Stepping Out: Life and Sexuality in Rural India

What is the biggest obstacle you faced while doing research for this book?

Official silence and a lack of official data. I had to get most of my information from NGOs. When the government talks of reproductive health and sexuality, it sees these issues only from the point of view of obstetrics and gynaecology. There is complete silence on the psychological state of women, and the traumas they face.

Mrinal Pande...opening a window to the life of rural Indian women © R.V.Moorthy

The violence and sexual abuse that women regularly face goes largely unrecorded. We speak of fertility so much, yet there is no word on infertility which so many Indian women suffer from. Women have no understanding of their own bodies, although they need that to control fertility and maintain reproductive health.

What perceptions about sexuality did you encounter?

People speak so little about sexuality because they don't even have the langu-age to do so. We wrote the Kama Sutra but when it comes to discussing sexuality, women do it in a roundabout manner. There is a complete reluctance to discuss matters like abortion. In fact, most women do not want to sound knowledgeable about sexuality since it is seen as a sign of immorality. There is also a deep mistrust of doctors when it comes to matters of sexuality. Contrary to popular perception, I found that men too are extremely shy of discussing matters related to sexuality.

Do you think women in rural areas want smaller families?

Yes, but the problem is that health functionaries are still stuck on targets and ugly sterilisation methods. Women are against terminal fertility control methods because of high infant mortality and also because it gives their husbands a reason to doubt their fidelity. Once the fear of pregnancy is removed, they feel, women will start seeing other men. Yet, women have no access to reversible methods of contraception � only 2 per cent of Indian men use condoms. In any case, most women are too scared to tell their husbands to use condoms.

How can we address the problem of maternity-related illnesses among rural women?

You have no idea how bad the situation is: There's both extreme lack of hygiene, resulting in recurring infections and lack of knowledge about these illnesses. I tell you the greatest pollution we have in India is the pollution of silence and shame. Many women go through their reproductive years in great pain. I met women who had as many as eight children but had no clue about their bodies or how to look after themselves.

Did you find that women have a son preference on their own or are they coerced into it?

A son is sometimes a woman's only chance of acquiring a stake in the family property. In the absence of social security, she often sees him as insurance for old age. She also has the fear of losing her husband if she doesn't produce a son. If these conditions were not there, most women would perhaps opt for a girl child. But as things stand today, a woman has no choice at all.

Do you think more investment in health would help?

Yes it would, but the priority has to be on health insurance for the poor. The government, instead of beefing up the health sector, especially for women, is withdrawing and leaving the field to the private sector. The private sector in health is highly exploitative and does not always offer the best treatment. In fact, government funds go to the private sector in the form of subsidies in return for which it is meant to provide help to the poor. But have you ever seen that happening? The poor are forced to go to the private sector where they are fleeced by quacks. Earlier, the government at least offered some health protection in the form of anti-malaria and TB programmes. All that public health now focuses on is tubectomies. We have been hearing about the cafe-teria approach in reproductive health, but actually what we see is the ration card approach.

This would mean that illegal abortions are increasing.

Yes. This is ironic because in India abortions are legal. It's the lack of healthcare access which forces women to undergo dangerous procedures at the hands of untrained people.

What then is the answer?

A healthcare system which is based on the needs of people and which is localised. Another issue which needs addressing is that our health departments are largely women-free zones. Above all, we need to discuss issues of sexuality and women's health openly. When the mighty are silent, the poor retreat even more.

In which direction should healthcare for women go?

We need to get away from this obsession that unless women are sterilised, the country is sitting on a ticking population time-bomb. We should not keep harping on the glories of our civilisation or how it once worshipped women when we cannot ensure basic dignity for them today.

This interview first appeared in the The Times of India, August 8, 2003. © The Times of India. All rights reserved.

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