Health in Latin America
Several decades have passed since the conclusion of what the United Nations addressed as the “Decade for Woman” (1975-1985). In many regions of the world, patriarchal relationships between men and women have been toned down, and hierarchies in gender roles have become less rigid. What did these changes mean for women in Latin America? Although Latin America today is not as it was 30 years ago, the remnants of a rigid patriarchal order still shape people’s lives. A focus on women and health will serve as a prism to gain insights into some of the characteristics of Latin American gender systems and into the options and obligations assigned to women.
Latin American Life Experiences
Since Latin American women are hardly a homogenous group, understanding their diversity is a first step. Women’s experiences in the Americas are shaped not only by class and gender, but also by ethnic identities and the differences between urban and rural lives. Diverse groups of people experience different challenges when attempting to live healthy lives: urban women of the middle sectors often find it easier to protect their health than women in isolated highland communities in the Andes, or rural women who cannot rely on the proximity of medical facilities. Cultural differences are important markers as well: indigenous communities are often disconnected from “modern” approaches to health care not only by geographical factors, but also by a cultural and ethnic divide. Gender; ethnicity or race; class; age; and geography are all among the factors that shape human options in coping with the multiple obstacles on the path to health in the modern world.
Few women in the region could attain roles of leadership like Eva Perón in Argentina or Rigoberta Menchú in Guatemala. Eva Perón, or Evita, made a transformation from a poor suburban illegitimate child into to the most famous First Lady in Argentine history. Evita’s role in politics helped women gain the right to vote in Argentina—but by the time of her death in 1952, gender equality had not improved beyond suffrage. A Noble Prize winner and Quiché Indian peasant woman, Rigoberta Menchú became a ceaseless advocate for the human rights of the indigenous populations in the Americas. Her work showed that Indian women and men have suffered disproportionately in the civil wars and political tensions that were the legacies of colonial rule on the region.
The different life experiences of Latin American women serve as constant reminders that everyday life in the region is still shaped by the systems of stratification that survived the formal end of Spanish colonialism in the 19th century. Interaction among Americans, Europeans, and Africans in the colonial worlds led to the creation of new racial identities, differentiated social classes, and to redefined relations between men and women. The consolidation of colonial rule and the longevity of the system relied on the introduction of patriarchal family systems and on race- and gender-based mechanisms of establishing political hierarchies that last well into the 21st century. Due to ethnic prejudice, for example, indigenous women confront different challenges than women who claim Spanish descent. Concepts of health and disease in this historical context depend on specific notions about gender that are connected to the formation of nation-states in formerly colonial territory.
Defining Health: Old Concepts and New Meanings
In 1948, the World Health Organization (WHO) adopted a definition of “health” that has not been amended since: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”1 The WHO broadened the traditional understanding of health, ready to acknowledge a more holistic understanding of well-being that went beyond mere physical evidence of illness. The definition opened the door to new options for preventing disease—yet, as a global designation it could hardly address the multitude of factors that define health on national, regional, and local levels.
National and international forums provided activists spaces where they could emphasize that optimal health throughout the life cycle needed to be connected to gender equality in the household and the “public” sphere where political decisions are made. All approaches to health, they confirmed, needed to be placed within the context of gender equality and human rights, including the sharing of family responsibilities, economic development, and a peaceful political setting. In short, health depends on gender equality in social, political and economic relationships—and, in turn, women’s empowerment and their ability to secure gender equality depend on their health as a basic prerequisite.
While global definitions of health have not accounted for much regional and local diversity, they have addressed a number of health issues particularly relevant to women. Reproductive health is one of these issues. At the Conference of Human Rights in Tehran in 1968, the focus on health as a basic human right was made explicit. The conference defined reproductive health as the “complete state of physical, mental and social well-being—not only the absence of disease—on all levels related to the reproductive system and its functioning and processes.”2
At the 1974 World Population Conference in Bucharest, 136 countries approved a World Population Plan of Action (WPPA), stating that “All couples and individuals have the basic right to decide freely and responsibly the number and spacing of their children and to have the information and means to do so.”3 Within these definitions, reproductive rights were explicitly recognized. However, while in theory reproductive rights are defined as the rights of women and men, the reproductive health and rights of women have been disproportionately limited due to a variety of cultural, political and socioeconomic factors.
Health and Gender: Analytical Approaches
Considering gender as a category of historical analysis illuminates the differences between the health challenges women and men may confront in the course of their life cycles. The study of women’s health concerns more than childbirth and reproductive health, and extends beyond biological differences between the sexes. Approaches that treated “Women’s Health” as mainly an obstetrical term relied on an understanding of the female life cycle that wrongly assumed the centrality of reproduction to women’s lives. Fertility does mark women’s lives, but the understanding of women’s health should not be confined to it. Economic status, the nature of the national health system she relies on, as well as a woman’s role in the family or community affect her health. Clearly, the relation between medical, social, cultural, political, and economic issues alike are critical to understanding the varied needs of women.
Historical documents on Latin American life in the 20th century are marked by an absence of women’s voices, and a presence of the more powerful to speak for,—or, on behalf of—women. Our focus on Gender and Health adds an additional challenge to the search for women’s voices in historical documents, as health, for many, is rather personal and not easily discussed in public. The voices that remain absent from public debates on health are often the voices of the least powerful, so one must consider the primary sources in that light.
First, legal debates concerning women’s bodies are an important factor in understanding women’s challenges. Laws and legal decrees passed by mostly male policymakers not only set the legal margins in women’s lives, but also give insights into dominant gender roles. Second, testimonial accounts by women offer very private insights and provide invaluable information about less powerful communities. Third, texts written as fiction provide informative source material. We can learn to read between the lines of poetry and novels to discover women’s views in spaces that are less censored and controlled than the official realm of politics.
From Historical Roots to Contemporary Challenges: Women’s Lives
Contemporary experiences of Latin American women, testimonial accounts, and descriptions of women’s activism illustrate the variety of challenges different groups of women have to confront. Their accounts reveal desperation, anger, poverty, and the inability to control their lives—but they also demonstrate creativity in addressing problems, courage in challenging oppressive and painful systems, and the desire to act and engage in activities that improve their lives. Rural isolation, urban poverty, and the widespread lack of access to political channels and power encourages admirable and surprising ways women find to resist. After all, it is important to keep in mind that the topics of gender and health are closely connected to contemporary real-life experiences, to women who experience the ups and downs of modernity. The study of the historical roots of gender- and health-systems offers learning experiences that can be moved beyond the realm of academics to guide future thought and action.
1Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.
2Definition of Reproductive Health, (New York: World Health Organization, Office at the United Nations, 1994).
3Marsha Freeman, Women's Rights and Reproduction: Capacity and Choice (Minnesota: Humphrey Institute of Public Affairs, 1991), p.2.
Women all over the world may undergo life-course transitions from daugtherhood to motherhood, a great similarity that shapes their lives due to what is perhaps the biological difference that most distinguishes women from men: their childbearing capacity. The circumstances under which women experience transitions, however, vary greatly. Female life histories—and meanings of motherhood—are shaped by multiple factors. Access to education is one of these factors.
The following table presents an overview of case studies gathered in an effort to promote education among women. It introduces information in comparative perspective and sheds light on women’s life cycles in poor sectors of 20th-century Chilean society. Most of the life histories presented here introduce women who have not had a wide range of choices in their lives.
In reading this source, consider the major experiences and factors that have shaped women’s decision-making patters regarding their health and well-being. Similarly, one should reflect on the ability of women to make independent and informed decisions.
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The sources on gender and health in this module allow educators to explore Latin American women’s history from different angles.
On one level, the module introduces characteristics specific to Latin America as a region. It is designed to illustrate the characteristics of women’s lives specifically connected to a Latin American historical trajectory. Women in Latin America, the selections suggest, have a common history that sets them apart from other regions of the world. What are the characteristics of the region that shape women’s experiences? How are colonial experiences, or legacies, related to contemporary structures of everyday life that influence men and women differently?
On a second level, the module is designed to enable students to develop an understanding of the diverse local experiences within the region. Adopting a comparative perspective, educators might compare and contrast women’s lives and gender systems within Latin America. Doing so would remind students that the category of women is not a homogenous category. Consider questions that explore how race, class, age, and geography all shape Latin American women’s lives. They confront a variety of challenges shaped by categories other than gender. Why do indigenous women confront challenges different from those of women who claim European descent? What are the causes of the increased health risks rural Latin American women have faced throughout the 20th century, and what distinguished their lives from those of urban women? How could these differences be overcome when looking for ways to improve the lives and health of all Latin American women?
On another level, the module allows for an exploration of general, structural as well as particular, personal influences on women’s lives. Several sources expose official views and cultural perceptions regarding the “nature” of women and men. Students can find such perceptions, for example, in the language used in legal documents and in news reporting. Others sources should inspire questions regarding women’s views and understandings of the worlds surrounding them. What are the problems women identify in their local experiences? How are their problems (and experiences) shaped by the legal, political, and cultural systems that surround them?
All three levels of analysis might be addressed simultaneously through the following discussion questions.
- How are women’s rights defined or limited in official sources and legal documents?
- What is the underlying understanding of the nature of women that has shaped legal documents?
- How have women attempted to control their own lives and health in these legal, political, and cultural settings?
- To what extent do women’s reactions and different ways of mobilizing confirm that women in Latin America are, indeed, not a homogenous group?
- What factors in women’s lives do we need to consider to understand the options and limitations they confront when addressing their rights and health?
- Which voices are we willing to take more seriously more than others? Why?
Human Rights and Class in Latin America
Three to four 45-minute class periods, depending on reading capabilities of students
After completing this lesson, students will be able to:
- summarize the issues regarding violence and reproduction for Latin American women.
- compare the treatment of women from different socio-economic classes.
- Sufficient copies of the following sources (in this order):
- White/black board and markers/chalk, or overhead, transparencies, and pens (if desired)
- Primary Source Analysis Worksheet: Texts (if desired)
Source 2: Official Document, Women’s Status
Source 9: Interview, Violence Against Women
Source 5: Law, Maternity Leave
Source 4: Newspaper, Domestic Violence
Source 1: Table, Life Histories
Source 3: Committee Hearing, Sterilization
Source 10: Personal Account, Education
- Historical Background/Prior Knowledge:
- Hook:Ask the students to define the term “human rights” as best they can. Ask the students for examples of human rights. Do/should human rights vary by culture, religion, ethnicity, or socio-economic class/status?
- Violence Against Latin American Women: Have the students read Part 2 of Source 2: Official Document, Women’s Status. Are the laws protecting women from domestic violence effective? Why/why not?
Have the students read Source 9: Interview, Violence Against Women. How has SOS Mujer in Uruguay responded to this issue?
Have the students read Source 5: Law, Maternity Leave. How has Cuba responded to this issue? Why do you think Cuba responded differently than Uruguay?
Have the students read Source 4: Newspaper, Domestic Violence. Is the violence against men a response to violence against women or something else? Should the law treat women abusers differently than men?
- Reproductive Issues for Women in Latin America: Have the students read Part 1 of Source 2: Official Document, Women’s Status. Ask why they think there are no accurate statistics for women’s mortality in the countries surveyed. Why are maternal mortality rates so high? Why are abortion mortalities so high? What options do women have? Why is the mortality rate so much lower in the United States?
Have the students read Source 1: Table, Life Histories. What patterns do they see between the six women?
Have the students read Source 3: Committee Hearing, Sterilization. Why would Latin American countries promote sterilization?
- Treatment of Women in Different Socio-economic Classes: Have the students read Source 10: Personal Account, Education. What class issues are evident in this reading? Look at Source 1: Table, Life Histories again. What role does socio-economic class play in domestic violence and reproductive problems? To what extent is education a factor?
- Human Rights Revisited: Have students ponder the following questions:
- Who determines human rights?
- Who has human rights?
- How do you get human rights?
- How are human rights implemented/enforced?
- What happens when different human rights conflict?
- Are human rights absolute?
- Are human rights universal?
- Can you lose human rights?
- Is the right to choose to have children (or not) a human right?
- Does it matter what class the individuals are?
- Should the government have the ability to regulate reproduction to avoid further stress on welfare programs?
- To what extent does religion help dictate existing policy?
Advanced Students: Depending on your students and your comfort and familiarity, discuss China’s one child per family policy, which began in the early 1980s. You might also want to compare it to India’s failed attempts to control population in the 1970s.
Less Advanced Students: Do more of the document investigation either in groups (reading partners/buddies) where the students read the documents to each other and work together to fill out the document analysis sheets, or as a class—reading the documents aloud and filling in the sheets to try to ensure comprehension. To build vocabulary, have the students identify words needing clarification. Assemble a list on the board. Have dictionaries scattered through the room (ideally one per group) for student reference. This could also be done as a group brainstorm.
For the DBQ, have students fill out the Essay Writing Guide Worksheet and evaluate it based on use of evidence and structure before having the students write out the full DBQ.
-Some knowledge of Latin American history and politics from the 1820s to modern day
-Knowledge of the role of religious beliefs, especially those of the Roman Catholic Church
-Some knowledge of Western documents advocating freedoms/liberties like the English Bill of Rights, French Declaration of the Rights of Man, and the Universal Declaration of Human Rights
Document Based Question
Document Based Question (Suggested writing time: 40 minutes)
Directions: The following question is based on the documents included in this module. This question is designed to test your ability to work with and understand historical documents. Write an essay that:
- Has a relevant thesis and supports that thesis with evidence from the documents.
- Uses all or all but one of the documents.
- Analyzes the documents by grouping them in as many appropriate ways as possible. Does not simply summarize the documents individually.
- Takes into account both the sources of the documents and the authors' points of view.
You may refer to relevant historical information not mentioned in the documents.
Question: Discuss whether "traditional" women's roles and views of women are still dominant in Latin America. To what extent does this vary by region, socio-economic class and/or culture?
Be sure to analyze point of view in at least three documents or images.
What additional sources, types of documents, or information would you need to have a more complete view of this topic?
Grateful acknowledgement is made to the following institutions for primary sources:
Center for Reproductive Rights
Comparative Education Review
Latin American Bureau
National Post Company
Organization of American States
About the Author
Jadwiga Mooney is Assistant Professor of History at the University of Arizona. Her teaching and research focuses on Latin America, Gender, and Comparative/Global History, with an emphasis on health and gender equality in the late 20th century. She is currently studying the social politics of fertility regulation in Chile from 1964-1989, and is involved in a project exploring challenges to reproductive rights by comparing and contrasting historical and political circumstances of groups of women in Puerto Rico, Peru, and North Carolina.
About the Lesson Plan Author
Bill Velto is an Upper School History Teacher at Cary Academy in Cary, North Carolina, teaching World History and an elective Terrorism: Modern Political Violence. Prior to that, he taught at James Pace High School in Brownsville, Texas, and Potsdam High School in Potsdam, New York. Bill holds degrees from St. Lawrence University and the University of Texas at Brownsville. He is a Teaching Fellow for the Choices Education Program at the Watson Institute for International Studies and has presented at numerous national conferences on a variety of topics.