Issue
10 - Gendered Epidemics and Systems of Power in Africa: A Feminist Perspective on Public Health Governance
Corresponding Author(s) : Ravayi Marindo
Africa Development,
Vol. 42 No. 1 (2017): Africa Development: Special Issue on Health Governance in Africa: Taking Stock
Abstract
This article is about systems of power, and the way different power systems – global, local, patriarchal and family – interconnect and create vulnerability to epidemic and infectious diseases among those with less power, mostly poor, resource-limited rural African women. The main argument is that to understand gendered epidemics in Africa, we need to examine the systems of power that create and perpetuate African women’s vulnerabilities at local, national and global levels. The article uses case studies, extracted from published epidemic stories and interprets these cases from a feminist and power analytical framework. The results suggest that while a disease or an epidemic affect a group of individuals, systemic factors regarding responsible governance and the role of national politics and policies; the role of global systems that control knowledge production and sharing; as well as patriarchy and culture all contribute to creating an environment that increases women’s vulnerability to epidemics.The article concludes by advocating for strengthening practical ways that can make hierarchical power less attractive and equitable distribution of power more attractive. Since current systems of power cannot be eliminated, they need to be challenged and transformed. The article has various limitations. It relies on a small number of case studies and though the literature refers to gender, the analysis is predominantly of women. Notwithstanding these limitations however, the article aims to contribute to the ongoing scholarly debate on governance of public health in Africa as well as to the growing field of African feminist epidemiology.
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- Adichie, C.N., 2007, Half of a Yellow Sun, London: Fourth Estate.
- Allen, A., 2014, ‘Feminist Perspectives on Power’, Stanford Encyclopaedia of Philosophy in, Zalta,
- E.N., ed., http://plato.stanford.edu/archives/sum2014/entries/feminist- power/.
- Anker, M., 2007, Addressing Sex and Gender in Epidemic Prone Infectious Diseases, Geneva: World
- Health Organization.
- Carastathis, A., 2014, ‘The Concept of Intersectionality in Feminist Theory’, Philosophy Compass 9
- (5): 304-14.
- Crenshaw, K., 1993, ‘Mapping the Margins: Intersectionality, Identity Politics and Violence against
- Women of Color’, Stanford Law Review 43: 1241-99.
- de Beauvoir, S., 1997 [1949], The Second Sex, London: Vintage.
- Delgado, R. and Stafencic J., 2001, Critical Race Theory. An Introduction, New York and London: New
- York University Press.
- Eisenberg, A., 1994, ‘Communicating with Patients of the Opposite Sex’, Dynamic
- Chiropractic 12 (9), www.dynamicchiropractic.com.
- Africa Development, Volume XLII, No. 1, 2017
- Fanon, F., 2005 [1961], The Wretched of the Earth, translated by Richard Philcox, New York: Grove
- Press.
- Foucault, M., 2000, Power, edited by James D. Faubion and translated by Robert Hurley et al., in
- Essential Works of Foucault 1954-1984. Volume Three, New York: The New World Press.
- Gaidzanwa, R., 1992, ‘Bourgeois Theories of Gender and Feminism and their shortcomings with
- reference to Southern African countries’, in R. Meena, ed., Gender in Southern Africa: Conceptual
- and theoretical Issues, Harare: SAPES Books.
- Govender, V. and Penn-Kekana, 2007, ‘Gender biases and discrimination: a review of health care
- interpersonal interactions’, background paper to Women and Gender Equity Knowledge Network (WGEKN).
- Hartman, B., 2009, ‘The “New” Population Control Craze: Retro, Racist, Wrong Way to Go’,
- http://www.ontheissuesmagazine.com/2009fall/2009fall_hartmann.php.
- Hill-Collins, P., 2008, Black Feminist Thought: Knowledge Consciousness and Politics of
- Empowerment, New York and London: Routledge.
- Imam, A., Mama, A. and Sow, F., 1997, Engendering African Social Sciences, Dakar: CODESRIA.
- Kaufert, P., 1988, ‘Through Women’s Eyes. The case for feminist Epidemiology’, Health Sharing,
- winter, 10-13.
- Ladson-Billings, G., 1998, ‘Just What Is Critical Race Theory and What Is It Doing in a Nice Field
- Like Education?’, International Journal of Qualitative Studies in Education 11 (1).
- Lukes, S., 2005, Power: A Radical View, 2nd expanded edition, London: Macmillan. Maathai, W., 2003,
- The Green Belt: Sharing the Approach and the Experience, New York:
- Lantern Books.
- Marindo-Ranganai, R., 1996, ‘Using Participatory Methods to Establish Community Based Information
- Systems. A Zimbabwe Case’, in De Koning, K. and Martin, M., Eds, Participatory Research Methods in
- Health. Issues and Experiences, London: Zed Books.
- McFadden, P., 2001, ‘Cultural Practice as Gendered Exclusion. Experiences from Southern Africa’, in
- Discussing Women’s Empowerment, Theory and Practice, SIDA Studies No. 3.
- Michalopous, S. and Papaioannous, E., 2011, ‘Divide and Rule or Rule of the Divided? Evidence from
- Africa’, NBER Working Paper Series 17184, http://www.nber.org/ papers/w17184, Cambridge MA.
- Morrock, R., ‘Heritage of Strife: The Effects of Colonialist “Divide and Rule” upon the Colonized
- Peoples’, Science and Society 37 (2):129-51.
- Obadina, T., 2005, Africa’s Crisis of Governance, African Economic Analysis, http://www.
- AfricanEcomincAnalysis.org.
- Ogundipe-Leslie, M., 1985, ‘Women in Nigeria’, in Badejo, D.L., ed., Women in Nigeria Today,
- London: Zed Books.
- Population Reference Bureau, 2012, Gender Based Violence and HIV/AIDS in
- Africa,www.prb.org/Publications/Articles/2011/gender-based-violence-hiv.aspx, accessed 10 January
- Marindo: Gendered Epidemics and Systems of Power in Africa 219
- Rathgeber, E.M. and Vlassoff, C., 1993, ‘Gender and Tropical Diseases’, Social Science and Medicine
- (4): 513-20.
- Rich, A., 1996, ‘Compulsory Heterosexuality and Lesbian Existence’, in Jackson, S. and Scott, S.,
- Feminism and Sexuality: A Reader, New York NY: Columbia University Press.
- Russell, B., 1938, Power. A New Social Analysis, London: George Allen and Unwin. Yuen-man Siu,. J,
- , ‘Communicating under Medical Patriarchy: Gendered Doctor
- Patient Communication between Female Patients with Overactive Bladder and Male Urologists in Hong
- Kong’, BMC Women’s Health 15 (44).
- Sisulu, E., 2002, Walter and Albertina Sisulu: In Our Lifetime, Cape Town: David Phillip Publishers
- and New African Books.
- Tsikata, D., 1997, ‘Gender, Equality and the State in Ghana’, in Imam, A., Mama, A. and Sow, F.
- Engendering African Social Sciences, Dakar: CODESRIA.
- Vlassoff, C., 2007, ‘Gender Differences in Determinants and Consequences of health and Illness’,
- Journal of Health Population Nutrition 25 (1) 47-61.
- World Bank, 2005, Gender and HIV/AIDS in Sub Saharan Africa: Putting Gender on the Map. Briefing
- Notes on Critical Gender Issues in Sub-Saharan Africa,http://
- siteresources.worldbank.org/EXTABOUTUS/Resources/GenderAIDS.pdf, accessed 12 January 2016.
- Zimbabwe Daily, 2015, ‘Mbuya Nehanda’s Second Chimurenga Prophecy’, 31 October.
References
Adichie, C.N., 2007, Half of a Yellow Sun, London: Fourth Estate.
Allen, A., 2014, ‘Feminist Perspectives on Power’, Stanford Encyclopaedia of Philosophy in, Zalta,
E.N., ed., http://plato.stanford.edu/archives/sum2014/entries/feminist- power/.
Anker, M., 2007, Addressing Sex and Gender in Epidemic Prone Infectious Diseases, Geneva: World
Health Organization.
Carastathis, A., 2014, ‘The Concept of Intersectionality in Feminist Theory’, Philosophy Compass 9
(5): 304-14.
Crenshaw, K., 1993, ‘Mapping the Margins: Intersectionality, Identity Politics and Violence against
Women of Color’, Stanford Law Review 43: 1241-99.
de Beauvoir, S., 1997 [1949], The Second Sex, London: Vintage.
Delgado, R. and Stafencic J., 2001, Critical Race Theory. An Introduction, New York and London: New
York University Press.
Eisenberg, A., 1994, ‘Communicating with Patients of the Opposite Sex’, Dynamic
Chiropractic 12 (9), www.dynamicchiropractic.com.
Africa Development, Volume XLII, No. 1, 2017
Fanon, F., 2005 [1961], The Wretched of the Earth, translated by Richard Philcox, New York: Grove
Press.
Foucault, M., 2000, Power, edited by James D. Faubion and translated by Robert Hurley et al., in
Essential Works of Foucault 1954-1984. Volume Three, New York: The New World Press.
Gaidzanwa, R., 1992, ‘Bourgeois Theories of Gender and Feminism and their shortcomings with
reference to Southern African countries’, in R. Meena, ed., Gender in Southern Africa: Conceptual
and theoretical Issues, Harare: SAPES Books.
Govender, V. and Penn-Kekana, 2007, ‘Gender biases and discrimination: a review of health care
interpersonal interactions’, background paper to Women and Gender Equity Knowledge Network (WGEKN).
Hartman, B., 2009, ‘The “New” Population Control Craze: Retro, Racist, Wrong Way to Go’,
http://www.ontheissuesmagazine.com/2009fall/2009fall_hartmann.php.
Hill-Collins, P., 2008, Black Feminist Thought: Knowledge Consciousness and Politics of
Empowerment, New York and London: Routledge.
Imam, A., Mama, A. and Sow, F., 1997, Engendering African Social Sciences, Dakar: CODESRIA.
Kaufert, P., 1988, ‘Through Women’s Eyes. The case for feminist Epidemiology’, Health Sharing,
winter, 10-13.
Ladson-Billings, G., 1998, ‘Just What Is Critical Race Theory and What Is It Doing in a Nice Field
Like Education?’, International Journal of Qualitative Studies in Education 11 (1).
Lukes, S., 2005, Power: A Radical View, 2nd expanded edition, London: Macmillan. Maathai, W., 2003,
The Green Belt: Sharing the Approach and the Experience, New York:
Lantern Books.
Marindo-Ranganai, R., 1996, ‘Using Participatory Methods to Establish Community Based Information
Systems. A Zimbabwe Case’, in De Koning, K. and Martin, M., Eds, Participatory Research Methods in
Health. Issues and Experiences, London: Zed Books.
McFadden, P., 2001, ‘Cultural Practice as Gendered Exclusion. Experiences from Southern Africa’, in
Discussing Women’s Empowerment, Theory and Practice, SIDA Studies No. 3.
Michalopous, S. and Papaioannous, E., 2011, ‘Divide and Rule or Rule of the Divided? Evidence from
Africa’, NBER Working Paper Series 17184, http://www.nber.org/ papers/w17184, Cambridge MA.
Morrock, R., ‘Heritage of Strife: The Effects of Colonialist “Divide and Rule” upon the Colonized
Peoples’, Science and Society 37 (2):129-51.
Obadina, T., 2005, Africa’s Crisis of Governance, African Economic Analysis, http://www.
AfricanEcomincAnalysis.org.
Ogundipe-Leslie, M., 1985, ‘Women in Nigeria’, in Badejo, D.L., ed., Women in Nigeria Today,
London: Zed Books.
Population Reference Bureau, 2012, Gender Based Violence and HIV/AIDS in
Africa,www.prb.org/Publications/Articles/2011/gender-based-violence-hiv.aspx, accessed 10 January
Marindo: Gendered Epidemics and Systems of Power in Africa 219
Rathgeber, E.M. and Vlassoff, C., 1993, ‘Gender and Tropical Diseases’, Social Science and Medicine
(4): 513-20.
Rich, A., 1996, ‘Compulsory Heterosexuality and Lesbian Existence’, in Jackson, S. and Scott, S.,
Feminism and Sexuality: A Reader, New York NY: Columbia University Press.
Russell, B., 1938, Power. A New Social Analysis, London: George Allen and Unwin. Yuen-man Siu,. J,
, ‘Communicating under Medical Patriarchy: Gendered Doctor
Patient Communication between Female Patients with Overactive Bladder and Male Urologists in Hong
Kong’, BMC Women’s Health 15 (44).
Sisulu, E., 2002, Walter and Albertina Sisulu: In Our Lifetime, Cape Town: David Phillip Publishers
and New African Books.
Tsikata, D., 1997, ‘Gender, Equality and the State in Ghana’, in Imam, A., Mama, A. and Sow, F.
Engendering African Social Sciences, Dakar: CODESRIA.
Vlassoff, C., 2007, ‘Gender Differences in Determinants and Consequences of health and Illness’,
Journal of Health Population Nutrition 25 (1) 47-61.
World Bank, 2005, Gender and HIV/AIDS in Sub Saharan Africa: Putting Gender on the Map. Briefing
Notes on Critical Gender Issues in Sub-Saharan Africa,http://
siteresources.worldbank.org/EXTABOUTUS/Resources/GenderAIDS.pdf, accessed 12 January 2016.
Zimbabwe Daily, 2015, ‘Mbuya Nehanda’s Second Chimurenga Prophecy’, 31 October.