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Feminizing and Queering Public Health and Associated Structures


Written by Kirthi Jayakumar

Following the announcement of a lockdown in India, a mass migration unfolded across the nation. Transport was stopped, inter-state borders threatened to close, and home seemed tremendously far away for many. Resorting to walking frighteningly long distances, carrying ill and sleeping children and all their belongings, several migrants struggled and continue to, to get home. The weight of this move bore heavily on several shoulders even as many collapsed on the way – never making it home, leaving painful last messages on phone calls to their loved ones. Meanwhile, flights ferried people from outside Indian borders, hurriedly and desperately trying to ensure that its citizens on foreign soil were returned home.

A group of migrants are pictured sitting in a group, even as three men in hazmat-like suits hang around – one of them hosing the group of people down with “disinfectant.” You can hear him asking them to close their eyes, and to close the eyes of the children among them. This video came from Bareilly, Uttar Pradesh, in Northern India. Those in charge later claimed to have sprayed them with “chlorine and water and no chemicals,” and argued that this was done as it was “important to sanitise everyone and there was a huge rush as large number of people had returned,” and that they had done what they “thought was best.” There is reason to believe that this is perhaps only one in many batches that may have been sprayed down. Meanwhile, no passenger that walked into the country through its airports were hosed down or disinfected in such a fashion.

Source: Rajesh Balouri / Pixabay


To say that these measures are dehumanizing and disrespectful is stating the obvious. It reflects the structural violence that is repetitively stacked up against people who are marginalized on caste and class backgrounds. Public health measures need to be informed by a feminist, queer affirmative, and intersectional approach (Crenshaw, 1991) with a dedicated focus on the impact of any approach taken. Admittedly, the urgent need of the hour may be to contain a virus, but the burden of “inconvenience” looks different for different people, ranging from the mild discomfort of “not being able to go out” up to facing threatening situations because of structural violence.  

The need for feminist and queer affirmative approaches
Responding to a pandemic is undoubtedly an all-hands-on-deck reality. It calls for authorities to pull all stops and leave no stone unturned in ensuring that communities are not harmed by the spread of a disease. However, these measures lose value regardless of their intent, if their impact turns out to be more – if not equally – devastating.

Viewing public health and economic agenda through a feminist and queer theory lens would call for an interrogation of structures and power dynamics in ways that prioritize empathy and human rights over all else (Herten-Crabb and Davies, 2020). It would call for an examination and interrogation of prevailing power dynamics and relative access to and use of wealth and resources among genders, states, classes, castes, ethnicities, sexualities, ages, able-bodied persons and persons with disabilities, and races, in ways that constructively contribute toward dismantling and dispensing with inequality (Morgan et al., 2018). It would recognize systemic and structural violence that enables and perpetuates disadvantage, discrimination, and marginalization.

A pandemic primarily requires accessible and quality healthcare as a response to affected communities and as a measure to prevent more communities from being affected – these systems are heavily wedded to existing structural narratives of inequalities mentioned above, that also serve as determinants of health (Kickbusch, Allen, and Franz, 2016). This means that the government’s expenditure is not only to be focused on robust health systems, but a range of safeguard that speak to these realities and lived experiences that complicate the experience of a pandemic or the solutions to a pandemic. 

It is imperative, then, to establish disaster and disease outbreak responses well in advance, to acknowledge what lockdowns and isolation can cause for different demographics, and to identify preparedness as a mainstream strategy and not a random, contingent, piecemeal what-if knee jerk response. This is, undoubtedly, difficult for poor countries whose fiscal and revenue regimes are controlled by the IMF and the World Bank. These organizations have raised the banner for gender equality and called for universal health coverage – but when it comes to framing and operationalizing intersectional policies, have fallen more than just short. The dedication to austerity measures and firm prioritization  of the private sector have led to a widening of the gap between the rich and the poor countries and have severely affected the achievement of gender equality and universal health coverage.

Development and public health are inherently human goals to pursue. To prioritize one subsection of humanity – be it on gender, caste, class, ethnicity, nationality, race, color, sexuality, age, ability, or any other identity facet – is to systematically weaponize structures against all those bodies that do not conform to the normative idea of humanity.

References:
Asha Herten-Crabb and Sara E Davies, (2020). "Why WHO needs a feminist economic agenda." The Lancet, 395(10229), p. 1018-1020. 

Ilona Kickbusch, Luke Allen, and Christian Franz. (2016). "The commercial determinants of health." The Lancet Global Health 4(12), e895-e896.

Kimberly Crenshaw, (1991). "Mapping the margins: intersectionality, identity politics, and violence against women of color." Stanford Law Review, 431241

Rosemary Morgan, Richard Mangwi Ayiasi, Debjani Barman, Stephen Buzuzi, Charles Ssemugabo, Nkoli Ezumah, Asha S. George et al. (2018). "Gendered health systems: evidence from low-and middle-income countries." Health research policy and systems 16 (1), 58.