by Jimmy Carter
In terms of geography and college major, there are substantial differences between male and female students in U.S. universities, with a wide variation among different regions. For instance, in 2005 there were 40 percent more women than men students in the Southeast, and 10 percent fewer in Utah. The following shows the percentage of women enrolled in different disciplines in that same year: arts and humanities, 53 percent; biology, 53 percent; business, 43 percent; education, 69 percent; engineering, 15 percent; physical sciences, 43 percent; social sciences, 66 percent; technical, 27 percent; and computer sciences, 22 percent. These disparities in choice of major study are the result of many factors, including family influence, personal choice, preference for particular professors, and bias in hiring, but academic discrimination in enrollment is not significant.
I remember from my childhood during the Great Depression the very real threat that a woman might die during or shortly after giving birth. At that time, the death rate due to complications from childbirth for all American women was more than 600 per 100,000 births, and black women died at a much higher rate. My mother worked with the African American midwives in our Archery community to improve their skills. It was not the custom for prospective mothers to go to a hospital unless they were known to have an abnormal pregnancy, but the more affluent families could afford to have a trained obstetrician come to supervise home deliveries. Mama was the operating room nurse at Wise Sanitarium in Plains, and the chief surgeon, Dr. Sam Wise, was eager to reduce the amount of time away from her duties. It happened that there was an empty room available; Mama occupied it, and I turned out to be the first American president born in a hospital.
With the advent of antibiotics and more sterile techniques during childbirth, the maternal death rate for all American women decreased dramatically, reaching its lowest point in 1987 at 7.2 deaths per 100,000 live births. But since then it has been creeping upward. Because of poverty and other causes, black women are three to four times more likely than white women to die during pregnancy and childbirth. When the Centers for Disease Control and Prevention began assessing the causes of maternal deaths in 1987, hemorrhage was blamed for more than one in four deaths. Now the causes have shifted to stroke and other diseases of the heart and blood vessels, with obesity an increasing cause of concern.
Women’s bodies can be particularly vulnerable because of our responsibilities and our duties around pregnancy, birth, and childcare. So for me, knowing the needs of women and ensuring the rights of women to fair and equal access to healthcare is core to the work of bioethics. The free market argument, while it has worked out for some, clearly has failed to deliver a world of peace and justice. The voice of religion says there has to be areas of human life that are not subject to the justice of the market. Most of those areas are ones about love, one’s family, the human body, where those aspects of human life can’t be sold and can’t be commoditized in ways that are fair, because they live outside the language of the exchange. And here we need language about hospitality, generosity, abundance, and love.
DR. LAURIE ZOLOTH, BIOETHICIST AND PRESIDENT OF THE AMERICAN ACADEMY OF RELIGION
On a global basis, one of the most notable examples of discrimination against women is their comparative lack of access to adequate health care. According to the World Health Organization, the fourth leading cause of death for women worldwide is poor conditions at childbirth, exceeded only by HIV/AIDS, malaria, and tuberculosis. Some significant progress is being made in most areas, as overall health care improves. In 1980, my last year in office, there were 526,300 deaths of women worldwide while pregnant or during childbirth, and 287,000 in 2010, which was a 45 percent reduction. The United Nations Millennium Development Goals had called for a 75 percent reduction by 2015, a target that obviously will not be reached. In Sub-Saharan Africa the maternal death rate is actually increasing. Globally 99 percent of maternal deaths occur in poor developing countries. This dramatic difference in maternal care between rich and poor countries is demonstrated clearly by the maternal mortality rate (MMR), the number of mothers’ deaths for each 100,000 births.
According to the most recent data published by the World Health Organization and UNICEF, the MMR world average is 210, ranging from 2 in Estonia to more than 1,000 in Chad and Somalia, and the MMR average for all of Sub-Saharan Africa is 500. The average rate in Scandinavian countries and Western Europe is less than 10, and in the United States is 21. This places America at the bottom among industrialized nations, despite spending more per average patient than any other. The highest total number of deaths occurred in India (56,000), with a rate of 200, and Nigeria (40,000), with a rate of 630. Not surprisingly, the risk of maternal mortality is highest for adolescent girls under fifteen. Aside from the death itself, the tragic consequences for surviving children are tremendous.
One nation that is making good progress in correcting this problem is Ethiopia, among the poorest countries on earth, which we began visiting in 1988, when the oppressive communist dictator Mengistu Haile Mariam was still in power. It is said that he had gained his authority over the populous nation by personally smothering Emperor Haile Selassie in his bed, and all Western nations had broken diplomatic relations with his regime. While observing one of our agriculture projects in Tanzania in 1989, I received an urgent request from the International Red Cross and UN High Commissioner for Refugees to go to Addis Ababa to negotiate some arrangement by which supplies could be delivered to the two large refugee camps in Ethiopia that sheltered people escaping the ravages of wars in neighboring Somalia and Sudan. After an argument between these agencies and Mengistu, he had forbidden their access to the camps, and Rosalynn and I made an appointment to meet with him. Almost immediately he accepted my proposal to let the two agencies deliver food, water, and medicine to the camps, provided his troops could supervise the process. I became interested in the country, and later became a friend of Meles Zinawe, a revolutionary from Tigray, who eventually overthrew Mengistu, forcing him into permanent exile in Zimbabwe.
Meles became prime minister after a series of elections and launched a number of projects to improve the lot of his people, especially in the rural areas. On one of my visits, he asked if The Carter Center might be willing to train health workers, and, as described in a previous chapter, we met this request with an emphasis on providing women throughout Ethiopia with skills in midwifery, because maternal deaths were extremely high there. These workers also help with other projects of our Center in Ethiopia, including the treatment and elimination of malaria, trachoma, Guinea worm, and river blindness. Still at a very low level of income per person, Ethiopia has benefited greatly from an enlightened prime minister, dedicated cabinet officers, and citizens who are determined to improve their own lives. We are now planning similar training programs for public health workers in Sudan and Nigeria.
In 2008 the International Monetary Fund described the speed of Ethiopia’s progress as “fastest for a non–oil exporting country in Sub-Saharan Africa.” Ethiopia was also ranked as the second most attractive African country for investors. Meles was given the Africa Political Leadership Award and donated the $200,000 to a foundation called Fre-Addis Ethiopia Women Fund, which was dedicated “to empower girls through providing educational opportunities” by giving support to needy and orphan rural girls to pursue their education.
Intensive work is in progress to establish the post-2015 Millennium Development Goals. When they are adopted by the UN there is little doubt that maternal health will remain one of the top priorities, still unreached. It is hoped that publicity about sexual discrimination in politics, economics, work, and education plus stronger and more persistent demands from women’s organizations will help to minimize these abuses.
18 | THE ROAD TO PROGRESS
There is no religion that despises women. Hatred cannot come from the heart of God. If there is hatred, its source is not the Creator. Only humans have the capacity to see and treat others as less than they truly are. It is our minds an
d hearts that must change to release women, girls, men, and boys from the bondage of gender-based limitations or violence. That change is happening, right now in this very moment, in thousands of homes, schools, synagogues, chapels, mosques, and centers of power around the world. That change is coming. Have faith. It will be here soon.
RITU SHARMA, COFOUNDER AND PRESIDENT, WOMEN THRIVE WORLDWIDE
It is interesting and helpful to have a way to assess how different countries compare in achieving equal status between men and women and to ascertain if they are making progress. The World Economic Forum has performed this service with its Global Gender Gap Report for the past seven years. It “assesses countries on how well they are dividing their resources and opportunities among their male and female populations, regardless of the overall levels of these resources and opportunities.” The four primary criteria used in these assessments are (1) economic participation and opportunity (salary level and skilled employment); (2) educational attainment (access to basic and higher education); (3) political empowerment (involvement in decision making); and (4) health and survival (life expectancy and sex ratio of surviving children).
A score of 1.000 would indicate that women and men are treated with absolute equality. Iceland has the highest score, .8731, and other Scandinavian countries plus Switzerland, Ireland, New Zealand, the Philippines, and Nicaragua are in the top ten, all with scores above .7700. Other rankings and scores of interest are for Cuba (which ranks nineteenth, with a score of .7540), the United States (twenty-third, with .7382), Israel (fifty-third, with .7032), and Bangladesh (the highest ranked Islamic country at seventy-fifth, with .6848). The entire report can be found on the Internet. The individual factors indicate that the United States lags behind in wage equality at sixty-seventh and in numbers of women in political office at sixtieth.
The reports cover the status of gender equality in 136 countries, and since women comprise approximately half a nation’s talent base, there is usually a direct relation between their treatment and their homeland’s economic status. As expected, most of the Arab nations and those in Sub-Saharan Africa rank quite low. The general conclusion is that during the seven years of assessment the majority of countries have made very slow progress on closing the gender gap. For instance, the United States improved from .7042 in 2006, an increase of about 5 percent in seven years, but during the past year dropped from twenty-second to twenty-third in the global ranks.
One tremendous untapped resource in the global move to enhance women’s rights is the private but formidable influence of first ladies and other prominent women who don’t hold elective office. Let me give a few examples with which I am familiar. In the United States the most vivid illustration of this point has been Eleanor Roosevelt, who was a courageous spokesperson for black people while her husband was president, long before there was a detectable civil rights movement. I remember that she was despised by many in the Southland, even while FDR was winning repeated campaigns with overwhelming support from this region, which was overwhelmingly Democratic at the time. When World War II ended and nations began striving to conclude agreements to end war and protect human rights, Eleanor Roosevelt played a key role in representing our nation in the formulation of the Universal Declaration of Human Rights. This remarkable document, which could not be formulated and approved in our much more polarized world, has remained the solid foundation and inspiration for generations of individuals and organizations that strive to protect women and girls from abuse.
President Lyndon Johnson used his exceptional influence in the U.S. Congress to orchestrate the passage of civil rights legislation in the mid-1960s, and his wife, Lady Bird, helped in this effort, also exerting her charm and status as first lady to originate the concept of using native shrubs and flowers to beautify highways and cities throughout America. She broke precedent and worked directly with Congress to help pass the Highway Beautification Act and later, in retirement, continued to manage the family’s large media conglomerate that she founded before her husband became prominent in politics. Rosalynn and I visited her and her family often during those days.
We first knew Betty Ford when, as first lady, she visited us in the Georgia governor’s mansion. In addition to being a stalwart supporter of her husband, President Gerald Ford, she was a pioneer in espousing women’s rights. She became famous for her unprecedented support for the Equal Rights Amendment to the U.S. Constitution and for being remarkably outspoken regarding her breast cancer and addiction to drugs when she underwent a mastectomy and later became addicted to painkillers and alcohol. Later she and Rosalynn would go to Washington to lobby for their special projects, approaching both Democratic and Republican legislators to promote legislation to support the treatment of alcoholism, drug addiction, and mental illness.
Not only did my wife play a vital and unprecedented role in my campaigns for governor and president, but she was active in promoting her own projects. She inspired and directed the work of blue-ribbon commissions to promote mental health at the state and federal level and has become a world leader in pursuing this goal since we left the White House. She worked tirelessly, but unsuccessfully, to secure passage of the Equal Rights Amendment, calling hundreds of state legislators to induce them to vote for it. With the exception of state secrets that involved security, I discussed all my major challenges with Rosalynn and sought her advice when I had difficult decisions to make. I did not always accept her recommendations, but my personal staff and cabinet officers knew that their best access to me was through Rosalynn, and she and I shared this knowledge as a personal joke.
Rosalynn has been a full partner with me in founding and operating The Carter Center and, aided by a worldwide group of queens and first ladies, has become the foremost champion of mental health. The Rosalynn Carter Institute for Caregiving does exploratory work on the potential and needs of those who are caring for loved ones suffering from Alzheimer’s or other debilitating ailments; tens of thousands of these dedicated volunteers are being trained by a cyber university that telecasts lessons from South Korea. She urged me to write this book and will join me in striving to reach its expressed goals. I hope that all first ladies and other women who occupy positions of influence will adopt this project and pursue it with determination.
The international community has made significant strides in assessing the problems and prescribing cures in the arena of sex discrimination, and official statements, declarations, and covenants have had a beneficial impact. A major international conference on women was held in Copenhagen, Denmark, when I was president. Just its convening in July 1980 was controversial. Our country had been struggling with the failed adoption of the Equal Rights Amendment to the U.S. Constitution, and many countries had reacted adversely to the innovative recommendations issued by the first women’s conference five years earlier, in Mexico City. The delegates had set minimum targets for the UN and every nation to meet by 1980, focusing on equal access for women to education, employment, political participation, health services, housing, nutrition, and family planning. Some religious leaders of all faiths openly opposed the idea of sexual equality, as did entrenched politicians who didn’t want female challengers and employers who wanted to continue paying less to clothing workers and other female employees. Several of my closest political allies warned me that my endorsement of the meeting would be damaging during the coming presidential election, following my bitter primary battle with Senator Ted Kennedy.
Despite these concerns, there was a consensus that significant progress was being made on women’s rights as representatives of 145 nations met in Copenhagen, because the UN General Assembly had recently adopted the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), one of the most powerful instruments for women’s equality. The Convention, which has been termed “the bill of rights for women,” obligates signatory states to report within one year of ratification, and then every four years, on the steps they are taking to comply. It was at this conference t
hat I directed my representative, Sarah Weddington, to sign CEDAW on behalf of the United States.
For Muslims, the Revelation was made by God to protect the rights of all people, especially those most vulnerable, and to promote the human dignity of all people. Because of this, no religious leader can remain silent or refuse to become engaged given the serious discrimination and abuse of many women and young girls in the world today. Any attempt to provide religious justification for refusing girls their right to education or for condoning practices such as female genital cutting, child marriage, exploitation, or enslavement [is] a betrayal of the very principles that religious leaders have the role to defend.
SHEIKH MUHAMED CHÉRIF DIOUP, ISLAMIC RIGHTS SPECIALIST AND CHILD PROTECTION OFFICER, TOSTAN, SENEGAL
There was concentrated opposition to the planned participation at the Copenhagen conference of Jehan Sadat, wife of the Egyptian leader who had signed a peace treaty with Israel and was condemned by almost all other members of the Arab League. Unlike other wives of Islamic political leaders, she openly espoused justice for women and had played a key role in promoting a series of legislative reforms in Egypt, known as “Jehan’s laws,” that greatly enhanced gender equality, such as the right to alimony and custody of children in case of divorce. She is the founder of the Arab-African Women’s League and has led unprecedented efforts to promote children’s welfare and to endorse peace efforts as an alternative to war in Africa and on other continents. She became world famous as she participated in conferences in many countries, and her condemnation by Arab political and religious leaders has only enhanced her reputation as a spokesperson for women and for peace. Her status as first lady of Egypt changed the global image of Arab women.