As a nonprofit leader, I have dedicated much of my working life to bringing health care to rural populations of mothers and infants in East Africa. Through years of proximity to rural families, I have learned some of the challenges women face in remote locations.
As a male, I now better understand that the barriers to maternal and child health care are not only resource barriers or technical barriers, but also moral and gender barriers.
So long as girls as young as 13 are taken by men as brides, so long as school girls are coerced by men into unwanted sex, so long as women are legally treated by men as property and valued only for their child-bearing, and so long as male dominant practices such as polygamy, wife inheritance and female genital mutilation exist, then our efforts to care for women and children must morally and culturally persuade men, not just financially and technically support women.
In these cultural and moral realms, the church has the power to influence men as family decision makers and as difference makers between life and death for the women and children in their village communities.
Let me put this in real terms through the story of a young mother I know in Kenya named Vivian. Vivian grew up in a small rural village near Lake Victoria. Like many girls, she was unable to complete high school due to an unexpected pregnancy. At 17, she became the wife of a man named Richard, who was six years older. By the time Vivian was 19, she had a second child, and the family was surviving through subsistence farming.
One day in 2011, Vivian and her family plowed their field with the help of a neighbor's bull. That evening, as Vivian was leading the bull back to its owner, the animal charged her from behind and caught her with his horns, throwing her into the air. As she was gored a second and third time, she screamed, and the neighbors came to her rescue, somehow managing to distract the bull and pull him away. The bull had badly wounded Vivian in the genital region, and she was rushed to the hospital on the back of a motorbike.
At the hospital, clinicians cleaned, stitched, and dressed her wounds, but within a day, complications ensued and Vivian had to be transferred to a larger Catholic mission hospital for surgical repairs. As she was recovering, doctors explained the imperative that Vivian delay future pregnancies until the wound could fully heal. They counseled her on family planning options, and she decided on an intrauterine device, a long-acting but reversible method.
However, upon being discharged from the hospital and returning home a week later, Richard forcibly removed the device, arguing that Vivian needed to bring him more children. Some days later, Vivian sneaked away to the local hospital to request help in her situation. The clinicians talked her through other options, and Vivian elected to try a contraceptive implant, two tiny rods placed just under the skin in her inner arm.
By November 2012, Richard had become frustrated that his wife was not conceiving again. Vivian confessed to her husband that she was using contraceptives, and Richard became infuriated, threatening to cut the implant out of her arm himself. He forcibly brought Vivian back to the community hospital and demanded the implant be removed, holding his wife by the arm and screaming, "This is my property!"
The clinical staff separated the couple and spoke privately with each spouse, explaining the importance of delaying any new pregnancies due to the injury. Without shame, Richard said, "I am the one to decide when she gives birth and when she needs family planning. If she comes home with this implant, I will beat her."
A short time later, Vivian conceived a third child. By the grace of God, the baby was born safely in 2013.
This is a story about culture and about values, not just health care. When women are valued primarily for their child bearing and treated as "beasts of burden," there are consequences for health, education and the economy. There are moral and spiritual implications here for anyone who believes in a God of mercy and justice. Theologically, what does it mean for Vivian to be Richard's property? What does it mean for her freedoms to be restricted?
On the surface, this is the story of a controlling husband who lacks sympathy for a wife who has had a terrible injury, but through a lens of faith we see something more deeply true. In a fallen world, each of us as men carry a bit of Richard in us—his broken view, his selfish attitude, and his narrow and untenable belief about the role of women. Maybe his behaviors and circumstance feel extreme, but we men are all Richards at some level by either what we have done or by what we have left undone.
Male leaders in the church are powerful vehicles for moral persuasion in villages around the globe and possess the capacity to change the attitude and behavior of the Richards of this world. Male leaders in the church have the capacity to address the deep-seated prejudices that push Vivian from school, value her only for her ability to bear children, and marry her off at a young age.
Vivian's challenge is not primarily accessing needed contraception. Her challenge is a lack of basic freedoms—to make decisions about her health, to have equal say in her family, to be protected from harm. The barriers to achieving these freedoms are holistic—gender-based violence, lack of education, teen pregnancy—so the solutions must be holistic as well.
Women like Vivian cannot negotiate these challenges and solutions alone. Men of conscience will need to stand up alongside women as advocates in local communities and in global spheres of influence. As men, we must be co-laborers in the effort to increase the freedoms women and children enjoy. As the Vivians of this world look for help in achieving healthy lives and having the right to make decisions, what are we as men doing, and what are we leaving undone?
James Nardella is a parent, husband, and global health advocate. He was the long time executive director of the Lwala Community Alliance, a health and community development agency in Western Kenya. He now serves as a Principal at the Skoll Foundation. He is a contributor to the recently released Mother and Child Project: Raising our Voices for Health and Hope, a compilation from Zondervan Publishing on global maternal and child health issues, from which this piece was taken.
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