Hans Rosling, the Swedish public health stats guru behind the ever-so-brilliant Gapminder, has a new TEDtalk on washing machines! When we were living in Ghana, I honestly didn’t pine for much of the comfort of Western society. I’m a bit of a minimalist, so even when I have a dishwasher, for instance, I prefer to do my dishes by hand — I do a better job and use less water. That said, there were a few comforts that we really found ourselves missing, and a laundry machine was at the top of the list. Rosling correctly makes the association between laundry duties and significant, gender-biased hardship. In Ghana and Nigeria we saw two duties the hardship of which disproportionately affect women: laundry and cooking. A washing machine is a great first step. A food processor might be next of my list. And, hey, what about some vitamin-rich foods to reduce infant mortality and morbidity? Let’s dream big.
Doctors from Partners In Health (the community-health focused NGO founded by Paul Farmer) have co-authored a new article that addresses the role of structural violence in maternal mortality. As Farmer has pointed out in his books, and the article and PIH write-up also address, 99% of the world’s maternal mortality burden lies within poor countries. Here’s a 2005 WHO study (see page 16) that goes into specifics — sub-Saharan Africa has an average of 900 maternal deaths per 100,000 live births. The rich-country average is around 8 or 9 per 100,000. A new study of California shows 14 per 100,000 … with women of color fairing — not surprisingly — much worse. This is structural violence at work. If you’re black and live in Liberia, you’ve got about a one-percent chance of dying in any given childbirth (don’t forget that Liberians have about 6 children per woman!). One percent may not seem so bad, but keep in mind that maternal mortality is preventable in virtually every case — maternal mortality in Singapore or Japan is 6, not the 900 of Liberia! If you live in the United States your chances are much better, of course, but at 46 out of 100,000 you’re still at three times the risk visited upon the white ladies who live in a different part of town. In fact, the ’46’ risk of black women in California is worse than Moldova, Ukraine, and other CIS countries. Paul Farmer wrote in Pathologies of Power about the life expectancy of African American men in Harlem being less than their counterparts in Bangladesh, and I’m sad to say that US maternal mortality is a similarly reminiscent example of structural violence. The preventable death of any child, of any mother, of any person, should matter greatly, no matter her ethnicity, socioeconomic status, or the country in which she resides.