I was pleased to be invited to provide remarks on “#MeToo Meets Global Health: A Call to Action.” I approach the topic as someone who has been active in addressing campus sexual assault and harassment, and believe that many of the same factors that allow universities to remain sites of gender discrimination and harassment are also present in the global health industry. From the selection of applicants to the training of practitioners; from the syllabi used to the gatekeepers who make or break careers; from the gendered politics of credibility to the hierarchies of power that accumulate advantage, or deny it — much of campus-based activism transfers well to promoting a broader gender justice agenda in global health.
The Statement begins by acknowledging that “global health is a women-centered enterprise.” I agree, and would add that much of the enterprise has been in the service of “reproductive governance” rather than gender justice per se. [1] This approach frequently positions women as objects of policy and intervention, operating within a protectionist scaffolding that may perpetuate paternalistic forms of control in the name of “saving women” or “saving womenandchildren,” coupling women and their children as an undifferentiated mass of (innately?) vulnerable humanity.[2] This framework placates those for whom a more feminist agenda would be unpalatable — “mainstreaming gender” can be a double entendre, as the feminist critique of policy is mainstreamed into a policy that does not threaten the status quo of powerful countries or interest groups — and may also obscure the fact that women and their children (especially their fetuses) may be located within competing rights regimes. A clear example of the limitations of this approach was the recent debate at the United Nations regarding the language of proposed Resolution 2467, which seeks to combat rape in conflict zones. The wording of the resolution was watered down after vehement opposition from the United States and hardline abortion opponents who refused to sign off on references to women’s reproductive and sexual health, understood to include the right to terminate a pregnancy resulting from conflict-related rape.
This leads to the issue of gatekeepers, and to hierarchies of power that work to confer privilege and the right to determine its distribution. On college campuses, senior professors — frequently male — wield tremendous power over their students and junior colleagues: a letter of recommendation; a phone call to a prestigious university press about a particularly promising dissertation; an opportunity to work on a field-based research project to gain valuable skills; the opaque tenure process and the power to determine life-long employment. These gatekeepers operate with virtual impunity, administering silences, humiliation, and career-ending decisions. Within the field of global health, these powerbrokers sit on admissions committees at elite training programs and rank grant proposals that may determine vital institutional support to individuals and to programs. Absent transparency, this is precisely how silencing and impunity work to the disadvantage of those who would seek to speak up and unsettle the status quo.
Importantly, the wrong-doing and abuse of a few is made possible by the silence and complicity of the many around them who say nothing, do nothing, to stop systemic gender discrimination and harassment. This is where I have criticized the “breaking the silence” rhetoric when it places the narrative burden for speech and the call for change on the shoulders of those who may have the most to lose: survivors of sexual assault and harassment.[3] This is where #WeTooGlobalHealth strikes a resonant chord: when we know that people around us are being systematically harmed, the duty to speak up rests upon all of us. It is the responsibility we have to and for others to use whatever power we may have to stand up and speak out. As the #MeToo movement has demonstrated, part of changing gender regimes lies in reallocating the shame from the victim-survivors of sexual violence onto those who should bear the shame for sexual harassment and assault: the perpetrators who have too frequently abused their power with complete impunity.
Which leads me to my last point: The missing women. I frequently open my email to find some variation on the following. A colleague writes, asking for advice and expressing her outrage. She has recently learned that a former student, who had studied for her Masters Degree under my colleague’s supervision, has been driven out of her PhD program due to a sexually harassing professor. What to do? I offered the standard package of advice, knowing this young woman will most likely go quietly for fear of retaliation and career-ending retribution if she reports this professor. This has led me to consider #TheMissingWomen. From the actresses who left the film industry due to Harvey Weinstein, the musicians/composers/singers run out and ruined by Russell Simmons, the hostesses/servers/sous-chefs who gritted their teeth and let their pot of rage simmer on low, the hotel maids who escaped groping guests, to the young women who leave academia to avoid sexually harassing professors whose power over them makes or breaks careers — how can we begin to measure the missing women who leave their careers of choice (or necessity) because they have been ground down, groped, sexually harassed and driven out? This is about sexual assault and harassment, to be sure. It is about the violation of bodily integrity and personal dignity, with equal certainty. It is also about the loss of employment, career aspirations, dreams and economic security.
How can we begin to measure the impact of #TheMissingWomen in global health? Their absence begins with syllabi that are skewed toward male authors from the Global North, implying that some produce knowledge whilst others are the raw data that provide the grist of Theory with a capital T. Their absence extends to training programs and classrooms in which a male stands at the front of the room, and a woman speaker is invited in for one lecture to discuss “gender,” code for “women,” thereby leaving others’ genders — especially male — out of the discussion. Global Health thus remains a “woman-centered enterprise,” reducing many of our efforts to triage rather than structural change. It is my hope that #WeTooGlobalHealth reaches beyond these pages and into the realm of policy and politics, and that the authors of this statement adamantly refuse to “mainstream” their important and cutting critique of the current state of Global Health.
[1] Lynn M. Morgan & Elizabeth F.S. Roberts (2012): Reproductive Governance in
Latin America, Anthropology & Medicine, 19:2, 241-254.
[2] See Cynthia Enloe, Bananas, Beaches, and Bases: Making Feminist Sense of International Politics (2014).
[3] Kimberly Theidon. 2016. “A Greater Measure of Justice: Gender, Violence and Reparations.” In Mapping Feminist Anthropology in the 21st Century, Rutgers University Press, Leni Silverstein and Ellen Lewin, eds., 2016.