Cervical cancer narratives: invoking ‘God's will’ to re-appropriate reproductive rights in present-day Romania

Abstract

Drawing from ethnographic fieldwork in contemporary Southern Romania, this paper scrutinises local moralities governing some women's refusal to enrol in free reproductive healthcare initiatives targeting cervical cancer through primary and secondary prevention (human papillomavirus [HPV] vaccination and Papanicolaou [Pap] testing, respectively). Women backed up their rejection of participation in official reproductive care programmes by mentioning ‘God's will’ as the ultimate trigger of cervical cancer. They withheld their own and their daughters' bodies from biomedical intervention and used discursive references to divine logic to imbue their refusal with moral legitimacy. However, ‘God's will’ is not a mere rhetorical device, since it has a correlate in many of these women's embodied reproductive experiences. As this paper argues, religious narratives, far from stripping ordinary citizens of their reproductive choices, constitute the medium through which they display individual agency. In fact, invoking ‘God's will’ empowers Romanian women to challenge state control and it enables them to re-appropriate their bodies by making a counter-intuitive, yet bold, choice.

Apoyado por un trabajo de campo etnográfico realizado en el sur de la Romania contemporánea, el presente artículo analiza las moralidades locales que sustentan el rechazo expresado por algunas mujeres a inscribirse en programas gratuitos de atención a la salud reproductiva. Los mismos están destinados a controlar el cáncer cervical mediante la prevención primaria y secundaria, utilizando para ello el examen que permite detectar el virus del papiloma humano y el Papanicolaou, respectivamente. Las mujeres respaldaron su rechazo a participar en estos programas oficiales invocando que la causa fundamental del cáncer cervical es la «voluntad de Dios». Así, no permitieron que sus cuerpos, ni los de sus hijas, fueran sometidos a intervenciones biomédicas, usando referencias discursivas a la lógica divina para imbuir su rechazo de legitimidad moral. Sin embargo, la «voluntad de Dios» no solo representa un sencillo recurso retórico, ya que se correlaciona con muchas de las vivencias reproductivas encarnadas en las mujeres. El artículo sostiene que, lejos de despojar a los ciudadanos comunes de sus opciones reproductivas, las narrativas religiosas constituyen un medio a través del cual los mismos pueden ejercer la voluntad individual. En los hechos, las mujeres rumanas se empoderan para hacer frente al control del Estado invocando la «voluntad de Dios», lo cual les permite reapropiarse de sus cuerpos mediante esta decisión audaz, aunque contraintuitiva.

S'inspirant d'un travail ethnographique de terrain mené dans le sud de la Roumanie contemporaine, cet article examine en détail les valeurs morales locales qui déterminent le refus de certaines femmes de s'inscrire gratuitement dans des programmes de santé reproductive ciblant le cancer du col de l'utérus grâce à la prévention primaire et à la prévention secondaire (vaccination contre le HPV et frottis cervical, respectivement). Ces femmes justifient leur refus de participer aux programmes officiels de santé reproductive en se référant à « la volonté de Dieu » en tant qu'ultime élément déclencheur du cancer utérin. Elles préservent leur propre corps et celui de leurs filles des interventions biomédicales et utilisent des références discursives à des logiques divines afin que leur refus s'imprègne d'une plus forte légitimité. Cependant, « la volonté de Dieu » n'est pas un simple outil rhétorique, car elle a un corrélat dans beaucoup des expériences de reproduction incarnées par ces femmes. Cet article soutient que, loin de priver les citoyens ordinaires de leurs droits reproductifs, les récits religieux constituent un moyen par lequel ils exposent la capacité d'agir de chacun de ces citoyens. En fait, l'invocation de « la volonté de Dieu » renforce les femmes dans leur remise en question du contrôle de l'État et leur permet de se réapproprier leur corps, en faisant un choix qui, tout en allant à l'encontre de l'intuition, est néanmoins audacieux.

Keywords::

• God's will
• reproductive rights
• cervical cancer
• HPV vaccination
• Romania

Acknowledgement

This work was supported by Paul and Elizabeth Selley Fellowship and by Tulane University School of Liberal Arts Summer Merit Fellowship.

Notes

^1. Romania ranks high. Cervical cancer strikes again, January 25, 2012 (http://medlive.hotnews.ro/romania-in-varful-clasamentului.html)

^2. Guidelines provided by US Centers for Disease Control (http://www.cdc.gov/cancer/cervical/pdf/guidelines.pdf)

^3.http://medlive.hotnews.ro/romania-in-varful-clasamentului.html

^4.http://data.euro.who.int/hfadb/

^5. Aproximativ 40,000 de femei au fost testate, gratuit, în primele 3 luni de la debutul Programului naţional de screening pentru depistarea precoce activă a cancerului de col uterin [Approximately 40,000 women have been tested free of charge in the 3 months since the start of the National Cervical Cancer Screening Program]. (http://www.ms.ro/index.php?pag = 145&id = 11995).

^6. Peste 18,000 vaccinuri, in valoare de 1.5 milioane lei, au expirat in depozitele DSP Vaslui [More than 18,000 vaccines, worth 15 milion lei, have expired in DSP Vaslui storage]. (http://www.ziare.com/vaslui/articole/doze+vaccin+hpv+expirate). In Zalau 3,452 doze de vaccin HPV expirate au fost distruse [In Zalau, 3452 expired HPV vaccine doses were disposed of as waste]. (http://www.ztv.ro/video/vezifilm/4511/social/in-zalau-3452-doze-de-vaccin-hpv-expirate-au-fost-distruse.html). Peste 2.000 de doze de vaccin anti- HPV au expirat în depozit, în Mehedinţi [More than 2000 HPV vaccine doses have expired in Mehedinti storage]. (http://www.realitatea.net/peste-2-000-de-doze-de-vaccin-anti-hpv-au-expirat-in-depozit-in-mehedinti_810841.html#ixzz34ulvn9Gt). 2014. Cancerul de col uterin ucide, iar dozele de vaccin HPV expira in depozite [Cervical cancer kills and HPV vaccines expire in storage]. (http://stirileprotv.ro/stiri/sanatate/cancerul-de-col-uterin-ucide-iar-dozele-de-vaccin-hpv-expira-in-depozite.html).

^7. See Aronowitz's (2010) analysis of Merck's One Less campaign for Gardasil.

^8. Spuneti NU vaccinurilor-Vaccinarea: eroarea medicala a secolului [Say NO to vaccines. Vaccination - the medical error of the century]. (http://www.crestinortodox.ro/forum/showthread.php?t = 15130). See also http://nuvaccinurilor.blogspot.com