By Shazia Salam

Published on 22th June, 2017
The government report on medically certified deaths in India puts the gender wise death statistics at 62.0% and 38.0% for men and women respectively. These figures and the difference therein reflect a gendered dynamics around basic access to healthcare.
Although various study reports suggest that the diagnostic healthcare utilization by women is more than men but the access to hospitals for women seems to be less as per the official data.
How does one account for why many women die in their homes while a greater percentage of men die in hospitals? How does one understand the intersection of greater healthcare utilization by women and lesser access to hospitals in times when the disease potentially leads to death?
The difference can be largely attributed to two factors; attitude of healthcare providers and attitude of family members. Although both of these factors stem from the social positioning of women, it is significant to look at them separately while being attentive to the interface between them.
Gender determines and shapes an individual’s access to healthcare system and the seriousness with which the pain is recognized.  In her essay, Grand Unified Theory of Pain, Leslie Jamison specifically touches upon such issues of discriminatory attitude of healthcare professionals as well as family towards the health concerns of women. She opines that in a standard patriarchal setup while women are conditioned to grow with a delicate subservient attitude with notions of being tender care givers to their family, in times of pain they are expected to be strong and not complaining.
There is a disjuncture of perception of sorts in how ‘masculine’ values of strength and fortification in women are seen as a departure from and a threat to the usual ‘feminine’ self, but in times of pain it is these very values that women are supposed to be exhibiting.
Various studies show that women’s pain is dismissed on the grounds of being a physical response to an emotional issue coming from the widely held perceptions of women being emotional rather than rational beings. Their pain is dismissed as a response to some kind of sadness and inability to resolve mental issues rather than a serious health emergency. Research shows that while men are given medication for their pain, women are generally given sedatives to ‘calm’ them down.
Apart from the critical gaps in healthcare system towards understanding women’s health issues, it is the societal norms and cultural traditions that the data is representative of. While men get adequate attention for a range of illness from mild headache to more severe diseases, women are supposed to be not feeling ‘ill’ ranging from painful periods to more attention deserving heath concerns.
Even during the bouts of fever, cold and many common ailments, women never forego their responsibility of managing the home but rather continue to work after popping in some antibiotics. This day to day normalizing of pain of women contributes to strengthening of the already existing frames with which women’s health issues are looked at.
Women are considered to be the repositories of providing care and emotional sustenance to their families. The burden of palliative care in a family always falls on women as the expectations to provide care in any circumstance are considered to be a woman’s duty.
Formal and non-formal settings of palliative care do not position men in the role of care givers. The institutional as well as non-curative comfort care system which burdens women with such expectations makes men to look at themselves in such contexts as a serious disjuncture in the normal routine of their lives.
To understand the intersectionalities of various injustices towards women in terms of access to hospitals one needs to look at the discriminatory healthcare practices alongside of the social models within which such practices are nurtured perpetually.