LAUSR

I applaud the efforts of researchers published in this issue of Health Care for Women International for studying vulnerable women. Such populations include women with health issues and their health practitioners. Both groups are vulnerable to stigma. I am impressed by the work of Gretchen Ely and colleagues, because their trauma-informed recommendations for practice with women who receive funding for abortions makes a theoretical contribution to the literature. I think readers will agree their theory may also be applied to other vulnerable populations including imprisoned women, sex workers, women whose genitals have been mutilated, and women who have experienced intimate partner violence. After reading all these manuscripts, it is my hope that you will understand why both health care practitioners and their patients are vulnerable. What practitioners and patients have in common is they lack sufficient resources to improve women’s health. Nagore Martinez-Merino and colleagues note in their review of studies of incarcerated women that globally penal institutions are androgenic as most cultures are androcentric. This fact limits both the resources available for health interventions for this population, and research evidence evaluating the few interventions that do exist. It simply is not politically correct, in many countries, to work with women in prison. Tais Cardoso Vernaglia and co-authors explain that vulnerable populations such as the crack users they studied are rarely researched because potential informants shy away from revelations to avoid greater vulnerability to stigma. The authors should be proud of their large sample of crack users in Brazil, which contained data aggregated by gender. Such data allowed them to conclude female crack users are more vulnerable than men in every area except the likelihood of being addicted to alcohol. Women had less education, were more likely to be unemployed, lacked economic resources to meet basic needs and were separated from their children. That these social conditions exist plus the knowledge that talking to the wrong persons could lead to imprisonment, make it difficult for health practitioners to engage such women in conversation. Varun Sharma and colleagues write about “predisposing and enabling factors” to predict who gets what health services among female sex workers in Andhra Pradesh, India. They argue that factors such as limited education and living in a rural community explain variation in services received, rather than a medical need for attention. Sex workers either don’t know they need medical help or they cannot access help when available. Regardless of predictable factors, it is health