Fra(m)menti & Share-Net Netherlands 2022 by Koninklijk Instituut voor de Tropen

FRA(M)MENTI & SHARE-NET NETHERLANDS 2022

from hubs to bubs

linking research policy and practice to critical creativity

ng arch po a rractice ttical creativ

olicy e About: “From Hubs to Bubs: Linking Research, Policy and Practice to Critical Creativity”.

This is a one-issue-only magazine on the 10th Annual Conference by ShareNet on Linking Research, Policy and Practice, an event that traditionally brings together policymakers, practitioners, and researchers working on sexual and reproductive health and rights (SRHR) and gender equality, and women’s empowerment (GEWE) in international development.

The focus lies on the work of young professionals who have recently submitted or are in the process of finishing research as part of a Master’s

program, postgraduate degree, research internship, or research consultancy. The magazine is structured in line with the original conference programme: some young researchers presented on Share-Net country hub contexts (Bangladesh, Ethiopia, Burundi & Burkina Faso, the Netherlands and Colombia) while other international contexts were grouped into three international sessions (Maternal and Menstrual health, SRHR & education and Underexposed perspectives). What we hope to achieve with this magazine is to, first and foremost, highlight the researches and voices of the young researchers who presented their work, but also to transform theory into praxis into what we like to call critical creativity. Academic research and data will be entangled with poetry and illustrations, with photography and prose, with loud slogans and subtle colours liberating the noise and messiness of art whilst maintaining a critical approach to how we can imbue the world with meaning.

vity

Share-Net International Share-Net International is a knowledge platform for Sexual and Reproductive Health and Rights (SRHR). Share-Net has 7 country hubs in Bangladesh, Burkina Faso, Burundi, Colombia, Ethiopia, Jordan, and the Netherlands, and facilitates training, conferences, and events. They also host the Share-Net International Digital Platform: an extensive e-library of SRHR articles,

research papers, and reports, and continuously publish the latest SRHR knowledge from their country hubs and members. Their mission is realized through strengthening links between research, policy, and practice, through knowledge sharing, generating, translating, and promoting the use of knowledge for the development of better policies and practices in SRHR.

Fra(m)menti Fra(m)menti (from the Italian “fragments”, but also “among minds”), is a transfeminist queer artistic collective based in Milan. We operate both online and offline, organizing cultural and educational events that discuss intersectional feminist topics through the lens of artistic practice,

for we believe that to be a unique site for critical creativity. The collective currently counts 9 people, all invested in creating an accessible, care-oriented, safe(r) space where we value pluralism, celebrate differences, practice mutualism and inclusivity, and suspend all judgment.

A moment to position ourselves We want to take a moment to share that Fra(m)menti collective is made up of a majority of European, white, middle-class, young people. Our gazes hold power and they are inevitably distorted by these privileged positionalities we inhabit. In an ideal world where time and money are not constraints, we would have worked on facilitating rather than actively creating content for those regions of the globe that the researchers focus on and that we have very little knowledge of; we would have collaborated more in-depth with artists and cultural troublemakers from those countries, inviting them to do with this space what they will. For now, we have invited local artists to create illustrations and have remunerated their work to the best of our abilities - you will find their work as covers for the various regional sections, prepare to be blown away by their beauty! We would like to hold space for anybody who would like to comment, share, correct or express any concern and we invite you to contact us at frammenti.m@gmail.com

what does it mean?

AYFHS ANC AOR ASRH CMS CSE DHO EBF ED EMR FP GBV GGR HPV HF HW IPV LLH LMIC MHM MMR MYP OOP OV PNLE PPP RMC SDG SDH SP SRHR STI TASH UHC UNSW WPVH WASH

Analysis of Youth-Friendly Health Services National Antenatal Care Adjusted Odds Ratio Adolescent and Sexual Reproductive Health Critical Menstruation Studies Comprehensive Sexual Education District Health Office Exclusive Breastfeeding Emergency Department East Mediterranean Region Family Planning Gender-Based Violence Global Gag Rule Human Papillomavirus Health Financing Health Workers Intimate Partner Violence Life, Love and Health Low and Middle Income Countries Menstrual Health Management Maternal Mortality Rate Meaningful Youth Participation Out-Of-Pocket (Insurance) Obstetric Violence Plan National de Lutte contre l’Excision Public-Private Partnership Respectful Maternal Care Sustainable Development Goal Social Determinants of Health Service Provider Sexual and Reproductive Health and Rights Sexually Transmissible Infections Tikur Anbessa Specialized Hospital Universal Health Coverage Undocumented Nigerian Sex Worker Workplace Violence in Healthcare Water, Sanitation and Hygiene

00 01 Intro ‡ ‡ ‡

About the Zine Fra(m)menti & Share-Net Glossary

Share-Net Netherlands

table of contents

topic keys Pregnancy and Birth Covid and SRHR Mental Health Sexual and Menstrual Health Knowledge Gaps and Recommentations Gender and Sexual Orientation Sex Work Artistic Contribution

NETHERLANDS Moderator: Gaia Zanaboni KIT Royal Tropical Institute/CHOICE for Youth and Sexuality Discussant: Judith Westeng Rutgers

Asylum-seeking women’s perspectives regarding a mental health screening method during pregnancy: a qualitative study

Sex Workers and the Host Gaze - How do sex workers in Amsterdam experience tourism to Amsterdam?

“Since you have a desire to have children, I would advocate freezing” An ethnographic study into the construction of reproductive care paths in a Dutch gender clinic.

You give them a voice: An ethnographic study on pregnancy care interactions among refugees and their healthcare providers in the Netherlands

Bakita Pietrowicz

Elena Soldati (she/her) Rijksuniversiteit Groningen

01 NETHERLANDS

ASYLUM-SEEKING WOMEN’S PERSPECTIVES REGARDING A MENTAL HEALTH SCREENING METHOD DURING PREGNANCY: A QUALITATIVE STUDY

The Mother of all Questions: What is pregnant asylumseekers’ perception on antenatal screening for mental health in the Netherlands? This study aims to identify a suitable and acceptable method to screen for depression, anxiety and posttraumatic stress disorder (PTSD) in pregnant asylum seekers. This is the first study in

Europe that assesses the suitability and acceptability of mental health screening in pregnant asylum seekers from their perspective. Asylum-seeking women would appreciate a mental health screening during pregnancy and think the RHS-15 is an acceptable and suitable method. Further research is necessary for health care providers and policy makers to consider implementing mental health screening for all pregnant asylum seekers.

Pregnant asylum seekers find themsel in an underserved, an disadvantaged situat They find it meaning and acceptable to tal about mental health their midwife or othe health care professio but they would not in a conversation on mental health spontaneously. Presence of an interpreter is important; further research is necessary for implementation.

Recommendations

We conducted semi-structured interviews with pregnant asylum seekers. Before the interview, participants filled out a demographic questionnaire and a mental health screening test, the Refugee Health Screener 15 (RHS-15). During the semi-structured interview, we discussed the acceptability and suitability of the RHS-15 to screen and start a dialogue about PTSD, anxiety and depression. To analyse data, an inductive thematic analysis was performed by two researchers. The interviews took place at the Asylum Seeker Centre of Ter Apel, the Netherlands in the months of November and December 2020.

Eight asylum seeking women participated in the study. The following main themes were identified: ‡ ‡ ‡

Importance of mental health screening Talking about mental health Use of the RHS-15

Pregnant asylum seekers find themselves in an underserved, and disadvantaged situation. They find it meaningful and acceptable to talk about mental health with their midwife or other health care professionals, but they would not initiate a conversation on mental health spontaneously. They would appreciate encouragement in disclosing matters regarding their mental health and help with navigating the Dutch health-care system. Barriers and enablers to talk about mental health included a language barrier, cultural differences, relationship with health care providers and practical barriers. Participants considered the RHS-15 suitable for mental health screening.

COMMON FINDINGS

METHO -DOLOGY

lves nd tion. gful lk with er onals, nitiate

Saidiya V. Hartman

Lose Your Mother: A Journey Along the Atlantic Slave Route “To remember what they had lost and what they became, what had been torn apart and what had come together, the fugitives and refugees and multitudes in flight were called the Sisala, which means ‘to come together, to become together, to weave together.”

Saskia Jacobs (she/her) University of Groningen

02 NETHERLANDS

SEX WORKERS AND THE HOST GAZE HOW DO SEX WORKERS IN AMSTERDAM EXPERIENCE TOURISM TO AMSTERDAM?

The concept of the Host Gaze is understudied within the field of tourism studies

This research seeks to expand on the previous literature on this topic by applying this concept to a population, sex workers, that, to my knowledge, has not been studied before with this concept in mind. To do this, this research investigates how sex workers working in Amsterdam experience tourism to Amsterdam using the concept of the Host Gaze. This concept analyses how tourists are seen by a host community and why they are seen that way.

Methodology:

Power relations between Hosts and Tourists

Expected knowledge of Tourists

Cultural distance between Hosts and Tourists

Original Mind Map by Jacobs, 2021

Using a grounded theory approach, a total of 15 sex workers were interviewed who were engaged in different forms of sex work in Amsterdam or in its suburbs.

Differentiation betweeen Locals and Tourists

Perceived impact of Tourists

Perception of Tourists

Common findings: The main findings were that the participants primarily evaluated tourists by their spending habits, their general attitude towards the sex workers, and how they compared with other locals and tourists from other countries. In particular, the higher spending tourist clients were most appreciated. This economic benefit appeared to be the most important in how tourists were evaluated and appeared to make up for norm violating behaviour. This research further speculates that the presence of tourism also favoured the sex workers in the power relations between them and their clients. Due to tourism, there were more clients in Amsterdam, leading the sex workers to be in a better position to turn down potential clients. They further had to do less emotional labour in finding clients, as there were generally plenty of other potential clients.

Recommen - dations: ‡

‡

Policy efforts aimed at improving the working conditions of sex work should include promotions of tourism. Future research is recommended on the role of language proficiency in how sex workers present themselves to their clients. Further research is also recommended in Bangkok, Thailand, another city with a reputation for sex work and sex tourism, to compare how working conditions influence sex workers their interactions with tourists and clients.

Host Gaze

Interaction with Tourists

Silke Baas (she/her) University of Amsterdam

03 NETHERLANDS

“SINCE YOU HAVE A DESIRE TO HAVE CHILDREN, I WOULD ADVOCATE FREEZING” AN ETHNOGRAPHIC STUDY INTO THE CONSTRUCTION OF REPRODUCTIVE CARE PATHS IN A DUTCH GENDER CLINIC

The Mother of all Questions: How does the gender team construct new reproductive care paths in the transitioning process and how do they navigate the changing legal and social environment that transgender care takes place in? 27

Theoretical Framework; Building on Inhorn & BirenbaumCarmeli’s (2008) conceptualization that ARTs are socio-technical products and access to reproductive care is deeply culturally, politically and economically embedded, this thesis highlights how the complexity of developing new reproductive care paths within transgender care is intensified by the everchanging socio-political context in which trans healthcare takes place.

Ethnographic research in a gender clinic in the Netherlands. Through semistructured interviews with clinicians and observations of fertility counseling sessions with trans people, the tension between future fertility and gender transitions and the implications of this tension for the implementation of fertility-preserving techniques and future access to assisted reproductive technologies (ARTs) was studied.

COMMON FINDINGS

METHO -DOLOGY

Another dimension in complexity is added by the gendered meanings attached to technologies, bodies, reproductive organs, reproductive cells, and their functioning by people going through the transitioning process.

This research suggests that the construction of new reproductive care paths within transgender care in the Netherlands was not only about navigating new possibilities in fertility preservation and assisted reproductive technologies. It was also about coming to terms with a national past of state-mandated sterilizations and negotiating new types of reproductive care, bodies, and families.

In the gender clinic, clinicians attempted to navigate the legal and biomedical possibilities and limitations inherent to reproductive care while working in a heteronormative institutional culture where, until recently, the option for trans parenthood was simply invisible.

Recommen -dations ‡ ‡

‡ ‡

For researchers: We must research and understand the sociocultural environments care is constructed in For clinicians: Creating gender friendly environments within reproductive health clinics and hospitals For educators: Creating more space in education to talk about gender diversity and alternative families Normalization of trans parenthoodand families

Some terminology ‡ ‡ ‡

‡ ‡

Transgender and trans are umbrella terms Not all trans people wish to transition and that is valid This research focuses on a gender clinic that provides medical, social and psychological care to trans people who do choose medical intervention Medical intervention can consist of hormone therapy and genderaffirming operations These interventions can impact future options for genetic parenthood

“

Fertility counselling: a balancing act. Clinicians engage in a balancing act between not wanting to harm their patients... while also feeling a great responsibility to convey the gravity of the choice to (not) secure future reproductive options. 29

Sterre van Ede (she/her) University of Amsterdam

04 NETHERLANDS

YOU GIVE THEM A VOICE: AN ETHNOGRAPHIC STUDY ON PREGNANCY CARE INTERACTIONS AMONG REFUGEES AND THEIR HEALTHCARE PROVIDERS IN THE NETHERLANDS

EGALITE research project from the Erasmus Medical Center in Rotterdam, Netherlands. Reproductive inequity

The Mother of all Questions: How do care interactions shape the pregnancy experience of refugees in the Netherlands?

In recent years, growing research has found that immigrant populations within the Netherlands, namely refugees, have unfavorable birth outcomes compared to Dutch citizens. As a result, there is a growing demand to understand both qualitative and quantitative factors that influence birth outcomes for refugee women.This thesis aims to describe how pregnancy care is experienced by the refugee women themselves, narrowing a major gap in the literature. 31

“…but that they reall feel a chance to ask a the questions they ha and then they ask us because they can fin communicate with someone.” - Roos, Midwife

“Everybody is lookin at me strange” - Hani, Asylum seeker

How do cultural differences come into play? All are pregnant refugees but where do they come from? How did they become pregnant? And how does it all come into play?

Questions/comments V

ly all ave, s nally

METHO -DOLOGY To understand care interactions between Dutch healthcare providers and pregnant refugees, data was collected in nine semi-structured interviews with Dutch midwives, five semi-structured interviews with refugees, four observational days at midwifery practices, and one observational day at an asylum-seeking center. 9 interviews with Dutch Midwives at midwifery practices across the Netherlands 5 interviews with refugees: 3 status holders 2 asylum seekers 4 observation days at midwifery practices and asylum-seekers centers

ng COMMON FINDINGS This thesis highlights the deep significance of communication and trust for pregnant refugees during care interactions. Further, the paper presents that when Dutch midwives cultivate environments with considerate communication and trust for refugees, the quality of pregnancy care is improved.

RECOMMEN -DATIONS It is recommended that the Dutch healthcare system implement support structures for both healthcare providers and pregnant refugees that foster empathetic care interactions to improve birth outcomes in the Netherlands.

Payboy Mees Peijnenburg A photography series on male sex workers “These

conversations

were

very

special. It was a different perspective that I was immediately intrigued by. Many of the guys really wanted to be heard and to share their stories. Some guys were extremely open and proud about it, others would burst into tears as it was the first time they

lots, backyards, parks, cars, you name

had spoken about this to anyone.

it, anywhere. Another ‘rule’ was to

Most of the time there was a level of

portray them bare-chested. I didn’t

reservation in the way they shared

want to do a nude series, but the feel

their story but, at the same time,

of skin gives a physical, visceral feel

it seemed like it was important for

to the pictures. And the last rule, the

them to tell it. So there was such a

most important one to me, was that

duality about this topic which has so

the participants decided themselves

much stigma around it. [...]

which pictures we were going to use.

The participants decided where we

After

would meet, but it had to be a place

where they would be with clients. It

themselves decided which picture

could be anywhere – indoor, outdoor,

they felt comfortable with. It was

quiet places, crowded places, parking

very important to me that everybody

the

shoot,

selection,

would it,

and

make they

agreed, felt good. It was a very collaborative process. It is a very delicate subject matter, I didn’t want to undervalue that.”

Silvia Bocchero

Researches and base texts by Silke Baas Alis Bambara Doreen Birungi Sterre van Ede Ana Margarita Fernández de Castro Peñaranda Ededia Firdawoke Lambert Hakuziyaremye Femke van Heun Arnaud Iradukunda Tonima Trisa Islam Saskia Jacobs Yohannes Keflie Margherita Magoga Yasser Meneses Zepeda Paola Moreno Molly O’Meara Linda Teresa Orcasita Pineda Tahia Rahman Aminat Salami Elizabeth Salazar Niño Putri Widi Saraswati Tewodros Seyoum Rezwana Shahrin Elena Soldati Hipatia Fernanda Vega Lema

With the support of Share-Net Hubs Share-Net Bangladesh Share-Net Burundi Share-Net Burkina Faso Share-Net Ethiopia Share-Net Colombia Share-Net Netherlands and Share-Net International

Original illustrations by Dani Marie Bordignon Silvia Bocchero Matilde Cesareo Francesca Martelli Nuées Nasheen Jahar Nasir Alejandra Posada Bakita Pietrowicz Shaka Kabushemeye Woinshet Goshu

Moderators, discussants and Share-Net focal points Dr. Khadija Khatun (University of Chittagong) Dr. Sanzida Akhter (University of Dhaka) Kishore Basak (RedOrange) Assefa Seme Deresse (Addis Ababa University) Dr. Terefe Degefa (Addis Ababa University) Dr. Meseret Zelalem (Ministry of Health, Ethiopia) Semenhe Fekadu (CORHA) Olivier Makambira (Jimbere) Zalissa Bande (SOS Jeunesses et defis) Reverien Nshimirimana (University of Burundi) Charlotte van Tuijl (KIT Royal Tropical Institute) Pema Lhaki Gaia Zanaboni (KIT Royal Tropical Institute/CHOICE for Youth & Sexuality) Judith Westeng (Rutgers) Hannah Kabelka (KIT Royal Tropical Institute) Arushi Singh (UNESCO Paris) Laura Cala Vergel (Profamilia) Mónica Godoy (UNFPA) Nicole Moran (KIT Royal Tropical Institute) Olgah Namukuza

Editors Matilde Cesareo, Elena Ascione

Art Direction Silvia Bocchero Fra(m)menti team Dani Marie Bordignon, Francesca Martelli, Matilde Cesareo, Elena Ascione, Silvia Bocchero With contributions by Elle Conant, Tatiana Guerra Contacts frammenti-m.com frammenti.mi@gmail.com @frammenti_m

FRA(M)MENTI & SHARE-NET NETHERLANDS 2022