Fundamentos de su inserción internacional

The general lack of authority granted to women is reflected in the context of childbirth where women may not have the power to decide aspects of their care during labour and birth in medicalised settings. Moghadam (1992) argues that economic and educational development tend to erode classic male domination, though in parallel new forms of gender and class inequality may be created.

According to the statistical yearbook issued by the Central Department of Statistics and Information (CDSI, 2010) around 49% of the Saudi Arabian population were female during the data collection period, the rate of unemployed female was 33.4%, and the rate of unemployed male was 7.4% (CDSI, 2011). Most the women are employed within education and healthcare. However, within conventional

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dominated Saudi Arabian culture, only a small percentage of Saudi Arabian females are in employment (Gallagher and Searle, 1984; Ratner and El-Badwi, 2011).

Moghadam (1992, p.5) defined development as

“a broad process of economic and social change, usually promoted by

technological advancement but crucially affected by changes in social structure, property relations, and cultural understandings’.

He provides an overview of economic and social development since the 1960s within the Middle East as a whole and where the increased power of the state, economic development and the role of oil wealth have contributed to improved educational and work opportunities for women. This level of economic development also introduced changes in social structures, which saw the emergence of middle class women with a new degree of social and economic independence and this was also reflected in a more prominent public image of female emancipation.

According to Ratner and El-Badwi (2011) the Wahhabis have imposed strict gender apartheid and discrimination against women. This is disseminated through institutional rules, cultural concepts and artefacts. Gender apartheid is defined by Ratner and El-Badwi (2011, p.234) as ‘a distinctive pattern of gender relations’. Of course, gender apartheid did not just happen, nor did it emerge from the personal desires of individual men and women that were negotiated interpersonally. Gender apartheid in Saudi Arabia, including the exclusion of women from most areas of civil life, was imposed by the extreme conservative, autocratic Wahhabi Islamic authority in the 1970s which strongly emerged under Mohammad ibn Abd Al-Wahhab (Al-Rasheed, 2010). Women are segregated in Saudi Arabian schools and universities.

Female students have their own buildings and lecturers and are free not to cover

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themselves inside these buildings. Male students have their own buildings across the street and do not mix with women. However, in the hospital environment, students mix together since hospitals are considered a mixed place of work, although the wards are single sex for patients.

The house in Saudi Arabia is structured in such a way that the man and his friends have a space that is separated from the family space. The upper class is not bound by these restrictions as in some families, women freely interact with male outsiders without veils (Ratner and El-Badwi, 2011).

As a Saudi Arabian female, I witnessed the gender segregation enforced by gender segregation laws that prohibit unrelated men and women from having any contact with each other (Ratner and El-Badwi, 2011; Almutairi and McCarthy, 2012), with the hospital working environment being a key exception. Almutairi and McCarthy (2012) argue that gender-based segregation in Saudi Arabia is authorised by the society and imposed through government structures. While the nature of this gender segregation has changed slightly over the years, government laws restrict women’s freedom of mobility, for example by prohibiting women from travelling abroad alone without the written consent of their male guardian. Women in Saudi Arabia have some restrictions on the right to travel, and limitations regarding education and work opportunities through the supervisory role of the male relative (Vidyasagar and Rea, 2004).

Vidyasagar and Rea (2004) reviewed the work experience of 28 female Saudi Arabian doctors working in Saudi Arabia, describing their experiences and providing details of the nature of the problems they encountered. While they identified issues within the constitution and the legal system, more obvious issues arose due to the

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policy of segregation of the sexes, which influenced both their choice of specialty and their prospects of career development. However, satisfactory career progression among some older female doctors gave encouragement to younger colleagues.

2.3.3.1. Autonomy of Saudi Arabian women

In Saudi Arabian culture, the authority of the family overrides people’s individual autonomy (Al-Shahri, 2002). Decisions taken by women can often be altered according to the views of the family. In the Saudi Arabian context, a male member normally leads the family and is often the main source of income, as well as being the authoritarian protector and spokesperson, and usually the ultimate, but not absolute, decision maker (Al-Shahri, 2002). Women in Saudi Arabia should not be examined by male healthcare professionals without a mentally competent adult (either a male or female relative or other female healthcare professional) being present (Al-Shahri, 2002). However, Al-Shahri (2002) argues that some women may consent to be examined by male professionals to avoid embarrassing the ‘authority figures’ of health professionals, particularly during childbirth. Female patients may request female physicians when available. A male family member, or spouse, will often request to be in continuous attendance during the female patient's entire stay (Sutherland and Morris, 1995). However, from my own experience this does not happen all the time, as any family member can attend during women’s entire stay when hospital policy permits it.

Western culture has had a significant influence on Saudi Arabian culture, however, with the governing role of the Saudi Arabian royals initially being achieved through British influence and subsequently nurtured by the United States. In addition, the class of educated professionals in Saudi Arabia has had wide exposure to Western

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influence through educational contacts and many Westerners have work contracts within Saudi Arabia (Vidyasagar and Rea, 2004).