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By Lindah Mhando
This is a dedication to my dear sister friend Aaronette White. The use of the word “warrior” doesn’t suggest women as warmongers ready to pick up the sword; instead it deploys critical thinking on how issues of Womanist health can be thought and re-thought in the academy. To me this topic raises many personal health, political, philosophical, and pedagogical questions. I first briefly comment on the sparse link and nodes between poverty, oppression, and poor health in black communities; I then talk about the complicated relationship of black women’s health and the Ivory tower, and conclude with a statement on my personal trajectory as a stroke survivor.
Indeed, feminists-womanists who have gone too soon blazed the trail in black women studies. The pressing issue of our times is the very question put forth by our beloved Barbara Smith, “Is it possible to be a Black woman academic and live?”
(Re)thinking /black feminism/s and (Re)membering black health
The fear and distrust of the health care system in black communities is the logical response to the history of experimentation and abuse that the previous generation endured. The body, therefore becomes the site of profound struggle in black communities; an indication that there are implicit and complex links between global power relations, local experiences in spatial location, and women’s subjective experiences of health, illness and disability.
In the last couple of decades, feminist sociologists have become increasingly engaged in feminist research on the subject of feminists’ theory and research on various areas. Notwithstanding, only few studies included the experiential knowledge and the work engaging critical theory particularly that of the health of Africana woman. With respect to the patterns in health status or health care service usage such as the right to choose, and struggles over the body, feminist geographers and those in the bio-ethics fields, have made strides in articulating overall health related issues (Gober & Rosenberg).
The foundational moments of feminism in the 1970s was realized by the momentous events choreographed by black women who “broke the silence.” In the 1980s, Women developed a “voice” about their womanhood (Collins 1990). They used this standpoint to “talk back” (hooks 1989). Thanks to them, it was during this period in time where Toni Cade Bambara’s Salt Eaters (1980), Paule Marshall’s Praise song for the Widow (1983), Gloria Naylor’s The Women of Brewster Place (1983), Toni Morrison’s Beloved (1987) among others, came to the forefront, to articulate the conditions of black women and their health in their communities. They also challenged medicine into rethinking its role in healing in black communities. They foregrounded the connection between an individual’s physical well-being and her collective history.  Thanks to these sojourners who advanced the discourse on women and health, albeit not at the risk of being ghettoized, the discussion has continued to conceptually flourish and debates on women health and illness ensue. Ever since, inroads have been made into facing up to intersectionality and integrating oppressions, although very little is being said in regard to the relationship between the political economy of race and the inescapable nexus between poverty, oppression and poor women’s health.
Conversely, the wide criticism by the feminist wave in regards to the claim of women as homogenous groups may be traced from late 1970s. Black women from various backgrounds challenged the notion of homogenous womanhood. From a context that has known both colonial domination and neocolonial exploitation, international comparison enhances the understanding of how ‘where women live and what they do’ profoundly affects their health status and access to health care, emphasizing gender relations as the crucial locus of power. Relative poverty is a major risk factor for increased morbidity and mortality, both nationally and internationally. For example, HIV/AIDS in Africa (Craddock, 2001); sexually transmitted diseases in India (Tripathi, 2001) and low birth weight babies in New York city (McLafferty & Templaski, 1995) are produced in conditions forged through complex relations and scales of economic and patriarchal power that constrain women’s ability to achieve ‘safe womanhood’ (Lewis & Kieffer, 1994).
More recently, other feminists like bell hooks, in the “Sisters of the Yam” (1993) made a salutary dedication to Toni cade Bambara’s The Salt Eaters. hooks articulates black women’s healing and multiple paths of healing and ways of thinking spiritually. This book, transformed my consciousness not only as a black woman but as a stroke survivor.
Nonetheless, further examination with respect to the connections between gender, health, poverty and also power distribution in public health still remains a myth in black communities.
Health and Womanist Warriors
Specific statistics on Black women and cardiovascular health are dismal. According to the Center for Disease Control (CDC), the stroke is a leading cause of death in the United States. Over 800,000 people die in the U.S. each year from cardiovascular disease and strokes. Someone in the United States has a stroke every 40 seconds; translation, every four minutes someone dies of a stroke. Strokes are among the five leading causes of death for people of all races and ethnicities; but the risk of having a stroke varies. The National Stroke Association asserts that, one half of all African American women will die from stroke or heart disease. Compared to whites, African Americans are at nearly twice the risk of having a first stroke, and ironically it’s not just the poor or uninformed, or uninsured who are most at risk. African Americans and Hispanics are more likely to die following a stroke than whites.
A stroke, sometimes called a brain attack, occurs when a clot blocks the blood supply to part of the brain or when a blood vessel in or around the brain bursts, damaging parts of the brain. In 2011, data from British Medical Journal, in five European Centers, concluded that between 20% and 40% of strokes in women of child rearing age with migraine, seemed to develop directly from a migraine attack.
While the cause of my stroke was ruled as stress related, surely there were no visible warning signs that I was a candidate of such ailment. To the contrary, I started taking rigorous kickboxing classes a couple of months prior to the incident. The class was tailored for us, a group of doctor sisters (mainly junior faculty and staff at Penn State). What I have learned from my seeming good health that preceded my stroke, is that constant stress that has you feeling disillusioned, helpless, and completely worn out is a recipe for a stroke. You may be suffering from burnout, but when you are burned out, problems seem insurmountable. It is difficult to muster up the energy to care—let alone do something about your situation, and the unhappiness and detachment burnout causes, can and does threaten your health, your relationships, and in effect, your job.
Here is the story of what happened to me, two summers ago in “happy valley,” or better known as “recession proof city” (nickname for the area in which Penn State sits…)
Even before my class started in the fall, I dreaded it. I was going to have a big class (bigger than other classes I had taught before) and from time to time, I would reflect on how to best develop effective feminist pedagogical praxis and a transformative learning space. Unlike hooks, I wasn’t afraid that I wouldn’t wake up and would miss the class. Instead, I had constant fantasies about ways to be the super scholar— mastering both the teaching texts and “successfully” publishing at a university where prestige of publishing houses and establishment auspices prevail over ideas. Suffice to say there are a lot of pressures to be a “super scholar” and granted there are a lot of trade–offs and external constraints in the academy.
Back to my story; one summer day, while in a meeting, unsure if I was awake or dreaming, I began to feel odd. Everything looked bleak, and I felt like a giant elephant was rolling over my head; dripping in sweat, I passed out. Luckily, my colleagues alerted the paramedics who revived me by administering oxygen, rushed me to the ER and then the hospital bed where I spent several days, before being transferred to the rehabilitation center, for about six weeks of recovering from the episode. Needless to say it was the beginning of the long rehabilitation from the stroke attack that I never knew was coming. When I asked my doctors if I could have prevented that ugly episode, the answer was, “you need to take care of your health, get to know your numbers (e.g. Cholesterol & blood pressure), manage diet/exercise.” Other culprits may of course, include community-wide factors such as poor access to fresh food, health care, the effects of poverty and racism, and differences in the severity and duration of underlying health conditions.
With lots of prayers, I have recovered and do now appreciate the simple joys of life and what it has to offer. But I continue to wonder if all this stress could have emerged from holding everything in all the time, being afraid to show emotion for fear, and what we’ve been socialized to think and do as black women?
Does this story sound even the least bit familiar? Extreme as it is, the statistics on strokes suggest that it happens far too often to many women. A dear sister friend and colleague, Dr. Aaronette White, recently passed away, apparently from brain aneurysm. She and I were in constant communication, and one thing that I know for sure is that she never experienced the symptoms of her fatal incident nor understood that things were far worse than they appeared. May her soul rest in peace.
I constantly ask myself, how many smart, well-educated black women professionals, are working too hard at everything, except taking care of themselves? Too many of us are walking around in denial, ignoring the obvious signs (headaches, exhaustion, dizziness, vision changes, weakness, numbness) that should send us to the doctor, not to the office, conference or department meeting. Following my episode, I had to re-learn some of the most basic and mundane of tasks. For one, the impact of a stroke on health related quality of life (Qol) can be disastrous, as it can affect multiple life domains. Researchers and physicians have often used a health related Qol focus on the impact of an illness and/or the treatment, on the patients’ perception, of their overall status of health, and on subjective wellbeing. To invoke Salt Eaters, Praise song for the Widow , The Women of Brewster Place and Beloved, the texts probe the complexities of private and individual wellness, and simultaneously refuse to separate illness from its social context, and against the grains of strict biomedical account. Illness therefore is positioned within multiple sites of power relations, and it constitutes and is constituted by various social relations and processes.
This bell hooks quote remains ever powerful for me:
Did you ever wonder why so many sisters look so angry? Why we walk like we’ve got bricks in our bags and will slash and curse you at the drop of a hat? It’s because stressed is hemmed into our dresses, pressed into our hair, mixed into our perfume and painted on our fingers. Stress from the deferred dreams, the dreams not voiced; stress from the broken promises, the blatant lies; stress from always being at the bottom, from never being thought beautiful, from always being taken for granted, taken advantage of; stress from being a black woman in white America. Much of this stress is caused by how the world outside us relates to us. We cannot so that the outside world cannot over-determine our responses, cannot make our lives a dumping ground for stress control that world, at times we can change it but we can assert agency in our own lives.
Opal Palmer Adisa, “Rocking in the Sunlight: Stress and Black Women”
This is more personal but also liberatory to me. As Hansen (1999, p. 139) points out, producing knowledge about women is an important ingredient in creating change, and that ‘we start by creating change where we are, within the places and institutions in which we are located.’
More importantly, we cannot afford to continue divorcing ‘women’s health’ from other life aspects; it is an outright mistake, for what is doing gender if it is not ‘doing health’?
Motivations of “womanist warriors” range from trying to inform their audiences of relevant debates, to efforts to demonstrate scholarship. Many feminist intellectuals present their work as the basis for rewards in academe and the entertainment industry, suggesting influences synonymous to the colonization of intellectuals. The key question especially among the rising generation of women remains whether this intellectual ferment will lead to new understandings of the potential links between women’s struggles or whether the academy will continue to be perceived, even if implicitly, as a space for market driven forces?
 For a more detailed discussion, see Anne Folwell Stanford Bodies in a Broken World: Women Novelists of Color and the Politics of Medicine. Chapel Hill: University of North Carolina Press, 2003.
 See for example, Gloria T. Hull, Patman Bell Scott, & Barbara Smith eds. But some of Us are Brave. (Old Westbury, N.Y. Feminist Press 1982), Cherrie Morage & Gloria Anzaldua. This Bridge Called my Back: Writings by Radical Women of Color ( N.Y. Kitchen Table & Women of color Press, 1983)
Hooks, bell Sisters of the Yam: Black Women and Self-Recovery
 Roger VL, Go AS, Lloyd-Jones DM, et al. Heart disease and Stroke Statistics-2011 update: A report from the American Heart Association.
 QoL is difficult to define and no universal definition of this term exists. However, there is a general agreement that QoL is a multi-dimensional construct that consists of at least three broad domains: physical, mental and social. For further discussion about (QoL) see Jaracz K, Kozubski W. Quality of life in stroke patients. Acta Neurol Scand. 2003; 107(5):324-329.
Lindah Mhando is a Sociologist and a feminist. Her research is focused on, the relationship between cultural forms and power, the politics of knowledge and representation, the dynamics of gender and the question of women’s rights and HIV/AIDS in the African diaspora. She has published extensively, including an edited book, Birthing Masculinity: Dialogues of Peace and Social Justice (African World Press), co- authored with Ali Mazrui, Nyerere, Africa’s Titan on a Global Stage (North Carolina Academic Press). Lindah, a recipient of numerous awards, is an Assistant Professor in the Department of African & African American Studies and Women Studies at the Pennsylvania State University, currently a Visiting Assistant Professor at Duke University.