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Review by Cynthia Peters

My dogeared copies of Where There is No Doctor, A Village Health Care Handbook (the Hesperian Foundation) and an early edition of Our Bodies Ourselves (Boston Women’s Health Book Collective) both have bent covers, broken spines, and ripped pages. They have absorbed coffee spills, close encounters with mud puddles and leaky roofs, and much handling from me and my friends who have pawed over them eagerly trying to understand our bodies and affect our health care.

In the 1970s, I looked to Our Bodies Ourselves for personal information as well as a political framework for understanding women’s healthcare and patriarchal views of women’s bodies. In the 1980s, I dragged Where There is No Doctor along with me on various sojourns to Central America. I consulted it when we had private run-ins with malaria and other tropical diseases, and it was a comfort to know that its straightforward explanations and simple drawings might be of great consequence to us and others around us when we were far from medical help. Perhaps most importantly, both books demystified and politicized health care. Although some health problems require expert medical attention, there is much that we can do on our own to positively affect our health.

Now the Hesperian Foundation has provided a groundbreaking service to women and communities all over the world. Where Women Have No Doctor speaks directly to women about their health, providing step-by-step instructions for diagnosing and treating all sorts of illnesses and injuries, and concretely grounds women’s health in a social/political/economic context that allows women to see the political roots of some of their health care problems. Moving fluidly between the micro and the macro, the authors drive home the point that diagnosis and treatment do not always require experts, that being empowered individually and as a community is integral to good health, that the solution to many health related problems does not always lie in treatment and access to health care, but access to a "fair share of the resources in their communities and in the world."

Thanks to the many people who made the book a reality—four authors, dozens of illustrators from all over the world, numerous consultants, editors, writers, researchers, and producers—Where Women Have No Doctor never shies away from relating health care to social and economic justice. The underlying premise is that women are disproportionately affected by poverty, overwork, violence, discrimination, and lack of access to legal rights. Structural adjustment—global capitalism’s response to Third World debt—is mentioned as one of the negative influences on women’s health because it contributes to their poverty and disempowerment. In addition to analysis, Where Women Have No Doctor gives concrete suggestions for how women can work for change in their families, communities, and countries. Using short descriptions of real-life stories and cartoon drawings of women sharing feelings and ideas about their health, their status in the community, and ways they might affect change, the book communicates a radical view of what it means to be healthy.

Here’s a small sample of what you will find: step-by-step instructions on medical procedures (such as how to deliver a breech baby) and mundane tasks (such as how to lift a heavy object), but also how to lobby for an improved diet. With chapters on Work, Pregnancy, Growing Older, Abortion, AIDS, Sex Workers, Cancer and Growths, Mental Health, and much more, Where Women Have No Doctor speaks to individual women and community health workers. It offers enough explanation for lay health workers to perform simple tasks on their own and it educates women about what they should expect during a medical procedure. A detailed index answers questions about the form the medicine comes in, the side effects it may have, and how much to take.

Throughout, there are illustrations, diagrams, and cross-references—all attractively laid out. Various chapters were field-tested in communities around the world to ensure that the writing and illustrations would be culturally appropriate and useful.

Currently working on the Spanish, Arabic, and Haitian Creole translations, the Hesperian Foundation is also planning a Chinese edition. The book will be of great use in villages and communities around the world, including the United States where immigrant women, because of the their legal status, are afraid to seek medical help and in poor urban and rural communites and Indian reservations where medical care is in short supply or women are simply not empowered to seek it.

Whether you want to address a specific concern or are trying to understand the ways your place in the community and the world, the environment, the economy, and the family operate on your health, Where Women Have No Doctor gives you the tools to make a change for the better.