Thursday, December 31, 2009

The summer of my medical tourism, Part III

There's a big topic looming for this blog.  "Is going overseas for egg donation -- some could call it fertility tourism -- something leftists do?"  
I've put off this topic for months now, given that H and I returned from Cyprus, pregnant, in late August 2009.  
I've felt compelled, all this time, to address this topic because this blog isn't just "All About Moi" or "Procrastination for writing a journal article" or  "My Pregnancy Journal" or "Yet another psychology professor's blog."  I choose the quirky name "I married a communist" for some kind of purpose, so from time to time there should be something about how being associated with the political far left influences one's daily life or at least internal monologues.  
H already had this discussion with one of his communist friends, a sometimes reader of this blog.  I hear they mused about the topic but didn't come to a conclusion.   
But I've come to some tentative conclusions, after conversations with friends, on two topics:  Is it okay to be the wealthy foreigner throwing money around in a less-developed country?  Did I exploit a woman from an under-developed country by purchasing a part of her body?  
Is it okay to be the wealthy foreigner? Yes: I have a choice where to spend my money -- why not spend it in a developing country?  
In the world I want to live in, disparities in wealth would be sufficiently small that there would be no economic motivation for anyone to build a hospital in poor country X with the hope of bringing in overseas clients from wealthy country Y.   Am I acting to continue global wealth inequalities by participating in fertility tourism?  I'd enjoy hearing comments from globalization experts, but here's what I've gleaned from some diverse readings:  Many experts are saying we need less *aid* and more *trade.*  When wealthy countries directly give money/resources to poor countries, it breeds corruption.  'Free' money incites competition to confiscate the give-away.    
Regular tourism isn't an ideal wealth-creating  industry because it can sequester locals in dead-end jobs of being maids and gardeners.  Medical tourism is hard work.  Yes, there may be a rich capitalist in Turkey who is making extra money off of his investment in Istanbul's Jinemed hospital, but Jinemed doesn't just serve rich tourists -- it's a vibrant city clinic.  Medical tourism has the advantage of training locals for the whole necessary panoply of medical professionals, doctors, nurses, technicians etc.   The prenatal/fertility clinic in Cyprus that  did my invitro sees several infertile foreign couples per day, but still most of their work is with Cyprus locals.  The day of my embryo transfer we waited while a dozen or more Cypriots gathered to attend/celebrate a birth, as my doctor was also their obstetrician.  So locals benefit from the presence of the expertise that was partially funded by the wealthy tourists.  
The feminist angle: Poor women's bodies have always been exploited -- by man and by wealthier women.   Did my action of buying a woman's eggs contribute to that?  
There are certainly some delicate issues here.  
In the realm of buying a piece of someone's body, egg donation seems to me to be on the more benign side, for the following reasons:  
Because women produce about 400 eggs in a life-time,  I bought a replaceable piece of a woman's body.  Not as benign as purchasing blood, but no where near as drastic or life-influencing as buying a kidney.  
Side-effects are rare (between 1 in 500 and 1 in 1,000), but span the spectrum from an easily-cured infection to infertility.  Because of the rare chance of an extreme negative outcome like infertility, in Cyprus, women are encouraged to be egg donors only if they have already had all of the children they want.  I was told my donor was married, 25 and already had the 3 children she desired (3 children is the average for Turkey/Cyprus).    
One reason I choose Turkey/Cyprus as the place for egg donation was that I had read some exploitative stories about Eastern Europe, where young women are drawn in from the country side to the supposedly glamourous, fast-paced cities, housed in dormitories, given little compensation, treated like egg-donation machines, and thrown aside when they had a negative outcome. In contrast, Cyprus is a small island that doesn't leave room for the phenomena of women leaving rural areas to go to the big city where bereft of family support they can be exploited by ruthless organ middle-men.    (But see this story about eggs of Eastern European women being sent to Cyprus.) 
An angle I know less about is the Islamic side.  Under Islam, egg and sperm donation are not permitted, being t is tantamount to adultery. For historical reasons including influence from Greece, Cyprus has never been as Islamic as Turkey (it takes work and locomotion to hear a call to prayer).  Still, because the citizenry is Islamic, egg donation is not something to openly discuss.  Women do it privately.   In order to continue to be allowed to legally provide egg/sperm donation,  the clinics have to be careful to avoid scandals,  and thus need to be scrupulous about medical care and treatment of their egg donors.  
Finally, the communist/internalist perspective.  Classically, communists are opposed to nation states  (the communist anthem is the "International").   Even in a utopian, egalitarian society, there will be infertile women who want the chance to become pregnant via egg donation, and there will be fertile women who don't mind being a donor, either for some extra cash or for just for the secret joy that they gave an infertile woman the gift of pregnancy.    

I think often of the "Cypriot Beauty."  Did my clinic (a Cyprus clinic, not run by overseas organizations) tell her that implantation worked, in my case? Will she wonder about the twin boys that are her genetic offspring, growing up half-way around the world?  I imagine that in the future we'll visit Cyprus as a family, and my sons may feel their Eastern Mediterranean roots.   Comrade, thank you.

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