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Interview – Suchitra Dalvie

A front profile of Dr. Suchitra Dalvie.

Suchitra Dalvie is a gynaecologist with more than 10 years of experience in the field of development. She has worked on reproductive health and rights with national, regional and global organisations. Currently, she is the Coordinator of the Asia Safe Abortion Partnership. She has served on the Board of the Safe Abortion Action Fund, as well as Women on Web. She is currently on the Board of INROADS and a Champion of She Decides. Best known for her strong pro choice views and her unflinching support for safe abortion, Suchitra is also a blogger and a book lover, with deep insights on feminism and women’s rights. She is India’s first certified Conscious Uncoupling coach and has recently written a book called Roadmap to Managing Divorce. More on her work in this area is explained on her website.

Shikha Aleya (SA): Thank you Suchitra, for making time and headspace for this interview! We are emerging from behind the masks, physical distancing, and multiple health concerns of the COVID-19 pandemic. What do you spot from your vantage point today?

Suchitra Dalvie (SD): I think for me, the biggest, fascinating, and slightly alarming observation is how quickly we have forgotten that we went through a global pandemic, unprecedented in scale, which caused a lot of deaths. And we have just moved on as if it never happened! What we’ve done is, whoever has moved on and survived, we’ve just gone back to where we were earlier. People are probably not even extra invested in their own care, despite all that we have gone through. Even now, when I travel by flight, I tend to wear a mask, simply because COVID made me realise that I don’t really want to be deep breathing the air of 200 other people, many of whom are coughing, sneezing and having various viral infections. So I wear a mask and I tend to be the only one. People look at me sometimes with a little bit of curiosity, sometimes with alarm, as though thinking, “Why is she wearing a mask now?” So I find that very interesting.

A lot of the things which emerged during those days made the middle classes and the upper classes realise how broken our public health systems are – you know, all the news that created headlines in the newspapers about shortages and barriers to access. The first few times I saw these headlines, I just thought to myself that poor people and those living in marginalised areas or communities have always suffered this. They have never had access, easy access, to safe, effective, cheap, respectful, good quality healthcare. Now the middle classes are not finding it, so they are so alarmed by it. But what really bothers me is that despite all that, we haven’t really fixed the system.

Really speaking, many of our current health systems had been created at a confluence of the industrial and colonial ages with a few countries also having a welfare focus. But it has not really worked for most people, most of the time. Although that is exactly what it is meant to do as a public system. It needs to provide healthcare for the public! That’s really what the government’s role primarily is, and this is something I often say in our workshops that people came first and governments came later – but the way governments behave now, it’s almost as if they own us and we exist only to serve their interests.

SA: In light of this, what is showing up for you in the big picture landscape of SRHR, sexuality and social justice?

SD: We’ve definitely failed to take advantage of the potential or the opportunity to really go all in and say – Look, the system is broken; the next time something like this happens, we are all going to suffer very greatly, so let’s amp up the public sector health facilities. Let’s put our resources there, put our thinking caps on, figure out a way to make it work.

The Black Plague wiped out one-third of the population of Europe and in some ways paved the way for the Renaissance! The Bombay Plague led to the founding of the Haffkine Institute and reshaped the city that was the second most important port after London.

What dramatic shift in healthcare seeking behaviour or healthcare facilities have we seen post COVID?

Especially in the landscape of SRHR, or sexuality, again what I see is, it’s kind of just been a blip. We haven’t really learnt anything much from it. Some countries legalised telemedicine for medical abortion during the pandemic and that has stayed with them, but again, very few, just a handful of countries. India, for example, brought in telemedicine guidelines but neither included, nor specifically excluded abortion, or medical abortion pills, so we lost that opportunity there as well.

Two things that showed up in a big way is that, one, we don’t have enough trained healthcare personnel, whether at community level or at tertiary care level, to take care of the populations that they should, in an ideal ratio. The second thing that showed up was that the vast majority of these healthcare providers are women. Neither the systems, nor the communities, nor any of the other structures really take into account the very high level of double duty these women are doing. They are primary caregivers, primary parents, homemakers, in the domestic sphere, but they are also your nurses, lab techs, doctors, surgeons, pathologists, radiologists, they’re everywhere.

The huge number of women that are a part of the healthcare services and that we don’t see that as an important enough fact to uplevel the way healthcare systems work in order to support these women, I think that to me, showed up as a glaring blind spot. For many people, working from home was a whole new context, particularly for women, even in civil society. Working from home actually meant double, triple duty because you were looking after the elderly and the sick at home, cooking and domestic chores, managing the children’s online schooling, as well as trying to put in eight hours at work.

Women and the queer community were even more vulnerable to domestic violence (and I really dislike that framing because what is the opposite of domestic violence? Feral violence? State-supported violence? Violence is in itself an absolute term, never to be minimised by labelling it as ‘domestic’!)

During the pandemic and with lockdowns, people facing violence at home couldn’t even leave or spend time away and suffered greatly with no support from the system.

As I said, to me, standing here right now, almost half way through 2024, it feels like for many people, they would rather just forget the pandemic even happened. That is quite disturbing, because we had this huge opportunity to shift things in a big way. That’s really a failure of people like us, policymakers, leaders, who had the privilege and the potential to do that.

But at the end of the day, we are also human, we were also in lockdown, we also had our own limitations. So there has been this wave of, what they call in the US, the Great Resignation, where people left unfulfilling and underpaid jobs in thousands. But there has also been a wave, that I see in my work as a divorce coach, of what I call The Silent Separation. Many people, many women particularly, disengaged and disconnected because they did not have emotional safe spaces, either within the house or outside. I think the loss of social spaces at that time, did definitely have an impact on people. There is, I think, even now a vast amount of unrecognised mental health and emotional health issues that people are grappling with and struggling with and navigating, and now the whole conversation around it has also died down. That is what I see in the big picture.

SA: When speaking of access to services such as contraception and abortion, you have used the phrase “high level of secrecy”. Do you feel the pandemic caused upheavals related to privacy, secrecy, and being found out? What would you say to families, friends, co-workers, and communities, that could help in negotiating relationships and be both positive and supportive going forward from here?

SD: In terms of the access to services, the pandemic definitely caused upheavals because privacy is one thing, secrecy is another. Privacy is when you say – this is my private matter. Secrecy is when you are terrified of harm, or some kind of injury or even death if you’re found out. In this context, here is a quote, attributed to Oscar Wilde, that I think is really important: “Everything in the world is about sex, except sex. Sex is about power.” We spend so much time and energy, collective energy, in creating rules, monitoring people, conducting surveillance, ensuring the rules are followed – everything really is about the power that derives from sex. What we control is actually sexual relations, but I think that is because collectively, that is all we grasp. Why we are freaked out by people who are different, or by somebody who dares challenge cis heteronormative patriarchal norms of when and who should have sex, is because we see, inherently, that sex has power.

So, what would I say to families, friends, co-workers, and communities that could help in negotiating relationships and be both positive and supportive? I think that’s the game changer, right? Because none of these groups is homogenous.

In families, you may have one parent who is very conservative in their political beliefs, one parent who is not confident enough to face up to their own identity and therefore willing to subsume to a different power dynamic, or just follow what they have been told is good. I don’t think I put that much weight on families. I mean especially with the work I’m doing as divorce coach, families seem to be the hotbed of a lot of damage, whether deliberate or inadvertent. Of course, parents damage their children, whether they want to or not, whether they do what they think is good parenting, or not. For children to recognise that, and emerge from it in adulthood without causing further damage to their own children, I think that too is a game changer.

So families are made up of individuals, communities are made up of individuals. I think what I would urge is, creating systems of support within existing systems which already take on that role. So whether it is a system of support within healthcare services, within educational facilities, or within services like police – who are supposed to actually protect the vulnerable or prevent crime – I think those systems need to be upleveled first.

What I feel is, even if communities or families are supportive, they need to be able to refer to someone, there still needs to be someone who, in some kind of professionalised way, trained way, has the capacity to offer support, to redirect ahead. I think those systems need to be in place. That’s my perspective.

SA: Suchitra, thank you for bringing awareness to the concept of systemic support, as a need and a requirement. A last question please! How would you connect safety, inclusion, and an environment that fosters the ability to be self-affirming to conscious awareness of healing and recovery from what we experienced as a global pandemic?

SD: Globally, post-pandemic, if anything, we have seen a resurgence of conservative values. We’ve been seeing what’s happening in the US, one state after the other going down like nine pins, coming down on women’s right to control their bodies through abortion. Wherever we see criminalisation increasing and rules increasing, it always makes me question the role of government. Government is there for governing. The government is not there for ruling. We got rid of the kings and queens and we replaced them with what looks like a democracy but isn’t something that is necessarily catering to the greatest good of the greatest number. Laws that are actually meant to protect somebody who is most vulnerable in a particular situation are ending up being more punitive.

Another point I want to make is something I had posted in an ASAP blog a while ago now. It was very frustrating for me, when we were working on proposing amendments to the MTP Act. The MTP Act did get amended in March 2021, after being tabled in March 2020, right on the cusp of the pandemic, so everything got postponed. It was presented by the government as an Act for women, but it doesn’t really shift the power. It is still an Act which protects service providers from being criminalised. It does not shift the locus of power from the provider to the seeker. That was very problematic for me. So one day I wrote this satirical piece called The Creation of Pregnancy Act, in which I postulated that only under certain circumstances, with approval of three people, and an entire Board, and this and that, ensuring financial and emotional capacity, etc., then only, in a specific location, like the MTP Act says, in a specifically approved place, in presence of a specifically trained and certified person, then, and only then, are you allowed to create a pregnancy. It shows the absurdity of what is considered normal and what we are trying to control!

It seems to me that restricting abortion really is at the heart of patriarchal control, because what abortion does is allows a woman or a pregnant person to terminate an unwanted pregnancy. Now, many pregnancies which are planned can also become unwanted for various reasons, health reasons more often than not. But they can become unwanted due to social reasons as well, like if a relationship breaks down or something like that.

Inherently, an unwanted pregnancy, to start with, is in a body which is considered to not be suitable to be pregnant at that time. So either it’s an unmarried girl, or it’s someone who is married but having the pregnancy with someone else, or it’s someone who is separated, widowed, perhaps a sex worker, or a transman maybe. If such bodies could terminate an unwanted pregnancy, easily, safely, effectively, then the punishment that comes to them as a result of this visible growing pregnancy, and their struggles to terminate and get rid of that pregnancy, if all that is eliminated, then these persons could have sex with as little consequence as men currently do.

That is the biggest terror for patriarchy, because if that is something that women are able to do – have sex, whenever they choose, with whoever they choose, the way men have the freedom to, without having to bear on their own bodies the growing or visible or obvious consequences of that sex, then what else is really going to control them? Marriage is like a watershed moment. Before that you can never have sex. After that you must have sex. Before that you can never have children. After that you must have children. It’s still very much the cis, heteronormative, patriarchal system, in which your worth or your place within that system is determined by whether you fulfil all this – whether you are a heterosexual person, man, woman, producing a child, preferably a son, who will then inherit your property.

We have to be able to shift this kind of thinking, which is not impossible to do. I love what Ursula K LeGuin said in an acceptance speech: “We live in capitalism. Its power seems inescapable. So did the divine right of kings. Any human power can be resisted and changed by human beings. Resistance and change often begin in art, and very often in our art, the art of words.”

We think it’s ludicrous now, that one person should be allowed to dictate, control and rule over people. So maybe this is the other future we need to aspire towards, where we dismantle all these oppressive structures and see children as our opportunity to do better with the next generation. Not an opportunity to load their shoulders with our dreams and aspirations for some nebulous success metric which has been created through largely a capitalist system.

We need to free ourselves from the burden of needing to control sex and sexuality, constantly prepared for war so that you can ensure peace. Being able to have sex with another being in order to reproduce was a huge milestone for evolution of life on this planet compared to say amoeba who reproduce by just dividing into two. But humans have sex not just for procreation but also for pleasure and to assert power! This is why we do need a shared understanding of where the boundaries lie.

My own healing journey made me realise that even though I had so much education, experience and privilege, I had very little emotional literacy! I didn’t know what I didn’t know. Getting to know who I really am has been a game changer. Prejudice, anger, control and violence all emerge from fear. What are we always so afraid of? If each person is comfortable with who they are and can live with acceptance and compassion towards their own self, then there is no need for external validation and any desire to control or assert power over others, whether in the domain of sex and sexuality, or gender, or any other identity.