Sai Hankuri

The Anti-Entitlement Society & The Indeterminable Wait

I like getting what I want. I demand to get what I deserve. I don’t deal well with injustices. I’m told that I’m not good with authority.

If I don’t have confidence in my doctor, I do my own research – I read journal articles and Wikipedia, I get second opinions. If I don’t understand what’s being told to me, I ask questions. And I ask again. I feel entitled to information about my body, I feel entitled to care. Indeed, I probably feel entitled even when I’m not.

Like most people, I am a product of my culture – and I do come from a culture of entitlement. Just ask Mitt Romney about 47% of Americans, or conservative pundits  who shake their heads at “the entitlement society” or “the entitlement nation”. While “entitlement” has been thrown around as a pejorative, describing the belief that one deserves certain goods, rights, or services (that ostensibly haven’t been earned), I think entitlement can be a really good thing. A sense of entitlement allows us to be our own advocate when no else will be.

Most of us (regardless of our political leanings) are taught as children to feel entitled to fairness, entitled to respect, entitled to sovereignty over our own bodies. We are taught to ask ‘why’ – we feel entitled to answers. We are encouraged to stand up for what is right, even if that means going against someone who is older, richer, or more powerful. It’s not only fighting for what you deserve – but believing in the first place that you ‘deserve’ at all.

Everyday I speak with Nigerien women who endure hardships beyond what I can imagine. Women who seem forgotten and deprioritized. I’ve spoken with women who’ve waited months  hoping to be scheduled for an operation. I’ve interviewed women who’ve been referred from rural clinics to fistula centers in Niamey, only to wait years for an operation that never seems to come. They’ve left behind parents, siblings, spouses or children, departing alone on their quest for health. One woman told me “to me, Niamey was as far away from my home as I could imagine. After Niamey, there was only the great unknown. I cried for three days before leaving my village. But I was assured that here they would fix me. Here I’d regain my life”. Full of anticipation and anxiety, these women make their way to the big city. For months they wait patiently. Some learn to make small crafts like beaded bracelets or knitted hats, others learn to read Koranic Sutras in Arabic. Mostly, though, they just wait. But after a year of waiting without having even been seen a doctor, some conspiratorially whisper amongst themselves, losing confidence and quietly questioning. Still, no one asks directly. No one pushes. No one demands.

“But why!?” I whine during interviews – “What are you waiting for? Why don’t you leave? Why don’t you go to the hospital yourself, or find another hospital?”

“They give us food. We are in their place. We are guests. They told me to be patient. So, I will wait until they tell me otherwise” one woman tells me, looking down and covering her face, hiding what looks like frustration edging on anger. But she’s far too polite to betray these unbecoming emotions.

I’ve spent a lot of time lately thinking about what makes these women so willing to wait. Is it simply that they don’t know what their other options are? Are they afraid to return home without something to show for their time? They don’t have the money to leave? They don’t feel they have the right to leave? They are unwilling to offend their hosts?

I ask one woman why after three years without treatment, and a family to whom she’s become more and more peripheral as the months march on in her absence, she still waits. “While I’ve been away, my sisters have had babies, my cousins have married. I try not to think about it. Sometimes I call my parents and ask them if I can come home. They tell me to be patient. They say God will provide. They tell me if I were at home, there too I’d wait”.

Many claim that educating girls in school is the most powerful tool towards “development” – more powerful than improved roads or small-scale economic reform. Some posit that that the power of educating girls isn’t simply that schooling leads to literacy or improved arithmetic – allowing women to thrive in small business ventures and more actively participate in adding to the household economy (although I am sure that this is also true). Rather, the hypothesis is that women who’ve been educated are used to raising their hands and asking questions, standing in front of the class and speaking – in short, in school they learn to be assertive. (Similar findings on the importance of early education can be seen in the famous Perry Preschool Project  which demonstrates the lifelong utility of “soft skills” learned in early education in the U.S.).

Approximately 30% of girls and 40% of boys in Niger attend primary school. However, it is often noted that for women with fistula, those numbers are drastically lower. Of my sample, the women have an average of half a year of education, although the vast majority have never been to school.

Anthropologists are often far better trained in detecting problems than in identifying solutions. As I sit on a urine-soaked mat hour after hour, day after day, trying to understand the experience of living with fistula, I find it easy to bury myself in a surfeit of problems. I still haven’t figured out why these women are waiting so long for treatment.  There are still so many questions to be answered.  Still, before answers there is anger, and I feel moved to act. But, while I can identify structural violence and Foucaldian power struggles, I come up empty handed as to what to do. How to help. These women are entitled to solutions… but what are they?