![The Pain Gap: How Sexism and Racism in Healthcare Kill Women by [Anushay Hossain]](https://m.media-amazon.com/images/I/41hErFxT7PL.jpg)
Tiller Press, Paperback, 253 ppgs, $26.99, ISBN: 978-1-9821-7777-5
By Arnold Zeitlin 3 October 2021
Author Anushay Hossain grew up in privileged circumstances in Bangladesh. Her father, Anway Hossain Manju, is a long-time member of parliament, founder of his own Jatiya political party, a minister in several governments and editor of the Bengali daily Ittefaq. Her mother, Tasmima Hossain, known widely by her nickname, TipTip, also has served as a member of parliament and founded a Bengali magazine for women. Her late grandfather is Tofazzel Hossain Manik Miah, the earliest editor of Ittefaq, revered for his role in the movement that eventually led to Bangladesh independence. It wasn’t until she nearly lost her life giving birth did she recognize that poor healthcare kills women not only in Bangladesh and elsewhere in the undeveloped world but in the developed world as well. Out of her experience has come this book, part memoir of growing up in South Asia, part polemic against the medical treatment of women, particularly women of color.
Her education in Bangladesh about healthcare for women ranged from visits with her father to his Pirojpur-2 constituency in the delta country south of Dhaka to her own home in the Dhanmondi district of Dhaka. She spoke to rural women .who “shared stories about being pressured into caesarean sections at ‘big city hospitals’, their concerns being dismissed because they were female.” At home, her mother championed the plight of sex workers, inviting them to her home, where one woman named Shamoli told Anushay “your mother is the first person to treat us like human beings.” Her mother’s work, Ms. Hossain writes “…showed me…how dangerous it was to be a woman in an uber-patriarchal society like ours.”.
From the age of 3 to 17, Ms Hossain had a nanny, Wasifa. They grew so close her sisters joked that she thought Wasifa was her mother. Wasifa’s husband pressured her to give birth. A diabetic, she underwent a series of miscarriages. A doctor warned her that another pregnancy might kill her. She finally gave birth to a son in a normal delivery. But she hemorrhaged severely. By the end of her first day as a mother, Wasifa was dead.
“Losing Wasifa was a turning point in my seventeen-year-old life,” writes Ms. Hossain. “Wasifa’s death also made it impossible to ignore that for the vast majority of women in Bangladesh, access to healthcare was based on pure luck, and even then, it couldn’t save you”
When she was 8 years old, an aunt severely injured in an auto accident underwent treatment in a Dhaka hospital that was out of most basic supplies. The little girl pleaded with her parents to send the aunt to America for treatment.
“It wasn’t until later,” she writes, “that I realized how naive I had been…Giving birth in the richest country on earth, I never imagined I could die in labor. But I almost did. The experience put me on a journey to explore, understand and share how women — especially women of color — are dismissed to death by systemic sexism in American healthcare.”
She cites figures that Black mothers are three times more likely than white women to die in pregnancy-related issues (The mortality rate for Black mothers in Louisiana, Ms. Hossain reports, is the same as in North Korea, 72.6 for every 100,000 births. Finland. Iceland, Greece and Poland have the world’s lowest rate, 3 per 100,000). . For those who believe that poverty is behind the statistics, she noted the U.S. Center for Disease Control claims college-educated Black women are 5 times more likely than college-educated white women to die in pregnancy-related issues.
Ms. Hossain fills her book with a horrific litany of cases involving women of color who were maimed or who died as a result of malpractice, misdiagnosis or dismissal. Padma Lakshmi, for example, a TV host and author, suffered with pain for two decades of unproductive visits to clueless physicians before she found a doctor who diagnosed and treated her for a rare condition called endometriosis, a disorder involving diseased tissue growing outside the uterus.
The author offers solutions to poor female healthcare ranging from urging women to speak up to their doctors to a proposal from Reshma Saujani, the first Indian-American woman to run for Congress, for a Marshal Plan for Moms that included stipends for mothers.
Ms. Hossain has written an angry book that sheds light on an issue that confronts families the world over. It is a worthwhile, often disturning, read.