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Women’s Knowledge, Women’s Work

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Raising the Dust

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Abstract

In this chapter Jones notes that while there are no strict gender lines in the practice of traditional medicine locally, there are some obvious distinctions. Jones shows that these relate mainly to the expectations of women; as carers, as cultivators and as firewood collectors. Here women must generate a livelihood to sustain themselves and their families. Due to these social roles, women find themselves close to other women and children, they spend many hours engaging in agricultural activities and they are dependent on the local forests. These linked factors put women at the forefront of providing primary health care in the community. This is evident in the way they practice, and for some this means acting as traditional birth attendants. Jones explores these expectations, limitations and opportunities through a number of case narratives.

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Notes

  1. 1.

    MMCT & the Department of Forestry (2012).

  2. 2.

    On returning to the field in 2017, I did find a woman tailor sewing in a small stall in the local market place and she provided me with an efficient and proficient tailoring service by making me two aprons in a short space of time.

  3. 3.

    The term “tuckshop” is used locally to refer to a small stall. This particular stall was near the guesthouse and I passed it every day on my way to and from the Mulanje Boma during fieldwork. I found that the tuck shop had been dismantled when I returned to the field in 2017. Upon speaking with this woman on my return visit, she said ongoing “family problems” had caused her to close her business. Another informant said that it was a common occurrence for businesses to close due to family pressures.

  4. 4.

    In these situations, girls are less likely to remain at school than boys, thereby setting up a cycle of illiteracy, poverty and dependency. Women generally have lower literacy levels than men in Malawi and this is seen to be a determining factor for poor health outcomes (Ministry of Health 2011). The low literacy skills of the interview participants seemed to be consistent with rural trends (Nangoma and Nangoma 2013) rather than gender. There may be some discrepancy between formal education levels and health literacy though. Women can have a good knowledge about traditional health without literacy.

  5. 5.

    On returning to the field in 2017 I met up with this woman and her husband and she explained that her lack of interest was due to property ownership rules, and that she did not want to invest in this shop, which was still trading, because it would never belong to her. She and her husband made a request of me for 750,000 kwatcha (around a thousand US dollars) for her to set up one of her own.

  6. 6.

    During fieldwork, the hardware store owner’s wife had reported that she had begun ovulating again after a number of years of failing to menstruate. When I returned in 2017 she had not conceived another child.

  7. 7.

    Statistics are according to the MMCT & the Department of Forestry (2012).

  8. 8.

    Statistics are according to the MMCT & the Department of Forestry (2012).

  9. 9.

    In spite of these high population figures, the population growth rate for Malawi as a whole has fallen by more than 1 percent from 3.2 in 1994 to 2 percent in 2006 due to the repatriation of refugees from Mozambique and the impact of HIV/AIDS related disease (Malawi Government 2006:1). The rate of growth has since been estimated at 2.3 percent (Ministry of Health 2011). High fertility rate and low contraception rates are seen to be the cause of the steady population rates in spite of these declining factors (Ministry of Health 2011).

  10. 10.

    The Bretton Wood agreement was signed by post World War II western allies in 1944, establishing the American dollar as the global currency, replacing gold, monitored by the World Bank and the International Monetary Fund.

  11. 11.

    The government bans de-registered traditional birth attendants in 2006, prohibiting them from practicing. An informant explained that during former President Bingu wa Mutharika’s term of office there was some talk of officially reinstating traditional birth attendants but these changes had not been implemented and the bans were still in force in 2017.

  12. 12.

    There are slightly more females than males in these areas (National Statistics Office 2008).

  13. 13.

    Bernice did not specify if “they” referred to the hospitals or to local government officials, or if the payment scheme includes the mission hospitals and other private hospitals.

  14. 14.

    These issues are under researched with biomedical obstetrics blaming rapid labour as one of the causes of placenta rupture but there is limited research available (Maliwichi-Nyirenda and Maliwichi 2010a).

  15. 15.

    Bernice did not explain what she meant by her use of this term and she did not say how she made this assessment. I interpreted her use of the phrase to refer to cases of difficult birth or what is referred to as “obstructed labour” (Maliwichi-Nyirenda and Maliwichi 2010a:2610).

  16. 16.

    This information is based on personal communication with researchers at the Blantyre College of Medicine which took place during the course of fieldwork.

  17. 17.

    Margret did not specify the size of her home clinic but the general standard for a home clinic in the area is that it is at least one separate room with a small door and at least one small window.

  18. 18.

    Based on her study in Nepal, Pigg agrees that there is “little scope” (1995:56) for dialogue or exchange of ideas between traditional and medical birth practitioners.

  19. 19.

    In a discussion on retention rates for health professionals in Malawi, Muula and Maseko (2005) identify a variety of biomedical roles. Interview participants interchanged the terms, ‘medical persons’, ‘medical personnel’ and ‘medical professionals’ to describe these same roles.

  20. 20.

    TMPs is a commonly used acronym for traditional medical practitioners.

  21. 21.

    ICCO Cooperation (2012) “Safe Motherhood Communities in Malawi” can be accessed at http://www.icco-international.com/int/searchresults/?searchInputField=safe+motherhood&searchWebsite=true&searchProjects=true&searchDownloads=true.

  22. 22.

    This information came directly from a local researcher.

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  1. Inner Sense Intuitive Counselling Services, Brisbane, QLD, Australia

    Theresa Jones

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Jones, T. (2018). Women’s Knowledge, Women’s Work. In: Raising the Dust. Palgrave Macmillan, Singapore. https://doi.org/10.1007/978-981-10-8420-1_4

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  • DOI: https://doi.org/10.1007/978-981-10-8420-1_4

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