Reproducing Inequities (in Haiti)
Last week in Berkeley, I had the chance to hear Catherine Maternowska speak about her new book, Reproducing Inequities. In the book, she reflects on 12 years of fieldwork in Cité Soleil, Haiti, developing a political economy framework to explain the causes of inequities in reproductive health services in an urban slum of Port-au-Prince. In part, what makes it interesting is that she worked in a very dangerous part of Haiti during tumultuous times. Just last week, two Jordanian UN Peacekeepers were shot dead in Cité Soleil (BBC News).
Related to the concerns of technology, health, and development were her observations regarding clinical studies. At one time in Cité Soleil, 22 simultaneous studies were being conducted, including one for Norplant, a subdermal contraceptive. Here is some info from a Population Research International report on the Norplant study:
USAID has carried out Norplant testing in Cite Soleil, one of the poorest communities in Haiti. Norplant insertions were done without the informed consent of the women concerned. Norplant removals were denied or delayed, even to women who suffered extremely severe side effects such as bleeding extensive enough to cause anemia or paralyzing headaches.
Needless to say that the realities of informed consent on-the-ground were very different than the policy of the foreign managing organizations.