Women’s Health and Safety in Costa Rica
Reported, January 2, 2012
Based on principles of solidarity, universality, equity and efficiency, the Costa Rican model of health (salud) represents a social product of long-term governmental efforts. For the past decade, public health has received integral attention, with interventions being made in key areas such as the environment, lifestyle, and services. The prevalence of AIDS and malaria in the general population has been kept in check with mandatory testing and the provision of effective treatments. Both urban and rural citizens have benefited from increased accessibility to health professionals and community clinics.
The Costa Rican health care system has been touted in the past as one of the finest in Latin America, if not the world. Since the formation of the Caja Costarricense de Seguro Social (C.C.S.S.), which today assures basic medical treatment and prevention for nearly all Costa Ricans, national health concerns have been shifting slowly from acute infectious diseases towards chronic problems such as cancer and obesity.
Although all of these health improvements have been concerted and impressive, the Costa Rican system now has to confront the spectre of domestic violence, which has become a significant challenge to the well-being of its individualsparticularly its women.
At a clinic in San Jose, a woman speaks of women’s health: “You first become conscious of what health is when you don’t have it”. Here in Costa Rica, she details, it is difficult for women to negotiate safe sex. Because of this, women can become involved in unprotected sexual activity as early as twelve years of age, exposing themselves to an increased risk for STDs such as gonorrhoea and AIDS, as well as teen pregnancies and the associated birth complications. Preventing such health problems would naturally require these Costa Rican women to become more “selfish” with their bodies, and in their relationship choices.
The speaker broached the subject of domestic violence, and how this ties in with women’s health and their socially constructed inability to choose to be “selfish” in that regard. Domestic violence affects the physical, sexual, emotional, and psychological spheres of a woman’s life. It is a growing problem in Costa Rica, where rising statistics for such violence are suspected to be significantly underestimated.
In these cases of violence, the abuser is often someone close to the individual: an uncle, or a family friend. If the girl is not pressured herselfby the abuser’s promising or threatening whispersto continue consenting’ to acts of sexual abuse, then it is often her parents who will pressure her to meet the abuser’s needs, for this abuser is often in a higher position of economic and social power.
Victims get minimal support after experiencing sexual violence. They do not know what sorts of diseases they may have contracted. They experience unmitigated personal guilt and shame as well as social blame, contributing to heightened chances of addictions and low self-esteem. In addition, as many as 50% of these girls become pregnant and, because of the Catholic influences in Costa Rica, have no option but to bear that child, because abortion is not an option. Fortunately, though, a Costa Rican woman will often accept and even embrace the idea of having a child, because that is the one thing that becomes her ownmaybe the only thing that could really belong to her. However, this blessing often comes with a double price of health risk and trauma.
With the Law Against Domestic Violence enacted in 1996, Costa Rica has taken an important step towards reducing abuse within the family and neighbourhood. Yet the effectiveness of this existing mandate hinges largely on how well it is enforced in the cities, and in the villages. If this problem is overlooked, or accepted, by local governments, then women will continue to face an inescapable cycle of abuse in their communities. It is essential, therefore, that directed efforts continue to remove the stigma and blame associated with victims of sexual abuse, and enforce laws against violence and implement tangible consequences for offenders. Ultimately, though, Costa Rican women need to be empowered with strategies to reduce the incidence and cope with the trauma of the physical and sexual violence they may experience in their homes.
By taking an active, conscious approach against violence, Costa Rica can continue its commitment to all sectors of public health.
Credits and More information: Karmel Wong . Check out at:
http://www.11-55.org/issues3/issue.php?iss=42&art=42.3