Jurema Pinto Werneck, a young physician from Rio de Janeiro, is focusing her attention on changing the alarming sterilization rates among Brazilian women, particularly among very poor (and thus primarily black) women. She is also trying to develop a therapeutic system to deal with the physical and psychological aftereffects that are specific to this large group of Brazilians.
The New Idea
Jurema is building a model care and support center, as well as a national awareness movement, based on the problems and effects she is documenting while working with five groups of women in the Baixada Fluminense, a densely populated, poor peripheral district of Rio de Janeiro. Jurema listens to the women's reasons for using sterilization as a form of contraception when other methods are widely available, and observes the psychological and other consequences of their decisions. She is also persuading other medical health services to gather similar information and data on sterilized women so that sterilization's reputation as the simplest and safest form of birth control can be countered with hard evidence. From this work, she has seen a need for a specialized health center for women in the Baixada Fluminense. This center will provide the contraceptive and preventive health information that so many poor women never get, as well as offer supportive therapy for those psychologically pained by their sterilization. Jurema wants to complement this center with a national awareness-raising campaign. To do this, she has set up the Rio de Janeiro Forum Against Mass Sterilization. The Rio Forum directs the attention of over 30 groups, including black movement groups, women's groups, and state councils, to the problem and involves these groups in coordinated action. Jurema is already helping start other forums in Sao Paulo, Minas Gerais and Rio Grande do Sul; together, these state forums will act as a network for information and action.
Jurema's strategy works on three levels. First, she is working with groups of sterilized women in the Baixada Fluminense developing a direct understanding of their needs and a therapeutic approach to their problems. These groups are multiplying. She has also produced educational pamphlets on contraceptives and sterilization, and has distributed them among these groups. Second, she is drawing public attention to the issue of sterilization. The state forums are steps towards a national Campaign Against Mass Sterilization. Finally, she is working on the National Congressional Committee charged with reviewing all aspects of sterilization. This committee was set up following a proposal to Congress that sterilization be legalized. Though the bill has not been approved for lack of a quorum, Jurema is trying to make sure the policy-makers understand the perspective of the sterilized women.
Jurema has always been concerned with community health. While at the university, she helped design and implement an internship program in community health, then became one of its first interns. After graduating from medical school, Jurema began work with the Rio de Janeiro City Health Secretariat. Her work in several favelas and in the city's leading black umbrella organization led to her involvement in women's health and to her focusing on the social and medical implications of the country's extraordinarily heavy dependence on sterilization.