Archive for May, 2010

29 de Mayo: Una variedad de ironías

Posted in Bolivia, women with tags , , , , , , , , , , on May 29, 2010 by eugeniadealtura

This week, a smattering of news pieces on women and mothers in Bolivia, and a heartening noticia about Bolivia’s neighbor.

Last Thursday was Mother’s Day in Bolivia, and in La Paz, this manifested itself in schoolyards full of children dancing in expensive costumes (that mothers doubtless had to pay for), sales of stuffed bears and other kitschy items, family dinners, and even an evening display of fireworks. Although I was hopeful that the local press would highlight some of the more sinister aspects of motherhood in Bolivia–such as the fact that Bolivia continues to be the most dangerous place in Latin America to undertake the journey of motherhood, with the highest maternal mortality rates in the region–I was, as I often am with the local press, disappointed.

Instead, the La Paz daily La Razón brought us two light-hearted stories for mother’s day, one highlighting a concert for local mothers, and the other discounts to take advantage of when buying gifts for mom.  For anyone unfamiliar with Latin American cultural paradigms, it bears noting that the mother-son relationship is laden with all kinds of real and imagined meanings in Latin America.  Local men often liken their own mothers to the Virgin Mary, and unfavorably compare their girlfriends and wives to this unrealizable model.  Although this pattern can clearly prove disastrous for Latin American women and heterosexual relationships, it can also be kind of funny. All I’m gonna say is, even if you don’t read Spanish, check out the picture of the singers at the mother’s day concert and imagine the mother-son dynamic playing out in the audience last Thursday night.

In addition to the “official” mother’s day articles, La Razón brought us two other stories related to motherhood this week.  The first is the terrible account of a woman whose infant was stolen from a hospital in the city of Santa Cruz just hours after birth.  Although child trafficking is a serious problem in Bolivia, this kidnapping seems to just be a horrible fluke, unrelated to that broader phenomenon.  The article notes that a woman dressed in white took the baby from its mother’s room saying that she was going to have it vaccinated, and then disappeared.  Oddly–considering that Romani are not known to live in Bolivia–police believe that the kidnapper is a “foreign woman, a gypsy.”

This infant’s kidnapper could indeed have been a foreigner to Bolivia. Regardless, however, the belief that a kidnapper of Bolivian children is foreign speaks to another cultural paradigm in Bolivia, one with deep historical roots–that of the pishtaco. In Andean lore, pishtacos are typically white, man-like creatures that harvest indigenous bodies for profit.  When the railroad first barreled through the Bolivian countryside at the turn of the twentieth century, indigenous campesinos believed that pishtacos would suck fat out from their bellies and use this to grease the rails.  (If your interest is piqued, I would highly recommend Mary Weismantel’s Cholas and Pishtacos: Stories of Race and Sex in the Andes.)  Cultural paradigms aside, let’s hope police are able to reunite this woman with her child.

This image of La Paz from El Alto’s 16 de Julio market was provided by a guest photographer.

La Razón’s second unofficial mother’s day piece informs us that, from now on, all pregnant women in Bolivia will be required to undergo mandatory HIV and Syphilis testing.  Apparently, “there are 150 children in Bolivia living with HIV/AIDS, and 12 of every 1,000 newborns are infected with congenital syphilis.”  Although reducing STI rates in mothers and infants alike is a goal any right-thinking individual would support, I am, as I have mentioned before, wary of programs that force or coerce women to seek health care.  These programs are often intrusive, and do not generate enough patient trust in health care facilities to bring them through the door.  The current article does not share any details on how mandatory testing will be implemented, but so far, I am skeptical.  Stay tuned for more details.

Finally, the kick-ass women at Women on Waves bring us some good news about Peru: on May 27, Lima’s Collective for Free Information for Women (CLIM) announced the introduction of a new telephone hotline for women seeking information about medical abortion, or the “abortion pill.”  Free hotlines such as this one are key in countries where abortion is illegal, since many desperate women take medications to terminate pregnancy without the necessary medical information to make these procedures safe.  Since 350,000 women in Peru are estimated to abort illegally every year, this hotline could play a crucial role in reducing maternal deaths due to abortion.  Congrats, CLIM!

And to women everywhere: happy Mother’s Day.  Here’s to all the work that you do, and to supporting your right to decide when, and if, to do it.

22 de Mayo: Ni amante, ni amigo

Posted in Bolivia, violence against women with tags , , , , , , , , on May 22, 2010 by eugeniadealtura

In general, I make an effort to highlight new issues in the blog, and not write in detail about themes I have covered previously.  That is, until reality forces me to. Last Saturday night, a young Bolivian man named Víctor Avendaño killed his “friend” Betty Condori by hitting her over the head with a bottle.  Once she was dead, Avendaño carried Condori’s body around the city–first to pick up some plastic bags at a garbage heap, and then to leave some items of the woman’s clothing at his parents’ home, where he lived–before dousing the body with kerosene and setting it on fire on a La Paz city street.  During his confession to police, Avendaño said in his own defense, “‘My only crime was to love a woman that did not pay attention to me.'”  (As always, all translations are my own.)

But clearly, Avendaño is mistaken.  Even before he murdered this young woman and then burnt her body on a street corner, Avendaño had committed other crimes.  First, he recorded and downloaded Condori’s private cell phone conversations with a young man in another city. Sometime in the last few weeks, Avendaño reports that he begged Condori to at least be his friend—a proposal that the young woman allegedly accepted.  Then, last Saturday night, Avendaño bludgeoned his “friend” over the head with a bottle.  Adding insult and disrespect to death, the murderer then stole some of Condori’s clothing—the article does not tell us which garments he took, but we can imagine—and then desecrated her body by setting it on fire.

Although feminicides such as this one occur frequently in Bolivia, my first reaction is always, “how is this possible?”  And by this, I do not simply mean the murder.  I mean, how can it be that so many men in Bolivia believe that any of these actions against women—harassment, spying, murder—are acceptable?  How can so many men have it in them to commit these crimes, and to hold the ideas about women that they must have to in order to make these crimes possible?

Last Thursday night, after a few beers at a pub across town, my friend “Alicia” and I decided to enjoy the crisp night air of La Paz and walk the 20 minutes to our homes.  The constant, and often violently themed, catcalls that we received on our walk, plus this article on yet another murder of a young woman in La Paz, sparked much reflection.

As I have mentioned before, I do not believe that Bolivian men’s frequent alcohol abuse is a cause for high rates of sexual and physical violence in the country.  However, what alcohol does do, is lower inhibitions.  That’s why people all over the world go out to bars, grab a few drinks, and end up hooking up with someone at the next table—it’s a natural part of life that often facilitates lasting romance.  But when drunk men on a La Paz street comment on women’s bodies as if they are something to be consumed, and even reach out a hand to see what they can grab on a passer-by, that is not the alcohol.  When drunk men go home and beat their wives and children, that is not the alcohol. That is the man.

I do not mean to imply that every drunk man in La Paz that catcalls women on the street could end up committing rape or murder.  What I do mean to say is this: if he’s doing it drunk, he could do it sober.  If—drunk or sober—your partner, or any man you know, is taping your cell phone conversations, threatening you, or showing way too much interest in your relationships with other men, then this man is not your friend. He’s not your friend, and he does not deserve to be your lover.  And he might just try to kill you.

Si usted cree que podría estar en riesgo de violencia de su pareja o de cualquier otra persona, comuníquese con CIDEM al 249-0358 (La Paz), o al 281-0041 (El Alto).  If you believe that you might be at risk of violence by your partner or by any other person, call CIDEM in La Paz or El Alto at the above telephone numbers.

15 de Mayo: Lo que es ilegal, se puede ignorar

Posted in abortion, adoption, Bolivia, child abandonment with tags , , , , , , , , , , on May 15, 2010 by eugeniadealtura

This week, New York Times blogger Nicholas Kristof opines, “my sense is that the illegality of abortion isn’t as large an element in maternal mortality as some people believe it is.”  On the one hand, Kristof points to a certain truth–just because abortion is illegal does not mean that it is not available.  Thousands of women undergo relatively safe abortions every day in countries where the procedure is illegal.  However, in these same countries, many more thousands of women end up getting unsafe abortions, since the key to accessing a safe pregnancy termination is usually money.  And most women worldwide–let’s face it–are poor.

The problem with abortion’s illegality is that it creates a class-based abortion industry, where women with money can access safe procedures, but women without, cannot.  Since where it is illegal abortion officially does not occur, government and public health officials can ignore the glaring class disparities in abortion care and in the resulting maternal deaths.  Since it is difficult to regulate an industry that officially does not exist, unscrupulous, unsafe abortion clinics exist alongside relatively safe medical centers, and most women do not have the information they need to make careful decisions about which to visit.

Reflecting on Kristof’s comments, I am further struck by how many aspects of unwanted pregnancy operate on the margin of the law in Bolivia.  The illegality of abortion–just one strategy for confronting unwanted pregnancy–is by far the most glaring.  Womankind estimates that 30,000 illegal abortions occur per year in Bolivia.  According to the country’s penal code, the individuals who perform abortions and the women who have them are subject to incarceration for three to six years.  However, as of 2004 only two judicial cases were ever brought against abortion practitioners, and both cases were later dismissed by the Supreme Court.  As far as I know, no woman has ever been incarcerated in Bolivia for having had an abortion.  In other words, the law criminalizing abortion doesn’t work on two fronts–it doesn’t prevent illegal abortions, and it doesn’t penalize abortion practitioners or the woman who undergo the procedures.  Finally, as I have mentioned before, laws allowing for legal abortions in Bolivia–in cases of rape, incest, or to protect the woman’s health–are equally ineffective.  Since 1973, when a stipulation was made in Bolivia’s penal code to allow abortion in the above cases, only a handful of legal abortions have ever been performed.

Other women, when met with unwanted pregnancy, end up abandoning their children rather than having abortions.  This may be because they are so traumatized by the pregnancy, or too poor to afford an abortion, that they are unable or unwilling to terminate the pregnancy before the child is born.  In other cases, women may abandon children that were and are “wanted” due to crushing economic circumstances or domestic abuse.  While some women will abandon infants in orphanages like the one pictured in this post, others will leave their children with neighbors, on street corners, or, notoriously, in garbage bins.  Like laws penalizing women who get abortions, laws targeting parents who abandon their children seem to be equally ineffective–in 2003, the national police registered two cases of child abandonment in the La Paz department, while local anti-abandonment activists argue that 17,000 children are abandoned in the country yearly.

Regardless of where they are left, most abandoned children will end up in orphanages. Orphanages in Bolivia come in several varieties; some depend on the state, some on private institutions and donors, and still others are illegal and even clandestine, with no relationship to local authorities.  One association of young people who grew up in orphanages recently told me that children residing in illegal orphanages have little chance to be adopted–at least not through legal channels.  (Even worse, sexual abuse in all types of orphanages is apparently the pan de cada día, or an everyday occurrence.)  While adoptions do take place, most Bolivian parents hope to adopt children under the age of one, who they can pass off to neighbors as a natural child.  The bureaucratic processes required to adopt children are so lengthy, however, that few children are adopted before they reach their first birthday, and once s/he turns one year old, a child’s chance of being adopted plummets.

Although it is difficult to find trustworthy data, activists in the fields of child abandonment and adoption insist that illegal adoptions are likely more numerous in Bolivia than legal ones.  While some of these adoptive parents have discovered children on their doorsteps or taken in kids from neighbors and friends, others, desperate to adopt, resort to illegal channels to bring kids home from orphanages.  Even adoptive parents who have completed the adoption process legally admit that they were tempted to go the illegal route to avoid the costly and lengthy processes associated with adopting a child.  Because of the increased legal and ethical issues involved with international adoptions, most of these are subject to rigorous scrutiny to ensure their legality. Since the rise of President Evo Morales, however, international adoptions face new restrictions and are on the decline.  In the meantime, nearly all of the orphanages in La Paz and El Alto are facing serious over-crowding–even the illegal ones, to which the state, when in a pinch, occasionally sends children.

In sum, abortion is not the only consequence of unwanted pregnancy that is illegal in Bolivia–child abandonment, the housing of abandoned children, and even adoption often operate under the table.  On the one hand, these institutions, even illegal, function–women get abortions, and children are adopted.  But how well do these institutions function?  I must say that I have to disagree with Kristof.  Illegal abortion does lead to devastating rates of maternal death. Illegal child abandonment, and the housing of these children in clandestine orphanages, leads to children who lack the possibility of legal identities and families.  When the state allows problems of this magnitude to languish in dubious legal territory, it reserves the right to ignore their consequences.  But avoidance will not work forever.  Eventually, something has got to change.

14 de Mayo: Las mujeres bajo Evo

Posted in blogging, Bolivia with tags , , , on May 14, 2010 by eugeniadealtura

I want to bring it to my readers’ attention that I have a guest post up today at Womanist Musings exploring the situation of women under Bolivian President Evo Morales.  This post is designed to speak to non-Bolivianists about women’s rights under Evo and under progressive Latin American governments more broadly.  Check it out, and feel free to join in on the debate in the comments section.

8 de Mayo: No tiene que ver con el agua

Posted in Bolivia, sexual violence with tags , , , , , , , , , on May 8, 2010 by eugeniadealtura

This week, two brief but terrible stories about sexual violence in El Alto, Bolivia.  First, “a thirteen-year-old boy has been accused of attempting to rape a seven-year-old girl” in an El Alto school building.  A week later, police arrested a 24-year-old man for allegedly raping and impregnating a 15-year-old girl who he claims was his “girlfriend.”  Evidently, “the mother of the minor realized that her daughter was pregnant” and reported the crime.

ENOUGH with violence against women.

There is so much to unpack in these two brief notes that it is difficult to know where to begin. First, there is the disturbing prevalence of sexual violence against women in Bolivia. Reproductive rights organization IPAS reports that “four of ten Bolivian women have suffered some form of sexual violence.”  Often, women suffer sexual violence at the hands of their lovers and husbands, upon whom they and their children may be financially dependent, and so do not report the crimes.  Other women who are raped by strangers or acquaintances also may fail to report the attacks due to fears that police or family members may blame them, rather than their aggressors. This means that actual rates of sexual violence may be much higher.  IPAS director Eliana Del Pozo also notes that few rape cases that women do report actually make it to the courts, much less result in convictions.

Why do so many men sexually assault women in Bolivia?  The guarantee of impunity alone cannot explain it.  In Bolivia–where until recently a married woman had to obtain the signature of her husband in order to undergo a tubal ligation–machismo dictates that women’s bodies belong to men.  Sexism permeates much home life in Bolivia, so that young boys learn from an early age that they enjoy privileges that their sisters and mothers do not.  Although we do not know much about the background of the thirteen-year-old who nearly raped a child in an El Alto school, the culture of machismo alone in Bolivian (and Latin American) society makes these incidents more common here than in many other countries.

An advertisement for a church-led seminar on violence in families.

In the case of the 15-year-old rape survivor, fear also seem to have played a role in delaying the aggressor’s arrest.  As the article notes, the girl’s attacker threatened her family with violence if she ever revealed the rape.  Only six months later (most likely when she was no longer able to hide her pregnancy) did the girl’s mother discover that her daughter was pregnant and file the report for the crime.

Even in cases where an attacker does not threaten his victim’s family, young women in Bolivia often fear to tell their parents that they have been raped since so many are blamed for provoking men’s advances.  If an adolescent girl becomes pregnant in Bolivia, whether through rape or consensual sex, her parents often hold her accountable for the pregnancy and excuse the man involved.  Many women I have spoken with who became pregnant at an early age report that they waited months before telling their parents, since parents are often very concerned with the que dirán de la gente, or, of what people will say.

Recently, I had the opportunity to speak with several members of the community police force in Bolivia, a special division of the police that engages with average folks through personal interventions and community orientations on a variety of topics.  According to these six men, rising rape rates in the busy, La Paz market district of Max Paredes are due to an increase in adolescent drinking.  Although alcohol abuse doubtless exacerbates many social problems, I find adolescent drinking a poor explanation for the high prevalence of rape in Bolivia.  The truth is, if a man would not rape a women sober, he would not rape a woman drunk.  If when sober, a man does not believe that a woman owes him something, or that her body is his property, he is unlikely to develop these beliefs after five or six cervezas. Let’s face it–the propensity to rape is not something that’s in the water, or in any other beverage.  It’s something that’s in the machismo.

1 de Mayo: Siempre equivocada

Posted in Bolivia, health care with tags , , , , on May 1, 2010 by eugeniadealtura

This week, the La Paz daily La Razón reported on a slew of complaints being leveled by patients of the local Hospital de Clínicas  and their families for mistreatment and misinformation. Apparently, the Minister of Transparency and Against Corruption, Nardi Suxo, visited the large public hospital in order to speak with patients in person about their complaints, which are largely that, “‘[they] do not have information about their family members or about the treatment that they must follow, in addition to mistreatment'” (all translations are my own).

Regarding the visit, the director of the hospital, Dr. Eduardo Chávez Lazo, remarked that, “‘it has been seen that the care (at the hospital) is very appropriate, and in any case, the Minister has come to verify this in person.'”  With respect to patients’ complaints, Chávez said, “‘a patient, when s/he is sick, changes her/his character and way of being, and becomes depressed, whiny, and aggressive… When one is sick, the treatment that the patient receives is not what s/he expects, and this results in complaints.”

To avoid the long lines and mistreatment at many public hospitals, many people go to small private clinics like these ones in busy market districts of La Paz.  The care here is not necessarily any better than at the larger facilities.

In my mind, this piece is a non-story.  I have become so accustomed to hearing women state that they are “afraid” to go to medical centers, that sometimes I forget to ask why.  When I do remember, they say that they are afraid of being yelled at and chided for: crying out during childbirth; for not going to prenatal visits; for coming in to the hospital either too soon, or too late, in labor, or for having any request at all during their hospital stay.  Indigenous women are often yelled at for not understanding Spanish, for requesting food and hot beverages during labor, for wanting to give birth in the traditional squatting position, for asking to be bundled in blankets during labor, and for requesting to take the placenta home after the birth. (Consuming hot food and drink and being wrapped in blankets are indigenous birth rituals that heat the body and facilitate cervical and pelvic dilation for birth, while burying the placenta protects the child from illness throughout its life.)

Dr. Chávez’s dismissal of patient complaints is, although infuriating, completely unsurprising. The fact is that, with regards to medical care, the old customer service adage is reversed: if the customer is always right, in Bolivia, the patient is always wrong. In Bolivia, where higher education is less of a universal right than a luxury for the few, poorer, uneducated Bolivians are taught to treat doctors and other professionals as their superiors.  Most Bolivians recognize that they are being mistreated at medical facilities, but rather than confronting well educated doctors and nurses about the abuse, they prefer to simply not go to the doctor.  In addition, many indigenous Bolivians prefer to visit medical providers from their own communities, rather than western medical institutions.  The government, rather than dealing with the mistreatment, instead institutes poorly conceived, incentive-based health care programs like the Bono Juana Azurduy or the tuberculosis testing program to lure patients into hospitals.  They do this rather than deal with the abuse because they are more concerned with Bolivia’s international reputation, which is scarred by high maternal mortality and other health statistics, than with the health of actual Bolivians.

This La Razón article may tell us nothing new, but at least it gets the word out there about the poor state of affairs at many Bolivian medical facilities.  While medical infrastructure and technology in the country have improved considerably over the past several decades, these achievements will not bring patients in the door.  And they will not substitute for comprehensive, sensitive, culturally competent, and non-judgmental care.