A group of women in Hawaii are showing the nation that post-pandemic economic recovery can be visionary, just, and transformative. They have crafted a plan that centers women, insists on gender equality, and advances deep cultural change. In this episode of Radical Imagination, host Angela Glover Blackwell speaks with Khara Jabola-Carolus (3rd picture), the executive director of Hawaii’s Commission on the Status of Women, which released the plan, titled “Building Bridges, Not Walking on Backs: A Feminist Recovery Plan for Covid-19.”  And we hear from activist and midwife Tanya Smith-Johnson (center), who co-authored the plan and works to improve maternal and neonatal care in Hawaii’s rural areas. 

Khara Jabola-Carolus is the Executive Director of the Hawai'i State Commission on the Status of Women. Previously, Khara served as the Public Affairs Director of Strategies 360, the largest political strategist firm in the western US. She also directed the Hawaii Coalition for Immigrant Rights where she passed landmark legislation that extended driver's licenses to undocumented immigrants.She earned her Juris Doctor from the University of Hawaii with a specialization in Native Hawaiian law.

Tanya Smith-Johnson is a mother of six, homeschooler, Naval Hospital Corps veteran, birth worker and advocate for the midwifery model of care, reproductive justice, birth equity and the improvement of birth outcomes for black, native and indigenous people.

Tanya is the former vice-president of Californians for the Advancement of Midwifery where she worked tirelessly promoting the need for more Midwives, especially Midwives of color and those who care for under-served marginalized communities. She was instrumental in the transformation of the board and the creative force behind program creation and shifting of focus and priorities to a more equitable lens. She acted as co-chair of the Birth Disparities and Equity Team from 2017 to 2019. She helped create and develop a program for student Midwives of color to help them prepare for the NARM exam. She acted as lead program developer, creating, writing and building the curriculum and program framework.

Tanya has extensive experience in bringing the consumer voice to birth advocacy and policy. As the former president of California Families for Access to Midwives, she worked with California stakeholders and legislators to help the passage of key legislation to increase access to licensed midwives. Tanya served on the board of directors of the Midwives Alliance of Hawaii as the former Vice President and Oahu representative. She is on the Board of Directors of the Foundation for the Advancement of Midwifery where she works to provide education to the public and policy makers regarding midwifery care as a quality health option for birthing people in North America and to increase access to quality maternity care. Tanya is the newly appointed strategist and Director of Outreach, Advocacy and Education for The Big Push for Midwives, where she works on a national level to help states work on advocacy, policy and legislative change to incorporate and integrate midwives on a national level. Tanya is a member of the Hawaii Commission on the Status of Women’s Feminist Covid-19 Response Team and co-authored the nations first Feminist Economic Recovery Plan in response to Covid-19 , Building Bridges, Not Walking on Backs. 

Tanya holds a Bachelor’s of Science in Biology and Masters of Science in Medical Science from Hampton University. She received her didactic midwifery education from the Midwives College of Utah. She currently resides in Honolulu with her husband of 20 years and six children.

Angela Glover Blackwell: (00:05)
Welcome to the Radical Imagination podcast, where we dive into the stories and solutions that are fueling change. I'm your host, Angela Glover Blackwell the death of more than a hundred thousand people from the pandemic in the United States and the ongoing murders of Black and Brown Americans at the hands of police have raised the loud collective demand for change

Media clip: (00:27)
Global protest against institutionalized racism are continuing more than a week after the killing of George Floyd in Minneapolis. The message echoes across America, defund the police.

Angela Glover Blackwell: (00:38)
After the pandemic hit a group of women in Hawaii gathered to shape a post COVID economic recovery plan that should serve as a model for the rest of the country. In April of this year, Hawaii's Commission on the Status of Women came up with the nation's first feminist economic recovery plan. The proposal centers, women, and gender equality, as a way to push for deep cultural change in society. The plan prioritizes the needs of indigenous and immigrant women, non binary people, caregivers, the elderly people with disabilities among others. For more of a ways recovery plan we're joined by Khara Jabola-Carolus she's the executive director of the state's commission on the status of women, and also a coauthor of the plan. Building Bridges, Not Walking on Backs, a feminist economic recovery plan for COVID-19. Khara, welcome to Radical Imagination.

Khara Jabola-Carolus: (01:37)
Thank you for having us, Aloha.

Angela Glover Blackwell: (01:39)
Could you give us an overview of the state of the economy and society in Hawaii leading up to the moment when the pandemic hit?

Khara Jabola-Carolus: (01:46)
Well, people usually give oohs and aahs when I mentioned that I'm working from Honolulu, Hawaii. But from the eyes of a woman, our economy, and the situation here was really brutal pre COVID. We are totally reliant on tourism and war, frankly, for our lives to be sustained here. And so women were more likely to hold multiple jobs than men. 80% of Filipinos, 70% of native Hawaiians were living paycheck to paycheck. And 85% of them were women. We had women, frankly, burying newborns who had to go to work too early. And so their babies had to be in institutional settings before they were old enough. We had women selling their breast milk to survive here. So the situation for us on the ground here in Hawaii is really different from what's branded to the public and to visitors who come here. It was really difficult and becoming increasingly unlivable prior to COVID-19.

Angela Glover Blackwell: (02:49)
What were some of the needs and struggles indigenous communities have a long face there, and you've already talked about native women, but more specifically, what are some of the challenges that native women face?

Khara Jabola-Carolus: (03:00)
Well, this is not the first time at the rodeo, so to speak, with a pandemic. Infectious disease, wreaking havoc on the population and society have been something that native Hawaiians have had to grapple with since Western contact and native Hawaiians in particular are some of the least equipped to handle the turmoil and the economic shocks of this pandemic. Some of the issues are, of course, you know, landlessness, struggling with homelessness, health disparities, access to health, equal opportunity, pay, issues that impact their ability to govern their own bodies. So sex trafficking is another issue that disproportionately impacts native Hawaiians that we're seeing. This is just some of the metrics that are usually used to gauge how power is spread throughout Hawaii and native Hawaiians are really some of the most marginalized, if not the most marginalized here.

Media clip: (04:12)
Today, the health department reports 11 more cases for our statewide total of 106 patients, most are on O'ahu. 15 are non-residents. The new reports says the crisis has caused nearly half of all Hawaii lose income.

Angela Glover Blackwell: (04:27)
Last April, when the pandemic swept through the U.S. Hawaii came up with the nation's first feminist economic recovery plan. How did this proposal come together?

Khara Jabola-Carolus: (04:38)
A critical ingredient, I think is a really strong, independent feminist movement. We're a government agency. And for me, because of this movement, I know that I need to be accountable. And so at the outset, we put together a feminist COVID-19 response team and started doing rapid response. We started tracking the situation as it impacted women across the board, and this included grassroots organizers, it included academics, it included service providers, and we saw really quickly that the state was rushing to recreate the status quo. So we wanted to make sure that we were seizing this moment to create a post COVID that is actually capable of delivering gender equality and restoring the respect and status of women in Hawaii, which we did not feel is possible under the current system.

Angela Glover Blackwell: (05:30)
That's exciting. So describe what recovery that actually centers equity in frontline workers looks like.

Khara Jabola-Carolus: (05:38)
So for us, some of the key elements are full economic self sufficiency regardless of work. And that sounds really neutral at first. But if you think about it, many of us, especially women, women with disabilities, women who are caregiving and don't have the same ability to access employment, and will never have that same value as workers. And so making sure that universal basic income, which has been a long intergenerational rallying cry of feminists is at the center was really important.

Khara Jabola-Carolus: (06:18)
Some other key aspects are reorienting our economy away from tourism, militarism and luxury development. So ending harmful industries and bringing women out of it in a way that doesn't hurt them. And we want to build up our economy based on needs and create new jobs around caregiving, for example, because right now there are 39,000 children under the age of two in Hawaii and only 3,700 childcare seats for them. And so those are just some examples of jobs to create. I think some other key elements are also intentionally structuring the recovery to make sure that women have access to the jobs that are being created, because in 2008, we saw women were slower to recover than men, and that industry's targeted for stimulus like construction trades, renewable energy. They are still almost entirely male. So how do we not recreate that? How do we make sure that we're understanding the holistic support that women need to get into those?

Angela Glover Blackwell: (07:26)
I noticed that you also target a higher minimum wage and free public childcare.

Khara Jabola-Carolus: (07:30)
Yes, right now it's ridiculous that we have a minimum wage that is less than half of what a single mother needs to survive. That just doesn't make any sense at all.

Angela Glover Blackwell: (07:40)
And what do you think the minimum wage should be?

Khara Jabola-Carolus: (07:42)
Well, according to MIT, it needs to be at least $24 an hour in Hawaii to live.

Angela Glover Blackwell: (07:49)
Now, a lot of what you've talked about and you spoke to this in your answer really applies to low wage frontline workers. Why have you called it a feminist economic recovery plan? And has it helped to be able to lift up the challenges because it has that label?

Khara Jabola-Carolus: (08:09)
Really important that we talked about feminism because we see in the mainstream white led movement space around women, that it's moving away in many ways from feminism and kind of becoming this fun house version of feminism. And this type of feminist economic recovery is about transnational feminism, Black feminism, indigenous feminism, all of the feminisms that we stand on. And it was really great to have a team consolidated around addressing systemic sexism. So that's one of the main goals is undoing the gender hierarchy. And so we had to call it a feminist economic recovery.

Angela Glover Blackwell: (08:55)
One of the things that I think you have explicitly talked about, or perhaps the plan does is the need for deep cultural change in this plan, pushing in that direction. I think there are a lot of places in society that need deep cultural change. Talk more about that, why the plan advances it and why that kind of change has to be called out explicitly.

Khara Jabola-Carolus: (09:20)
Yeah. I think, you know, people in my position, we're usually supposed to just focus on passing laws and policies, but then the environment around us, you know, doesn't share the politics that we do. And so one, it's a real challenge to pass those policies and educate people. And secondly, when they get implemented, they get implemented in racist or sexist or classist ways. And so for me in the government, I don't see it as I'm here to transform the government. I see it as I need to transform the culture and you know, for us at the end of the day, that's the goal is really shifting power culturally and changing the way our society values women and LGBTQs and sees our role. And that's what we work for at the commission. So I think that because of our theory of change, shifting culture is our number one priority.

Angela Glover Blackwell: (10:17)
And there are unique needs that often don't get addressed if you don't do that deep cultural change. So that is important to call out specifically incarcerated women, unsheltered women, and who else?

Khara Jabola-Carolus: (10:31)
Older women, I think after a certain age, we feel we act like women expire. And I don't see a lot of people talking about older women who, you know, fought the fight for us and are not included. I think too, women who are criminalized, who are in the sex industry, who have been exploited, women with disabilities is also really critical. You know, there are a lot of different vulnerabilities that women have and, and they're not being centered.

Angela Glover Blackwell: (10:58)
Well, it is an exciting and an inspiring plan. What type of response has this plan gotten in Hawaii? And in other parts of the country, is it gaining support?

Khara Jabola-Carolus: (11:08)
I've actually been shocked and struggling to keep up with, uh, the, the reaction to it. So we've had, boy, anybody from the United Nations to Center for Feminist Foreign Policy, women and organizations all over the world have contacted our office and, you know, want to engage with us and find ways to replicate it locally. We've seen parts of it already go into motion. So the County of Maui, the County Council is about to introduce legislation to commit to a feminist economic recovery. So we're seeing it at the local and municipal level. We're also debating CARE's Act funding and all of that money coming in and needs that we articulated for our state legislature. So there are pieces of it already emotion. There are certain States, I think the most recent one, Iowa that's seeking to replicate the plan. There have been criticisms kind of the norm, right? This is not the time to talk about women. You know, thank you very much, but don't talk about gender. You know, this is reverse sexism, kind of the usual, but overwhelmingly it's been incredibly positive.

Angela Glover Blackwell: (12:15)
So what comes next in terms of this plan? How do you hope it will remain sustainable years after the pandemic, as advocates continue to look for their North Star? What role will the plan play?

Khara Jabola-Carolus: (12:25)
More than policy? And the material reality. We hope it becomes is also a statement to our sisters, brothers and non-binary folks. You know, it's not just feminist who need to be intersectional. The climate justice movement, the movements for racial justice, for economic justice also need to be intersectional and center, gender and feminism. And so I think that there's a lot of promise there, and I'm really hopeful that because of the attention, this has gotten that there's more consciousness and that consciousness will grow. So that's my hope and my anticipation

Angela Glover Blackwell: (13:11)
I actually find that people who know how to use the position, they sit in and get to where they need to be. Even if those two things weren't designed to be connected, really bring a, a superpower to their work, takes a certain kind of person to be able to make use of whatever it is that you have in front of you. You seem to be doing that. What's your super power.

Khara Jabola-Carolus: (13:36)
I think that women generally have stamina and endurance, no offense to the men in our lives that, you know, we're forced to have the stamina and endurance and to expect to live at a time of war. As one of my favorite quotes goes, and my super power is really the memory of the women all around me and before me and remembering them every day and showing up to carry on their work.

Angela Glover Blackwell: (14:05)
Khara, thank you so much for speaking with us.

Khara Jabola-Carolus: (14:07)
Mahalo. Thank you so much too.

Angela Glover Blackwell: (14:11)
Khara Jabola-Carolus is the executive director for Hawaii's Commission on the Status of Women. Coming up on Radical Imagination, we continue the conversation with Tanya Smith Johnson, a coauthor for Hawaii's plan calling for better maternal and neonatal health care in the state's rural areas. She is an activist and a midwife. Stay with us. More when we come back.

Angela Glover Blackwell: (15:06)
And we're back a key section of Hawaii's feminist economic recovery plan includes the need for better maternity and reproductive care. For more on this, we're joined by Tanya Smith Johnson. She's an activist and a midwife focused on reproductive justice and birth equity, and she coauthored a key recommendation of the plan. Tanya, welcome to Radical Imagination. Thank you so much for having me, Tanya, you're originally from St. Louis and you eventually joined the military and also went to med school. What was it like for you before you got to Hawaii? What drove you to become an activist and a midwife?

Tanya Smith Johnson: (15:43)
Well, first and foremost, um, just growing up in st. Louis, I always pursued becoming a doctor. So that was my vision. At the time, I didn't know there was such thing as midwives, especially midwives that helped people give birth at home. And I thought that was something that our ancestors did, and that was, you know, a path that was long gone. My experience as a birthing person and mother of six, and having a variety of experiences within the medical establishment and outside of it, since I've had three of my babies at home, it changed my perspective completely.

Angela Glover Blackwell: (16:16)
So it sounds like some of it was deeply personal for you. You talked about having your own children. You want to say more about that?

Tanya Smith Johnson: (16:24)
I have six children, my oldest just graduated high school and my youngest is two. And after having my babies in the hospital, you know, I had a particular experience that turned me off from wanting to do it there ever again. Um, the nursing staff was just really condescending towards me. I felt, you know, just microaggressions as a Black woman, just in my autonomy and decision making, even to the point to where my husband had to actually kind of advocate for me in some of the things that we wanted, you know, with white nurses. And after doing that, I just never wants to go back. And so I explored what it would be like to have other options. And where we were previous to that, Mississippi, home birth midwifery was illegal. So I didn't have the option. So once I came here to Hawaii, I made sure that I was able to birth outside of the hospital. And I did that at a birth center.

Angela Glover Blackwell: (17:15)
Well, before we start talking about your experience in Hawaii, back up a little bit and describe exactly what a midwife does and why their role is so important.

Tanya Smith Johnson: (17:25)
Yeah. So there are two types of midwives and midwives said, you know, attend to birthing people within the hospital. And most of those are nurse midwives. And then there are community midwives, home, birth midwives, and those are CPMs. And that stands for Certified Professional Midwife. And they are the ones who have been trained to tend to women who are birthing at home. And they are the primary care providers. They do everything that, you know, a doctor or nurse midwife would do inside the hospital, but it's different. It's the family is more involved. So it's really this kind of circular moment when it comes to the birth and just how your prenatal care is given as well as your postpartum care.

Angela Glover Blackwell: (18:15)
So could you describe some of the issues and inequities that you've come across while working in the field as a midwife, you talked a little bit before about micro-aggressions and women not being respected. Could you dig deeper into that?

Tanya Smith Johnson: (18:31)
Some of the things I saw were just unbelievable. There were instances where, you know, we're home working or the client was choosing to birth within the birth center, but we needed to transport to the hospital and just seeing vast difference in care between when they're with us and then we have to go into the hospital. And seeing doctors and nurses ignoring Black women's pain and their requests for pain medication, even seeing and hearing doctors flat out lie to clients about their choices or what's happening or what they can or cannot do. Having police called because they want to get discharged early and being threatened with CPS, coming to the hospital and potentially taking their children and coming to their homes. I've seen all of that happen in the course of taking care of black women. I've seen the exact same scenarios, play out completely different for white women.

Angela Glover Blackwell: (19:27)
What happens with the white women? How are they treated?

Tanya Smith Johnson: (19:30)
White women, they're heard instantly. They have a need. They say they have pain. They're given pain medications instantly. They're able to push back in ways that I would never ever, you know, see a Black woman being able to do without some kind of, you know, harsh repercussions. Um, I've seen Black clients being drug tested without their knowledge. And, and there have been white women that never happened to them, even if they had known drug histories or there was calls your reason for them to do so. You know, so things like that happen all the time, you know, where, White clients can say they want to leave right now with their children. And that stay the mandatory days and doctors and staff are like, okay, absolutely. But seeing a Black or Brown person do the same thing and they want to get the police involved because they think it's negligent. So those are the experiences that I see people have.

Angela Glover Blackwell: (20:35)
How did you first become involved in the collaborative effort to draft this country's first feminist economic recovery plan? And what was the process like?

Tanya Smith Johnson: (20:45)
It was a beautiful unfolding. I was asked by the Hawaii Commission on the Status of Women and their executive director to possibly sit on the task force as someone who's done legislative policy in other states, and just bring my kind of lived experience to the team, to look at things from that lens. And so the, that task force was created with the intention of having black, native, indigenous voices on it, to inform in ways that we haven't seen policy informed before. It was just beautiful to see all of us there and really just dream up this document. We sat there and we said, if we had nothing to lose, what does it look like? How do we build it and how not only do we make sure we tend to what's happening here in the moment, but that we make sure that, you know, the future is built out in the way that it doesn't go back to the status quo. And we're actually being, you know, radical and dreamy in the ways that we look at taking care of women and children and elders.

Angela Glover Blackwell: (21:48)
It is interesting that Hawaii and the group that got together to write this feminist economic recovery plan thought to center something like maternity and reproductive care. Now, I understand that you actually wrote that section. And one of the key recommendations of the plan calls for harnessing midwifery to improve maternal and neonatal health care in rural areas of Hawaii. How does the two fit together midwifery in rural areas and how do they relate to the economy?

Tanya Smith Johnson: (22:20)
Yeah, so that actually was the section that I had the biggest hand in writing. So it was written from that lens. It was written from the care that I give as a birth worker, but also as the best care that I received. And that should be what everybody has access to. In Hawaii, you know, interesting in that it covers several islands and each one is different and there are parts where it's completely rural to where on the other islands where people have to fly in, if there's any kind of complication or there's no resources on the Island. So everyone comes here to O'ahu. So we had to make sure that we spoke to all of that and that we encompass that when we think about how do we take care of birthing people who are living in the mountains, in the rural area of Maui. How do we make sure those people are seen and heard as we write this report?

Angela Glover Blackwell: (23:16)
And how did you feel that COVID-19 impacted the need for midwifery for rural Black and Brown women?

Tanya Smith Johnson: (23:24)
Well, what we saw when COVID hit is just how unprepared we were. Many places, you know, hospitals shut down their maternity ward. So they became Covid wards. And so that made the perfect scenario for us to really highlight. We have midwives, you know, and this is the opportunity to use this force that's here and already has been trained and works outside of the system outside of hospital. So what does that look like? How can we upscale that? How can we make it work if we're in this for the long haul and we need to, you know, take care of birthing people ,cause birth doesn't stop just because COVID is here. You know, women are still having their babies in the midst of this, and we have to make sure that we tend to them properly.

Angela Glover Blackwell: (24:07)
And so since the opportunity emerged to be able to really focus on midwifery and put it in the plan, what were some of the recommendations?

Tanya Smith Johnson: (24:16)
Upscale the force make, you know, make sure that we are doing what we can to, you know, train particularly midwives who are native and indigenous, midwives who are Black, so that we can make sure that we have this force here to make sure that we're collaborating, and there could possibly be a doctor, nurse and community midwife partnerships. We can possibly give birth for instance, in a hotel, if it came to that, right. It's where hospitals are overrun. So what does that look like to have births happen someplace else? Another recommendation has been to make sure that midwifery care can be covered because, you know, as of now midwifery care, isn't covered by Medicaid or insurance. So the push is to why don't we make it accessible for everyone, especially, you know, Black and Indigenous and Brown women, where a lot of them are receiving either Medicaid or a lot of them have insurance, but they can't use those insurances to cover midwifery costs, meaning they have to pay for those out of pocket, which in and of itself makes it limiting and inaccessible to them.

Angela Glover Blackwell: (25:27)
When you and the other women were working on this Feminist Economic Recovery Plan, and you were centering women and centering the most vulnerable in society. Did you feel like you were doing something revolutionary?

Tanya Smith Johnson: (25:40)
We, the people who do this work, it's not revolutionary or radical to us. You know, it's just something that Black, Brown, Indigenous people talk about within our own circles, but to actually put it into a plan and make it policy and make it something that, you know, as a governing document is the part this revolutionary, you don't see government speaking like this, and it's about time that they did.

Angela Glover Blackwell: (26:04)
Tanya, it's so exciting to think that someone spends their professional life, bringing life into the world and doing it in a way that is supportive and natural and allows women to actually feel so safe during a time when they're often anxious. I think that people who make those kinds of choices to live their lives, that way bring their superpower to their work. What's your superpower?

Tanya Smith Johnson: (26:26)
I always say my superpower is mothering and nurturing and caregiving. The work I do as a midwife is about replenishing and nourishing people and making sure that they're loved and cared for. The policy work I do is because I want people to be cared for. So from that place is why and where I do the work.

Angela Glover Blackwell: (26:48)
Tanya, thank you for speaking with us.

Tanya Smith Johnson: (26:50)
Thank you.

Angela Glover Blackwell: (26:52)
Tanya Smith Johnson is an activist and a midwife. She joined us from Honolulu, Hawaii.

Angela Glover Blackwell: (27:05)
The halting of business during the pandemic has provided a rare opportunity to reimagine the economy. There has never been a shortage of ideas for how to build an economy that works for all, but until now few leaders have been willing to translate those ideas into systemic change. Hawaii is boldly taking the lead its recovery plan, honestly, appraises the frailties and deep inequities of the state's economy and invest in the future. The plan is dedicated to mining the talents and responding to the needs of all people, especially those who have been left behind. It recognizes that if you solve the problems of the most vulnerable among us, if you create conditions for them to participate and thrive, the benefits will cascade out. The results are a stronger, more resilient society. The title of Hawaii's Feminist Recovery Plan says it all: Building Bridges, Not Walking on Backs. Let that vision guide the whole nation as we move forward.

Angela Glover Blackwell: (28:25)
Radical Imagination was produced by the Futuro Studios for PolicyLink. The Futuro Studios team includes Marlon Bishop, Andrés Caballero, Ruxandra Guidi, Stephanie Lebow, Julia Caruso, Leah Shaw, Lita Hollowell, and Sam Burnett. The PolicyLink team includes Rachel Gichinga, Glenda Johnson, Fran Smith, Jacob Goolkasian, and Milly Hawk Daniel. Our theme music was composed by Taka Yusuzawa and Alex Suguira. I'm your host, Angela Glover Blackwell. Join us again next time, and in the meantime, you can find us online at radicalimagination.us. Remember to subscribe and share.

Angela Glover Blackwell: (29:15)
Healthcare is a human right.

Media clip: (29:16)
We have a medical crisis and there is not one endocrinologist, who are diabetes specialists within a hundred mile radius of where I currently practice.

Angela Glover Blackwell: (29:25)
That's next time on Radical Imagination.