low life expectancy is well established.  According to the UN TFR Ranking (2009), the top twenty nations in terms of fertility rate per woman include Niger, Yemen, Somalia, and Afghanistan; each of these countries has a fertility rate more than three times that of the U.S. and Western Europe.  The UN TFR has also provided this helpful visualization of average fertility rates worldwide:


Anyone who has taken a class in logic knows that correlation does not imply causation.  With a little imagination, though, it's not difficult to picture how a rapidly growing population coupled with a finite number of resources keeps literacy rates low and poverty rates high, fuels political unrest, and greatly facilitates the spread of disease.  And that's not even touching the impact on the women who are actually bearing these children.




Unfortunately, the international community is unlikely to embrace worldwide family planning measures any time soon.  For one thing, one of the world's most powerful men, Benedict XVI, would not approve.  A large number of charities aimed at alleviating poverty are religiously affiliated, and these groups prefer to combat world hunger by collecting canned food, building new churches, and praying.  Contraception, of course, is not in the Catholic or Evangelical vocabulary.  This view has played no small role in the House's recent defunding of the United Nations Population Fund.

It's not just the right wing that's to blame, however.  Even liberal and pro-choice groups shirk from advocating contraceptive use abroad, less they be accused of promoting eugenics or forcing Western practices and culture upon the developing world.  Additionally, the realm of international charity seeks to project itself as bipartisan, eschewing controversial issues such as contraception.  Food, water, health, and education are all hot topics of conversation, but one of the best long-term solutions remains, for now, grossly overlooked.

At the end of the day, it's touching and inspiring to see a a picture of volunteers building a school abroad or serving food to little brown children.  It's very difficult to evoke the same feelings with a picture of a couple using a condom.