This book presents the collective wisdom of a group of Obstetrician/Gynecologists (OB/GYNs) from around the world brought together at the 2012 meeting of the International Federation of Gynecology and Obstetrics (FIGO) to contribute their ideas and expertise in an effort to reduce maternal and neonatal morbidity and mortality and obstetric fistula in sub Saharan Africa (SSA). The discussions focused on how to increase human capacity in the field of obstetrics and gynecology. The meeting was hosted by the University of Michigan Department of Obstetrics and Gynecology Global Initiatives program and was supported through a grant from the Flora Family Foundation.
Within the pages of this document, the current status of women’s health and OB/GYN training programs in 10 sub-Saharan African countries are described, with a Call to Action and Way Forward to training new OBGYNs in country. These are the words of obstetricians in the field, some who work as lone faculty in fledgling OB/GYN departments. These committed people are charged with the task of not only teaching the next generation, but may be the only OBGYN per 500,000 population or more. Their tireless pursuits are recognized, and their yearning for collegial support is palpable.
Every country should have a cadre of highly trained OB/GYNs to teach the next generation, contribute to policy development and advocate for progressive legislation, conduct the research needed to solve local clinical problems, and contribute to the field of women’s health in general. But most of all, it must be recognized that women across the globe have the right to access a full scope and high quality obstetrical and gynecological care when and where they need it. These pages bring to light successes achieved and shared, and lessons learned that have already spurred new programs and given hope to those eager for a new way forward.
Clifford Trafzer's disturbing new work, Death Stalks the Yakama, examines life, death, and the shockingly high mortality rates that have persisted among the fourteen tribes and bands living on the Yakama Reservation in the state of Washington. The work contains a valuable discussion of Indian beliefs about spirits, traditional causes of death, mourning ceremonies, and memorials. More significant, however, is Trafzer's research into heretofore unused parturition and death records from 1888-1964. In these documents, he discovers critical evidence to demonstrate how and why many reservation people died in "epidemics" of pneumonia, tuberculosis, and heart disease.
Death Stalks the Yakama, takes into account many variables, including age, gender, listed causes of death, residence, and blood quantum. In addition, analyses of fetal and infant mortality rates as well as crude death rates arising from tuberculosis, pneumonia, heart disease, accidents, and other causes are presented. Trafzer argues that Native Americans living on the Yakama Reservation were, in fact, in jeopardy as a result of the "reservation system" itself. Not only did this alien and artificial culture radically alter traditional ways of life, but sanitation methods, housing, hospitals, public education, medicine, and medical personnel affiliated with the reservation system all proved inadequate, and each in its own way contributed significantly to high Yakama death rates.
In Managing Motherhood, Managing Risk, Denise Roth Allen persuasively argues that development interventions in the Third World often have unintended and unacknowledged consequences. Based on twenty-two months of fieldwork in the Shinyanga Region of west central Tanzania, this rich and engaging ethnography of women's fertility-related experiences highlights the processes by which a set of seemingly well-intentioned international maternal health policy recommendations go awry when implemented at the local level.
An exploration of how threats to maternal health have been defined and addressed at the global, national, and local levels, Managing Motherhood, Managing Risk presents two contrasting, and oftentimes competing, definitions of risk: those that form the basis of international recommendations and national maternal health policies and those that do not. The effect that these contrasting definitions of risk have on women's fertility-related experiences at the local level are explored throughout the book.
This study employs an innovative approach to the analysis of maternal health risk, one that situates rural Tanzanian women's fertility-related experiences within a broader historical and sociocultural context. Beginning with an examination of how maternal health risk was defined and addressed during the early years of British colonial rule in Tanganyika and moving to a discussion of an internationally conceived maternal health initiative that was launched on the world stage in the late 1980s, the author explores the similarities in the language used and solutions proposed by health development experts over time.
This set of "official" maternal health risks is then compared to an alternative set of risks that emerge when attention is focused on women's experiences of pregnancy and childbirth at the local level. Although some of these latter risks are often spoken about as deriving from spiritual or supernatural causes, the case studies presented throughout the second half of the book reveal that the concept of risk in the context of pregnancy and childbirth is much more complex, involving the interplay of spiritual, physical, and economic aspects of everyday life.
Death threatens migrants physically during perilous border crossings between Central and North America, but many also experience legal, social, and economic mortality. Rooted in histories of colonialism and conquest, exclusionary policies and practices deliberately take aim at racialized, dispossessed people in transit. Once in the new land, migrants endure a web of systems across every facet of their world—work, home, healthcare, culture, justice—that strips them of their personhood, denies them resources, and creates additional obstacles that deprive them of their ability to live fully.
As laws and policies create ripe conditions for the further extraction of money, resources, and labor power from the dispossessed, the contributors to this vibrant anthology, Migration and Mortality, examine restrictive immigration policies and the broader capitalist systems of exploitation and inequality while highlighting the power of migrants’ collective resistance and resilience.
The case studies in this timely collection explore border deaths, detention economies, asylum seeking, as well as the public health and mental health of migrants. Ultimately, these examples of oppression and survival contribute to understanding broader movements for life and justice in the Americas.
A collection of essays on the medical and social articulation of death, this anthologyconsiders to what extent a subject as elusive as death can be examined. Though it touches us all, we can perceive it only in life—with the predictable result that we treat it either as a clinical or social problem to be managed or as a phenomenon to be studied quantitatively.
This volume goes beyond these models to self-reflexively question how the management of death is organized and motivated and the ways that death is at once feared and embraced. Drawing on the very latest in the medical humanities, Spectacular Death gives us an enlightening new perspective on death from the classical world to the twenty-first century.
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