Emily Perper | Staff Writer
It’s all about women, and she’ll explain why in fives.
“For ancient Egyptians, five was for worship” — Dr. Afaf Meleis raised her right hand — “and it was for offerings” — she extended her right hand — “and it was on temples to keep the evil eye away, which now is the khamsa that’s used in so many cultures … (and) brings its owner happiness, luck, health, good fortune and safety. And that’s what we want to bring to women of the world.”
So it should come as no surprise that Meleis chose to organize her lecture, “Empowered, Healthy Women: Overcoming Universal Challenges,” by fives.
She started with five reasons she loves visiting Chautauqua: her admiration of Rev. Joan Brown Campbell, the “warm and inviting” Chautauqua community, the presence of her colleagues and opportunities to make new friends, intellectual stimulation and spiritual inspiration.
“I simply love this place!” she said.
Meleis is the Dean of Nursing of the University of Pennsylvania and directs the university’s WHO Collaborating Center for Nursing and Midwifery Leadership. She is also Council General Emerita of the International Council on Women’s Health Issues.
“This talk today is about advocating for safe womanhood and diplomacy about women’s health, diplomacy that’s not about health in general but is particularly about women’s health,” she said. “This is not about maternal-child health; it’s not about women as reproductive beings. This is about women as productive human beings. It’s about half the population of this world who are vital for productivity, for economic security, and for peace. … This is about safe womanhood, not safe motherhood.”
In her next set of five points, Meleis shared the experiences that fuel her passion for safe womanhood.
First, she listened to the stories of women around the world. Meleis has traveled to 60 countries and researched formally in 10, but her own roots inspired her.
“My listening actually started with my own grandmother … who was illiterate in terms of education but she was wise in terms of life,” she said.
Half of her grandmother’s children died at a young age.
“She helped me ask the questions — why she didn’t get help with her birthing and why so many babies died — which are the questions we’ve been asking this week,” Meleis said.
Her second inspiration was her grandmother’s determination to secure an education for Meleis’ mother, who went on to become the first woman to receive advanced nursing degrees in the Middle East.
“It was my mother’s knowledge, perspective, compassion, and passion and diligent work as a nurse-midwife that ignited my passion for women’s health,” she said.
Her third inspiration was her childhood friend. Close to tears, Meleis described how her friend, who was just 12 years old, left one summer and never returned, fated to be a child bride.
Nursing was her fourth inspiration.
She said she learned that nursing and midwifery help to solve many of the health issues women face.
Her extensive research, in countries from Brazil to Yemen to the United States, was the fifth factor.
This same research helped her to identify many myths about women’s health. She shared five of these misconceptions with the audience.
Pregnancy, she began, is not a wonderful time for all women. The No. 1 killer for women between ages 15–19 is the complications that arise from pregnancy.
“For many disadvantaged and marginalized women, (pregnancy) comes with grave risks,” Meleis said. “A woman dies every 90 seconds from a pregnancy complication. What’s even more staggering is that 90 percent of these deaths are preventable.”
In some parts of the world, a proverb describes cultural attitudes toward pregnancy: “To be pregnant is to put one foot in the grave.”
“There is a global shortage of nurses and midwives … because of lack of investment … because of lack of valuation of the work that those caregivers provide, because these are women’s professions,” she said.
Investment in these professions has not been a part of programs like the President’s Emergency Plan for AIDS Relief or other foreign aid packages.
But Meleis emphasized this is not just a problem in faraway countries.
“In the United States, one in five women of reproductive age lack health insurance and can’t afford prenatal care,” she said. “We rank 50th among the nations with the lowest rates of maternal mortality. It’s unforgivable.
The second myth is that motherhood is joyous for all women. For one, female children are devalued in some societies.
“When we put our gender glasses on, we find out that (technology) has some perils for motherhood,” Meleis said. “Mothers suffer the loss of their daughters before they are even born… They abort them because society does not like having daughters.”
She referenced the book Unnatural Selection by Mara Hvistendahl, who estimates that 163 million girls have been aborted since 1970 because of their sex.
In addition, malnutrition plagues motherhood.
“Malnutrition is the cause of one-third of all maternal and childhood deaths,” she said.
Malnutrition leads to delayed cognitive development, which can affect a country’s overall economic development.
Other phenomena, like hunger and human trafficking, complicate women’s ability to care for their children. Again, Meleis emphasized that such problems are local to the United States as well as global.
The third myth is about women and work.
“Women comprise half of the global population and workforce. They earn 10 percent of the world’s income,” Meleis said. “Women’s jobs outside the home tend to be the worst compensated, the least secure and the most dangerous.”
She said a lack of legal protection encourages manipulation, abuse and exploitation, and the work that women do inside the home is not counted by governments as “real” work.
The fourth rumor is that marriage is bliss. One out of seven women are married before the age 15, she said.
“Child marriage is one of the major obstacles preventing 600 million girls from getting their education and reaching their full potential,” Meleis said.
Child marriage also increases the risk of contracting diseases like HIV, she said.
“This is not unusual in the United States, so please don’t sit here and think this is happening somewhere else,” said Meleis, citing the incidents surrounding Warren Jeffs and the Yearning for Zion Ranch in 2008.
She said honor killings pose a serious problem, and according to the United Nations, 5,000 women are killed annually.
“Marriage is a risk factor,” Meleis said, referencing a “culture of silence” that causes a woman to worry her husband might take a second or third wife if she complains about her situation.
The fifth myth concerns urbanization.
“It contributes to scarcity of resources, lack of infrastructure, the provision of a social network … women face new health risks,” Meleis said.
Of the world’s people who live in urbanized areas, 32 percent reside in slums, and 70 to 80 percent of those who live in slums are women, she said.
Meleis then named five national and international actions that are happening today that treat “women as whole, rather than reproductive beings.”
First, Meleis discussed political progress in the United States.
“President Obama and Secretary of State Hillary Clinton made girls and women central, not mothers and not pregnant women only, but girls and women, central in U.S. global health programs, advocating also for maternal and child health,” she said.
Obama requested an increase of 20 percent funding for global maternal and child health programs, and appointed Melanne Verveer to the position of ambassador-at-large for Global Women’s Issues, she said.
Meleis said she regards Verveer as an influential, articulate spokesperson.
The U.S. State Department recently released new information and ideas to combat human trafficking.
“When you have a report like that, it becomes a key diplomatic tool,” Meleis said.
Former first lady Laura Bush has developed the Women’s Initiative, which encourages women in the United States and abroad to take part in the political sphere.
“(The initiative) looks at how to give (women) a voice in the election process and put them in parliaments,” Meleis said. “It encourages girls and women (in the United States) to transform their communities.”
In addition to actions in the United States, Meleis explained the positive impact of the G8 Summit. Canadian Prime Minister Stephen Harper introduced a multi-billion-dollar initiative to target maternal and child health.
“It’s focusing on nutrition and relationships and immunizations,” Meleis said.
Though she would rather such an initiative focus on empowering women, she said she was encouraged by the parts of the initiative that went beyond disease prevention and treatment.
Meleis praised United Nations Secretary General Ban Ki-moon.
“(He) speaks so passionately about (women’s health) … he also appointed Michelle Bachelet the under-secretary of UN Women,” she said.
Bachelet was the first female president of Chile. Her full, formal title is Under-Secretary-General for Gender Equality and the Empowerment of Women.
“The priorities (of the committee) are about ending violence, expanding women’s voices and leadership and enhancing economic empowerment,” Meleis said. “All those lead to better maternal and child health, but (don’t only) focus on maternal and child health.”
The fourth factor is the emphasis on the investment and training of midwives and nurses, demonstrated by World Health Organization and United Nations’ call for 1 million more health care providers.
The fifth action is an initiative taken by Meleis’ own University of Pennsylvania.
“We are preparing a capacity of future physicians and nurses who think about women and women’s health,” Meleis said. “(University of Pennsylvania) President (Amy) Gutmann invited 25 presidents of universities from 25 countries, and we partnered with the United Nations in calling for each of those universities to come up with a plan on how their participation in their own country (can help to empower women). We developed a white paper to be a model for other organizations.”
To conclude the lecture, Meleis offered six actions for the audience to consider.
- A is for Act, Advocate and Ask questions.
- B is for Be a voice and Be involved in your neighborhood.
- C is for Collaborate.
- D is for Dispel myth and Disseminate accurate information.
- E is for Engage with groups working for the safety of women.
- F is for move Forward.
“Make sure wherever you are, that you advocate for accountable maternity leave, benefits of eldercare, for childcare, for public safe places for women,” Meleis said. “We need to be enraged and nurture a passion for making a difference in the world.”
UPDATE: The story has been changed to correct the spelling of Afaf Meleis’ first name.