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Author(s): Meredeth Turshen
Review by: Meredeth Turshen
Source:
Journal of Public Health Policy,
Vol. 14, No. 3 (Autumn, 1993), pp. 366-368
Published by: Palgrave Macmillan Journals
Stable URL: http://www.jstor.org/stable/3343047
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366 JOURNAL OF PUBLIC HEALTH POLICY - AUTUMN I993
lic Health Service recommended that Haitian-Americans not donate
blood, and school blood drives openly excluded Haitian adolescents.
Haitian children were beaten in schools and many families were
evicted from their homes. Haitian merchants experienced economic
stringencies because some consumers refused to buy from them. "Even
today, Dr. Farmer concludes, many health professionals have distorted
views about AIDS and Haiti." It is a view which fuels some of the
prejudices against people with black skin.
The single strongest part of this book is its documentation (some-
times in painful detail) of the facts about AIDS in Haiti and the Hai-
tian-United States connection, all within the context of what the
author refers to as the "Western Atlantic System"-a socioeconomic
network centered in North America. This documentation under-
scores the need for the public health and social services communities
to enlarge their frame of analysis of HIV transmission and its many
implications for access to care, adequacy of services, availability of
qualified health personnel, and escalating health care cost.
Dr. Farmer's theme is a magnificent one, illuminating many of the
important connections between Haiti and the United States brought
into sharper focus by the advent of AIDS. He exposes the gnarled and
tenacious roots of problems that are very much with us today.
In summary, AIDS and Accusation is a stirring performance, a tes-
tament to how an individual can be innovative, resourceful, brave,
and achieve a prescribed set of objectives. It is among the books that
one most hopes students of public health and of social and economic
policy will find time to read.
BAILUS WALKER, JR.
Marge Koblinsky, Judith Timyan, and Jill Gay, editors. The Health of
Women: A Global Perspective. Boulder, CO: Westview Press, 1993.
viii+z9I pp. $49.95 cloth, $I6.95 paper.
There are at least three ways to approach the subject of women's
health-by country or other geographical locality, by age group or
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BOOK REVIEWS 367
through the life cycle, and by medical topic or health condition. The
advantage to the geographical approach is that it is potentially the
most historically specific, allowing the author to locate health prob-
lems in time and space, and the least biological, meaning that eco-
nomic, social, and political determinants of ill health can be fully ex-
plored. The advantage of the life-cycle approach, sometimes favored
by anthropologists, is that it includes younger and older age groups
that are too often excluded from discussions of women's health,
which tend to focus on the reproductive years. The advantage of the
topical approach is that it conforms to medical practice and academic
disciplinary divisions, making books organized in this way conve-
nient to adopt as texts in colleges and medical schools.
The volume under review, The Health of Women: A Global Per-
spective, employs the last of these approaches, with some of the
twelve chapters incorporating life-cycle perspectives. This compre-
hensive international overview covers the topics of nutrition, infec-
tion, family planning, abortion, maternal mortality, violence against
women, and mental health, and the administrative questions of ac-
cess, quality, and women-centered care. The inclusion of new or ne-
glected issues, such as violence and mental health, and the emphasis
on women's activism, make this collection especially noteworthy. Ad-
dressing the issue of AIDS in the context of infection, McDermott et
al. put this new health problem in proper perspective among other re-
productive tract infections and other sexually transmitted diseases.
The problems of women's occupational health, treated here as the
health risks of prostitution (pp. I4-i6) and the burdens of the "dou-
ble day" (pp. 5 I-53), deserve broader consideration. Several chapters
conclude with useful recommendations, divided into sections on pol-
icy, programs, and research.
The collection is the product of the I99I conference on women's
health organized by the National Council for International Health, a
U.S.-based nonprofit nongovernmental organization. Two hundred
presenters, 45 speakers, and over i,Ioo participants representing 74
countries attended the conference. Given this wide representation,
one wishes that more than two or three of the twenty-six contribu-
tors to the book came from third world countries. The resulting es-
says might have better reflected their preoccupations. When asked
what they want, third world women attending the conference made
very broad economic, social, and political demands-debt reduction,
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368 JOURNAL OF PUBLIC HEALTH POLICY * AUTUMN I993
capital investment, favorable terms of trade, sustainable strategies
for natural resource use-as well as specific health-related claims for
universal access to contraception, disease control, vaccines, and med-
ical equipment. The authors did a good job of articulating micro-
level medical data with macro-level social concerns, but the larger
economic and political issues were subsumed under the concepts of
poverty and patriarchy, which are the symptoms rather than the causes
of the problems studied.
MEREDETH TURSHEN
Michele McKeegan. Abortion Politics: Mutiny in the Ranks of the
Right. New York: The Free Press, Macmillan, I992. x+227 pp.
$22.95.
In the best of times, when President Clinton has reversed the anti-
choice policies of the Reagan-Bush administrations, and in the worst
of times, when fanatics continue to harass abortion clinics and their
patients, with violence resulting in the shooting death of Dr. David
Gunn, an abortion provider in Florida, Michele McKeegan's Abor-
tion Politics is essential reading for every concerned American.
This compelling and well-researched book is important for two
reasons. First, it provides a fully documented historical account of
how the new-right coalition of conservative politicians, Protestant
fundamentalists, and Catholic Clergy succeeded in making abortion
a political issue, helping to sweep into office two conservative presi-
dents and a conservative Congress and distorting health policy for
more than a decade. Second, in illuminating the philosophy and strate-
gies of the Moral Majority, the National Right to Life Committee,
and other anti-abortion groups, the book provides chilling insights
into the ways in which hard core conservatives, fundamentalists, re-
ligious fanatics, and Catholic authorities can influence national pol-
icy on social issues and, what is even more frightening, undermine
the democratic process.
This book covers the activities of the anti-abortion new right from
I974 to I99I. The author describes how a "dedicated corps of four
right-wingers" set out to raise money and amass mailing lists to fo-
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