1. Gender and Women Health
Pinar Okyay, MD,PhD
English version at 34821
Department of Public Health, School of Medicine
Adnan Menderes University, Aydin Turkey

2. “Have a son and your name continues!
My presentation, renowned author Malouf'un Amen "after the first century Beatricen" I want to start with his book
Skarabe , a folk figure for fertility.
A popular drug that ensures women will give birth only to boys has sharply reduced the world's female population and cut fertility rates. The industrialized nations, seeking to curb Third World population growth, have encouraged the drug's use in poorer countries, which. Here it (skarabe) has inspired and pharmaceutical firms, a similar drug produced in the beginning of the century then released it. The birth of female children in the world decrease and population balance is distorted. The result is a disaster. Migration from South to North, rebellion and civil wars, the rape ... unforeseen chaos! Men everywhere, frustrated sexually and deprived of normal family life, turn to violence and delinquency.

3. "Peasants of China discover new way to weed out girls."
“Last year only one girl child was born in our village. All other families had sons”
Kristof, Nicholas D
"Peasants of China discover new way to weed out girls."
The New York Times, 21 July, 1.
Two years later, this science-fiction novel of Maloouf’ signed by New York Times Nicholas Kristof is a special news broadcast.
The news on families in China to have a male child with the sex selection practices.
In paper, a peasant with pride "in our village last year, only one girl child was born. All other families had sons. “

4. Today, the vast majority in Asia, I in different populations,
60 million girls at least, otherwise expected to be alive,
are missing due to gender selective abortion, infanticide or neglect .

5. 1980: Ultrasound usage
Oomman N, Ganatra BR., Sex selection: the systematic elimination of girls. Reprod Health Matters May;10(19):184-8.

6. In CHINA:
21 of 31 (%67.7) provinces have higher ratio than (expected sex ration at birth)
40 million single men by 2020
This is a very important issue in China. The expected sex ratio at birth in China has largely distorted. The expected sex ratio at birth of 21 of the 31 provinces is great. Since 2020 with projections for Structured single men will be 40 million. The first century is about to come after Beatrice.
Gu B, Roy K. Sex ratio at birth in China, with reference to other areas in East Asia: what we know. Asia Pac Popul J Sep;10(3):17-42.

7. Gender and Women Health
In many societies, women systematically fail to achieve or fail to use some basic human rights according to men.
Most of the time, women's health status and problems related to affect:
morbidity
disability
mortality
DISCRIMINATION ALL THROUGH THE LIFE OF WOMEN

8. Neglect
Cannot benefit from the services
Violence
Social pressure
Increase in morbidity
ADOLESENT/ADULT
Unwanted pregnancies, STDs
Sexuel harassment/abuse
Turnpike sex
Smoking and substanve abuse
OLDERS
Increase in morbidity /problems on quality of life
CHILDHOOD
Sex selective abortion
Female mutilation
Nutrition problems

9. Female Genital Mutilation (FGM)
An estimated 100 to 140 million girls and women worldwide are currently living with the consequences of FGM.
Each year 2 million girls at risk!
Female genital mutilation (FGM) includes procedures that intentionally alter or injure female genital organs for non-medical reasons.
An estimated 100 to 140 million girls and women worldwide are currently living with the consequences of FGM.
In Africa, about three million girls are at risk for FGM annually.
The procedure has no health benefits for girls and women.
Procedures can cause severe bleeding and problems urinating, and later, potential childbirth complications and newborn deaths.
It is mostly carried out on young girls sometime between infancy and age 15 years.
FGM is internationally recognized as a violation of the human rights of girls and women.
WHO, Female Genital Mutilation
The prevention and the management
of the health complications
Policy guidelines for nurses and midwives, 2001.

10. FGM / Problems Obstetric Menstruel Phychological Urinary
Other problems..
WHO, A systematic review of the health complications of female genital mutilation
including sequelae in childbirth, 2001.

11. Violence and Women
World scale: Today one of every 3 women are subjected to different forms of violence.
(Heise, Ellsberg, Gottemoeller, 1999).

12. Discrimination against women
"...any distinction, exclusion or restriction made on the basis of sex which has the effect or purpose of impairing or nullifying the recognition, enjoyment or exercise by women, irrespective of their marital status, on a basis of equality of men and women, of human rights and fundamental freedoms in the political, economic, social, cultural, civil or any other field."
(UN, CEDAW-1994)

13. Violence Pandemia depends on gender
Researches from various countries between the years
: women within the percentage of 16-41, were physically attacked by men with whom they had close relations.
Violence exposed is the 10th cause of death in the age group women.
7% of all women deaths in the world are associated with violence.
WHO,1998
A gender-based violence is a pandemia today. In every community in the world, society, country or region it can be found. The problem is really too large.

14. CEDAW Report of Turkey-1993
Domestic violence
Of women;
84% slap
70% being punched
43% being beated hard
55% threatened with death
Home is the place violence most experienced.
In the violence acts, the aggresive is mostly husband or the man with close emotional relationships.
CEDAW Report of Turkey-1993

15. Turkey Turkey Demographic and Health Survey 2003:
The percentage of justification of the thusband in hitting or beating his wife is 39%.
Rural 57%
Lower education level 62%
Reasons of the violence:Şiddet nedenleri:
If she;
Burns the food
Argues with him
Refuses to have sex with him
Recent years have witnessed an increasing interest in violence against women, in
particular domestic violence. Domestic violence against women is acknowledged worldwide
as a violation of the basic human rights of women. Tolerance and experience of domestic
violence form significant barriers to the empowerment of women and women’s autonomy in
all spheres of social life and have adverse consequences for women’s health, health-seeking
behavior, and the health of their children. In the TDHS-2003, women were asked a number of
questions on their attitudes regarding especially physical violence, which is one of the special
types of domestic violence, with regard to whether they viewed physical violence as justified
under given circumstances.
Women were asked whether a husband would be justified in beating his wife for each
of the following reasons separately: if she burns the food, if she argues with him, if she spends
too much money, if she neglects the children, and if she refuses to have sex with him. Table
3.6 gives the percentages of ever-married women who agree with the specified reasons for
wife beating by background characteristics.
Thirty-nine percent of women accept at least one reason as a justification for wife
beating. Women are most likely to think that wife beating would be justified in cases when
the woman argues with the husband (29 percent), spends too much money (27 percent) and
neglects the children (23 percent). Only 6 percent of women agree that wife beating would be
justified if the woman burns the food. Younger women, currently married women, and
women with high fertility are more likely than their counterparts to think that wife beating is
justified for at least one of the reasons.

16. Pablo Picasso/The Rape of the Sabin Women
Kadına yönelik şiddet, en acımasız yüzünü cinsel şiddet olarak göstermektedir.
Pablo Picasso/The Rape of the Sabin Women

17. In the World
Completed rape at least once during the life of women completed rape
USA 14-20%
Canada: 40%
12-25 percent of all adult women have been specified that they were victims of rape or attempted rape.
Koss et al.,1997; Killpatrick et al.,1992; Randall and Haskell, 1995

18. A systematic weapon : Rape
In South Africa every 83 second one woman is rapedA report by the U.N. (1996)
Special Rapporteur on Rwanda estimated that at least women were raped during the genocide.
During the conflict in Bosnia-Herzegovina between and women were raped
“The militia at the barriers said they would protect me, but
instead they kept me and raped me in their homes. One
militia member would keep me for two or three days and
then another would choose me… I managed to flee Kigali
and when I returned, I learnt that my husband had been
killed.” (Survivor of the Rwandan genocide, HIV positive
woman from Kigali)
In conflict situations, women and girls are at greatly
increased risk of physical and sexual violence. Many
women and girls are subjected to rape including gang
rape, forced marriages with enemy soldiers, sexual
slavery, and other forms of violence (being forced to
witness others being raped, mutilations, etc.). Many
have fled their homes, have lost their families and livelihoods,
and may have little or no access to health care.
All these factors create conditions in which women
and girls’ vulnerability to HIV is disproportionately
increased. This information bulletin is the second in a
series highlighting the intersections of violence against
women and HIV/AIDS and it focuses on sexual violence
against women in conflict settings and their risks
for acquiring HIV.
Violence against women and girls has been a feature
of all recent conflicts. In many of these conflicts, some
of which have been regarded as ethnic cleansing, rape
has been and is used as a deliberate strategy to brutalize
and humiliate civilians and as a weapon of war or
political power. It is also likely that all forms of violence
against women, including intimate partner violence,
increase during conflicts and this may be linked to a
ready availability of weapons, high levels of frustration
among men, and a general breakdown in law and order.
Integrated Regional Information
Networks (IRIN)
WHO, Sexuel violence in conflict setting and the risk of HIV, 2004.

19. Sexually Transmitted Disease
Young women know very little information on STDs and because of the fear of being branded as sexual active they hardly try to learn information.
Woman equipping less power as a decision maker has resulted with late diagnosis and treatment.

20. Sex trade/tourism..
4 million people in sex abuse traffic is estimated in the world.
The revenue / year of organized criminal organizations is 7 billion dollars
500,000 women and children for the sex trade is estimated to infiltrate into European Union countries in 1995.

21. Older Ages and Women
The expected duration of life in our country, the birth (DIE-2000) years for women years for men
At least 35 countries in the world in the birth of the expected life span for women has reached 80 years. Women live average 6-8 years more than men. (WHO)

22. Older Ages and Women
A long way with diseases Health care access problems In our country, all illiterate population over 65 years is 24% and 74% are women. Elderly women than elderly men are poor and lack social protection.
Long live all the time does not mean a healthy life. Women than men for a long time are living with health problems to have, especially cardiovascular diseases and cancer. And access to health services for the elderly woman is problematic. This in front of some obstacles are linked to gender. Women's education, especially in the elderly, according to men is significantly low. According to State Institute of Statistics 2000 data 19.4% of women in our country is not literate, the rate of 6.1% for men in this case. All illiterate population over age 65 is not 24% or 74% that are women. At the same time, old women than old men are poor and lack social protection. “Feminization of poverty”.
The feminization of poverty is a change in the levels of poverty biased against women or female headed households. More specifically, it is an increase in the difference in the levels of poverty among women and men or among female versus male and couple headed households. It can also mean an increase of the role that gender inequalities have as a determinant of poverty, which would characterize a feminization of the causes of poverty.

23. Blindness
The most important reason for blindness is cataracts, and according to the results of studies in five countries, 53-72% of all with cataracs are women.
Blindness connected to cataract may be reduced at a rate of 12.5% if only women and men have the same operation rates.
Dünya üzerinde milyon kişiyi etkilemektedir. Önümüzdeki 25 yılda bu durum kontrol önlemleri geliştirilmezse ikiye katlanacaktır.
Tüm dünyada kadınlar bu resmin yaklaşık üçte ikisini oluşturmaktadırlar.
Bu ülkelerde körlüğün en önemli nedeni kataraktdır; ve beş ülkedeki çalışmaların sonuçlarına göre kataraktlıların %53-72’sini kadınlar oluşturmaktadır.
Daha da önemlisi, kadınlar erkeklere benzer ameliyat hızlarına sahip değillerdir. Bir tahmine göre katarakta bağlı körlük sadece kadınların erkeklerle aynı ameliyat hızlarına sahip olmaları ile %12.5 oranında azaltılabilir.
Abou-Garaeb, Lewallen, BassettCourtright.
Gender and Blindness: a metaanalysis of population based prevalence surveys.
Ophthalmic epidemiology 2001; 8:39-56.

24. In Disaster
Women, with lower rates of education and years of education, more work at home,
at disaster their preparedness and education are less,
they have little information about the preparation and risk approach.

25. Target: Gender Equality Strategy: Gender mainstreaming
    

27. Equity in Health
The Convention on the Elimination of All Forms of Discrimination against Women (CEDAW)-1979 / Turkey1985
Madrid-2001
Political and technical process
Health systems should be settled identfying of men and women biological differences and gender
Gender-related evaluation indicators should be identified and data shoul be collected
Research on gender must be supported
In September 14, 2001, 28 European countries talked how they might integrate the gender perspective to the country's master plan.

28. What we know about gender on the women health
Key word: “gender”
Turkish MEDLINE: 14
Ulaknet National Medicine dizini: 3
Key words: “gender identity AND women”
PubMed: 1019
METHOD:
Gender Analysis

29. Atatürk, Founder of the Modern Turkey; Thank you..