Feminism in Zambia: Finding an Unexpected Champion

Our last guest post this month is by Stephanie Reinhardt. Stephanie is a Program Officer with Jhpiego and is currently working to support HIV/AIDS and maternal health programs in east and southern Africa. Growing up in San Francisco and joining forces with Larkin Callaghan at the age of 4 has left her overly opinionated and easily distracted by all the exciting things around her. Hey look – a baboon just walked by my office window! When she’s not bouncing around the globe, she’s very busy procrastinating.

Gabriel, a Zambian taxi driver who works outside an overpriced hotel in the capital Lusaka, drove me to a township on the outside of town last week. We started with the usual conversation.

“Where are you from?” he asked.

“California,” I responded, “though I’m starting to feel like Zambia is my second home”.

I’ve been to Zambia six times in the past four years supporting public health programs run through Jhpiego, an affiliate of Johns Hopkins. After some discussion about various locations in the US he had learned about from other passengers, he jumped into his favorite story about American history to see if I knew it as well.

After slowing his taxi to traverse a particularly rough patch of potholes, Gabriel looks at me and said, “Well, you know about the Gremich sisters?” (Upon further research, I learned the correct spelling of Grimké sisters). I shook my head no, which gave Gabriel the green light to dive into his story:

“During the time of slavery in America (perhaps in California, or Texas or wherever), there were two sisters who wanted to put an end to slavery.”

I jumped in to briefly describe (with my best recollections from high school) the divisions between the north and the south that eventually led to the civil war, which I explained, for future reference was on the east coast of America, so I would guess that the Grimké sisters were probably from a state like New York. (Turns out they were from South Carolina, but later joined abolitionist circles in Philadelphia, New York and New Jersey.)

Gabriel gave me a polite nod, but the civil war was clearly not his target conversation. With the eagerness of a school kid sitting in the front row, he continued his story, which he credited to a book he had read called, No Fear of Trying. Gabriel’s eyes grew large as he told the story of these sisters’ amazing bravery to publicly speak out against slavery. He looked at me and repeatedly tapped the top of the steering wheel with his palm to emphasize the profundity of this story. “These were the first women to speak at a podium…to men. Women did not do that at that time.” He described the message of equality and freedom that they took all the way to the US government. “People thought that women should not give public speeches to men. Lots of people threatened them and told them to stop, but these women were so brave, ” he continued. I was nodding in agreement, but apparently not giving the reaction he wanted.  “Isn’t that amazing?” he exclaimed. “It’s great!” I responded.

Despite a few factual inaccuracies (that the Gimké sisters final speech ended slavey, and this all took place in the 1950s), Gabriel’s story is pretty spot on. The Grimké sisters grew up in South Carolina with all the advantages of a privileged class awaiting them.  Unlike many other northern born abolitionists, the Grimké sisters had seen slavery first hand and felt compelled to not only put an end to the practice, but to put an end to racial and gender discrimination – an idea radically progressive for their time. They promoted extremely advanced messages for both racial and gender equality. Angelina Grimké letters demanded “educational reform, equal wages and an end to other forms of discrimination against women.”

What fascinated me most about Gabriel’s story was not that I was previously unaware of this significant historical biography (I am never shocked by the amount of information I don’t know or frankly, don’t remember). Rather, I was completely taken aback by his emotional response to this story. He loved these women for their bravery to stand up to men and wanted to share it with anyone who got in his cab.

Zambia is not a country known for its progressive gender relations. Women unfortunately still live very much as the mercy of their husbands, cultural laws and the State. As explained in a 2002 OMCT report on violence against women in Zambia:

Women in Zambia currently face many obstacles to the realisation of their human rights including high rates of violence against women in the family, in the community and by the State, discrimination in the application of customary laws relating to family and inheritance rights, low levels of representation in political and other decision-making structures, a lack of access to education and employment opportunities, poor health care services and the limited availability of affordable contraception.

The 2007 Zambian Demographic Health Survey (DHS) included an assessment of women’s empowerment by asking questions on employment and decision-making.  While great variations exist with regard to education level and location, overall 37 percent of men think that decisions about how to spend the wife’s cash earnings (if she has employment outside of the home) should be made mainly by the husband.  These views extend to a woman’s body as well – 46 percent of men think that the husband alone should make the decision on the number of children to have.  Only 64.8 percent of currently married women responded that they are the primary decision makers or make joint decisions with their husbands regarding their own health care.

So, given this context, I was baffled. I wondered if I had stumbled into the cab of an outspoken Zambian male feminist. As Gabriel’s taxi approached our destination, I probed him on his thoughts on women’s rights in Zambia. “Oh,” he responded, “we have learned a lot from Americans. Everyone is equal here.” Then he dropped the famous development buzz word “gender” and it was all over. “Yes, we have learned gender is important, so now we are all equal.” Ack.

I was hugely disappointed. My image of this Zambian male taxi driver in a superhero outfit championing women’s rights quickly vanished. I thanked him for the ride and started to get out of the car. As I was about to depart, he pulled out a small piece of paper and said, “You work in health? Can I ask you a question?” I nodded, and he continued: “My wife has decided that we should only have three kids, and so we want to stop now that we have three. Can you look at this list and tell me what you would recommend?” On the piece of paper was a list of family planning methods that they had received from their local clinic. I sat with him and explained the differences between some of the short term methods and the long term methods. I also described the vasectomy process should he be interested in the procedure. I explained that if his wife wants no more kids, a long term method, such as an IUD might be best, as it offers protection for 5-7 years. He smiled and responded, “Great, thank you. I will tell my wife this information and see what she wants to do.”

Maybe we have our champion after all.

Looking for More Attention? Drop Some lbs.

At least that’s what Skinny Water is promising in their latest advertisement, which I spotted yesterday. The ad shows a woman facing a throng of cameramen snapping her picture, elegant earrings dropping to the top of the headline which says: “Skinny Always Gets the Attention.” Take a look:

Thinspiration, thanks to Skinny Water

A close-up, to see all the text:

Close-up, for good measure.

Below the headline and photo of the various flavors, it also says “Zero calories, Zeor sugar, Zero Carbs, Zero Guilt.” With all that’s not in this water, you might wonder what it does offer. The website tells me that depending on the flavor of water, they’ve added vitamins B3, B5, B6, B12, C, A, and E. They’ve also thrown in magnesium, folic acid, calcium and/or potassium.

Despite trying to market itself as healthy, Skinny Water is instead perpetrating the cultural message that the best – nay, only – way to ensure that you get attention is by being skinny. This of course positions them well to try to push their product on those women who have been pulled into this lie. This ad tells us that the best way to skinny is not through healthy food choices and exercise and an understanding of what “skinny” means for our particular body type and shape, but essentially through fasting – which is what zero calorie drinks are the equivalent of.

In fact, Skinny Water is doing precisely the opposite of what a health-conscious company and product should be doing. Promoting the idea that those who are skinny deserve attention more than those who are not creates communities that support harmful diet-related behaviors and disordered eating for the goal of a wispy appearance . Not to mention reinforcing the ever-present undercurrent of disapproval of those who are overweight – or even normal weight! – and do not bow to the hierarchy of beauty that says those who are thin are the best. It’s just one more item in the laundry list of products that tell women their size and appearance are what is most important and will attract loyal friends and fans.

In defiance of that, let’s use our brains to remind ourselves why Skinny Water is wrong. While the website details the added vitamins and dietary minerals of each drink, it’s far better to get your needed supplements through a healthy diet rich in cruciferous  and dark and leafy vegetables, fruits, whole grain and lean proteins. Washed down, in fact, by regular old water that keeps you hydrated and helps your body process and absorb nutrients. Skinny Water is telling its buyers that by adding these vitamins and minerals to their product, one can cut out food entirely and survive on a calorie-free but vitamin-rich manipulated water diet. Don’t be fooled! (I know you aren’t. Hopefully, you’re equally horrified.) For example, the“Power,” “Sport” and “Fit” drinks are all fortified with calcium, magnesium, and potassium – to help activate metabolic enzymes, keep your blood regulated, and support strong bones and teeth. Do you know what else can do that?  Bananas, yogurt, kale, almonds and cashews, and quinoa. Frankly, there seems to be little difference between the “Power,” “Sport” and “Fit” drinks despite the claim that they each support different “goals” of the drinker – which lends support to the conclusion that these are madly marketed products that don’t substitute a healthy, well-rounded diet and instead are capitalizing on the now-entrenched notion that women care more about being skinny than anything else.

Summer’s Eve has Bad Marketing. And the Product is Terrible for You.

In light of all the on-point criticism of the ridiculous feminine hygiene ads and how they portray a woman’s relationship with her reproductive organs, I think we should point out a couple things.

First, douching is actually not good for you – it disrupts the balance of good versus not so good bacteria, which maintains a certain acidity level and in turn is key to a healthy vagina. Douching can destroy this careful equilibrium, causing an over-growth of the bad bacteria. This can lead to yeast infections and bacterial vaginosis; both of which are uncomfortable and cause symptoms that are more disruptive than the non-existent issues one thought they were getting rid of in the first place. More dangerously, douching can actually force unhealthy bacteria up into the uterus and ovaries, which if untreated can lead to Pelvic Inflammatory Disease (PID). This, more disturbingly, can cause infertility issues. While this may be rare, why risk the possibility by doing something that is unnecessary at best, but very damaging at worst?

The Summer’s Eve website has an “education” section, which does point out that some regular discharge is normal and offers some good snippets about the importance of wearing 100% cotton underwear. However, in their advice about yeast infections, they include “don’t sit around in a wet bathing suit,” “eat berries and yogurt often,” “don’t wear tight-fitting, non-breathable clothes,” and “eat less sugar,” concluding the list with “use pH-balanced washes formulated for the vaginal area.” Up to that last point, the list was fairly on target. In fact, the list I’ve gotten from my gyno every year has read very much the same with the exception of that last line. In fact, their advice has always been along the lines of: “do not use washes formulated for the vaginal area, even if they say they are pH-balanced, because your body balances that pH like a pro on its own.”

Summer’s Eve says their products have been dermatologist and gynecologist tested – I would be interested in what that test entailed, but also would be remiss to not point out that “tested” does not in any way necessarily equate with “approved.” I can test drive a Mercedes and it tells you nothing about what I think of it (I’d like one). Look, the American College of Obstetricians and Gynecologists as a body of physicians do not recommend douching. I am more inclined to trust them than a Summer’s Eve label.

Interestingly, the site does admit that the vagina is like a “self-cleaning oven.” This begs the question – why do I need this?

Women and their reproductive organs have thrived for thousands of years. Those reproductive organs have done a remarkably efficient job of cleaning themselves all those years without the “help” of douching projects. It doesn’t take a genius to deduce that these people are trying to tell women that their vagina is supposed to smell like a Laura Ashley store. It’s not. It should look and smell the way it has for centuries. Vaginas have spawned babies for generations without the help of branding and perfume, and it seems the marketing efforts could be better spent educating men and women that the vagina isn’t supposed to be the fertile ground of daisy chain making and delicate blossoms.

Your vagina is the foundation of your holistic health as a woman. Summer’s Eve is a masking product, not a health product.

Bottom line – if something seems off down there, swabbing it to make it smell like a bouquet is not the right course of action. Seeing your gynecologist is.

How Images and Ads Impact Self-Image and Human Development

I got a lot of traffic and messages about a piece I wrote regarding Duke Nukem. People in the gaming community condemned it for its lack of originality, how it strayed from the original premise of apparently ostensibly mocking the ’80s action-hero genre, and how it overall disappointed those who are used to more complex and engaging videos. Some replies also included people needing to “get over it” when discussing images of coerced sexual activity or the game’s encouragement of merging violent and sexually explicit content together (I don’t post comments that are condescending or don’t encourage dialogue), something I found…disturbing. My initial argument, however, did not change – that is, that the imagery and the actions the gamer supposes in this video are tragically abusive and in fact detrimental to both men and women.

Many gamers also respond that they know when they are playing a game, and that their non-virtual socializing is not impacted by the game’s content. This, along with the recent news that the American Medical Association finally condemned the use of photoshopping in advertising campaigns and photo shoots, got me thinking about what repeated exposure to images and actions actually does to our brain and with who and what we identify.

A well-known study published in the Journal of Consumer Research found that repeated exposure to images and advertisements ultimately were processed in people the same way actual experiences were processed. That is, if you see or watch something enough times – in a video game, in a fashion magazine in which models are photoshopped to near obscurity, in a parent abusing your sibling – you begin to process it as though it was you yourself experiencing the act and identify with the “player” (model, game character) you are watching. You see enough pictures of a model like this:

Courtesy fashion-o-lic.com

And you begin to think you are supposed to align yourself with her, that this image is what is normal (the image on the right was criticized heavily in 2009 for being so drastically photoshopped). After so many exposures, you begin to mold yourself after her, to think that since this is how we project women for adoration in our culture, that you should begin appropriating yourself to match her image. Just like a gamer, after so many exposures, can begin to mold themselves after the image of the character they are impersonating in a game. And while they may not go out on a shooting spree, they are desensitized to the effects of that reality, just as they are desensitized to the effects of coerced sex in a game, which can lead to difficulty distinguishing that from a healthy sexual relationship.

As I have also discussed in previous posts, a foundational theory in behavioral science and education is the Social-Cognitive Theory, which has informed educators and psychologists for years in explaining that people learn by watching, and that even one observation of a behavior can influence perspective. It also importantly points out that while full on adoption of behaviors witnessed may not occur, the more we see, the more our attitudes and beliefs about them change. This can be good and bad. It can make us more accepting of others’ opinions and outlooks, and it can also desensitize and normalize the opinions and behaviors that are harmful.

We’re humans. We learn by watching, by then mimicking and imitating what we observe. It doesn’t happen all at once, which is why fashion moguls or game designers claim they have no real impact. Are girls entering periods of self-mandated starving as soon as they open this month’s Vogue? Are adolescent boys heading to the hills for a sawed off shotgun fight after the first round of Duke or stealing cars after playing the new Grand Theft Auto? No, of course not. But can it impact their sense of compassion, affect their interpersonal relationships? Can it make violence seem less threatening, less damaging, and less impacting than it is? Yes. Can that change the way people behave, from nuance to imitation? Sure. Even researchers who admit that it won’t necessarily turn children violent admit that’s likely true (and, interestingly, still disallow their children to play). Human development takes time – language acquisition, understanding of and the processing of visual messages, being able to comprehend meaning from a block of text – these are all cognitive functions that take years to develop and perfect, and their influence lies in the words and actions of children’s families, friends, teachers. Unfortunately, messages of gender have been largely commandeered by the media. And the repeated exposure, over years, to these specifics of models’ physical appearance has resulted in the erosion of self-confidence that many girls and women – and boys and men – experience as young children becoming adolescents. And the repeated exposure, over years, to the specifics of war, sexual violence, and the presentation of hyper-masculinity, can also result in the erosion of what kind of impact violence truly has, as they become desensitized, and what a healthy understanding of and relationship with the opposite sex is (as opposed to its portrayal in my Duke Nukem piece). As the study articulated, it’s about changing people over time, it’s about how perceptions and perspectives change when a new definition of the norm that is not contested or dissected – a Ralph Lauren model, a Duke Nukem – enters the picture. Women who suffer from eating disorders and body dysmorphia, while not blaming the fashion industry, have emphatically articulated that it certainly has had an impact as it normalized this destructive self-image and behavior.

I think it’s also relevant here to bring up the Supreme Court’s decision about a week ago to shoot down California’s attempt to ban the sale of violent video games to children. Timothy Egan, a Times columnist, had a great commentary on this, noting how ridiculous it seems for there to be a perpetual ban on nudity and sexually explicit images, but not on virtually dismembering a human or sexually assaulting a woman. It does seem…well, more than troubling, that a game in which a player can simulate murder and rape is protected by free speech but a bare breast is the height of vulgarity. (I found a great post from a female gamer about this kind of sexual violence in video games, and I agree with her assertion that sexual expression can in fact exist without it also involving violence and degradation.) I don’t think any of the representations of sexuality that I have seen in video games are appropriate for children because they overwhelmingly associate it with abuse and/or coercion (I’ve done a lot of viewing in the past couple days after my Duke Nukem post). To say that sexuality would have a more harmful impact than violence seems questionable, when representations of both are equally unhealthy.

It should also be said that I am far from someone who believes nudity and sexuality itself is vulgar. I celebrate and support healthy (and protected!) sexual expression in any way the individual consents and desires. I firmly believe that discussions of sex and sexuality should be brought up early on, so children can ask questions, be informed, protect themselves when they do engage in sex, and have an understanding of what a respectful, consensual sexual relationship is. I also believe that when these discussions in families don’t take place, and when sex is a taboo topic, that it is a disservice to these children, and that any confusion they have about sex or uncertainty about what a healthy sex life actually is will be magnified by the messages the media sends them.  I’m an advocate of early onset, comprehensive sexual health and reproductive health education. Sex shouldn’t be confusing, and it shouldn’t be stigmatized. Sexual violence, however, and a misappropriation of the presentation of sexual relationships that are abusive, coercive, and violent, should be condemned.

This is also why a diversity of exposures is important. It’s important to not be inundated with the same message over and over again. Advertisers know that repeated exposure is key to getting people to buy what they want to sell. If you see an image of a Coke bottle once, it won’t register with much impact. If you see it every time your favorite TV show breaks for commercial, when you’re leafing through the pages of a magazine, when you’re driving down a freeway and it’s up on a billboard, when you’re listening to the radio and it breaks for the Coke jingle – it adds up, as do afternoons in front of a game console, as do hours reading “women’s” magazines and fashion spreads, as do episodes of spousal or child abuse, (which we know increases the likelihood of the child being in an abusive relationship him/herself and hampers healthy development – the others are logical extensions, to a lesser degree). We have to have enough positive images, positive games, positive and healthy discourse about relationships to not just equal the stream of negative imagery and messaging, but to overtake it. Positive, healthy messages, not abusive, harmful, violent messages, have to be in the majority. The norm. It’s nice that the docs finally said so.

China Cuts HIV Transmission and AIDS Mortality

Great news reported by the NY Times yesterday – China, by distributing antiretroviral medications, to nearly 63% of those who need them, has cut their AIDS mortality by about two-thirds. Not only have they done a great job of drug distribution, but as I wrote in an article in 2006 for my alma mater’s magazine (p. 9), they actually did a noteworthy job of forming partnerships between hospitals, government agencies, and educators. This full-scale effort is important to note because it’s not just drug distribution – though that is undeniably, emphatically essential, particularly in light of recent studies showing that ARVs drop viral loads to such a low level that they are nearly undetectable and prevent transmission from HIV+ to HIV- partners – but it’s a concerted effort on all fronts, reaching at-risk populations through educators, healthcare providers, and even as governments.

When I wrote my article in 2006, we used figures that had been reported from 1999 – 2003, and the projected HIV+ population of China (at its infection rate increase of 30% a year in 1999) if it went unchecked, with no interventions of any kinds, was in the millions. Instead, since implementing these policies, it has held steady. This just goes to show how important these kinds of interventions are, and how effective they can be – literally saving millions of people from infection. Just imagine Well done, China.