Alyne Silva Pimentel was a 28 year-old Afro-Brazilian woman living in Rio de Janeiro. In her 6th month of pregnancy, on November 16th, 2002, she passed away. Alyne died because both a state clinic and hospital misdiagnosed her symptoms and denied her timely care. It was later concluded that her life could have been saved if she had had access to basic medical attention.
Alyne’s case is not unusual. In Brazil, approximately 98% of maternal deaths are due to avoidable causes. I chose to mention this specific incident is because last month the United Nations Committee on the Elimination of Discrimination Against Women condemned Brazil for Alyne’s death, making it the first case of maternal death to be pursued under International Law.
This case demonstrates that achieving global health is much more than a medical or scientific challenge. It is first and foremost a socio-economic one. Science is continually advancing, allowing medicine to save more lives and to make people healthier. However, these benefits are not accessible to society as a whole. Therefore, in order to achieve global health, it is fundamental that we seek social justice and equality – in its various forms.
Gender inequality is one the biggest challenges to achieve global health –the World Health Organization labeled it ‘unequal, unfair, ineffective and inefficient’. Every day 1500 women die from childbirth or pregnancy-related complications. 99% of these deaths happen in developing countries, showing how socio-economic inequality impacts global health. That`s why gender equality and maternal health are two of the eight United Nations Millennium Development Goals. The international community agreed to reduce maternal mortality by three quarters between the years 1990 and 2015. By 2005, the mortality was only reduced by only 5%. We need to hurry up!
In addition, another one of the Millennium Development Goals, combating HIV and AIDS, has important gender implications. Traditional gender roles prescribe double standards for men and women for sexual health awareness and sexual behavior, sometimes even legitimizing sexual violence against women.
Gender inequality in health is not only a result of biology, but also of traditional gender roles: how girls and boys are educated, how their behavior is supported by norms about masculinity and femininity and how power relations are established among men and women. Health inequality based on gender is also frequently due to a mixture of both biological and social conditions. This means that if the problem is built into social norms, it can be solved through social change.
Brazil - as well as many other states - has the constitutional and international obligation of guaranteeing healthcare to its citizens. Therefore, I will conduct a research into avoidable maternal deaths, to identify who is responsible for them. Where the government is responsible, we will verify what legal measures are taken to hold our representatives accountable, if they are punished or not and how. The results of this research will allow us to urge policy-makers, politicians, lawyers and judges to take specific actions to guarantee this basic human right, through advocacy and policy-suggestions. I invite all of you to join me in this project.
Alyne was part of a more vulnerable social group in Brazil, but we all have to highlight the existing disparities in our nations, so that we can fix them, and promote a more just and equal world – where people’s health and lives are respected, regardless of gender, race or any other biological, cultural or economic differences.
*This was a speech on Global Health delivered at One Young World Summit, in Zürich, Switzerland - Sept. 3rd, 2011.