02 décembre, 2017

FEMINISM AND ACCESS TO HEALTH SERVICES: HOW A PROFESSIONAL ACTIVITY CONTINUES TO BE A STRUGGLE

This article has been presented within Symposium intiteled Modernization, Islam, (neo)Liberalism and reproductive Policies in Tunisia and Turkey, Practicing feminist medecine in the system that took place on November 13, 2017 in Geopolis Lausanne

Tunisia has been precocious compared to other Arab and Muslim countries when it comes to the emancipation of women. 
Long before independence, Ibn Abi Dhiaf, (1804- 1874), a Tunisian historian and politician, known to be the author of a multi-volume chronicle on the history of Tunisia And private secretary of five successive beys of Tunis ; wrote in 1856, his Epistle on Women, (Risalah fi al'mar'a), as a response to a list of 23 questions asked by Léon Roches, General consul of France in Tunis.
This thirty-pages manuscript examines the social role of women in Tunisia, their ights and duties with regard to the family and conjugal relations (marriage, divorce, polygamy, presence in the public sphere (veiling). isolation, segregation and repudiation), housework and lack of education.

Nearly in the same period, Minister Khair-Eddine, a major actor in the Tunisian reform movement, called for women’s education and the modernization of the political system based on the reconciliation of Western contributions with Islam.

Half a century after that, Tunisian activist Habiba Menchari called for veil abolition at a conference in Tunis in 1924 and publically removed her veil. Four years later, she was pleading for the abolition of polygamy, and from 1924 to 1929, public interventions by Habiba Menchari and feminist activist Manoubia Ouertani aroused scandal among conservatives.
In that same intellectual motion, Tahar Haddad, syndicalist and Tunisian author, raised the question of the Personal Status of Women in 1930 to the public opinion.
From 1930 to 1955, several newspapers published articles on women's dowry, polygamy, veil, education and voting rights.

There have been pioneering women's organizations in the colonial era like
Muslim Women's Union of Tunisia (1936-1956) made of committed women of the upper middle class anticolonialist activists like Bchira Ben Mrad  (1913-1993)- anticolonialist activist who created the Muslim Union of Women of Tunisia in 1936, linked to the Zeitounian circles, (visa in 1951 and dissolution in 1956).
Meanwhile, The Union of Tunisian Women U.M.F.T was created in 1944 after the victory of the French Left that favored the establishment of and was linked to the Tunisian Communist Party ; whose demands mainly concerned the schooling of young girls but which, under the Protectorate, turned into political demands for the victims of colonial repression.
This NGO focused mainly on the emancipation of women and the schooling of disadvantaged children, it’s activities were reduced after independence, until its dissolution, in 1963.

Since the independence of the country (1956), women's emancipation has been closely linked to nationalism, modernity and even universal access.
The Code of Personal Status had secular orientation, published in August 13, 1956 (before the constitution)  and it Abolished polygamy, replaced repudiation by the judicial divorce that the two spouses also have the possibility of claiming,  and abolished of the matrimonial guardian ; 
CSP gave also women the right to vote and eligibility in municipal elections.
In the years following independence, women got the right to work, to move, to open bank accounts or to set up businesses without requesting the permission of their husbands.
From the early 60s, a vigorous family planning policy was implemented making contraceptives available throughout the country   and legalizing unconditional abortion.

The emancipation dynamic, however, lost its impetuosity in the 1970s. At that time,The political will to break the Marxist intellectual left lead to the constitution of "Safeguarding the Quran" associations, first nuclei of what will be the Islamist movement.
And in 1973, a circular prohibiting the celebration and registration of marriages between Muslims and non-Muslims was published making all mixed marriages where the spouse has not converted to Islam null and void in the eyes of the Tunisian authorities.
Bourguiba renounced in 1974 to modify the inheritance law aiming gender’s equality and in the late 70s, a total stagnation of women's status took place since the improvement of women situation was no longer a main priority.
Nevertheless, in 1981 a law that automatically conferred to the mother the guardianship of minor children in case of the death or incapacity of the husband, and new measures in favor of women in case of divorce. During this period, the first research topics on women, especially in history and sociology in universities
Luckily previous social changes helped the emerge of feminine consciousness capable of rethinking the question of women and femininity; the Tunisian feminist movement was born during this period: the Autonomous Feminist Movement (1978 to 1982). The exacerbation of socio-economic contradictions generates a movement of opposition in the wake of which is born an autonomous feminist movement, marked by the creation in 1978 at Club Tahar Haddad, of the Club of the Condition of the Women, carried by a group of students of the Human Sciences  University of Tunis aiming the creation of a Women's Trade Union Commission.
Feminine members of the Teachers and Scientific Researchers Union created this commission on March 8th 1982, during an event, in the presence of Taieb Baccouche, general secretary of the UGTT who gave his approval for the creation of the Study Commission on the Status of Women at Work, within the UGTT.
This NGO could also have been created as a response to the National Union of Tunisian Women (1958-2012) created in January 1956 under the aegis of the Neo Destour, which first president was Radhia Haddad. This organization was never independent because it was always subordinated to the ruling parties under Bourguiba and Ben Ali. UNFT was charged with balancing effective participation of women in economic and social life with the promotion of a harmonious family life. This structure has always executed the programs of the ruling party and was a force of political mobilization.

The Autonomous Feminist Movement got more structured between 1978 and 1982 and the consolidation of the Movement took place in 1989 with the creation of two independent NGOs in opposition to the established power, namingly  AFTURD (Association of Tunisian Women for Research on Development) and the ATFD (Association of Democratic Women), who have contributed a lot to the promulgation of new laws for women, maintaining the pressure on the power in place from 1989 to 2011.

An importent event took place on November 7th, 1987, when Ben Ali took over power  and this was accompagned by new cultural practices as Interruption of television programs to transmit the daily five prayer calls but also Reopening of the former theological university of Zitouna suppressed shortly after independence by Bourguiba and Beginning of the glorification of "Arab-Islamic identity" of Tunisia by the new regime.
Surprisingly Official receptions had become exclusively masculine.
For the feminist movement, it was no longer a question of feminists claiming but of defending the CSP against attacks not only of Islamists, but also of the political party in power ;
Ben Ali publicly affirmed his attachment to the CSP in 1988, but nothing more. During 1989 election campaign, candidates of the ruling party tried to attract votes through an Islamic discourse.
But in 1990, following the conflict of the state with Islamists, the president reconnected with a state feminism without breaking up with the Arab-Muslim identity.
So in 1991, the Center for Research, Studies, Documentation and Information on Women (Credif) was founded  and a national commission "Woman and development » was established ; the President even announced the creation of a State Secretariat for Women and Family and Women got appointed to ministerial offices. In addition, in 1993 some changes are made on the CSP without responding to all the wishes of the feminist movement, who advocates for a clear recognition of gender equality, they are nonetheless not negligible and tend to change paternal authority towards shared parental authority between the two spouses and the consent of the mother becomes mandatory for the marriage of a minor girl. Legislative innovations were made since 1995 in the distribution of property within the couple following the demands of feminist activists and mechanism to facilitate donations during lifetime aiming to mitigate the effects girls' inequality in inheritance were studied.

The cause of the woman was used to promote the regime but the regime wan’t ready to grant the equality of inheritance under the pretext of respecting the Arab-Muslim identity

After the revolution, many events took place, the one with the most strong symbolism when it comes to women emancipation was that the two tombs of Tahar Haddad and Bourguiba were desecrated by Islamic extremists.

Several feminist NGOs were created, aiming for the fight for parity, women empowerment and insuring the mobilization of civil society whenever the ruling party seemed to be slipping.
These NGOs had a common struggle: the inclusion in the Constitution of the principle of total equality, the separation of politics and religion and the universal dimension of human rights and women's rights in particular so discussions about modifying the CSP impulsed strikes in 2014.

Feminist NGOs have been also active in lifting the reservations to the UN Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW).

                  Since then feminist NGO worked on the eleboration of a law proposal against gender based violence that has been lately discussed in the national assembly.

After this overview of the history of feminism in Tunisia,it seems obvious that Machismo is a bias and it distorts history and science; since history is written by the strongest when it comes to civilizations, It is mostly written by men all the time which implies the constant minimization of the role of women;  Even in science, the veracity of purely scientific data is sometimes doubtful because, without being aware of it, the scientists having a machos bias, cannot stand feminine figures being more represented than masculine and tend to give explanations, create classifications… aiming the promotion of masculinity; like the famous story of the fastest, strongest spermatozoide that isn’t right at all since the ovocyte is the one who chooses the spermatozoide and aspire it
Sometimes we just have to stop and observe how much the patriarch can harm women by this self-destruction that he maintains; Oedipus kills his father and becomes his own father (Capitalisme et schizophrénie – Gilles Deleuze et Felix Gattari) ; it’s a destructive narcissistic dynamic that makes women often a collateral damage;

Things are quite the same when it comes to medical practice and more specifically in sexual and reproductive health services since services for women are always criminalized based on a religious approach ; not accessing health services is a violence
This is a truth in the general population; but the most affected people when it comes to unsatisfied health needs, are women belonging to vulnerable populations; they sum up being a woman and other specific barriers to each population.

Indeed, Women with Handicap do not access to the most basic human rights neither information since they lack autonomy and have a permanent need for assistance they cannot have confidentiality mainly within the absence of adapted services.
This group of women have a significant experience of violence and rape and at the same time they suffer a denied sexuality by society that is an unspoken non-right to sexuality and imposed infertility and / or maternity.

The second group are Migrant women that suffer Perceived barriers to health services due to Stigma and  Fear of being incarcerated if migrating illegally and Real barriers being Financial (no social security), Administrative (no identity document) or Non access to information and total ignorance of the health system and rights . Migrants do not access the same services as citizens in many countries.
Within this group, some are  also Victims of human trafficking which is a the modern slavery.

I think that there is a specific group that is the most affected by barriers to sexual and reproductive health services: Women drug users. Indeed, they suffer intense stigma. In addition,  there is a huge lack of adapted services in the public sector when it comes to drug use in general ; Nonetheless, there are some services offered by NGOs that are statistically insufficient in number for the general drug users popultaion and in gender approach due to lac of funds but also Punitive Law (article 52).
Many of those women sum up several risky behaviors  and some of them are victims of criminal organisation and human trafficking.

Nature hates the void, the planet needs a ground feminism to respond to the needs and services beyond which, these needs will be phagocyted by the patriarch since the lack of services makes verbalization of needs much easier to eliminate; while the provision creates an airway that acts as a protection for the services that exist and a basis to build on.
There is a necessity of a popular feminism approach that will be able to reach for all women from different social classes and backgrounds, in addition to the feminism carried out by the intellectuals;
Feminism should aim the empowering of women with little or no education and those belonging to vulnerable populations; it should step out its intellectual sphere and become easier to be adopted by all women regardless education, financial status…
That's what I would call Basic Feminism : a way to assert feminism in society, to protect women's achievements and to continue fighting for more.
Access to sexual and reproductive health services is an outcome, several factors intervene in the behavior of seeking care: culture, financial means, perceptions, morality ...
In order to have an impact, a holistic approach that integrates education, women's empowerment, financial independence must be though about.
A government should provide the services and  insure the protection of its citizens and stop playing moralizing father; the patriarch is weak, it tries to compensate for this impotence by giving itself the impression of controlling the intimate life of the citizens using absurd laws; Feminism have to set the record straight.


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