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Nicaraguan migrant reproduction in costa rica: examining the bio-political, economic, and gendered factors leading towards cultural citizenship and accessibility to health care

5/1/2017

 
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Rosa Maldonado is a Chicana and Central American Studies major. Her research interests include environmental justice, transnational bio politics, and food studies. She plans to write on the Mexican/Central American experience, as she is the daughter of a Mexican mother and Guatemalan father. 

Abstract

The Costa Rican government extended its universal health care to non-citizens during the 1990s to increase tourist revenue and display the country’s development in the world of medicine. This paper reviews the relationship between Nicaraguan migrant workers and Costa Rican citizens constrained over decades of political and economic dispute. Contested borders between the neighboring countries and the continuous migrant profiling contributes to the strong negative perceptions of migrant workers. The racism, sexism and maltreatment towards migrant workers, particularly the women migrant workers is evident in the healthcare industry. One of the major issues migrant women in Costa Rica face is the issue of reproductive control. Migrant women are involuntarily pushed towards contraception as an economic“relief”; thus, constructing a discussion of gendered politics of the body and immigration.

nicaraguan migrant reproduction in costa rica: examining the bio-political, economic, and gendered factors leading towards cultural citizenship and accessibility to health care

By Rosa Maldonado
While the country’s slogan of “health for all” was promising to United States foreigners considering investing capital in Costa Rica, restrictions applied towards Nicaragua, the country's next-door neighbor. Nicaraguans have been migrating to Costa Rica since the 1800s because of economic adversity. Over time, disputes emerged over the input and influence of public sector Nicaraguan migrants on the economic flourishment of the country. Migrants have argued that they should not be excluded from accessing universal health care and should also be granted cultural citizenship because of their contribution to the country’s development. Furthermore, while Nicaraguan migrant men have been partially successful in gaining access to health care in Costa Rica, migrant women have not. Therefore, this gendered division, which is fueled with a misogynistic sentiment towards women because of machismo and the influence of the Catholic Church, has prevented migrant women from gaining the same rights as their male counterparts.  

The South-to-South Economic Migration from Nicaragua to Costa Rica and The Cultural Citizenship Dilemma 

The Catholic Church’s institutional influence on Costa Rica during the 19th century, subdued women’s rights and controlled society’s social behavior regarding gender roles. The country’s suffrage movement consisted of elite women with social capital from European or U.S. American descent, whose feminism was not inclusive to lower class, uneducated, immigrant, and indigenous women of color. The exclusion of these women in feminism created a discourse of “migrant reproduction.” Consequently, Nicaraguan migrant reproduction creates a bio-political, economic, and gendered discussion towards cultural citizenship and the accessibility to health care for Nicaraguan women in Costa Rica.  

Migrant women increasingly sought work not only in domestic fields but also the agricultural sector (Fouratt 147). These women were employed between 44–51% as domestics and 71-81% as sellers, in restaurants, and in cleaning occupations (Funkhouser 2002). A case study on migrant women workers in the piñeras in Pital displayed the restrictions migrant women faced on the job. The agricultural sector had to meet international exporting demands; thus, they industrialized and standardized piece-wages and unregulated work shifts (Lee 337). Migrant women workers interviewed in the case study knew of other existing work opportunities in Pital as well as the exclusion from the better-paying pineapple jobs because of their documentation status. Costa Rican residents and Nicaraguan migrants have stigmatized this work as undocumented women’s work and as poorly paid, dirty work, with irregular hours. Additionally, Migrant women experience an established hierarchy between migrant men and themselves in the piñeras because the men are responsible for bringing unprocessed crates of produce to the migrant women workers; consequently, controlling women’s access to their pieces and further maintaining the power difference. 

The Social Constructions of Gender in Costa Rica: Nicaraguan Migrant Women and the Tica’s Experiences Under A Machista Country 

There is a gendered division fueled with a misogynistic sentiment in Costa Rica towards women because of machismo and the influence of the Catholic Church. During the suffragist movement in Costa Rica, women’s right to vote was nonexistent. Women were considered second-class citizens and policies were male oriented. Men dominated the political arena and demonized women if they were educated enough to have a political consciousness. Education for Costa Rican women consisted of schoolteachers, secretaries and domestic oriented work. Education and the influence of the Catholic Church affected women’s right to vote because it socially prohibited women from talking about politics, going against their husbands and following marianismo (Leitinger 72). Politics and the media fueled discourses on how women should behave: being subordinate to men and not going against God. The media’s role of suffragist movement was negative. When a woman questioned a man’s authority, the “tyranny” of a woman is overtaking man’s ability of being free. The feminist movement in Costa Rica did not have the support of the general population because of fear of going against the Church, husband(s), and society. In Costa Rica, Catholic men or those of other religions, considered sterilization a "sin,' and did not permit their spouse from obtaining one, even for reasons of health or socioeconomic conditions (Sailer 2001). This right should not be within the power of men because it pertains to the bodies, health and lives of women. This discrimination translates into the idea that when a woman becomes pregnant, she deserves to die in childbirth. It also denies women access to control over their own bodies and their decision on motherhood. 

Gender theory holds that patriarchal gender norms mitigate the power of relative material resources, which it is not the actual income that each spouse brings to the household, but the gendered meaning they attach to that income. The Costa Rican government adopted a set of neoliberal reforms known as structural adjustment policies--massive cuts in public spending. High employment agricultural industries, like the banana industry also experienced massive layoffs by downsizing men and limiting job growth in the manufacturing and service sectors but it favors women. Women’s wages were lower on average, but increasing levels of education and declining fertility allowed women to take advantage of these new job opportunities (Mannon 2006). 

Stereotypes of migrant women exhausting Costa Rica’s limited resources by purposely becoming pregnant are spread with the usage of the media. Nicaraguan migrant women have becoming stigmatized for the type of work they obtained because the work is poorly paid; it is dirty work, with irregular hours. Migrant women have faced backlash and back in 2004, a law was passed where medical institutions had the right to refuse non Costa Rican citizens the right to access healthcare if the person was uninsured (Goldade 484). The concept of the “politics of the body” with regards to medical citizenship intersect with the construction of gender in the sense that migrant women have been persecuted with this law and viewed by the nation as “parasitic”. The moral worthiness versus the state healthcare with respects to migrant women is weighed from a male’s perspective. Costa Rican residents have created biased assumptions of migrant mothers abusing and exhausting healthcare resources in order to demand residency; however, many of the migrant women opt out of filing for residency because of the institutions that police their bodies and shift blame to them. 
 
Therefore, the concept of “politics of the body” with relation to how migrant women are using their bodies in a positive and physical form through bio-politics is challenging the patriarchal and elitist political arena of Costa Rica and its relationship to the Catholic Church.

Bio-Political Factors: Access to Health Care and Cultural Citizenship   

Migrant women have been using their bodies in the form of pregnancy and conception to access Costa Rica’s health care (prenatal care, birth control, or other complex medical procedures). Consequently, Nicaraguan migrant reproduction in Costa Rica has reshaped the bio-political discussion on immigration policies in relation to health care and the path towards gaining cultural citizenship. In response, the government projects a paradox encouraging born citizens to reproduce while discouraging migrant women from having Nicaraguan-Costa Rican children. Sheelee Colen’s coined phrase “stratified reproduction” is useful in explaining this phenomenon. Stratified reproduction analyzes the intersections of a woman’s individual position within other social hierarchies such as race, class, and migration status; thus, resulting in the glorification of certain women’s reproduction and the devaluation of others  (Goldade 547). Therefore, the concept of “politics of the body” with relation to how migrant women are using their bodies in a positive and physical form through bio-politics is challenging the patriarchal and elitist political arena of Costa Rica and its relationship to the Catholic Church. On the contrary, women have been subjected into tubal ligation and “family planning workshops,” in which the “politics of the body” have been exerted through a negative power dynamic with a woman’s sexuality policed by medical institutions and providers.   

Despite these factors, Nicaraguan migrant women attempt to birth their children in Costa Rica because a child born in the country is by law a citizen and will inherit the benefits of free education, universal healthcare, employment, and low-cost housing (Goldade 546). Migrant reproduction is viewed negatively, especially through stereotypes of migrants exhausting limited resources by purposely becoming pregnant. Case studies conducted about the experiences of undocumented migrants and medical provider’s views have uncovered covert and overt approaches aimed at denying migrant women healthcare unless they “voluntarily” consider contraception. A method of recruitment used in one of the case studies were medical referrals for pregnant women into “family planning” workshops that encouraged tubal ligation at their free-will. The providers’ tone included shaming if mothers had more than two children (Goldade 554).  Migrant women are often coerced into obtaining tubal ligation as the only method of birth control that would be performed for free. From the perspective of providers, the purpose of tubal ligation is to control the limited resources of each medical facility.  

Additionally, the economic insecurity and stigma Nicaraguan migrants face during the immigration process also defers many from pursuing legal residency. Candida, a participant in Goldade’s case study, mentions the taxing costs of fees and traveling back to Nicaragua in order to obtain proper matriculation that would be valid in Costa Rica (Goldade 557). Her testimony is a response to the misconceptions of migrants emigrating from Nicaragua as they please. Many Nicaraguan mothers do not have the economic resources to travel leisurely, let alone be able to process their residency in Costa Rica. Migrant mothers develop a sense of belonging  because of the  status their children have in Costa Rica. Mothers carry their children’s birth certificates as a form of cultural citizenship because it has become a symbol of protection against deportation.   

Conclusion 

The Costa Rican government provides universal healthcare to non-Costa Rican citizens, welcoming foreigners; in return, Nicaraguan migrants have become targets of scapegoating for “exhausting Costa Rican resources”. Nicaraguan citizens have been migrating south into Costa Rica because of employment opportunities, economic adversity, a natural disaster and the attempt to access the country’s universal healthcare. Tension between Nicaraguan migrants and Costa Rican citizens exists because of the historical and economic influence Nicaraguan migrant workers inputted into the public sector as agricultural workers in Costa Rica. Nicaraguan migrants have argued to the Costa Rican government over the exclusion from accessing universal healthcare and their entitled to acquire cultural citizenship because of their contribution to the country’s economic development. While the Nicaraguan migrant men have been partially successful in gaining access to healthcare in Costa Rica, Nicaraguan migrant women are continuously excluded from accessing healthcare unless they opt for family planning. The medical institution has assumed the role as “gatekeepers” and asserts their power through intimidation, blame and serving as “patriots to their country”. There is a gender division, fueled with a misogynistic sentiment in Costa Rica towards women (Costa Rican and Nicaraguan) because of machismo and the historical influence of the Catholic Church. These sentiments have syringed itself onto Costa Rica’s immigration policies, (fueled with neoliberal policies) creating a discourse of “migrant reproduction”. Nicaraguan migrant reproduction has created a bio-political, economic and gendered discussion towards cultural citizenship and the accessibility to healthcare for Nicaraguan women in Costa Rica. 

works cited

Costa Rica:Assessment of the Damage Caused by Hurricane Mitch, 1998 Implications for Economic and Social Development and for the Environment.  http://www.cepal.org/publicaciones/xml/4/15504/l373-1-en.pdf  

Fouratt, C. (2014). “Those Who Come to do Harm”: The Framings of Immigration Problems in Costa Rican Immigration Law. International Migration Review, 48 (1), 144-180. 

Funkhouser , Edward, Juan Pablo Perez and Carlos Sojo. "Social Exclusion of Nicaraguans in the Urban Metropolitan Area of San Jose, Costa Rica." Washington DC: Inter-American Development Bank.  

Goldade, K. 2011. Babies and Belonging: Reproduction, Citizenship and Undocumented Nicaraguan Labor Migrant Women in Costa Rica. Medical Anthropology, 30:5, 545-568.  

Goldade, K. 2009. “Health is Hard Here” or “Health for All”: the Politics of Blame, Gender and Healthcare for Undocumented Nicaraguan Migrants in Costa Rica. Medical Anthropology Quarterly 23(4):483-503.  

Leitinger, Ilse Abshagen. “The Suffragist Movement in Costa Rica 1889-1949” (61-81) 

Mannon, S. (2006). Love in the Time of Neo-Liberalism: Gender, Work, and Power in a Costa Rican Marriage. Gender and Society, 20(4), 511-530. 

Martínez, Bettina Elizabeth. “What is Neo-Liberalism?” (1-2).  

Ramos-Chaves, A. (2010). Essays on Economic Development in Costa Rica. 

Sailer, N. 2001. Sterilization, Gender, and the Law in Costa Rica. Yale Human Rights & Development Law Journal [1548-2596] Vol:4 pg:109 –171. 

Sintonen, H. , Bonilla-Carrión, R. , & Ashorn, P. (2013). Nicaraguan Migration and the Prevalence of Adolescent Childbearing in Costa Rica. Journal of Immigrant and Minority Health, 15(1), 111-118. 

Tesler, L. 2006. “Now There is No Treatment for Anyone”: Health Care Seeking in Neoliberal Nicaragua. Dissertation, University of Arizona.

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