Doctors: Agents of Change!

This blog is part of a series that catalogues the learnings and the reflections from the recently conducted 10th Anniversary Conference titled the ‘Power of Partnerships’.  

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 Riti Sanghvi, Youth Champion, India


It is a universally acknowledged truth that medical students have to go through an incredible no. of pages in their undergraduate years. Despite this, we often fail to learn about socio-political-cultural practices and patriarchal systems and their effects on sexual and reproductive health.

In a country like India, where topics of contraception, sexuality and even menstruation have been heavily stigmatized, it seems like forever before we even discuss abortion, making abortion look illegal. And even though our country has quite a liberal abortion law, it lacks clarity and is not a rights-based document. It requires doctors to exercise their judgment and this is where doctors can often impose unnecessary restrictions. This limits access to abortion despite a law which was seen as very progressive when it was passed in 1971.

Thus, it is time that we address the potential of doctors as agents of change and start conversations around safe abortion as a human right, and not just a medical procedure and a public health issue.

This is where ISAY comes into the picture. ISAY was founded by a group of medical students from Mumbai, who are passionate about leading the work of safe abortion advocacy amongst fellow students after attending the YAI organized by ASAP. We at ISAY propose to sensitize key stakeholders i.e. mainly medical students and other healthcare workers involved.

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Becoming a doctor is a long and often difficult process where knowledge and attitudes are shaped not just by textbooks, but by teachers and seniors. We spend up to 10 years in college without ever hearing the words misogyny or patriarchy, though its reflections are obvious in almost every textbook and teaching. These are the aspects of abortion and other reproductive health problems which our textbooks and teachers fail to address. We would like to create a future where doctors are sensitive, aware, and empowered to bring about change in health and well-being of a person as a whole. This is only possible if we start right from when they are medical students.

 Textbooks and healthcare training should sensitize medical students on patriarchy, and its impact on decision making power for women regarding sex and contraception, its relation to interpersonal violence , unwanted pregnancies and the constraints that women, especially poor, young, unmarried  from rural areas face in seeking access to abortion, which very commonly lead to unsafe abortion practices, hence leading to complications.

I have also been working on the analysis of the current level of gender sensitivity in the textbooks being used for undergraduate medical training and the potential impact that it has on developing attitudes.

Here is an example of the language in the textbooks which reflects not only facts but the attitude or even prejudices of the authors, thus creating a bias in the minds of students who have never been exposed to the other perspectives related to the issue in discussion.
UntitledWe have been trying to overcome these issues by carrying out sensitization workshops and YAIs for medical students across 5 medical colleges from Mumbai and beyond, building awareness among them on topics of gender, power, patriarchy, sexuality and building a rights-based perspective for abortion issues.

Our very first Youth Champion, Mubasshir Babar, organized the first sensitization workshop in Mumbai along with ASAP and the Medical Students’ Association of India, in May 2016 and till date we have conducted 4 such workshops and 4 YAIs reaching out to a total of close to 200 students. We have all been conducting sessions as peer trainers with the support of the trainers from ASAP and most of us have also had an opportunity to attend the Youth Advocacy Refresher Institute where we were able to engage in on depth with issues such as ethics, sexuality, neoliberals economic policies, law and using theatre as a tool for resistance.

We also hope to have more participation from students of various colleges across Maharashtra, but most medical students find it difficult to make time for such workshops, and therefore it is crucial that eventually, this becomes a part of our medical curriculum. And even though we have only worked with students as for now, we hope to reach out to our faculty members and encourage them to have a healthy discussion with the medical and nursing students and staffs, explaining to them the urgency of this.

We are very much determined to work on safe abortion issues as well as continue involving more healthcare workers through these workshops and collaborate with other organizations working for a similar cause.

 This is only the beginning, a bigger change is due. Not only medical students, but many young people outside of the medical field are also strongly committed to gender and rights issues and we would work to include them and create a diverse network/ group of young individuals working to improve access to safe abortion for women and girls in India.

 Safe Abortion is every woman’s right and we should provide it regardless of our religious belief and political stand. And even though we are all not going to Obstetricians, gynecologists or direct abortion providers, the way we talk about abortion in our community is going to influence decision and policy-making, and even direct provision of it. It’s time we understand that abortion is a human right and we as doctors don’t get to make decisions about anyone’s body.

Because…

IT’S HER BODY, HER CHOICE, HER RIGHT!

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Learning by Doing

This blog is part of a series that catalogues the learnings and the reflections from the recently conducted 10th Anniversary Conference titled the ‘Power of Partnerships’.  

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– Smriti Thapa, Youth Champion, Nepal


I hear and I forget, I see and I remember, I do and I understand: Chinese proverb

The first time I saw Dr. Ea Mulligan doing a Papaya workshop was in in ASAP’s Gender and Medical curriculum meeting in Vietnam. I was so thrilled and fascinated by the idea of trying MVA in a fruit, which further inspired me to bring this amazing learning experience back home among my students. As a result of which, I conducted similar workshops among my students. Before each workshop, I went through a lot of presentation video clips on it (as well as the TEACH abortion training workbook developed by Dr. Sarah Mc Neil (at TEACH in California)

To be able to join Dr. Ea for a similar demonstration during the two days of ASAP’s Anniversary Conference was another learning curve for me. This time, we tried the procedure with a dragon fruit and it was much better in terms of the process of evacuation since it was more reflective of the actual evacuation of the contents of the uterus during the termination of pregnancy in comparison to a papaya.

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The demonstration was set up for both days of the conference and I had this opportunity to help Dr. Ea as one of the facilitators of the demonstration. Along with the Manual Vacuum Aspiration, she also demonstrated the use of IUCD in a dragon fruit and we were able to demonstrate that to other participants. Not only did the participants see our demonstration, but they also had a chance to do some hands-on skills practice.

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Some of the participants with backgrounds in medical science really found this procedure simple and non-threatening, and felt that this will help them tackle the anti-choice rhetoric which often shows old and outdated sharp instruments to describe surgical abortion, when in reality MVA has really shifted the paradigm of abortion services.  On the other hand, a few others, especially with non-medical backgrounds, weren’t quite sure of how much this learning was useful to them. Nevertheless, they enjoyed the hands-on practice and were excited to share their experience with other people. The majority of them were really curious and excited to see the contents coming out of dragon fruit after being sucked by manual vacuum aspirator and were struck by how simple the overall procedure was.

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The entire setup wouldn’t have been possible without the amazing Dr. Ea Mulligan and Dr. Dalvie whose relentless support and guidance for the demonstrations really helped the stalls team of me, Riti and Thuy to develop the necessary background for the successful outcome of the demonstration.
Personally, it was a great learning curve for me and I really hope it has inspired abortion advocates, both with medical and non-medical background to really think of abortion as a simple and quick procedure, and further debunk the myths associated with it.


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What Does Feminism Mean to you as a Man?

By Suyash Khubchandani, Youth Champion, India


Reflecting on his experience as a member of the panel that discussed the nature and role of ‘male feminism’ at our 10th Anniversary Conference, our Youth Champions spells out what feminism and progress mean to him. 

This blog is part of a series that catalogues the learnings and the reflections from the recently conducted 10th Anniversary Conference titled the ‘Power of Partnerships’.  

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“What does “Feminism” mean to you as a man?”

That was the question thrown across to the 6 of us on stage. Each of us taking a deep breath, before speaking out what our heart has been driving us to do, all the time we’d been working in the field of SRHR.

You see, to speak about working in a field where you’re an ally to those fighting your own kind, it’s a lot harder to accept if you just sit there to hear people speak. At the end of the day- we, as men, have been part of the privileged community that’s been blessed, often at the cost of women’s rights.

To me, it was indeed a moving experience- to hear from so many accomplished men who continue identifying, standing up and speaking out for what’s right.

While appreciating the importance of male involvement  ensuring women’s health and rights and for men to be potentially equal partners in dismantling the patriarchy, many feminists think that a male feminist is a contradiction and “for feminism to be successful as a philosophy and as a policy platform, it needs to stay undiluted by male appropriation. The mere espousal of or belief in the ideology of feminism doesn’t automatically make one a feminist. For now, men are at best allies of feminism, not feminists per se.”

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Another school of thought says: “Their support of the women’s movement does not erase the fact that they, on an individual level, are capable of harassing, assaulting, or silencing women—nor that, on a structural level, they continue to benefit from a system that establishes male dominance at the expense of women. And even though male allies may genuinely feel guilty, they will continue to benefit from male privilege. The patriarchy does not offer special exceptions for men with good intentions. Male allies often undermine the very movement they claim to support because they fail to acknowledge the role that they themselves play in perpetuating female subordination. This is not to say that men can never be feminists—rather, that feminism should not cater to men.”

It was interesting how almost everyone denied that there is such a thing as a “male” feminist but yet agreed that you don’t always need to go through something to fight against it. Hearing so many stories about the experiences and challenges every single panelist had faced back home, it sort of prepares you for what is to come.

Being the youngest one, both in age and experience, I was thrilled to have gotten the platform to speak. What was also really eye-opening was the set of questions put forth to us.

It was really like this review of the panel that had just gotten through and it was intriguing to see what women actually think of men working in the field of SRHR and safe abortion.

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Let’s talk about Abortion!

Neelam Saleem Punjani, Youth Champion, Pakistan


On #InternationalWomensDay, our #YouthChampion reflects on her work and the need to #PressforProgress in order to ensure that every woman, everywhere has access to #safe and #legal #abortions. 

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Working with women on some of the most stigmatized topics like women’s right to safe abortion is not a challenge that many people would welcome. It is sometimes difficult, often frustrating and at times confrontational. But for me advocating for women’s right to safe abortion is simply the best job in the world!

I was motivated to work with women by my own experience of growing up in a patriarchal society where speaking about women’s right is always considered a taboo.

Young girls and women around the world face abortion stigma every day due to restrictive laws and policies. The young girls and women are humiliated for seeking abortion services regardless of the country laws on abortion.  This prevents them to look for timely help which results in 46% of unsafe abortion worldwide. Not only this, every year 47,000 women die due to unsafe abortion which increases the burden of maternal mortality.

I strongly believe that abortion should be legal and safe for every woman.

Based on the human rights to equality and dignity, women should never be forced to continue the unwanted pregnancy against their wishes. The consequences of stigma, silence, and shame around abortion end up in life-threatening consequences for the women. It is high time that all governments should acknowledge women’s reproductive rights to safe abortion and create a conducive environment for women to fulfill their rights.

As an abortion advocate, my motivation is always to give young girls and women the opportunity to access their sexual and reproductive health rights and providing them awareness, support, and opportunities which they may never have had before due to the taboo attached to such topics.

We need to start challenging the prevailing stereotypes about abortion for young girls and women in our societies.

I have noticed that people around me are extremely uncomfortable to even say the word “abortion”. Just the sound of it is shameful to them. However, after I have spoken up publicly at various forums about women’s rights to safe abortion, many people around me feel less awkward discussing the topic. I believe that the young generation does have the power and rights to speak up and be well-informed about decisions that determine their health and well-being, in order to protect themselves from harmful consequences.

In order to make women empowered, governmental organizations along with private sectors should prioritize women’s sexual and reproductive health through scaling up the existing programs. This will ensure the protection of fundamental human right which is a key to achieve sustainable development.

My message to young people is –if I can talk openly about abortion, so can you!

So let’s stand up, together, and speak out to ensure women’s right to safe and legal abortion!

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The pro-choice movement in Asia: A retrospective

Dr. S. P. Choong. Founding Member, Asia Safe Abortion Partnership


As a founding member of ASAP,  I  am taken aback to suddenly realize that it’s been 10 years since we adopted the idea of a regional alliance for abortion rights. I guess it has been such an enjoyable and fulfilling ride for me to witness the growth of the pro-choice movement – in different countries, involving different professions and especially different generations.

Starting out as an individual abortion rights activist 50 years was a lonely business – facing stigma from friends and professional colleagues. No matter how strong our own internal convictions, it can still be stressful

Fortunately in Asia, unlike in the US, the anti-choice groups have not begun demonstrate and harass abortion clients right up to the doorsteps of abortion clinics. But there are now groups of pro-choice doctors there formed to meet up regularly for mutual psychological support.
I must confess that for a long time my self-introduction to strangers was as a director of a ‘family planning clinic’. Since building up advocacy networks through RRAAM in Malaysia and ASAP, I am now an up-front abortion rights activist. My view now is if we have self-censor our role as abortion rights activists, how can we possibly convince others of our cause. I hope all our younger activists can adopt that position.

The anti-choice movement has become so vocal and aggressive, it is important that everyone of us must as it were,  come out of the closet. Meeting colleagues in the pro-choice movement should make this shift in outlook move a lot easier for us..

Coming out as a pro-choice activist when meeting new people can be an interesting experience.  A good starting point in assessing the prejudices of the listener. And perhaps to initiate an interesting conversation!   And you may get some surprises on the way. People are not so bigoted on the abortion issue you may think.

A story told to me by Dr Susan Yanow made a point. When she casually mentioned her work on abortion to an air stewardess,  she was promptly upgraded to business class! So you never know your luck!  So try this out on new friends and colleagues at work and see their reactions.  Make it like a game!

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