Friday, September 23, 2011

Gender and the Company We Keep

A recent study cited in the New York Times showed that testosterone in human males dropped after fatherhood. Further, the study noted that the hormone dip accelerated the more time men spent in child-rearing activities. The New York Times editorial mulled over implications of manhood and masculinity as currently debated in these changing times here in America, where more mothers are working and more dads are delving into the diaper-changing, car-pooling, bath-time, bed-time arenas once reserved for stay-at-home moms. But let's take a broader view.

Research conducted by Anna Meigs in the 1970s among the Hua of Papua New Guinea suggest a characterization of masculinity and femininity that mirrors this study of fathers and their changing testosterone levels. I will summarize here, but the whole concept made me think that the Hua, who numbered between 100 and 300 people at the time of the study, were light years ahead of our rigid Western ideas of gender and sex.

The Hua believe that all humans possess a real life-giving force called nu that can be transferred person-to-person. Nu helps people age and mature. As females have lots of nu they are moist and grow fast while males have smaller amounts and are dry and need assistance to grow-up. So one's masculinity and feminity is characterized both by genitalia and by one's amount of nu.

One can get nu from someone's breath, women's bodily secretions, eating particular foods that are high in nu qualities and generally by being married to or hanging around women. Those with little nu include boys getting ready for puberty ceremonies who avoid women and nu rich foods to make themselves dry, hard and fierce. People with high amounts of nu include children of both sexes (because they spend so much time with their mothers), married women with children and - here we hark back to the aforementioned study - old married men! With a lifetime spent having intercourse with women (who are considered polluting) and eating nu rich foods, middle aged and older men become more 'like women.' Conversely, post-menopausal women have lost nu by having children, through menstruation and by handling and preparing food - they are more 'like men,' entitled to live in the men's house. They are no longer a threat.

In thinking of the Hua, I would like to know if pre-menopausal women who spend no time with children, little time with women and more time with men (such as women in corporate or managerial positions with high ratios of men to women) have lower levels of estrogen and progesterone and higher levels of testosterone? I think about women in their thirties and forties who marry then quit their jobs or work part-time in order to start families and then find it difficult to get pregnant. After years of trying, sometimes infertile couples choose to adopt. Once they become mothers, some women then find it possible to have a biological child. Does having a child/hanging around children and other women by participating in play groups, PTO, etc., influence estrogen and progesterone levels? After all, women who cohabit find that their menstrual cycles get somewhat synchronized - maybe hanging around men does the reverse?

I think the Hua are on to something with their concept of nu, just not yet sure how it applies.

Sunday, September 18, 2011

Working at the Dump

Outside of Siem Reap in Cambodia, the city where literally hoards of people from around the world arrive to visit the ancient ruins of Angkor Wat, sits a unique income generating opportunity for the underclass in this region, the dump. Due to its distance from the city, Siem Reap's dump receives little aid from NGOs. Everyday 140 children and many more adults sort through the smelly paper, glass and plastic. Their schedules are dictated by the arrival of twenty garbage trucks a day from Siem Reap. The location of the dump makes access by NGOs difficult but some are trying to help. According to the article ""Life on the Margins" in the Siem Reap Insider/ Phnom Penh Post:

At the nearby Kaliyann Mitt Centre operated by NGO Friends International, group monitor Kem Phalla said there were 145 children living in the dump according to a survey this year, with 42 attending local schools.  “This is the last place that people come to when they need work,” she said. “Some days the mothers go to the dump and leave their babies for someone to find and take care of, and then go and find a job farming or something else.”  Phalla, who coined the “dirty little secret” moniker for the dump, said casualties from working in its disease-filled environment trickle into the centre’s clinic every few days, with broken bones and infected cuts among the most common injuries.  “Usually if a wound is bad it’s become infected from handling glass bottles. At the centre we mostly try to divert children away from working in the dump towards other jobs. We send the children who want to find skills to our education centre in Siem Reap where they can learn tailoring, cooking and other trades.”

However, another dump exists outside of Phnom Penh, Cambodia, the Stung Meanchey. For intrepid visitors, says, “If you ever wanted to remind your children how lucky they are, this is the place to bring them.” Dump tourism, who'd have thought. On a visit to Phnom Penh in 2006 a friend and frequent visitor to the city first made me aware of this unique travel opportunity when she told me about the dump and offered to arrange a visit. The Stung Meanchey dump is even mentioned in a two-page photo essay in a university textbook for introduction to sociology courses by James M. Henslin. But Cambodia is not the only place where the poor can scrap out a living on garbage.

While visiting India to volunteer for Empower the Children,
Garbage sorting, Dakshindari slum
I accompanied some children on a tour of their 'slum' in Kolkata called Dakshindari. Throughout the lanes people could be seen methodically separating the waste into metal, plastic, glass, etc., both in the street and in their yards. Old and young were at work. Some women looked to be in their 80s as they sat bent over with gnarled hands working quickly as they looked nimbly for 'treasures.'

The Global Post recently ran a photo essay titled, "Disposable Communities: living and working in the world's largest trash dumps (see below). These workers help countries recycle their garbage cheaply. However, the dangers of this activity are horrific: the health hazards associated with picking through medical waste, getting crushed by the huge machinery disposing of and moving around the waste, and the menace of disease and ailments from parasites and bacteria found in decaying food sometimes consumed on the spot by hungry workers. It's not a career of choice, but for hundreds of thousands of people around the world it holds both a means of survival and a daily threat of death.

Wednesday, September 14, 2011

Babel in New York City

I have a particular fascination with how we use language in this big world of ours. At school, I hear students on campus joking with their friends saying things like, "Oh yeah, she's my b*tch!" (this is one girl referring to another) which translates into "we are best friends." Now, "stupid b*tch" would mean the opposite, so the same word can have different applications depending on not only the adjective but the gender of the speaker (boys can never use the word in a positive way). The f-word is used freely as both an adverb and an adjective, punctuating everyday conversation among friends. If you listen to rap or hip hop you can hear a whole new vocabulary (the urban dictionary online can be very helpful in deciphering the meaning of "stacks" and "boo:). Of course, I believe there is an age cut-off at which time these words can never be used by any speaker of any gender (according to my children, I am in this category).

Then, there are world languages. It is difficult to know how many languages ever existed in the world but experts estimate that between 4,000 and 9,000 have disappeared since the 15th century. Others say that a language disappears on average every two weeks as native speakers die and their children assimilate. Today about 6,800 languages exist with approximately 4,800 spoken in Africa and Asia (and of those, about half have less than 10,000 native speakers). In Papua New Guinea alone there are 830 distinct languages! In Papua New Guinea, pidgin is the lingua franca spoken across the country, comprised of words from English, French and other sources. It is not a hodge podge of phrases but follows particular rules of grammar as do more 'formal' languages.

Linguists are very interested in coding languages before extinction and guess where they are looking? New York City. According to a recent article in the Economist, the five boroughs host speakers of 800 languages, many of them endangered. A group of academic linguists called the Endangered Language Alliance are trying to make a record of those most vulnerable before they are gone and have codified 12 so far including "Garifuna, which is spoken by descendants of African slaves who made their homes on St Vincent after a shipwreck unexpectedly liberated them; Mamuju, from Sulawesi in Indonesia; Mahongwe, a language from Gabon; Shughni, from the Pamirian region of Tajikistan; and an unusual variant of a Mexican language called Totonac." Along with the language, these researchers are collecting stories and cultural artifacts unique to the participants.

Right here in New York City! Fascinating. Can't wait for the online dictionary.

To read the entire article from the Economist, click here.

For more on language and culture read:
Nigeria: pidgin and culture 
Female Bloggers in India: the importance of language.

Monday, September 12, 2011

Saving Baby

A mother walks past the Door of Hope orphanage in Berea, central Johannesburg
A Johannesburg orphanage says its baby hatch gives desperate mothers an alternative to dumping their babies in rubbish bins
I saw this article in BBC News, "'Baby bin' to save South Africa's unwanted children. Mothers in Johannesburg's Berea suburb can anonymously leave their newborns in this 'Door of Hope.' Also referred to as 'baby hatches,' this method of allowing mothers to place their unwanted children in institutional care is not new. Italy established the first foundling wheels in 1198. In Florence, foundling homes were accepting newborns in the thirteenth century. The Innocenti Foundling Hospital was designed by Renaissance architect Filippo Brunelleschini which opened its doors in 1445. It is still in operation. Mothers who did not want to directly hand their babies to the hospital could place them in a basin to the right of the front portico beneath a window that opened to a space where a woman was always on duty to attend to the abandoned infant.

Throughout Europe, foundling wheels have existed since the 17th and 18th centuries. Today, in many European countries (Germany, Austria, Belgium, the Czech Republic and Hungary to name a few) as well as in Malaysia, Kuala Lumpur, Japan, Brazil, Canada and the US, it is legal for mothers to anonymously abandon their babies via the baby hatch in hospitals and social welfare agencies, though the details vary by country and state. In the US, all 50 states have a type of 'Safe Haven' law that permits mothers who choose not to keep their infants to legally leave them in official care. In South Asia, Pakistan has over 300 baby hatches. In both Pakistan and India, this practice provides an alternative to female infanticide. This killing of infant girls is motivated by the pressure of providing dowries for daughters among the poor as well as the traditional preference for boys (see the Economist's, Missing Girls in India and Bangladesh and India: violence against women ). 

In the 17th an 18th centuries, these infants were adopted, fostered out to families as farm labor or conscripted by the state into the military or into work programs. Today, many will find new homes or be cared for as sons as daughters if not in families, by state or social welfare agencies. At the very least baby bins can provide hope to replace the despair heaped upon children brought into the world under circumstances that cannot sustain them.

To read the full article on baby bins in BBC news click here.
Your baby will be cared for here
Baby hatch, Germany

Monday, September 5, 2011

Serbia: helping love along

This was just too cute to resist re-posting. Many European nations are not replacing their members as family size gets smaller and people move away for better jobs in other countries. The population of Serbia has been declining over the last 20 years and has now reached 25,000 people annually. Particularly hard hit are rural areas. Recent wars, poverty and a low standard of living are all part of the problem. To help, one mayor is trying something new.

But in the nearest town, Jagodina, there is a new and unusual attempt to reverse the tide: Mayor Dragan Markovic has introduced a scheme in which 150 single men and 150 single women, all over the age of 38, are being given a free holiday to the Greek coast in September in the hope that sparks might fly and a few more babies emerge. The venture is funded by the municipality and, he says, private sponsors. 

According to a BBC article, "Serbia tries singles nights to fight population decline" incentives to marry and have children include "free bus passes and stationery for schoolchildren, generous maternity leave and cash bonuses for new parents."

To read the full article, click here.

Hospital Donations Overseas

In her post in the New York Times, Making Medical Donations Work, Tina Rosenberg discusses ways to maximize and make sustainable humanitarian aid. The article specifically targets the ups and downs of sending expensive equipment and medicines abroad. In my experience conducting site visits in foreign hospitals in advance of medical teams and as a manager of surgical missions, I'd like to share a few things I've learned along the way.

To begin, and this is mentioned in the article, don't donate expired medicines or equipment or send along equipment that barely functions. It will just end up trashed, taking up space or eroding your goodwill.

All humans are opportunists. If you are giving something away, people will take it, even if it is not what they need. Let's say the hospital needs an x-ray machine but you have an anesthesia machine to donate. They'll take it - perhaps it will be used someday, perhaps not. I've seen a lot of expensive machinery sitting unused because no one has been trained to use it, parts are broken, there is intermittent electricity, film/ink/whatever needs to be replaced and is unavailable, etc. etc. The same is true of drugs: supplies of medicines sitting on shelves and used sparingly if at all as the supply is finite and the clinic/hospital/health center doesn't want to run out.

If you give, be sure you can train people to use and/or maintain the equipment. If you send a dermatome machine, they are going to need blades eventually, keep that in mind.

When I tour operating rooms examining the equipment so that our doctors will know how to prepare for their missions, I often see very nice equipment. I have learned to ask a basic question: does it work? I cannot tell you how many times the answer is 'no.' Perhaps there are three operating rooms that will be available to the team, but only one or two working anesthesia machines. Or, I will ask if the electricity ever cuts out (this happened on a trip in Vietnam in the middle of an open-heart operation). Is there a generator? How long till it kicks in? What can it support?

At this end, when  we hear the word "hospital" (or "doctor" or "nurse") we have certain expectations and assumptions. Best not to assume. I always say you have to stop thinking like an American on these trips. Doctors and other medical staff are doing their best under circumstances most medical personnel here would find not only challenging but debilitating. They see severely ill and injured patients they are at times unable to provide care for because they lack a few basic items. Which brings me to this: donations do not have to be huge to be effective. Everyday over-the-counter medicines have their place too. Hospitals always need supplies, like sutures - you don't have to think big and expensive to be helpful.

If you want to help, I believe it is important to have someone on the ground you can trust to facilitate your work overseas. Follow-up, visit and be sure you get accountability. Sometimes the best you can do is get close to the truth - and sometimes that is enough.

Click on the title to read Making Medical Donations Work from the New York Times.