Jun
27

Barriers to Healthcare Access for Women in Senegal: Research Updates

Salaa maalekum and bonjour! I am currently in Senegal working on my Honors Thesis, focusing on legal and social barriers to healthcare access for Senegalese women. This summer has been a whirlwind of gathering lists of articles and resources, finalizing my interview guides, and prepping for travel abroad in a sub-Saharan African country. Last week I finally made the journey to Senegal, arriving in Dakar, the capital, last Sunday night!

Dakar is a beautiful, fascinating place unlike anywhere I’ve ever been. It is common to see goats, horses, and donkeys strolling down the side of the highway. The city lies at the edge of the Sahara Desert, and most of the streets in the residential neighborhoods are made of sand, with mango and tamarind trees growing above the houses. I’m living in a homestay with a Senegalese family, with whom I communicate exclusively in French. This has been a great way to practice my French, learn a little bit of Wolof, and observe Senegalese customs (including eating foods like cee bou jen, the national dish, with my hands!) The World Cup is currently going on and it’s so much fun to watch Senegal’s games in Senegalese restaurants and bars. After Senegal’s win over Portugal everyone was celebrating in the street, and all of the study abroad students bought jerseys!

I’ve had the pleasure of visiting amazing sites like Gorée Island, just a 15 minute boat ride from the city. Though beautiful, the island has a dark and haunting history: it is the site of la Maison des Esclaves (the House of Slaves) and historians estimate that hundreds of thousands, or even millions, of enslaved people were housed on this island before being transported across the Atlantic. It was an incredibly moving and somber experience to visit this island and the museums paying testament to its history. I learned about how young female slaves were housed separately so that the slave-masters and male visitors to the island could pick ones they liked, and how slaves who were discovered to be pregnant would have to dig holes in the earth for their stomachs before lying down and suffering 29 lashes. This offered an early contextualization for my research, as I plan to open my thesis with a brief background on the position of women in Senegal from slavery and colonialism to the present.

I have also been making huge strides with interviews and accessing libraries here. I plan to interview several women in Dakar about their experiences as women, mothers, and wives interacting with the healthcare system, and some of the barriers to equality they have faced. I conducted my first interview two days ago and learned about many of the social norms and laws women must follow, as well as the difficulties of affording care. Women are blamed for wedlock pregnancies and for any problems with the child, and must get their husbands’ approval for operations like tubal ligation. Only about 20% of people in Senegal have health insurance, and there is still a great divide between the urban cities and the rural villages, where people are wary of doctors and modern medicine and believe evil spirits cause medical problems. I am also interviewing medical personnel here about their experiences with healthcare outreach, and I conducted my second interview yesterday, with a man who has served as a health coordinator for four different districts in Senegal. I learned about the intertwined problems of lack of education, poverty, poor health, and patriarchal beliefs preventing women from accessing care and contributing to a high maternal and child mortality rate. I conducted this interview entirely in French for the first time and was very pleased with how it went. I can’t wait to transcribe these interviews, and I have several more scheduled for the coming days.

My project has shifted slightly from my initial plan, as I have decided to expand the focus on maternal and reproductive health and women’s rights to healthcare in Senegal. Additionally, while I will still discuss colonialism and use Senegal’s colonial history to frame my project, I’ve discovered that almost sixty years after independence, people here are reluctant to associate themselves with France and to characterize France as the cause or creator of their institutions. In both interviews I’ve conducted so far my interview subjects have said that Senegal has significantly altered many remnants of French society here and that even if original medical structures were French, they were adapted to suit Senegalese needs. I plan to investigate this more but have decided to make women’s health the main focus of my project and use colonialism as more of an introductory framework.

My first week here has been an incredible learning and growing experience, and I’m so excited to continue!

A statue on Gorée Island.

A statue on Gorée Island.

 

Senegalese fans celebrating after Senegal's victory against Poland in the World Cup.

Senegalese fans celebrating after Senegal’s victory against Poland in the World Cup.

 

A private clinic in downtown Dakar offering OB/GYN services to women. However, only wealthier women are able to afford these clinics.

A private clinic in downtown Dakar offering OB/GYN services to women. However, only wealthier women are able to afford these clinics.

Comments

  1. Leah, this project sounds both interesting and important. One thing that caught my eye was the passage about Colonialism and the tendency for Senegalese people to alter French structures (maybe both physically and ideologically?). If you think purely about physical alterations to health buildings, I’m wondering if it is possible to disentangle changes that were made to distance Senegal from France simply for reasons of national pride/shaking off oppressors from reasons that have a medical underpinning.

    I ask this because I wonder if there are inherent problems with imposing a French medical system on a different country that fall outside the scope of colonialism. I pose this genuinely as a question because I don’t know!

  2. Danny McNeil says:

    Leah, your experience in Senegal sounds so informative and engaging. Learning so much and having the opportunity to interact with people on so many levels seems extremely rewarding. I can’t wait to learn more about your honors thesis, especially the applications across disciplines. The importance of language, medicine, economics, sociology, culture, etc. are all so intertwined in your post about Senegal. This sounds like an amazing project!

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