Where Women Have No Doctor

by A. August Burns, Ronnie Lovich, Jane Maxwell and Katharine Shapiro

Hesperian Foundation

Where Women Have No Doctor, is a health guide for women that has as its audience both lay health care workers and women who need information on their own health care when they can’t easily access modern medicine.

It is written in a lower literacy, easy-to-follow format with multiple illustrations inclusive of many races, body sizes and disabilities. The book often begins chapters with a story or case study, then follows with discussion on the case study and practical approaches to women’s health in this given topic. One such story is Mira’s Story, a 2-page piece about a woman who dies from cervical cancer. The chapter challenges readers to question what caused Mira’s death. Did Mira die because she didn’t know she should get a regular pap smear to detect cervical cancer before it was too late? Or did Mira die because when she first began to feel pain, her husband forbid her to seek medical care, in other words because Mira lacked power because she was a woman? Did Mira die because when she finally did seek medical care, the health worker wasn’t knowledgeable about women’s health problems and sent Mira away with an ineffective cream? Or did Mira die because her husband had genital warts but didn’t know to get treated or how to prevent passing the virus they cause to his sexual partners? Where Women Have No Doctor explores each of these causes in a nonjudgmental manner, respecting women’s cultures and beliefs while at times showing how some of these cultural norms can be psychologically or physically damaging to women.

Other stories in Where Women Have No Doctor talk about women who have made positive changes in their communities. In Zimbabwe, for example, the Musasa Project was created to help women who are victims of violence. Another story, written in the first person, talks about the narrator’s friend who died during child birth and how women in her community worked together to make child birth in their village safer for all. Two other stories talk about a woman and a couple who couldn’t conceive children and how they dealt with this.

Where Women Have No Doctor gives information to women on topics such as: how to decide whether an abortion (legal or not) will be safe, pregnancy and childbirth, sexual assault, infertility, mental health from a community point of view, female circumcision, how to make sure your water supply is not contaminated, and a section on women with disabilities. It has much to offer women in places where there are doctors as well. For example, it has suggestions on how to talk with your partner about safer sex, information on various birth control options, a chapter on sexual harassment, easy to understand material on STDs, and what to expect during a pelvic exam.

This book also has a great deal of pertinent information for health workers. It includes everything from how to give an injection, to various medications and their recommended doses, to how to tell if a fetus is positioned correctly for birth. It also gives clear indications or signs for when a health worker should transport a patient to more highly skilled medical care.

It seems the only notable exception to this books inclusiveness is its omission of talking about lesbianism and homosexuals in general. The topic is touched upon briefly when discussing gender roles in society and how, often, lesbians fall outside of these acceptable roles in many cultures. Discussions on lesbian health and lifestyle are, however, noticeably missing.

But aside from this omission, Where Women Have No Doctor is a wonderful book which can be both read cover to cover or simply kept as a reference tool. Information contained in this book is useful for lay health workers, women in other parts of the world, or women right here in the Bay Area looking for information on their own health or the global health of women and how it can be improved.

Where Women Have No Doctor is published by the Hesperian Foundation, 1919 Addison St., Suite 304, Berkeley, CA 94704, (510) 845-4507. ISBN 0-942364-25-2. 583 pages. $20.00.