{"id":1275,"date":"2018-10-30T13:50:13","date_gmt":"2018-10-30T13:50:13","guid":{"rendered":"https:\/\/blogs.bmj.com\/case-reports\/?p=1275"},"modified":"2019-01-16T16:57:26","modified_gmt":"2019-01-16T16:57:26","slug":"making-a-difference-in-gender-disparities","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/case-reports\/2018\/10\/30\/making-a-difference-in-gender-disparities\/","title":{"rendered":"Making a difference in gender disparities"},"content":{"rendered":"

Across the globe, women are made vulnerable by modifiable determinants in their homes, communities and cultures. In \u201cBarriers to healthcare for female patients in Papua New Guinea,\u201d Klaver and Coe address some of this risk. The authors present the case of a 25 year old woman who had complaints of abdominal distension, exertional dyspnea and amenorrhea. Despite trying to address these symptoms early on, she \u201chad been turned away\u2026 [d]ue to limited resources and high levels of tribal fighting in the area\u2026. The closest hospital where elective surgery was available was a 10-hour journey by dirt road for which she had neither transport nor funds to allow her to travel.\u201d Her husband had left her and taken a second wife due to her illness, and she had moved back to her family and was raising her child alone. \u201cShe currently had no contact with or financial support from her husband.\u201d She was diagnosed with HIV, treatment was initiated, and three months later had an ovarian cyst of 5.3 kg (12% of her body weight) removed in an uneventful elective surgery.<\/span><\/p>\n

While there are multiple reasons for her delayed presentation to care and the severity of her symptoms, the authors make clear that tribal violence in the highlands of Papua New Guinea was a major factor in her delayed presentation. First, \u201cWomen are commonly targeted in the tribal fighting and subjected to rape and sexual violence as part of the conflict.\u201d Second, \u201cDue to high levels of trauma and significant numbers of patients requiring emergency surgery\u2026 [the hospital] did not undertake elective procedures.\u201d Both of these facets of the tribal violence conspired against this patient to ensure she would remain in poor health.[1]<\/sup><\/a><\/span><\/p>\n

Papua New Guinea is the only country in the pacific where women have a lower life expectancy than men. As described by the authors, \u201cMany women are only allowed to attend\u2026 hospitals with the permission of their husbands, and any surgical procedure would certainly require\u2026 [his] consent.\u201d Many women in abusive relationships have no other options but to return to their abuser.[2]<\/sup><\/a><\/span> Her amenorrhea caused her husband to abandon her for a second wife, and she was forced to provide for herself despite her condition. The author\u2019s hypothesize, \u201cHad [her ill health]\u2026 not prevented her from working, she would likely never have voluntarily attended the hospital.\u201d These gender disparities are worsened in diseases associated with cultural stigma, such as HIV.[3]<\/sup><\/a><\/span><\/p>\n

While the outcome from this case can be construed as positive, this woman still suffered for years because of discrimination against her gender. This is not only a problem in Papua New Guinea, but worldwide. Health professionals can act as advocates for these patients by ensuring they receive the proper care, being aware of the gender biases present in each culture, and fighting for their patients on a local, national and global level.<\/span><\/p>\n

BMJ Case Reports invites authors to submit global health case reports that describe the disparities of healthcare based on gender. These cases could focus on:<\/span><\/p>\n

-The factors contributing to these disparities<\/span><\/p>\n

-The methods used to ensure equal care for all<\/span><\/p>\n

-The unique contributions made by female practitioners in areas of gender disparities.<\/span><\/p>\n

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Manuscripts may be submitted by students, physicians, nurses and allied health professionals to BMJ Case Reports at www.bmjcasereports.com. For more information, review our guidance on how to write a global health case report and look through our online collection<\/span><\/p>\n

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To read more about gender disparities at BMJ Case Reports, please review:<\/strong><\/p>\n