The Mango Rains Will Only Come When Women’s Health is a Nation-State’s Priority

Monique and the Mango Rains is a beautifully written true story of courage in the face of overwhelming odds and the power of women from vastly different cultures banding together to change the world. The book interweaves multiple themes including friendship, family, and acceptance of cultural differences. Two additional themes stuck with me throughout the entire book and one cannot be examined without the other: 1) the oppression of women under a patriarchal society and 2) public health, or “the science of protecting and improving the health of people and their communities” (CDC Foundation, 2019).

The book’s author, Kris Holloway, is a white woman from the United States of America who volunteers for the Peace Corps. While spending time in a small village in Mali, a country on the African continent, she ends up befriending a young woman Monique Dembele who serves as her village’s default midwife. In Monique’s culture, women are seen as of little importance and treated as second class citizens in many regards much to the detriment to their health and wellbeing; and the same can be said of women in many western countries such as the United States of America.

Mali is a landlocked country in Western Africa and is home to more than 18 million people. Mali faces a tremendous amount of public health challenges that can be traced to lack of proper nutrition, poverty, insufficient hygiene, and poor sanitation. Life expectancy at birth is estimated to be almost 58 years in 2016 (Countryeconomy.com, n.d.). According to the United Nations Human Development Reports (2019), in 2017, Mali ranked 182^nd out of 189 countries in gender inequality. This is proven to be true in Mali where 71 percent of all marriages are child marriages (where the woman is under the age of 18 at marriage); and “studies show that girls who give birth before the age of 15 are 5 times more likely to die in childbirth than women in their twenties” (unicef, n.d.). As of 2015, maternal mortality ratio for Mali was 587 deaths per 100,000 live births (Knoema, 2018).

As of 2016, the United States of America’s maternal mortality rate was on the rise at 26.4 deaths per 100,000 and causes for these deaths include: doctors entering maternal-fetal medicine being allowed to practice without ever spending time in a labor-delivery unit, 6% of federal and state funding for maternal and child health actually going to the mother, and hospitals being woefully underprepared for a fetal emergency (Martin & Montagne, 2017). While on the surface the causes of maternal mortality in the United States of America are much different than those of Mali’s; the fact that Mali has such a high rate of maternal mortality and the United States of America’s maternal mortality rate being on the rise while it is on the decline in other Western nations shows that both nations do not prioritize women and women’s health nearly as much as they need to.

 In Chapter 3 of Monique and the Mango Rains, a woman named Korotun is severely beaten numerous times by her husband. She believes that if she bears him a child then he will not be angry with her. Sadly, Korotun has no means to protect herself from the domestic violence she is suffering at the hands of her husband. In Mali, 35% of women will have experienced physical or sexual intimate partner violence, 27% of the woman population will have experienced this violence within the past 12 months, and a staggering 83% of women will have undergone genital mutilation and cutting (UN Women, 2016). Though the rights of women are said to be defended in the Malian constitution, women are discriminated against in a multitude of ways by provisions in legislation; some of which inherently give a woman no recourse should she be attacked, abused, or even raped by her husband. A polygamous marriage is the decision of the husband and not the wife, the minimum age to marry for women is 15, if a husband and wife divorce then the woman is required to repay to her husband the dowry her family received, and worst of all wives are obligated to obey their husbands (OMCT World Organisation Against Torture, 2003).

In the United States of America, a country with a population of more than 327 million, more than 22 percent of women have experienced severe physical violence at the hands of an intimate partner and nearly one-third have experienced domestic violence, yet slightly more than one-quarter of the female abuse victims seek help from a mental health professional—even though studies have shown abuse can lead to posttraumatic stress disorder among the loss of other temporary or permanent cognitive functions (Hayes, VanElzakker, & Shin, 2012)—and many do not report their abuse at all (Izadi, 2014). How could these statistics be accurate in a “developed” country such as the United States of America? Even in Chapter 3 of Monique and the Mango Rains, Monique can hardly believe that domestic abuse happens in a place like the U.S.

In 1994, the Violence Against Women Act was finally passed as a piece of federal legislation that earmarked $1.6 billion to address issues of violence against women; however, “it took an additional year to force the New Gingrich-led Congress to release the funding” (National Organization for Women, 2019). The safety and health and wellbeing of women was not seen as a necessity or a human right but rather as a pawn in a political game of chess. Additionally, according to the ACLU (2019), some landlords have chosen to evict survivors based on noise or property damage by the abuser even though the abuser did not live in the home, some cities pressure landlords to evict tenants in cases of domestic violence, and some employees have been fired when needing to take time off to go to court for an order of protection against their abuser.

If I were a domestic abuse victim—76 percent of whom are women (Truman & Morgan, 2014)—why would I report my abuse if I were faced with the threat of joblessness or homelessness—the deck seemingly stacked against me? The United States of America though quite different from Mali still has a great deal of issues in properly handling cases and caring for women who are victims of intimate partner violence. Both countries show a lack of respect and care for the health and safety of a woman—again, showing that each country views its women, in part, as second-class citizens. 

In Chapter 5, a woman Oumou does not want to get pregnant after losing four children in childbirth. However, her husband does not care and refuses to use a condom. He also forbids her to take birth control pills and has to obtain them and take them in secret. This is sad and unfortunate. Oumou’s health is at risk yet she is subject to the whim and will of her husband because according to Malian legislation, women are to obey their husbands no matter what. While not officially legislated, this is not all that different from the mindset of many legislators and citizens in the United States of America.

In 2016, the state of Ohio passed what is known as a “heartbeat law,” which prohibits “any person from knowingly and purposefully performing or inducing an abortion on a pregnant patient with the specific intent of causing or abetting the termination of the life of the ‘unborn human individual’ the pregnant patient was carrying and whose fetal heartbeat had been detected. The bill did not include an exception for cases of rape or incest” (Rewire.News, 2019). In 2019, “15 states introduced heartbeat hills that that would ban abortions after six weeks: Georgia, Illinois, Florida, Kentucky, Louisiana, Maryland, Minnesota, Missouri, New York, South Carolina, Tennessee, Texas, West Virginia, and Mississippi and Ohio, where the bills were signed into law, (Corbett, 2019).” Sadly, the life of the mother nor the life of the child are taken into account in any of these laws. If the mother is at risk to lose her life during the pregnancy, technically by law she must still go through with childbirth. And if the child is at risk for a severe disease that will prevent the child from having any quality of life (including the child forever being in a vegetative state), the child must still be delivered to term.

In Monique and the Mango Rains, the author Kris Holloway does a fantastic job of presenting the reader with information in an unbiased manner, which allows the reader to glean a lesson from the text on their own without it being force fed to them. I do feel that Holloway has, in part, written this book as a means to present the impact of Malian economic, cultural, and social policy norms on the health and wellbeing of women. Though the United States of America is in many ways culturally different and has created many economic and social policies in contrast with Mali; Monique and the Mango Rains presents us with lessons that can directly apply to women in the United States of America. Women’s health is not always seen as a priority and we need to introduce social norms and awareness campaigns on how to protect women who are victims of intimate partner violence and create legislative policy to back these norms and campaigns. Additionally, we in the United States of America need to place a higher priority on women’s health before, during, and after the process of child birth and properly train physicians and put policies in place, whether they be local or national, to ensure quality of care. 

References

• ACLU. (2019). Discrimination Against Survivors of Domestic and Sexual Violence. Retrieved from https://action.aclu.org/legal-intake/discrimination-against-survivors-domestic-and-sexual-violence
• CDC Foundation (2019). What is public health? [p.1]. Retrieved from www.cdcfoundation.org/what-public-health
• Corbett, E. (2019). 21 Abortion Restrictions Have Already Been Enacted in 2019. More Are Coming. Fortune. Retrieved from http://fortune.com/2019/04/23/new-abortion-laws-2019
• Countryeconomy.com. (n.d.). Life expectancy improves in Mali. [p.1] Retrieved from https://countryeconomy.com/demography/life-expectancy/mali
• Hayes, J., VanElzakker, M., & Shin, L.M. (2012). Emotion and cognition interactions in PTSD: a review of neurocognitive and neuroimaging studies. Frontiers in Integrative Neuroscience. 6: 89. Retrieved from www.ncbi.nlm.nih.gov/pmc/articles/PMC3466464/
• Izadi, E. (2014). Nearly a third of U.S. women have experienced domestic violence. The Washington Post. Retrieved from www.washingtonpost.com/news/post-nation/wp/2014/09/08/nearly-a-third-of-u-s-women-have-experienced-domestic-violence/?utm_term=.3a75a4264b11
• Knoema. (2018). Mali – Maternity mortality ratio. Retrieved from https://knoema.com/atlas/Mali/Maternal-mortality-ratio
• Martin, N. & Montagne, R. (2017). U.S. Has the Worst Rate of Maternal Deaths in the Developed World. Retrieved from www.npr.org/2017/05/12/528098789/u-s-has-the-worst-rate-of-maternal-deaths-in-the-developed-world
• National Organization for Women. (2019). Violence Against Women in the United States: Statistics. Retrieved from https://now.org/resource/violence-against-women-in-the-united-states-statistic/#endref14
• OMCT World Organisation Against Torture. (2003). Violence against Women in Mali A Report to the Human Rights Committee. Retrieved from www.omct.org/files/2004/07/2409/eng_2003_07_mali.pdf
• Rewire.News. (2019). Heartbeat Bans. Retrieved from https://rewire.news/legislative-tracker/law-topic/heartbeat-bans/
• Truman, J.L., & Morgan, R.E. (2014). Nonfatal Domestic Violence, 2003–2012. U.S. Department of JusticeOffice of Justice Programs Bureau of Justice Statistics. Retrieved from https://www.bjs.gov/content/pub/pdf/ndv0312.pdf
• Unicef. (n.d.). Child Marriage is a Death Sentence for Many Young Girls. Retrieved from www.unicef.org/sowc09/docs/SOWC09-CountryExample-Mali.pdf
• United Nations Development Programme Human Development Reports. (2019). Table 5: Gender Equality Index. Retrieved from http://hdr.undp.org/en/composite/GII
• UN Women Global Database on Violence against Women. (2016). Mali Prevalence Data on Different Forms of Violence against Women. Retrieved from http://evaw-global-database.unwomen.org/en/countries/africa/mali