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Depleting fragile bodies: the political economy of sexual and reproductive health in crisis situations

  • Maria Tanyag (a1)
Abstract

In a crisis-prone world, the number of internally displaced persons (IDPs) uprooted by both armed conflicts and environmental disasters has drastically increased and displacement risks have intensified. Despite the growing attention within global security and development agendas to sexual and reproductive health and rights (SRHR), there remain striking gaps in addressing SRHR in crisis situations, particularly among IDP women and girls. This article examines the continuum between social reproduction in times of crisis and the material and ideological conditions that restrict women’s bodily autonomy in everyday life. Using the case of the Philippines where millions of people are routinely affected by conflict and disaster-induced displacements, it argues that the failure to recognise the centrality of women’s health and bodily autonomy not only hinders the sustainable provision of care and domestic labour during and after crisis, but also fundamentally constrains how security is enacted within these spaces. Thus, the article highlights an urgent need to rethink the gendered political economy of crisis responses as a building block for stemming gendered violence and depletion of social reproductive labour at the household, state, and global levels.

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Corresponding author
*Correspondence to: Maria Tanyag, Monash University, School of Social Sciences, 20 Chancellor’s Walk, Clayton, VIC 3800, Australia. Author’s email: Maria.Tanyag@monash.edu
References
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6 UNFPA, The State of the World Population 2015, p. 5.

7 See, for example, Petchesky, Rosalind, ‘Editorial: Conflict and crisis settings: Promoting sexual and reproductive rights’, Reproductive Health Matters, 16:31 (2008), pp. 49 ; Urdal, Henrik and Primus Che, Chi, ‘War and gender inequalities in health: the impact of armed conflict on fertility and maternal mortality’, International Interactions, 39:4 (2013), pp. 489510 ; Davies, Sara, ‘Healthy populations, political stability, and regime type: Southeast Asia as a case study’, Review of International Studies, 40:5 (2014), pp. 859876 ; Davies, Sara E. and True, Jacqui, ‘Reframing conflict-related sexual and gender-based violence: Bringing gender analysis back in’, Security Dialogue, 46:6 (2015), pp. 495512 .

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9 Patel, Preeti, Roberts, Bayard, Guy, Samantha et al., ‘Tracking official development assistance for reproductive health in conflict-affected countries’, PLoS Med, 6:6 (2009), e1000090, available at: {doi:10.1371/journal.pmed.1000090}.

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11 Tanyag, Maria, ‘Invisible labor, invisible bodies: How the global political economy affects reproductive freedom in the Philippines’, International Feminist Journal of Politics, 19:1 (2017), pp. 3954 .

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19 Elias, Juanita and Rai, Shirin, ‘The everyday gendered political economy of violence’, Politics & Gender, 11:2 (2015), p. 428 .

20 Rai, Hoskyns, and Thomas, ‘Depletion’, p. 87.

21 True, Jacqui and Tanyag, Maria, ‘Global violence and security from a gendered perspective’, in Anthony Burke and Rita Parker (eds), Global Insecurity: Futures of Global Chaos and Governance (Canberra: Palgrave, 2017), pp. 4363 .

22 Sjoberg, Laura, Hudson, Heidi, and Weber, Cynthia, ‘Gender and crisis in global politics: Introduction’, International Feminist Journal of Politics, 17:4 (2015), p. 530 .

23 Urdal and Che, ‘War and gender inequalities in health’; Harman, ‘Ebola, gender and conspicuously invisible women in global health governance’; Robinson, The Ethics of Care.

24 Centre for Reproductive Rights, Hidden Casualties: Sexual and Reproductive Health and Rights and Sexual Violence in Conflict (2016), available at: {https://www.reproductiverights.org/document/hidden-casualties-sexual-and-reproductive-health-and-rights-and-sexual-violence-in-conflict} accessed 4 November 2017.

25 Harman, ‘Ebola, gender and conspicuously invisible women in global health governance’.

26 Benatar, Solomon, Gill, Stephen, and Bakker, Isabella, ‘Global health and the global economic crisis’, American Journal of Public Health, 101:4 (2011), pp. 646653 .

27 Ibid., p. 532.

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29 Nunes, ‘Questioning health security’, p. 957.

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31 Camilla Schippa, ‘War Costs us $13.6 Trillion: So Why Do We Spend so Little on Peace?’, World Economic Forum (8 June 2016), available at: {https://www.weforum.org/agenda/2016/06/the-world-continues-to-spend-enormous-amounts-on-violence-and-little-on-building-peace/} accessed 4 November 2017; Corps, Mercy, An Ounce of Prevention: Why Increasing Investment in Conflict Prevention is Worth More than a ‘Pound of Cure’ in Addressing the Displacement Crisis (Oregon: Mercy Corps, 2016).

32 Organisation for Economic Co-operation and Development (OECD), States of Fragility 2016 (Paris: OECD Publishing, 2016), pp. 26, 131 .

33 Stockholm International Peace Research Institute (SIPRI), ‘Trends in World Military

Expenditure, 2015’, SIPRI Fact Sheet (2016), p. 3, available at: {https://www.sipri.org/sites/default/files/EMBARGO%20FS1604%20Milex%202015.pdf} accessed 4 November 2017.

34 Urdal and Che, ‘War and gender inequalities in health’, p. 492.

35 Petchesky, ‘Editorial: Conflict and crisis settings’.

36 UN Women, Preventing Conflict, Transforming Justice, Securing the Peace.

37 Ibid., p. 78.

38 Fonn, Sharon and Sundari Ravindran, T. K., ‘The macroeconomic environment and sexual and reproductive health: a review of trends over the last 30 years’, Reproductive Health Matters, 19:38 (2011), pp. 1125 ; Benatar, Gill, and Bakker, ‘Global health and the global economic crisis’.

39 The Global Gag Rule (known formally as the Mexico City Policy) refers to the US policy that places limits on US aid distribution by excluding overseas NGOs that perform or promote abortion and related services, such as public information campaigns and lobbying. For further discussions, see Gezinski, Lindsay, ‘The Global Gag Rule: Impacts of conservative ideology on women’s health’, International Social Work, 55:6 (2012), pp. 837849 .

40 See, for example, the official statement from UNFPA, Statement by UNFPA on U.S. Decision to Withhold Funding (4 April 2017), available at: {http://www.unfpa.org/press/statement-unfpa-us-decision-withhold-funding} accessed 4 November 2017.

41 UN General Assembly (UNGA), A/68/297, Report of the Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health, 68th session (9 August 2013); UNGA, A/HRC/32/23, Report of the Office of the United Nations High Commissioner for Human Rights (Analytical Study on the Relationship between Climate Change and the Human Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health), 32nd session (6 May 2016).

42 UNFPA, The State of the World Population 2015; UNGA, Report of the Office of the United Nations High Commissioner for Human Rights.

43 See, for a brief overview on the WPS agenda, Laura Shepherd, ‘Advancing the Women, Peace and Security Agenda: 2015 and Beyond’, Norwegian Peacebuilding Resource Centre Expert Analysis (28 August 2014), available at: {http://www.peacebuilding.no/Themes/Inclusivity-and-gender/Publications/Advancing-the-Women-Peace-and-Security-agenda-2015-and-beyond} accessed 4 November 2017.

44 UN Security Council, S/RES/2122, Resolution 2122 (2013), 7044th meeting (18 October 2013).

45 True and Tanyag, ‘Global violence and security from a gendered perspective’, p. 52.

46 Shepherd, ‘Advancing the Women, Peace and Security Agenda: 2015 and Beyond’.

47 Asian-Pacific Resource and Research Centre for Women (ARROW), Zika: A Perfect Storm of Climate Change, Disease, and SRHR (3 February 2016), available at: {http://arrow.org.my/zika-a-perfect-storm-of-climate-change-disease-and-srhr/} accessed 4 November 2017.

48 Human Rights Watch, Dispatches: Zika Warnings Versus Realities Women Face (26 January 2016), available at: {https://www.hrw.org/news/2016/01/26/dispatches-zika-warnings-versus-realities-women-face} accessed 4 November 2017.

49 Vatican Radio, Card. Tagle: ‘Humanitarian Summit to Promote Trust in Religious Organisations (20 May 2016), available at: {http://en.radiovaticana.va/news/2016/05/20/card_tagle_%E2%80%98humanitarian_summit_to_promote_trust/1231204} accessed 4 November 2017. The special session was called ‘Religious Engagement: The Contributions of Faith Communities to our Shared Humanity’. A summary of the session is available at: {http://reliefweb.int/sites/reliefweb.int/files/resources/Religious%20Engagement.pdf}.

50 Association for Women’s Rights in Development (AWID), The Devil is in the Details: At the Nexus of Development, Women’s Rights, and Religious Fundamentalisms (Toronto and Mexico: AWID, 2016), p. 27, available at: {https://www.awid.org/sites/default/files/atoms/files/final_web_the_devil_is_in_the_details.pdf }.

51 Oxfam, Leaving No One Behind: LGBT Rights Post-Haiyan (Quezon City: Oxfam in the Philippines, 2016).

52 Lind, Amy, ‘Governing intimacy, struggling for sexual rights: Challenging heteronormativity in the global development industry’, Development, 52:1 (2009), pp. 3442 ; Lind, Amy, ‘Development, global governance, and sexual subjectivities’, in Amy Lind and Suzanne L. Bergeron (eds), Development, Sexual Rights and Global Governance (London and New York: Routledge, 2010), pp. 120 .

53 Jolly, Susie, ‘Why the development industry should get over its obsession with bad sex and start to think about pleasure’, in Lind and Bergeron (eds), Development, Sexual Rights and Global Governance, p. 25 .

54 Bujra, Janet, ‘AIDS as a crisis in social reproduction’, Review of African Political Economy, 31:102 (2004), pp. 631638 ; Kunz, Rahel, ‘The crisis of social reproduction in rural Mexico: Challenging the “re-privatization of social reproduction” thesis’, Review of International Political Economy, 17:5 (2010), pp. 913945 ; Elson, ‘Social reproduction in the global crisis’.

55 Peterson, V. Spike, ‘How (the meaning of) gender matters in political economy’, New Political Economy, 10:4 (2005), pp. 499521 ; Brickell, Katherine and Chant, Sylvia, ‘“The unbearable heaviness of being”: Reflections on female altruism in Cambodia, Philippines, The Gambia and Costa Rica’, Progress in Development Studies, 10:2 (2010), pp. 145159 .

56 See Sassen, Saskia, ‘Women’s burden: Counter-geographies of globalization and the feminization of survival’, Journal of International Affairs, 53:2 (2000), pp. 503524 .

57 Internal Displacement Monitoring Centre (IDMC), Disaster-Related Displacement Risk: Measuring the Risk and Addressing its Drivers (Geneva: IDMC, 2015), p. 23, available at: {http://www.internal-displacement.org/assets/publications/2015/20150312-global-disaster-related-displacement-risk-en.pdf }.

58 See Philippine Statistics Authority, 2015 Survey on Overseas Filipino (2016), available at: {https://psa.gov.ph/content/statistical-tables-overseas-contract-workers-ocw-2015} accessed 4 November 2017.

59 Philippine Statistics Authority, 2015 Survey on Overseas Filipino.

60 OECD, States of Fragility 2016, p. 17.

61 The Global Gender Gap Index ‘is designed to measure gender-based gaps in access to resources and opportunities in countries rather than the actual levels of the available resources and opportunities in those countries’. It is measured based on four subindexes: Economic Participation and Opportunity; Educational Attainment; Health and Survival; and Political Empowerment. For full notes on methodology, see World Economic Forum (WEF), The Global Gender Gap Report 2016 (Geneva: WEF, 2016), p. 4 .

62 WHO, UNICEF, UNFPA, World Bank Group, and United Nations Population Division Maternal Mortality Estimation Inter-Agency Group, Trends in Maternal Mortality: 1990 to 2015 Executive Summary (Geneva: WHO, 2015), available at: {http://www.who.int/reproductivehealth/publications/monitoring/maternal-mortality-2015/en/ }.

63 Philippine National Statistics Office (NSO), Final Results from the 2013 National Demographic and Health Survey (NDHS) (2014), available at: {https://psa.gov.ph/content/one-ten-young-filipino-women-age-15-19-already-mother-or-pregnant-first-child-final-results} accessed 4 November 2017.

64 SIGI is a composite of scores from five dimensions: discriminatory family code, restricted physical integrity, son bias, restricted resources and assets, and restricted civil liberties.

According to OECD, ‘discriminatory social institutions perpetuate gender gaps in development areas, such as education, employment and health, and hinder progress towards rights-based social transformation that benefits both women and men’. See OECD, Social Institutions and Gender Index, available at:{http://www.genderindex.org/}.

65 OECD, Social Institutions and Gender Index Synthesis Report 2014 (OECD, 2014), p. 9 , available at: {https://www.oecd.org/dev/development-gender/BrochureSIGI2015-web.pdf}.

66 Davies, True, and Tanyag, ‘How women’s silence secures the peace’.

67 Ehrenreich, Barbara and Hochschild, Arlie, Global Woman: Nannies, Maids and Sex Workers in the New Economy (London: Metropolitan Books, 2003); Yeates, Nicola, Globalizing Care Economies and Migrant Workers: Explorations in Global Care Chains (New York: Palgrave Macmillan, 2009); Dumitru, Speranta, ‘From “brain drain” to “care drain”: Women’s labor migration, methodological sexism and care devaluation’, Women’s Studies International Forum, 47 (2014), pp. 203212 .

68 See, for example, Blaine Harden, ‘In rural Philippines, a dearth of doctors’, Washington Post Foreign Service (20 September 2008), available at: {http://www.washingtonpost.com/wp-dyn/content/article/2008/09/19/AR2008091903678.html} accessed 4 November 2017.

69 WHO, ‘Achieving the Health-Related MDGs: It Takes a Workforce!’, available at: {http://www.who.int/hrh/workforce_mdgs/en} accessed 4 November 2017.

70 WHO, ‘Density of Physicians (Total Number per 1000 Population, Latest Available Year’, available at: {http://www.who.int/gho/health_workforce/physicians_density_text/en/} accessed 4 November 2017.

71 Twenty-eight-year-old female quoted in Daguino, Dolores and Gomez, Norma, Reproductive Health Among the Internally Displaced Persons (IDPs) in Pikit, Cotabato (Davao City: Mindanao Working Group, 2010), pp. 28, 34 .

72 Regine Cabato, ‘DOH secretary: Philippines lacks 15,000 doctors’, CNN Philippines (13 October 2016), available at: {http://cnnphilippines.com/news/2016/10/13/department-of-health-lack-of-doctors.html} accessed 4 November 2017.

73 Benatar, Gill, and Bakker, ‘Global health and the global economic crisis’, p. 647.

74 All reports are accessible through the Human Development Network: {http://www.hdn.org.ph}.

75 Philippine Statistics Authority, 2015 Survey on Overseas Filipino.

76 The reported cases are registered in the report as under RA 9208, ‘Anti-Trafficking in Persons Act of 2003’.

77 Benatar, Gill, and Bakker, ‘Global health and the global economic crisis’.

78 UN Office for the Coordination of Humanitarian Affairs (UN OCHA), ‘Philippines: Typhoon Haiyan – November 2013: Total Funding per Donor as of 17 August 2015’, Financial Tracking Service (2015), available at: {https://fts.unocha.org/appeals/441/summary}.

79 See, for example, Elias, Juanita, ‘Women workers and labour standards: the problem of “human rights”’, Review of International Studies, 33:1 (2007), pp. 4557 ; Chin, Christine, In Service and Servitude: Foreign Female Domestic Worker and the Malaysian ‘Modernity’ Project (New York: Columbia University Press, 1998).

80 The exact quote was ‘They might as well bring with them ‘yung pills wherever they go para di kayo mabuntis … otherwise pagdating dito manganak diyan sa toilet.’ This translates to English as: ‘They might as well bring with them [birth control] pills wherever they go so they don’t get pregnant … otherwise when they return they would give birth in a toilet [read: in secret; also implying self-induced abortion].’ See ‘Duterte Admits to Being a Flirt’, GMA News (31 March 2017), available at: {http://www.gmanetwork.com/news/news/nation/605454/duterte-admits-to-being-a-flirt/story/} accessed 4 November 2017.

81 Tanyag, ‘Invisible labor, invisible bodies’.

82 Oxfam, Women after the Storm: Gender Issues in Yolanda Recovery and Rehabilitation (Quezon City: Oxfam, 2015), p. 35.

83 UN Women, Preventing Conflict, Transforming Justice, Securing the Peace, p. 241.

84 Also known as Republic Act 9729. The full text is available at: {http://www.ifrc.org/docs/IDRL/RA209729.pdf}.

85 Also known as Republic Act 10121. The full text is available at: {http://www.ndrrmc.gov.ph/attachments/045_RA%2010121.pdf}.

86 Davies, Sara, Elbe, Stefan, Howell, Alison, and McInnes, Colin, ‘Global health in international relations: Editors’ introduction’, Review of International Studies, 40:5 (2014), pp. 825834 ; Davies, ‘Healthy populations, political stability, and regime type’.

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