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Most Canadians who watched the mega-popular adaptation of Margaret Atwood’s The Handmaid’s Tale (available on CraveTV) had the same thought: what a relief it is to not live in Gilead, a place where women are treated as second- (or third-, or fourth-) class citizens and subjected to strict controls, harsh punishments, and a complete lack of reproductive rights. But the scary truth is that there are places where the world portrayed in The Handmaid’s Tale comes uncomfortably close to reality—and some of them are closer to home than you might think.

The good news? You can do something about it. We spoke to Plan International Canada’s Senior Gender Equality Advisor, Saadya Hamdani, Carrie Schram, a family doctor with specialist training in women’s and public health, and Kelly Gordon, a Professor in Political Science at McGill University, to find out the ways that The Handmaid’s Tale borders on real life—and what we can all do to make sure it remains in the realm of fiction.

Just like in Margaret Atwood’s Gilead, there are millions of women and girls in the developing world who don’t get to decide their own reproductive future

Atwood has said that the world she created in her novel was simply an extension of the things she saw happening in the real world. Plan Canada’s Saadya Hamdani agrees: “Far too many women and girls around the world are denied their right to make decisions about their sexual and reproductive health. They cannot freely decide whether or not to have children, the timing, number, or spacing of their children, or with whom they have children, often because of coercion, discrimination and violence.”

Hamdani’s organization “works hand in hand with women, men, adolescent girls and boys, and religious, traditional, and community leaders to promote the value of girls and women in their societies, to engage men and boys as partners of change, and to support the empowerment of women and girls to lead the work towards gender equality that benefits everyone.”

To support their amazing work with your time or money, go here.

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Even when reproductive care exists, it’s not always accessible

In Gilead, Handmaids lived just across the border from Canada and the TV and IRL versions of our country look pretty similar. “In Canada, in the last couple of years, we have a lot to celebrate in terms of securing abortion rights,” Prof. Kelly Gordon says. “That often gets lost in this broader tragedy that’s happening at the international level. We’ve seen the extension of abortion care in the Maritimes. A lot of provinces have said they’re going to 100 per cent fund Mifepristone. And there’s a lot of survey data that says when abortion rights come up in political discussions in Canada, Canadians actually become more supportive of abortion rights as opposed to less.”

And yet for women living in remote, rural communities, access to abortion is still a huge challenge. “One of the outstanding problems in Canada is that often women have to travel long distances to access abortion care,” Gordon says. “The National Abortion Federation has a travel fund for low-income women… this is a fund that helps women who wouldn’t be able to afford to get to an urban centre. There are always women who need that money for childcare, for travel, [or] for a hotel overnight.”

You can donate to the fund here.

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Being a pregnant woman is dangerous to your health

Offred’s friend Janine suffers a complete mental health breakdown as a result of her forced pregnancy and the subsequent separation from the child she gives birth to. The character, played by Madeline Brewer, even attempts to take her own life.

For women in developing countries, the health risks are even more immediate. “Far too many pregnancies and births are characterized by death—of the woman, the baby, or both,” Hamdani says. “A woman dies of preventable causes related to pregnancy and childbirth approximately every two minutes. The situation is particularly dire for adolescent girls, who often face significant obstacles accessing appropriate maternal care, and who face additional health risks due to their age. Complications from pregnancy and childbirth are the leading cause of death for girls aged 15 to 19 across the world.”

According to Gordon, “Action Canada [for Sexual Health and Rights] is a great place to donate to—they do a lot of work at the domestic and international level.”

You can learn more about their program here.

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There are very few ways for women to protect themselves from sexually transmitted infections

Because conception is the goal, the implication is that sex in The Handmaid’s Tale is unprotected—and so women are at a huge risk of contracting STIs (men in Gilead still visit sex workers, even though it’s illegal). Women in the developing world face similar challenges in protecting themselves from STIs. “According to UNAIDS, HIV infection rates in girls and young women ages 15 to 24 are twice as high as in boys and young men, and account for 22 per cent of all new HIV infections,” Hamdani says.

“Girls, adolescents and young women are at greater risk of contracting HIV/AIDS when they are unable to negotiate safe sex, which is common in situations of child, early and forced marriage and sexual violence. Furthermore, the majority of women and girls we work with have little knowledge of sexual and reproductive health care issues, the risks they face, and where to find services.”

Locally, you can support your community’s sexual health centre, like The Bay Centre For Birth Control or the Hassle Free Clinic in Toronto, Ont.

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Men make the decisions about women’s access to healthcare and birth control

“In Nigeria, only about one-third of women make healthcare decisions for themselves. However, in the Nigerian communities where Plan International works, less than 1 per cent of women make their own healthcare decisions. Similarly, in Senegal, less than a third (19.7 per cent) of women make decisions on their own healthcare, meaning that they have virtually no decision-making capacity in their own households,” Hamdani said. “This means that in order to seek healthcare, they need to first get permission from their father, husband, or another family member. However, even if women and adolescent girls are able to seek out healthcare services, they are likely to face difficulty obtaining appropriate care once they get to the healthcare facility, especially if they are not accompanied by a male partner or family member.” This will sound very familiar to anyone who remembers the scene in which Elizabeth Moss’ Offred visits a doctor under uncomfortably close guard.

In places much closer to home, like Texas for example, women’s decision-making power and access to reproductive health services is declining at a scary-fast rate, thanks (eyeroll) to a charge led by the state’s male governor, Greg Abbott.

To help boost Planned Parenthood in the U.S. (which is at serious risk of being defunded under president Trump) go here.

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In many places, gender equality is a distant goal

Like in Gilead, men remain the authority on when and how reproduction happens in many developing countries. However, Hamdani says, “Plan International is working to help change the birth story in Bangladesh, Ghana, Haiti, Nigeria, Senegal, Tanzania, Malawi, and Mozambique. This means empowering women and girls as leaders of change for gender equality and engaging men and boys as partners in this change. Working together as equals, women and men and boys and girls can help reduce maternal and newborn deaths among the most marginalized and vulnerable women, adolescent girls and their children, and promote gender equality.”

You can express your support for Plan’s mission to change the birth story by adding your name to this list, here.

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Menstruation is taboo

In The Handmaid’s Tale, menstruation is viewed as a failure and a disappointment. In many place in the developing world, it’s also stigmatized. Girls often have to skip school due to a lack of proper washrooms, and access to sanitary supplies. In some places, they are even banished from their homes during their period. “We are seeing gradual progress,” Hamdani says. “[On] August 9, the Nepalese parliament successfully passed a law criminalizing the practice of banishing girls and women from their homes during menstruation.” The new law is proof that political engagement works.

“All of us need to exercise our right to vote and vote in accordance with our fundamental beliefs,” Dr. Carrie Schram says. “It’s important at every level of governance. It’s also important to express our views to our elected officials—through town halls, letters, and email. We need to challenge candidates to clearly and explicitly state their views on reproductive issues when they are running for office and ask the hard questions.”

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Our country borders one in which abortion rights are being clawed back dramatically

Like we mentioned, the real Canada and the fictional Handmaid’s Tale version both share a border with a place where reproductive rights are under attack—and have been, at a state level, for the last three decades. “I think it is naive to think that the ideas leading to the legislation limiting reproductive freedom in parts of the U.S. could not have an influence on people here, and our own rights and freedoms,” Dr. Schram says. “For people who believe reproductive rights should be limited, hearing and seeing the events in the U.S. can be encouraging and empowering. I believe women—and men—should be nervous.”

But, she adds, “there are many ways we can protect our reproductive rights. We need to start with being informed and educated and follow that up with vocal opposition to any threat that comes forward. We can reach out to politicians, write letters and participate in peaceful demonstrations. We can support organizations who serve to protect reproductive rights and volunteer with local reproductive rights centres. We can teach our children to be open minded, respectful and knowledgeable about their rights as well.”

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Our rights, and the rights of people the world over, are precious and worth protecting. If we’re ever tempted to say, “It can’t happen here,” we can look at where it is happening, and just how easily it happened in this fictionalized account and ask ourselves again, “Is it really that far fetched?”

Watch the first season of The Handmaid’s Tale on CraveTV.