Women's Health: An Alternative Perspective

Women’s health has become a popular topic over the past year as a result of changing sociopolitical climates which have highlighted this historically underrepresented healthcare sector. However, recent efforts to place importance on the overall wellbeing of this underserved demographic are commonly built on the perspective of the American healthcare system. To truly have an understanding that allows for progress in women’s health, we must take a more global approach; there is a great difference in the term “women’s health” when it comes to women belonging to underserved or marginalized populations in the developing world.

To have an all-encompassing perspective of women’s health requires an understanding of what women belonging to our world’s most underserved populations are experiencing when seeking medical care, an experience not all physicians are routinely exposed to, especially within the United States. Because of this “blind spot” in our collective approach to women’s health, the women who need compassionate health care the most are often overlooked. Locally, the St. Anne’s Free Medical Program is diligently working to correct this in the Worcester region. This group is a shining example of hard-working and dedicated health care providers that go above and beyond the standard to ensure equal health care to those in need. They are committed to serving the under or uninsured patients of the Worcester community with compassion and diligently addressing their often complex social and medical needs, as these patients often arrive with stories that reach into the core of your soul - heartbreaking tales of great traveling, loss of children and families, domestic violence, and perseverance which are otherwise unknown to our community. These patients shoulder the burden of desperation, isolation, and hardship in their everyday lives.

Unlike many patients within the American health care system, women from underserved or uninsured populations have no expectations of medical care. Their inability to receive care makes them victim to withstanding physical conditions that would be intolerable to many of us. This includes undiagnosed ailments that have progressed to critical stages – ailments that would have been detected at an earlier stage with standard health care insurance. I cared for one pregnant patient who traveled alone from Honduras, leaving her family and friends, with no knowledge of English with her hopes relying only on a letter from an unknown sponsor. Another patient was diagnosed with infertility due to premature ovarian failure, with no resources available to her. For patients with stories such as these, receiving necessary medical care is only the beginning of their healing – they require not only a provider’s medical knowledge to address the health care disparities which they have been subjected to, but also human compassion.

In addition to the inequality in women’s healthcare in our own community, I have also experienced a more global perspective on healthcare inequity during my medical missions to the Dominican Republic. After multiple medical missions, I – along with several of my dedicated and talented colleagues – have been able to explore this side of women’s health while serving the impoverished patients of this country. Here, we cared for the underserved female population of the Dominican Republic, as well as the Haitian immigrants occupying the bateyes. “Bateyes” are the villages interspersed in the vast acreage of sugarcane fields where migrant workers from Haiti live and work in harsh conditions; the residents are housed in rudimentary huts without running water, plumbing, or electricity. The women occupying these bateyes face obvious barriers to healthcare but are further burdened with a high prevalence of uterine myomata which make them prone to heavy menstrual bleeding. This can be extremely difficult to manage due to their limited access to health care and disposable hygiene products, as well as the lack of a waste removal system.

Unfortunately, this issue is not localized to the bateyes; globally, many women in developing nations are burdened with similar issues surrounding their menstrual cycles. In some nations, girls are made to sit in “menstrual huts” for the days each month that they have their menses, isolating them from friends and family while also placing them at the disadvantage of missing school and other activities. The solution to these conditions is multi-faceted, but there are organizations such as “Days for Girls” which are dedicated to correcting these clear inequities. “Days for Girls” and their volunteers sew reusable hygiene kits for girls in developing countries, enabling them to remain in school and their daily activities. Their efforts go a long way for the regular occurrence of menses in school age girls, but there is still much to be done for the women who suffer from more severe gynecological health concerns.

Another memorable patient was a young woman in her early twenties, who came to us with a large benign ovarian tumor which made her appear to be approximately 20 weeks pregnant; the tumor’s size was exaggerated even further by her otherwise bone-thin frame. Despite being benign, the tumor’s ramifications on this patient’s life were significant and spanned from not being able to fit into the fashionable tight jeans, to being ostracized from her community because she appeared pregnant and was not married. To remove the cyst took less than an hour of our time and, with minimal effort on our part, her life was transformed.

In our quest to provide for women in our community and abroad, it is important to keep an all-encompassing perspective on “women’s health” that allows for the voices of the underserved to be heard. To treat a woman who otherwise would not have access to healthcare goes beyond the act of a physician assisting a patient. It is the act of one human extending a hand to another, and a true demonstration of human compassion. It is important to realize that we all have the ability to improve the lives of others with what we may consider the smallest and insignificant of actions. To change someone’s life for the better is powerful and deeply fulfilling; it adds value to our own lives.

June R. O’Connor, MDWomen’s Health of Central Massachusettsjune.oconnor@umassmemorial.org