African womanhood, Health, Sexuality & Incontinent Bodies: A Case of Kenyan women living with Vaginal Fistulas

Author: Glory Joy Gatwiri

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Gatwiri, Glory Joy, 2017 African womanhood, Health, Sexuality & Incontinent Bodies: A Case of Kenyan women living with Vaginal Fistulas, Flinders University, School of Social and Policy Studies

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The propulsive project of this thesis borrows from a cliché: ‘one picture is worth a thousand words.’ I propose that the thirty stories conveyed in this doctoral research represent many more women who have experienced one of the most profound gender-related health issues but who are given limited space to be heard either inside or outside the refereed scholarly literature. The original contribution of this doctoral thesis seeks to answer the question: How can feminist critical perspectives broaden understandings of Kenyan women’s gender, health, and sexuality using women with vaginal fistulas as a case study? In answering this question, I have demonstrated how the social, cultural, and political constructions of gender, health, and sexuality affect the African womanhood with devastating consequences such as the development of vaginal fistulas. My research explores the theoretical underpinnings of gender inequality, power, and patriarchy, which underpin the discussion on vaginal fistulas and its impact on women and girls. To do this, I activate the critical feminist perspectives to ground the women’s stories in broader explanation thereby culminating the women’s experiences in even greater depth of meaning. The thesis explains why research on vaginal fistulas must incorporate feminist understandings of bodily experience to inform future practice and the knowledge related to the condition. By consulting directly with women affected, I am giving a voice to issues underlined by women who have been constructed as the diseased ‘other.’ A qualitative inquiry employing face-to-face in-depth semi-structured interviews with 30 women was used for data collection. By employing critical and post-colonial perspectives to understand the subjective experiences of Kenyan women living with fistulas, I argue that vaginal fistulae are more than a biomedical condition. Following an African feminist analysis, a thematic approach was used to synthesis the data while utilising both deductive and inductive approches. The data revealed that fistulas are a sociocultural phenomenon solidly tied to poverty, culture, gender inequality, power, patriarchy, and the abjection of Black bodies. In addition, I posit that the imperialistic health policies and systems adopted by Kenya after colonialism can wittingly or otherwise dominate, control and shame women in need of sexual and reproductive health services. Therefore, without challenging the underlying practices that put girls and women at risk of developing vaginal fistulas or challenging the systemic oppression they face, the entire social structure participates in the reproduction of the conditions that give rise to vaginal fistulas. The data shows how Black African women’s bodies are constructed as deviant. This ranking, stratification and marginalization of Black bodies in global maternal health care is crucial to understanding why women in Africa are at risk of developing vaginal fistulas, then having adequate treatment delayed or denied them. I answer the question: Why are African women so disadvantaged in the global dynamics and how does that inequality predispose them to poor health and development of conditions such as fistulas? While I focus on Kenyan women’s experiences, my arguments are also relevant to other post-colonial African nations that practice forced early marriage, premature motherhood, and other harmful practices towards women. Prevention, treatment, community education, decolonization, and social change are the key themes of my recommendations.

Keywords: Vaginal fistulas, African Feminism, African womanhood, leaking bodies, Incontinent bodies, Feminism, Africa, Kenya, Women, Obstetric Fistulas, Gender & health
Subject: Social Administration thesis, Policy and Administration thesis

Thesis type: Doctor of Philosophy
Completed: 2017
School: School of Social and Policy Studies
Supervisor: Prof Tara Brabazon