PREFACEThe International Women's Health Coalition (IWHC) formulated the concept of "reproductive tract infections" (RTIs) in 1987 to draw attention to a serious, neglected aspect of women's sexual and reproductive health, and to stimulate development of the necessary health services and technologies, information dissemination and wider program efforts. On the request and with the involvement of colleagues in many countries, IWHC has sponsored research projects and experimental clinical services to assess how to integrate RTI control into ongoing programs. We have commissioned and produced papers and a book on RTIs to publicize their prevalence, to document their costs and consequences, and to stimulate action.
In Bellagio, Italy, in 1991, the Rockefeller Foundation and IWHC co-sponsored a meeting of scientists, donors, and women's health advocates to review the relevance of RTIs to international health goals, including family, planning, child survival, maternal health, the prevention and control of sexually transmitted diseases and human immunodeficiency virus; and to identify specific actions to reduce girls' and women's vulnerability to RTIs The report of the meeting and a volume containing the papers presented provide a policy assessment of information on the prevalence of RTIs, as well as detailed recommendations of participants in the Bellagio meeting.
Bellagio participants recognized that women's experiences with RTIs, their relationships with their sexual partners, the knowledge and attitudes of service providers, and other behavioral dimensions of RTIs need to he studied in greater depth. They asked IWHC to convene a meeting of women from Southern countries to explore these concerns. This is the report of that meeting, co-sponsored by IWHC and the Women and Development Unit (WAND) of the University of the West Indies.
Since its inception in 1978, WAND has pursued a vision of a more holistic, equitable, and humane global order. WAND has identified women's health promoting "wellness for women" -as a unifying motif in its work, which aims at the empowerment of women through improved access to information, sharing information and skills among women, community development, and building leadership and solidarity among women across the Caribbean region. Although WAND works primarily with Caribbean women, it has long collaborated in building alliances with women in other countries of the South, as well as with Northern women WAND is the secretariat for Development Alternatives with Women for a New Era (DAWN), a network of Third World women DAWN analyzes critical development issues, including reproductive health and rights, from the perspectives of poor women.
In March 1992, in Barbados, IWHC and WAND brought together forty-four women from twenty countries, primarily in Asia, Africa, Latin America, and the Caribbean, to discuss the topic "Reproductive Tract Infections among Women in the Third World: Ending the Culture of Silence." Participants included prominent women leaders, activists, health professionals, journalists, and social scientists. All the participants had worked with women from a variety of backgrounds and shared a commitment to women's health. Some participants knew little or nothing about RTIs, though most had had at least one themselves participants learned for the first time about the wide variations from nation to nation and within countries in women's condition and in their vulnerability to RTIs. Few participants had previously had opportunities to share their experiences with RTIs in depth with other women from different countries, and many had never before been part of a women's movement.
The Barbados meeting produced detailed recommendations for national and international work on sexuality and gender relationships, and for public health and education initiatives. Participants issued an international call to action to build new alliances among women, and between men and women of all ages to generate new "sexual contracts." The purpose is to foster caring, respectful, and responsible sexual relationships, and to promote equity between women and men in the public sphere. All the participants and many of their institutions committed themselves to this vision, and to intensive efforts to prevent and control RTIs. Together, we call on donors, national governments, and international agencies to support these efforts.
Joan Dunlop
President, IWHCPeggy Antrobus
Tutor-Coordinator, WAND
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