– Nashilongweshipwe Mushaandja
Health work is care work that does not only happen in hospitals and clinics, but it also happens in our homes and places of business. It is a labour and commitment to helping ourselves and others to restore their wellness and encounter healing in the best possible ways. Although this is the ethos, women and non-gender conforming people in Namibia have testified that local health services need to be urgently equipped with a new relational ethics and value systems. In this article, I will focus on pleasure and consent as essential aspects of Comprehensive Sexuality Education (CSE) for care workers and society at large. I focus on pleasure and consent because CSE in Namibia has long focused on disease mitigation and the negative outcomes of sexuality.
Namibia’s health education is yet to adopt and commit itself to a holistic CSE praxis on all levels of teaching and learning in our society. CSE focuses on the cognitive, emotional, physical, and social facets of sexuality and it is aimed at equipping learners with the skills and knowledge to be self-reflexive about their sexual well-being, choices, relationships. It is geared towards protecting sexual rights and the dignity of everybody. In 2020, Namibia’s public discourse was marked by nation-wide uprising mobilized by the #ShutItAllDown movement and other stakeholders, responding to the national crisis of gendered and sexual violence. During this heightened gender discourse and public action, the Namibian government withdrew from an international and updated CSE education proposal, unashamedly citing its discrimination and unreadiness for a 21st century and feminist CSC framework. This was disappointing to witness as it reminded us of the long way to go in the fight for Sexual and Reproductive Health Rights (SRHR) in Namibia.
As a queer-feminist scholar, artist, and activist, I use this article to propose a practice-oriented framework as a guide for social and health scientists, practitioners, as well as primary care givers that they can adopt in implementing CSE in their respective contexts. This two-part curriculum is not exhaustive at all, in fact it is a contribution to existing efforts that are geared towards mobilizing a radical and care driven CSE in our various contexts. It is merely meant to highlight pleasure and consent as part of the larger CSE framework that is urgent for Namibia today.
Pleasure. It is significant to note that health care work is not only about attending to pain but equally about generating and working towards pleasure. We need to consider pleasure as a turn from the burden of disease and other negative sexual health outcomes. This must be understood and applied in the larger context of sexual health and rights. Medical Practitioner and SRHR activist Tlaleng Mofokeng co-developed a definition of sexual pleasure with the Global Advisory Board. It partly reads as follows.
“The physical and/or psychological satisfaction and enjoyment derived from solitary or shared erotic experiences, including thoughts, dreams and autoeroticism. Self-determination, consent, safety, privacy, confidence, the ability to communicate and negotiate sexual relations are enabling factors to sexual health and well-being.”
Health workers have the power to change public perceptions of sexual health by encouraging and centering sexual pleasure. This can be achieved by being aware of the stigma, fear and shame associated to sexual practices. Once there is an understanding of the political nature of pleasure and how women and gender non-conforming people are denied sexual pleasure as per heteropatriarchal standards, we can begin to dismantle and unlearn our inherent negative practices associated to it. It is also essential to know that sexual pleasure is not only implied in the context of intimate and sexual partnership, but it also implies the joy that comes with sharing information, learning, and facilitating a culture of openness about its significance. It is also about being aware of which bodies are on the margins of sexual pleasure and actively creating safe spaces for them to encounter and forge the enjoyment of sex and sexuality.
Consent. A chapter on practicing consent is necessary for a CSE framework given the crises of gender and sexual violence in our society. This is also because the notions of choice, free will and bodily autonomy are taken for granted even in health care services. In early 2021, local media reported one case of medical practitioner who raped a patient. There have also been multiple cases of women who were sterilized without their consent between 2005 and 2007. Both Namibian health and legal systems argued and justified these sterilizations by claiming that the women were HIV positive. These are just few of many cases that reveal the violent and careless nature of our health care systems. It is the duty of individual and systemic actors in health care services to encourage and practice a culture of consent to eradicate rape culture.
Consent is embodied in the artwork of the late revolutionary Namibian artist, John Muafangejo. In two of his prints, They are meeting again at home (1982) and They are shaking their hands because they are longing each other (1981), Muafangejo portrays how consent in intimate-partner relationships comes from all sides. The bodies are balanced and equal in terms of levels and hence, consent is embodied as a sexy and beautiful thing to do. The plants and flowers between and around the bodies represent a sense of harmony, peace and joy which are results of the consensus in these intimate encounters. The ‘longing for each other’ and ‘meeting again at home’ highlights the respect, safety and maturity required to practice consent. Consent from a commitment to critical self-reflexivity. Pleasure comes from consent.
In her feminist book on practices of care, Maria Puig de la Bellacasa writes about the complexity of care. She notes,
“Care is omnipresent, even through the effects of its absence. Like a longing emanating from the troubles of neglect, it passes within, across, throughout things. Its lack undoes, allows unraveling. To care can feel good; it can also feel awful. It can do good; it can oppress.”
The chapters on pleasure and consent as key contributors to reproductive justice ought to take class and race politics into consideration. This is to say that women who are not white or middle class do not always have access to this kind of information and yet this is not to say that sexual and gendered violence does not happen in contexts of economic and racial privilege. It is also important to frame consent and pleasure from the perspective of African indigeneity and trace how our ancient matriarchal societies have always practiced pleasure and consent as part of generating health care.