Article
Change
Climate
5 min read

Chasing the rains: why gender equality matters in development

An encounter with a Maasai woman, leaves Jane Cacouris pondering another encounter at a well.

Jane Cacouris is a writer and consultant working in international development on environment, poverty and livelihood issues.

Girls stand in the northern Kenyan scrubland holding water bottles.
Girls stand in the northern Kenyan scrubland holding water bottles.
Tucker Tangeman via Unsplash.

Rural communities living within Kenya’s vast, desolate and beautiful arid and semi-arid Lands have suffered over the past two years from the drought that has hit the entire region. Rainfall during the “rainy seasons” has been in decline, and with more than 80% of Kenyans reliant on agriculture to survive; livelihoods and food security are at risk. Livestock numbers have depleted, and the cattle that are still alive are underfed and unproductive. Women and girls, their skin shining with perspiration as they carry yellow jerry cans strapped to their heads, trek for up to tens of kilometres a day.  

They are in search of life-giving water for their livestock and families, returning home each day with shoes and feet scuffed with sun-scorched red dust. This is not an image from decades ago… before we started working towards global sustainable development goals and COP targets. No, this is happening right now in our world.  

Speaking to a Maasai woman living in a remote part of rural Kenya on a recent work assignment earlier this year, I asked her about the impact the drought was having on her community who are mainly rely on nomadic cattle herding to live. She explained that the men were leaving for months on end in search of pasture for their cattle; “they are chasing the rains” and leaving women to run the households and try to make ends meet, looking after children and extended family.  

But the women at home lack authority to make any decisions; about the land, about supplementing income with other employment, or about crops or food choices. They are disempowered by the social and cultural norms within their strict patriarchal Maasai society, and unable to stem the cascading flow of worsening poverty.  

Extreme weather events also increase the work burden of women and girls and their ability to perform their everyday tasks. They must walk further to collect firewood and water due to dwindling resources. 

ccording to the UN’s Food and Agriculture Organisation, people in poverty are more susceptible to climate change than wealthier people. Their livelihoods and assets are more exposed and they are more vulnerable to natural disasters that bring disease, crop failure, spikes in food prices and death. The World Bank estimates that without immediate action, climate change could push 120 million more people into poverty by 2030. And of those, the threat of climate change on agriculture in Africa could push 30 million people into extreme poverty.  

Gender inequalities present in many countries and societies exacerbate this already existing vulnerability of the poor to climate change. And women and girls are disproportionately affected by climate change. For example, an increase in child marriage has been observed in communities as a means of coping financially when a disaster occurs, such as a drought or flood. Families raise much needed additional funds through dowries. Extreme weather events also increase the work burden of women and girls and their ability to perform their everyday tasks. They must walk further to collect firewood and water due to dwindling resources. Women often lack land rights that are passed down through generations along patrilineal lines, as is the case in Kenya. Women’s access to climate emergency funding - in areas where such funding is available – is therefore limited as they don’t possess the collateral, in the form of land rights and ownership. In short, women and girls fare significantly worse than men and boys when it comes to the impacts of poverty and climate change on wellbeing.  

So what does Jesus think about gender inequality?  

Jesus treated all people with equal love and respect. Gospel writer Luke, records that He talked with respect about the Samaritans who were seen by the Jews as racial inferiors, he reached out to prostitutes, and to lepers who were social outcasts.  He without doubt had a special sensitivity to those on the margins and towards those who are poor.  

And Jesus goes one step further. He also demonstrates a radical approach to gender equality in the Bible. For example, John, the writer of another gospel, describes his encounter with a woman at a well. As Jesus passes through a town on his journey through Samaria, he is tired and stops to sit by a well. When a Samaritan woman approaches to draw water, he asks her for a drink, and begins a conversation that leads to Jesus showing her that he is the son of God. This speaks about gender equality in several ways.  

First, Jesus spoke to the woman at a time when it was forbidden for a man to talk to a woman in public, even a wife or daughter. Jesus was also a rabbi which would typically create multiple barriers between him and the woman; in terms of race, gender and lifestyle. But these things were not barriers for Jesus. He spoke to the woman as a human being. He demonstrated equality.  

Second, Jesus is vulnerable with her, asking her for a drink because he is thirsty. Here is a man asking a woman for help, openly admitting he needed something from her.  

Third, Jesus ignores The Talmud, a Jewish commentary on the Pentateuch, that taught it was immoral to teach a woman the Law.  

“Jesus answered her, “If you knew the gift of God and who it is that asks you for a drink, you would have asked him and he would have given you living water”.  

He discusses theology with her. Jesus did not regard his Jewish racial identity or being male as superior. Jesus clearly demonstrates through his actions in this passage that all who trust in Christ are equally God’s children, valued without differentiation or discrimination based on race or gender.  

As Jesus shows in this passage in John’s gospel, he doesn’t consider women feebler, less capable or less intelligent than men. Throughout the Bible, he continually recognises their value. In parallel, much evidence shows that greater gender parity in the world today would make it a richer and more sustainable place for human beings, biodiversity and the environment. Improved nutrition, food security, livelihoods and health come from greater access, benefit-sharing mechanisms and employment opportunities for women.  

For example, when women have greater control over household resources, spending patterns shift towards catering more for families’ food and education. According to the OECD, in Kenya and Malawi, levels of malnutrition are found to be lower among children in female-headed households. An NGO project that worked with women in agriculture across six countries found that when women were given ownership of land and when women’s participation was improved in farmer’s collectives, income from agriculture increased between 40 and 165 per cent. If vulnerabilities caused by poverty are reduced by supporting and recognising women as equal to men, this translates into households and communities that are less vulnerable and more resilient to the effects of climate change. It is all connected.  

Humanity can not “chase the rains” forever. In our race to find more stability and sustainability in this changing world, perhaps it’s time to take Jesus’ lead and really recognise and value women equally to men, both as people, and for the contribution they can make to lives, livelihoods and our world.  

Article
Change
6 min read

Are we forgetting how to care?

The profound act at the heart of nursing.

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

A nurse bends beside a bed and talks to a patient
Marie Curie.

Recently, at a nursing leadership programme in Oxford, attendees focused on the fundamentals of care.   Have we forgotten how to care? What can we re-learn from those who pioneered an ordinary yet profound act that affects millions?" 

Anam Cara is an old Gaelic term for ‘soul friend’, a person with whom you can share your innermost self, your mind and your heart. It is a term that Tom Hill, former chief executive at Helen House Hospice in Oxford, used to describe the relationship between his staff and the thousands of children and their families who passed through their ‘big red door’ in its first twenty-five years. The hospice (or ‘loving respice’ as it became known) had been founded by Sister Frances Dominica in 1982.  

Other care in this country can also trace its religious roots. Between 1048 and 1070 in Jerusalem, the Order of St. John was founded for the purpose of helping pilgrims (“our Lords, The Sick”) who had become lost, weary, or beset by other difficulties while on their way to the Holy Land. Today, in the United Kingdom, the British Association of the Order has extended care to older people first in almshouses and later in care homes. A trustee for ten years was John Monckton, a man of ‘considerable talent, enormous integrity and deep religious conviction’; his tragic murder in 2004 led to the creation of the John Monckton Memorial Prize, which recognised and rightly celebrated commitment to care by care workers. 

Today, across the world, seen and unseen, nurses, carers and families continue to provide compassionate care. “Assisting individuals, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge” is the very essence of nursing, captured by ‘architect of nursing’, researcher and author Virginia Henderson in 1966. Meeting more than basic needs such as breathing, eating, drinking and eliminating bodily waste (which are of essential importance), Henderson recognised the role of the nurse in enabling humans to communicate with others, worship according to their faith, satisfy curiosity and sense accomplishment.  

In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care?

An uncomfortable truth brought out in healthcare reports such as the Final Report of the Special Commission of Inquiry (The Garling Report) 2008, and the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (The Francis Report) 2013 is though that this type of nursing is too often done badly or even missed, leading to pressure injury, medication errors, hospital-acquired  infection, falls, unplanned readmission, critical incidents and mortality. According to nurse scientist and scholar Professor Debra Jackson, “missed care occurs much more frequently than we might think”. She cites a systematic review in which ‘care left undone’ on the last shift ranged from 75 per cent in England, to 93 per cent in Germany, with an overall estimate of 88 per cent across 12 European countries’. 

In one offensively-titled paper, “Shitty nursing - the new normal?” (in which the authors apologise for the title but not the questions raised), real-life pen portraits are drawn of patients lying for hours on hospital trolleys, immobile through infection or injury, ignored by staff. Whilst acknowledging contextual factors for poor care, such as a shortage of nurses and resources, the authors argue that circumstances cannot be the sole cause of missed nursing care. 

A report published by the University of Adelaide, School of Nursing, has called for nurses to ‘reclaim and redefine’ the fundamentals of care. It asks whether the cause of the problem (of missed nursing care) lies “deep in the psyche of the nursing profession itself?” “Has something happened to the way modern nursing views and values caring?” it continues. “Indeed, is nursing in danger of losing its claim to care? In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care? Or is this a broader social pattern where individuals are less inclined to show kindness, compassion, and care for others even if it is a necessary requirement of the job?” 

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness. 

Writing in the British Medical Journal, Professor of critical care medicine Peter Brindley and Consultant in intensive care Matt Morgan wonder whether doctors also “too often default to high-tech and low-touch” when patients are dying – a time “when community and connection matter most”. They powerfully begin with a mother’s comment: “Humans are gardens to tend – not machines to fix.” 

Professor Sir Al Aynsley-Green, the first National Clinical Director for Children in Government and former Children’s Commissioner for England, and past president of the British Medical Association, suggests that we as a society need a “momentum for compassion”. Struck by the extremes of compassion witnessed during his wife’s treatment in the last years of her life, Sir Al wants to see a cultural transformation in healthcare: for compassion to be a key operating principle in NHS and care settings, led by the Chief Nurse’s Office; for every organisation to promote the importance of compassion at the professional level; for the views of patients and families to be sought regularly; for much earlier and better focus on compassion in undergraduate and postgraduate teaching programmes for all staff; for compassion to be inspected against by the Care Quality Commission; and for a willingness to encourage staff at all levels to expose poor practice as well as celebrating excellent care.  

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness. “It’s putting yourself into somebody else’s shoes – and doing something about it.” Recently appointed the UK’s first Visiting Professor in Compassionate Care at Northampton University, at the age of 80, Sir Al certainly is doing something about it. He has made it his new purpose in life to “embed compassion into every aspect of care”.  

Like Sir Al, Queen Elizabeth II, the UK’s longest serving monarch, espoused compassion, in word and deed. Living a life of compassionate service, the Queen made clear that her Christian faith was her guiding principle. She speaks of Jesus Christ as ‘an inspiration,’ a ‘role model’ and ‘an anchor’. “Many will have been inspired by Jesus’ simple but powerful teaching,” she said in her Christmas Broadcast, 2000. “Love God and love thy neighbour as thyself – in other words, treat others as you would like them to treat you. His great emphasis was to give spirituality a practical purpose.”    

When nurses do unto others as they would have done unto themselves, and act as role model to colleagues, not only do patient experiences of care and their outcomes improve – but so does job satisfaction for nurses: a critical factor in nurse recruitment and retention – the biggest workforce challenge faced by healthcare organisations. Across the UK, there are currently more than 40,000 nursing vacancies, and thousands of burnt-out nurses are leaving the profession early. Whether nurses decide to stay or go is driven in part by their daily experience at work. The late Kate Granger, Consultant in medicine for older people, inspired Compassionate Care Awards in her name, envisioning that such a legacy would drive up standards in care - and surely also help retain nurses, through restoring a sense of pride, achievement and fulfilment to the nursing workforce.