Live from MenEngage Rio: How the Privileges of Patriarchy Can Work Against Men

Posted by Eric Ramírez-Ferrero

On day four of the conference, the workshop that clearly stood out for me was, “Gender and Masculinity in Post-Conflict Settings.” In it, we examined experiences of men in war-torn societies, including post-genocide Rwanda, northern Uganda and eastern Congo, East Timor and Gaza.

One speaker used an interesting phrase, “gender against men,” to describe how strict notions of manhood are a liability to those men who fall outside of the limits it sets, men who don’t live up to the expectations inherent in “being a man.”

In post-conflict settings, such men might include those who have been the victims of sexual violence. The speaker from Uganda showed a moving video documenting the experience of one Congolese man (his identity was protected) who candidly described the horror of being held prisoner by the forces fighting in eastern Congo: Over a period of days, he was repeatedly gang-raped by soldiers. Though the physical trauma was beyond daunting, this man also knew that his perpetrators’ intention was to humiliate him, to diminish him, to demonstrate their power over him by putting him “in his place”—as a “woman.”

This sounded disturbingly familiar. We know that, ultimately, rape is about power, even when both the perpetrator and victim are men. As an anthropologist, I also found it fascinating how gender definitions are used to make sense of those who have power and those who don’t. It’s not merely academic - it plays out daily in the most devastating ways: In these and other post-conflict settings, men who aren’t willing to fight—to take up that traditionally “male” role –are feminized and subject to the same reign of terrors as women.

Unfortunately, the humiliation of male victims of sexual violence is further compounded when they seek counseling and care. The limited systems available (in this case United Nations missions) to support survivors of rape are closed to men. Indeed, support workers’ own definition of rape has excluded men as possible victims, and even those who did “get it” conceded that, “We have programs for women at-risk and for those who traumatized by sexual violence, but we have nothing for men.”

The same speaker explained that this is in part a result of what he called “patriarchal feminism” – a one-sided concept wherein only women are vulnerable. He went on to say that this is quite damaging for women, too, because it limits them to the role of victims rather than as agents of change. He seemed to be saying that many efforts to promote women’s equality actually reinforce traditional visions of womanhood and manhood (thus the “patriarchy”).

I agree with the speaker that, inadvertently, some “empowerment” efforts may reinforce rather than change norms. But the term “patriarchal feminism” sounds like plain old patriarchy to me, because there is no doubt that pervasive and age-old ideals of what women and men should be and do really DO oppress women! Yet this workshop made clear that we all need to be more conscientious of and concerned by how the meanings of “manhood” affect men, too. Clearly, they continue to benefit men in power, but they render other men even more vulnerable and sometimes invisible—and in the worst cases, beyond the safety net of services and support.

Live from MenEngage Rio: Overcoming resistance to male involvement in health services

Posted by Eric Ramírez-Ferrero

One of the recurring themes at global symposium is the resistance to male involvement in reproductive and sexual health services that we’ve encountered around the world—resistance among individuals, in communities, and from governments. And it occurred to me yet again that this resistance may be due to simple lack of imagination: When people haven’t “seen” male involvement in practice, it’s hard to fathom what programs for men could look like. What resources are required to get men involved? What expertise is needed to start effective programs? And how would such programs affect current efforts that aim to improve women’s health and lives?

On Wednesday, I attended a training session on “Engaging Men and Boys in Clinic and Social Service Settings” in which we examined the nuts and bolts of programming and started to answer some of these questions.

The training, conducted in part by EngenderHealth’s own Manisha Mehta, started with a great activity where we were each put “in charge” of providing a health service focused on either men, or on couples, and asked to think about what our client, or clients, might need: Would it be counseling, clinical care (such as testing or treatment), health education, or would broader social marketing efforts be best? It got the room thinking about what we can easily offer from means within our reach.

My assignment was: “You are a nurse speaking with a couple in which one person is living with HIV, and the other does not have HIV. They want to know about their options for avoiding pregnancy and transmitting HIV.” (I decided this couple would need both health education and counseling—perhaps slightly more counseling.)

This activity led to enthusiastic conversations and demonstrated a diversity of what male involvement programming can look like, the huge range of services that are possible, that many services can be offered at low or no cost, and—perhaps best of all—that they actually could be integrated alongside existing services for women. In fact, there was a consensus that for reasons of ethics, equity, and sustainability, an integrated approach (rather than offering separate men’s services) really makes the most sense in settings like Tanzania, where there are is already a shortage of health services.

Next, we were divided into groups and given a case study. My group examined why young people in general—those between the ages of 15 and 24—and young men in particular are reluctant to use health services, even when they are designed to be “youth-friendly.”

We also had a larger discussion of why men are reluctant to use services ostensibly designed for them—so-called “male-friendly” services. We cited many reasons, but ultimately it seems like it’s a vicious cycle: Men don’t seek services, so health clinics become geared towards women, which means that they become “women’s” places, and then men won’t go to get care because clinics are “for women.” There’s also the reality that many health clinics aren’t open during hours that men have time to go.

I was lucky that my group included a senior member from Tanzania’s Ministry of Health. We talked very concretely about how CHAMPION and the Ministry could collaborate to provide male- and couple-friendly services. It was so encouraging to see the Ministry representative’s enthusiasm for integrating services—everything from prostrate cancer screenings, to counseling for sexual anxiety and dysfunction, to better vasectomy services, and improved treatment for sexually transmitted infections—as a start!

As importantly, we discussed how we might offer counseling to men—in a site outside of a clinic—that can help them examine and start to change behaviors (like having multiple sexual partners at the same time) that make them more likely to spread HIV.

This conversation cemented a key point of the training workshop: Male-friendly services cannot exist in a vacuum. Instead, they need to be an integral part of a continuum of care for whole families. This is what will make a difference in the lives of men, women and children.

Live from MenEngage Rio: Day Two

Posted by Eric Ramírez-Ferrero

The morning of day two I viewed the Symposium’s photo exhibit entitled, “The World’s Most Influential Men,” which highlights positive male role models for boys (and girls, too!) from 20 countries. Even more than the photos, I was moved by the accompanying captions. In particular, a beautiful portrait of a father and son from Ethiopia was tagged with the quote, “To the world you may be one person, but to one person you may be the world.”

Another photo was a powerful reminder that men’s roles are not limited to fatherhood but span the entire community—from brothers and uncles, to teachers, coaches, to local government leaders: One man’s beliefs and acts really do impact an extended network of people.

At CHAMPION, we had a similar idea. Our formative research revealed that most Tanzanians thought that gender equitable men did not exist. We thought it was critical to show that they did exist, that all over Tanzania there are men working for the health of their families and communities. We created a photo and story calendar of male “champions” from around the nation, and mounted an exhibit at our recent project launch.

The most provocative session of the day for me was the “Dialogue with Women’s Rights Movements,” which began with personal reflections by the speakers about how they came to their work (how have all of us ended up in this room together?) and later turned to recent press coverage of a disturbing trend in Brazil: the high incidence of rape and molestation of young girls and women. Where is the public outrage from men? they asked. There are gender-equitable men in all of our communities, and among our leaders. But where is their leadership at times like this? Where are their voices?

The photos and speakers in this and other sessions affirmed the importance of gender-equitable men speaking out – of our need to both see and hear them: Men who truly believe in the possibility of a transformed world have a responsibility to be visible, and to challenge other men’s sexist and damaging behaviors.

Live from MenEngage Rio: Empty Chairs No More?

Posted by Eric Ramírez-Ferrero

The Global Symposium on Engaging Men and Boys in Achieving Gender Equity kicked off at 6 p.m. on March 30, with leaders of UNICEF, UNAIDS, WHO and UNIFEM among those welcoming participants from more than 70 countries.

The mood was celebratory-the fact that more than 450 of us had gathered for the first global event for activists and practitioners supportive of male involvement was a reason to cheer! But there was also a cautionary tone: let's be realistic.we have a long way to go.

One veteran of the women's rights movement, Kim Bolduc, UN Resident Coordinator for Brazil, offered an image that stuck in my mind: Historically, when women gathered in global forums to act on issues related to gender equity and, ultimately, the well-being of women and families, there were often empty chairs. These empty chairs represented missing men, whose presence and commitment could have profoundly impacted and expedited progress on a range of sexual and reproductive health issues. I found this a mournful and regretful metaphor for opportunities lost.

Nevertheless, a spirit of hope pervaded and the speakers repeatedly lauded the efforts of individuals, organizations and governments for recognizing a basic idea - one which has informed EngenderHealth's own Men As Partners Program for more than 12 years: The beliefs and actions of men are intimately linked to the social well-being and public health of men, women and children.

Here in Rio, the chairs are full. Over the course of this week, the Symposium will examine how positive male involvement can lead to better health, indeed to a better life, for everyone. It's an issue I think about daily, and it reaffirms for me our decision to make CHAMPION about families. Our byline is "Men as facilitators of family health." We are building on men's capacity for leadership to act on behalf of their partners and families-the people who matter to them the most-while working to sensitize them, communities and policy makers that gender equality has health benefits for us all.

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Eric Ramírez-Ferrero was born in New York City in 1963 of Cuban immigrant parents. He was raised in New York and in Enid, Oklahoma. He received his A.B. in biology and anthropology from Bennington College in 1985. His graduate training includes an M.P.H. in population, family and reproductive health from the Bloomberg School of Public Health of Johns Hopkins University, and an A.M. and Ph.D. in anthropology from Stanford University, where he specialized in critical medical anthropology and feminist theory. His doctoral dissertation, Troubled Fields: Men, Emotions and the Crisis in American Farming (Columbia University Press, 2005), is a feminist analysis of men’s health in light of the ongoing economic restructuring of rural communities in the United States. Ramírez-Ferrero has taught at Oklahoma State University and the University of Tulsa. He has worked domestically and internationally in the promotion of reproductive and sexual health for the Area Health Education Centers Program, Planned Parenthood, and Family Health International. He is currently chief of party for EngenderHealth in Tanzania, leading CHAMPION—a project to promote positive male involvement in the prevention of HIV and other adverse reproductive health outcomes. He lives in Dar es Salaam.