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The Reproductive Lives of Chuukese Women: Transnationalism in Guam and Chuuk Sarah Ann Smith University of South Florida, [email protected]

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The Reproductive Lives of Chuukese Women: Transnationalism in Guam and Chuuk Sarah Ann Smith University of South Florida, Smith.Sassy@Gmail.Com University of South Florida Scholar Commons Graduate Theses and Dissertations Graduate School 6-4-2014 The Reproductive Lives of Chuukese Women: Transnationalism in Guam and Chuuk Sarah Ann Smith University of South Florida, [email protected] Follow this and additional works at: https://scholarcommons.usf.edu/etd Part of the Public Health Commons, and the Social and Cultural Anthropology Commons Scholar Commons Citation Smith, Sarah Ann, "The Reproductive Lives of Chuukese Women: Transnationalism in Guam and Chuuk" (2014). Graduate Theses and Dissertations. https://scholarcommons.usf.edu/etd/5311 This Dissertation is brought to you for free and open access by the Graduate School at Scholar Commons. It has been accepted for inclusion in Graduate Theses and Dissertations by an authorized administrator of Scholar Commons. For more information, please contact [email protected]. The Reproductive Lives of Chuukese Women: Transnationalism in Guam and Chuuk by Sarah A. Smith A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Anthropology College of Arts and Sciences University of South Florida Co-Major Professor: Nancy Romero-Daza, Ph.D. Co-Major Professor: Heide Castañeda, Ph.D., M.P.H. S. Elizabeth Bird, Ph.D. Ellen Daley, Ph.D., M.P.H. Keith “Mac” Marshall, Ph.D., M.P.H. Date of Approval: June 4, 2014 Keywords: sexual and reproductive health, gender and migration, Micronesia, applied medical anthropology, public health Copyright © 2014, Sarah A. Smith DEDICATION I dedicate this dissertation to all the women in my life, but a few in particular stand out: To my grandmothers, although neither of you are here to see me complete this journey. I was blessed by the stories of your interesting, dynamic lives often told by my own mother, and learning about your strength, your struggles, and your drive clearly inspired my interest to explore other women’s life histories. I also don’t doubt that my choice to become a medical anthropologist was influenced by your own careers in journalism and nursing. To my mother: without even knowing it or intending to, it is you who made me a feminist. Your life history continues to inspire the stories I seek and tell. I also wish to dedicate this dissertation to the women who shared their life histories with me for this project. Your honesty, laughter and life lessons will stay with me always. ACKNOWLEDGMENTS First, I would like to acknowledge my dissertation committee members: Nancy Romero- Daza, Heide Castañeda, Keith “Mac” Marshall, Ellen M. Daley, and Elizabeth Bird. I am grateful to each of you for consistent and continuous support, and your advice and expertise were invaluable. My major advisors Nancy Romero-Daza and Heide Castañeda provided exceptional support throughout the whole process, as you did throughout my entire graduate career. Mac Marshall also provided amazing support; I’m so glad you answered that email I sent you years ago. I would also like to acknowledge the financial support which made this possible: the University of South Florida through years of assistantship funding and the Fathauer Dissertation Fieldwork Travel Grant; the University of Guam CLASS Faculty Funding Grant, the UOG Cancer Center, and the U.S. Office of Minority Health Pacific Resource Center. I am also appreciative of the UOG Gender Studies Center for the office space and collegial support, especially Seyda Turk-Smith. Second, I would like to acknowledge the many people who made this research possible: first and foremost, those who took the time to speak with me in the clinics and the communities, and those who allowed me to “hang out” and follow you around. I wish I could thank you by name. I am also indebted to the administrative leaders of GDPHSS and Chuuk Public Health who allowed me to enter their clinics and scrutinize their patient care. In Chuuk, I am eternally grateful to all the women of the CWC, especially Kiki and Eleanor; and the Truk Stop family. Finally, I am very grateful to Lulu for her patience and dedication teaching me fosun Chuuk, and Achipen for her translation help. Most of all, I am grateful to my entire family for all of their support throughout this process. I am especially grateful to my parents for their love, patience and pride, and my father also for his hands-on help and feedback. I am grateful for all my sisters, the one I was born with and the ones I chose for always being there and trying to take interest in the work (Elizabeth!). You are loved and appreciated dearly. Thanks especially to my academic sisters. Conversations with the CC crew allowed me to grow as a scholar in ways I never imagined, further ground my interests in reproduction, and find time for fun too. I love you ladies. Karen, thanks for being a mentor too. The person I could not have done this without is my partner. Chris, you provided support in every way possible: mental, emotional, economic, domestic. Thank you for moving across the world with great ease and optimism, bearing the brunt of my grad school and dissertation mood swings, and continuously encouraging me. Most importantly, thanks for being a feminist in words and actions; supporting everything I do wholeheartedly. TABLE OF CONTENTS LIST OF TABLES ........................................................................................................................ vii LIST OF FIGURES ..................................................................................................................... viii ABSTRACT ................................................................................................................................... ix CHAPTER ONE: INTRODUCTION ..............................................................................................1 Key Terms……. ...................................................................................................................2 Micronesia................................................................................................................2 Reproductive Health ................................................................................................3 The Setting(s) ......................................................................................................................4 Reproductive Health Indicators ...............................................................................6 Theoretical Influences ..........................................................................................................7 Why Reproductive Health? ......................................................................................9 Research Questions ............................................................................................................10 Methods Employed ............................................................................................................11 Dissertation Outline ...........................................................................................................11 A Note on My Position as a Researcher ................................................................16 CHAPTER TWO: BACKGROUND AND SETTING .................................................................18 The Context: Guam, United States ....................................................................................19 Colonial History .....................................................................................................19 Socio-Economic Context .......................................................................................24 Health Care ............................................................................................................26 The Context: Chuuk, Federated States of Micronesia .......................................................27 Colonial History .....................................................................................................28 Socio-Economic Context .......................................................................................32 Health Care ............................................................................................................37 The Micronesian Exodus ...................................................................................................38 Compact “Impact” ................................................................................................41 Chuukese Migration, Gender, Reproduction and Sexuality ..............................................44 Sexuality ........…....................................................................................................45 Gender, Sexuality and Power .....................................................................46 Gender, Migration and Reproduction ....................................................................48 Intersections: Chuukese Migrant Reproductive Health .............................50 Summary……. ...................................................................................................................56 i CHAPTER THREE: THEORETICAL BACKGROUND AND CONTRIBUTIONS ..................57 The Anthropology of Reproduction ...................................................................................57 Birth of the Anthropology of Reproduction...........................................................58 Theoretical Traditions “Wrapped Up” in Reproduction ........................................59 Stratified Reproduction ..........................................................................................61
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