Inter Press Service » Women’s Health http://www.ipsnews.net Turning the World Downside Up Sun, 01 Mar 2015 16:39:38 +0000 en-US hourly 1 http://wordpress.org/?v=4.1.1 Environmental Damage to Gaza Exacerbating Food Insecurityhttp://www.ipsnews.net/2015/03/environmental-damage-to-gaza-exacerbating-food-insecurity/?utm_source=rss&utm_medium=rss&utm_campaign=environmental-damage-to-gaza-exacerbating-food-insecurity http://www.ipsnews.net/2015/03/environmental-damage-to-gaza-exacerbating-food-insecurity/#comments Sun, 01 Mar 2015 16:39:38 +0000 Mel Frykberg http://www.ipsnews.net/?p=139435 Safa Subha and three-year-old Rahat rely on Oxfam aid for food to fight malnutrition after having been accustomed to living on a diet of bread and tea. Credit: Mel Frykberg/IPS

Safa Subha and three-year-old Rahat rely on Oxfam aid for food to fight malnutrition after having been accustomed to living on a diet of bread and tea. Credit: Mel Frykberg/IPS

By Mel Frykberg
BEIT LAHIYA, Northern Gaza Strip, Mar 1 2015 (IPS)

Extensive damage to Gaza’s environment as a result of the Israeli blockade and its devastating military campaign against the coastal territory during last year’s war from July to August, is negatively affecting the health of Gazans, especially their food security.

“We were living on bread and tea and my five children were badly malnourished as my husband and I couldn’t afford proper food,” Safa Subha, 37, from Beit Lahiya told IPS.

“My children were suffering from liver problems, anaemia and weak bones. It was only after I received regular food vouchers from Oxfam and was able to purchase eggs and yoghurt that my children are now healthier.Lack of dietary diversity is an issue of concern, particularly for children and pregnant and lactating women, due to the lack of large-scale food assistance programmes and the high prices of fresh food and red meat

“But it is still a struggle as I have to ration out the food and my doctor has warned me to keep giving the children these foods to prevent the malnutrition returning,” said Safa.

According to the U.N. Office for the Coordination of Humanitarian Affairs (OCHA), in several communities, lack of dietary diversity was highlighted as an issue of concern, particularly for children and pregnant and lactating women, due to the lack of large-scale food assistance programmes and the high prices of fresh food and red meat.

Before the war, Safa’s husband Ashraf worked as a farmer, renting a piece of land on which he grew produce that he then sold.

“My husband used to earn about NIS 300 per week (about 75 dollars) from farming. After the land became too dangerous to farm, because of Israeli military fire and much of it destroyed in Israeli bombings, my husband tried to earn some money renting a taxi,” said Safa.

However, Ashraf’s attempts to support his family as a taxi driver did not provide sufficient income for their survival.

“He can only use the taxi a couple of days a week because it doesn’t belong to him and he often doesn’t have money to buy fuel because it is so expensive and Israel only allows limited amounts of fuel into Gaza because of the blockade,” said Safa.

Kamal Kassam, 43, from Beit Hanoun, in the northern Gaza Strip, has had to rely on Oxfam’s Cash for Work programme to support his wife and five children aged 6 to 12.

During the war the Kassam’s had to flee to a U.N. shelter after the family home was destroyed by Israeli bombs, which also wounded his wife and left one of his daughters severely traumatised, suffering from epilepsy and soiling herself at night.

Kassam’s wife Eman is ill and another daughter needs regular medical treatment for cancer.

The Kassams were provided with a temporary tin caravan to live in by aid organisations but were unable to purchase food or school clothes because they had received housing aid and were therefore “less desperate”.

“I used to work in a factory but lost that job after Israel’s blockade. Before the war I made about NIS 30 (about 7.50 dollars) a day by picking up and delivering goods from my donkey cart,” Kassam told IPS.

But during a night of heavy aerial bombardment, a bomb killed his donkey and destroyed the cart as well as his only way of supporting his family.

Israel’s extensive bombing campaign during the war also destroyed or damaged, infrastructure, including Gaza’s sole power plant and water sanitation projects.

As a result, untreated sewage is pumped out to sea and then floods back into Gaza’s underground water system, contaminating drinking water and crops and leading to outbreaks of disease.

Israeli restrictions on imports, including vital spare parts for the repair of sewerage infrastructure and agricultural equipment such as fertiliser and seedlings, has limited crop production.

Furthermore, the regular targeting of fishermen and farmers, trying to access their land and Gaza’s fishing shoals in Israel’s Access Restricted Areas (ARAs), by Israeli security forces has severely hindered the ability of Gazans to earn a living from farming and fishing.

OCHA identified the most frequent concerns regarding food security and nutrition as “loss of the source of income and livelihoods due to severe damage to agricultural lands; death/loss of animals; inability to access agricultural lands, particularly in the Israeli-imposed three-kilometre buffer zone; and loss of employment.”

Food insecurity in Gaza is not caused by lack of food on the market alone. It is also a crisis of economic access to food because most Gazans cannot afford to buy sufficient quantities of quality food.

“As a result of the lack of economic access to food due to high unemployment and low wages, the majority of the population in Gaza has been pushed into poverty and food insecurity, with no other choice but to rely heavily on assistance to cover their essential needs,” said ‘GAZA Detailed Needs Assessment (DNA) and Recovery Framework: Social Protection Sub-Sector’, a report by the World Bank, European Union, United Nations and the Government of Palestine.

“The repetition of one harsh economic shock after the other has resulted in an erosion of household coping strategies, with 89 percent of households resorting to negative coping mechanisms to meet their food needs (half report purchasing lower quality food and a third have reduced the number of daily meals),” said the DNA report, adding that the situation was expected to worsen in 2015.

Edited by Phil Harris   

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Farm Projects Boost Bangladeshi Women, Childrenhttp://www.ipsnews.net/2015/03/farm-projects-boost-bangladeshi-women-children/?utm_source=rss&utm_medium=rss&utm_campaign=farm-projects-boost-bangladeshi-women-children http://www.ipsnews.net/2015/03/farm-projects-boost-bangladeshi-women-children/#comments Sun, 01 Mar 2015 16:39:05 +0000 Josh Butler http://www.ipsnews.net/?p=139423 Women organise themselves into small collectives, to better bargain and trade their produce. Credit: Helen Keller International

Women organise themselves into small collectives, to better bargain and trade their produce. Credit: Helen Keller International

By Josh Butler
NEW YORK, Mar 1 2015 (IPS)

Women in Bangladesh are carving healthier, wealthier futures for themselves and their children – and they have chicken eggs and pineapples to thank.

Since 2009, the non-profit group Helen Keller International has overseen programmes in the eastern Bangladesh region of Chittagong, mentoring women in agriculture to produce food not only for their own families, but also to sell at market."It’s not just about growing their incomes, it’s about education leading to healthier and more productive lives.” -- Kathy Spahn

Kathy Spahn, president of HKI, said one-fifth of homes in Chittagong are considered hungry, while half the children are stunted and one-third are underweight due to poor nutrition. In the area HKI works, around 75 percent of people survive on just 12 dollars a month.

“The area is stigmatised and has little access to health services,” Spahn said at an event this week organised by Women Advancing Microfinance New York.

“We’re teaching women to grow nutritious fruit and vegetables, raise chickens for meat and eggs, and grow enough to sell at markets for extra money.”

The programme, ‘Making Markets Work For Women,’ or M2W2, gives both initial start-up capital and ongoing guidance. Women in Chittagong, who may have previously been viewed solely as homemakers, are given tools to grow nutrient-rich crops like spinach and carrots to feed their own families, as well as more lucrative crops like pineapple and maize to sell.

Chickens are raised, eggs are eaten and sold, ginger and turmeric are harvested and refined and packaged using supplied machinery; and women who never before had any control over family finances are suddenly bringing in their own income to pay for education and healthcare.

Helen Keller International – named for its founder, the inspirational deaf and blind author and activist – traditionally focused on sight and blindness projects, but today focuses on a broader gamut of health and nutrition issues, including blindness caused by Vitamin A deficiency. The group now runs 180 programmes in more than 20 Asian and African countries.

“HKI has been working in Bangladesh since 1978, doing work on nutritional blindness. Doing nutrition surveillance there, we saw the deeper pockets of Vitamin A deficiency,” Spahn told IPS.

“We call the programme ‘enhanced homestead food production.’ With that, comes nutrition information. It’s not just about growing their incomes, it’s about education leading to healthier and more productive lives.”

Women organise themselves into small collectives, to better bargain and trade their produce. While each household may only produce an amount too small to make market sale effective, joining forces with other women means each collective has a larger volume to sell.

“We want to build their capacity in business and marketing. We give them training on market research, demand, book-keeping, and organise the households into groups so they can aggregate their products,” Spahn said.

Credit: Helen Keller International

Credit: Helen Keller International

A group savings scheme is also offered, whereby women can place some of their income into a shared pool that any member can access for large expenses such as hospitalisation or replacement of packaging machinery.

“If something breaks down, we can’t replace it because that’s not sustainable. This is about development, not charity,” Spahn said.

M2W2 was originally a three-year pilot programme from 2009 to 2012, but received an extra injection of funds from the British government to continue until January.

“We are looking for more support to keep going,” Spahn said.

The programme’s outcomes are resounding. Spahn said of the 2,500 households involved, “nearly all” saw a 30 percent increase in income.

“When we started, everybody had a poor diet. Three years later, nobody did,” she said.

Eggs, a rich source of Vitamin A, helped address deficiency of that vitamin and vision problems associated with such deficiencies, but Spahn said the most powerful benefit was social, rather than physical.

“We found 90 percent of women had the sole decision over the money their raised. They were bargaining more efficiently, and feeling more empowered,” she said.

Empowerment and financial independence for women is one of the ideological pillars of Women Advancing Microfinancing New York. WAMNY board member Danielle LeBlanc said the microfinancing and social entrepreneurship can be among the simplest and most effective ways to advance the economic prospects of disenfranchised women in poorer countries.

“With an opportunity to earn income on their own, it helps women gain some independence and increase the financial sustainability of their families,” LeBlanc told IPS.

“When women received the profits from these businesses, they spent it back on their families – sending their kids to school, improving their home. The goal is not just to help create businesses, but to improve the welfare of the family.”

LeBlanc said the term ‘microfinancing’ was a broad concept, viewed differently by many parties. She said governments consider it to be grants of under 50,000 dollars and that banks consider the threshold to be closer to 250,000, but LeBlanc said vast progress can be made with an initial outlay of as little as a few hundred dollars.

“In the U.S., microfinancing might help out street vendors like in New York City, or to fund home daycare centres, or even small businesses with shopfronts. Overseas, we can be talking about the very poor, like women selling goods by the roadside, farmers, or craft makers,” she said.

“To us, the increase in income for a family in poor countries might seem very small, but it makes a huge difference in their lives. It helps increase the nutrition of children, increases the standing of the woman in the family, or can put a tin roof on a thatched house.”

LeBlanc said the increase standing of women in the eyes of their husbands and their community is one of the most important benefits that such projects can offer.

“It changes from community to community, but when women start bringing income into their family, it increases their confidence and they move from being totally dependant on their husband to someone bringing income into the house,” she said.

“There is more respect there for the woman. It makes a huge difference.”

She said the M2W2 programme was selected for presentation at the WAMNY event on Tuesday because of its “holistic” approach to empowering women, benefiting families, and changing communities.

“It is working with various women’s issues, from joint savings programmes to technical assistance and increasing farming output,” she said. “It is getting women working together, to co-operate as a community. Projects like this encourage our members to think outside the box for how to work.”

At its core, M2W2 is a simple one – give seeds and tools to women, show them how to farm, and teach them how to sell their produce. But both Spath and LeBlanc said that, in the field of microfinance, often the simplest ideas can have the most impressive outcomes.

“The key to whether a programme is successful isn’t necessarily the budget, it’s about whether it is based on a need. It needs clear communication with the community, if it is a programme they like and can use,” LeBlanc said.

Spath said HKI is currently working on a project in African countries including Mozambique and Burkina Faso, helping women there to grow sweet potatoes to make into chips, bread and cookies – again, both to sell and to feed to their own families.

“We’ve always said, we should aim for complex problems and simple solutions. We want to take a problem apart, and find a solution that isn’t overwhelming,” Spath said.

“The problem is in scaling things up, from one community to a nationwide programme. Once you have the solution, how do you reach the people hardest to reach? How do you take it past the village?”

Spath said HKI hopes to institute the M2W2 programme in other other countries.

Edited by Kitty Stapp

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UN at 70: Mega-Cities, Mortality and Migrationhttp://www.ipsnews.net/2015/02/analysis-mega-cities-mortality-and-migration-a-snapshot-of-post-u-n-world-population/?utm_source=rss&utm_medium=rss&utm_campaign=analysis-mega-cities-mortality-and-migration-a-snapshot-of-post-u-n-world-population http://www.ipsnews.net/2015/02/analysis-mega-cities-mortality-and-migration-a-snapshot-of-post-u-n-world-population/#comments Wed, 25 Feb 2015 16:43:38 +0000 Joseph Chamie http://www.ipsnews.net/?p=139346 The world's population reached 7 billion on Oct. 31, 2011. Pictured near an entrance to UN Headquarters is a banner for a global campaign by the UN Population Fund (UNFPA) to build awareness of the opportunities and challenges posed by this milestone. Credit: UN Photo/Rick Bajornas

The world's population reached 7 billion on Oct. 31, 2011. Pictured near an entrance to UN Headquarters is a banner for a global campaign by the UN Population Fund (UNFPA) to build awareness of the opportunities and challenges posed by this milestone. Credit: UN Photo/Rick Bajornas

By Joseph Chamie
UNITED NATIONS, Feb 25 2015 (IPS)

As the international community marks the 70th anniversary of the founding of the United Nations, one question worthy of some reflection is: Is world population better or worse off demographically since the establishment of the U.N.?

Some contend that the demography of today’s world population is markedly better than it was seven decades ago. Others argue that humanity is definitely worse off demographically and still others – often sceptics and cynics – feel it is neither better nor worse, but just different.This extraordinary demographic growth continues to pose serious challenges for humanity, including food production, pollution, global warming, water shortages, environmental degradation, crowding, reduced biodiversity and socio-economic development.

To consider the merits of those various perspectives and distinguish between personal opinions and measurable facts, it is useful and appropriate to dispassionately examine some fundamental demographic changes that have occurred to world population since the middle of the 20th century.

Perhaps the most visible demographic change is the increased size of world population, which now at 7.3 billion is five billion larger than at the time of the U.N.’s founding.

While world population has more than tripled in size, considerable variation has taken place across regions. Some populations, such as those in sub-Saharan Africa and Western Asia, have increased 500 percent or more over the past seven decades.

In contrast, other populations, such as those in Europe, increased by 40 percent or less over that time span.

The growth of world population, around 1.8 percent per year at mid 20th century, peaked at 2.1 percent in the late 1960s. The current annual rate of global population growth is 1.1 percent, the lowest since the U.N.’s founding.

In terms of absolute numbers, world population was adding approximately 47 million per year in 1950. The annual increase nearly doubled to a peak of 91 million in the late 1980s and then began declining to its current level of 81 million.

An important consequence of the differential rates of demographic growth globally has been the shift in the geographic distribution of world population. Whereas 70 years ago about one-third of world population resided in more developed regions, today that proportion is about half that level or 17 percent.

Also noteworthy are the regional demographic shifts that have occurred. For example, while Europe and Africa at mid 20th century accounted for 22 percent and 8 percent of world population, respectively, their current proportions are 10 percent for Europe and 16 percent for Africa.

Perhaps the most welcomed demographic change in world population that has taken place is the decline in mortality levels, including infant, child and maternal death rates.

During the past 70 years, the global infant mortality rate fell from approximately 140 to 40 infant deaths per 1,000 live births. The improvements in mortality across all age groups have resulted in an average life expectancy at birth for the world of 70 years, a gain of some 25 years since 1950.

Another remarkable transformation in world population over the past seven decades is the decline in fertility.

As a result of men and women gaining unprecedented control over the number, spacing and timing of their children, global fertility has decreased significantly from an average of about 5 births per woman at mid-20th century to 2.5 births per woman today.

Due to the declines in fertility as well as mortality, the age structure of world population has aged markedly. Over the past seven decades, the median age of world population has increased by six years, i.e., from 24 to 30 years.

In addition, the elderly proportion aged 80 years or older has tripled during this time period, increasing from about 0.5 to 1.6 percent.

The sex composition of world population has been relatively balanced and stable over the recent past, with a global sex ratio of around 100 -102 males for every 100 females.

Although slightly more boys are born than girls, many countries, especially the more developed, have more females than males due to lower female mortality rates.

Notable exceptions to that general pattern are China and India, whose population sex ratios are approximately 107 males per 100 females due in part to sex-selective abortion of female fetuses.

Whereas the sex ratio at birth of most countries is around 105 males per 100 females, it is 117 in China and 111 in India, markedly higher than their ratios in the past.

Increased urbanisation is another significant demographic transformation in world population. A literal revolution in urban living has occurred across the planet during the past seven decades.

Whereas a minority of world population, 30 percent, lived in urban areas in 1950, today the majority of the world, 54 percent, consists of urban dwellers. The migration to urban places took place across all regions, with many historically rural, less developed countries, such as China, Indonesia, Iran and Turkey, rapidly transformed to predominantly urban societies.

Another striking demographic change in world population is the emergence of mega-cities — agglomerations of 10 million or more inhabitants. In 1950, there was a single city in this category: New York, with 12.3 million inhabitants.

Today there are 28 mega-cities, with Tokyo being the largest at 38 million inhabitants, followed by Delhi with 25 million, Shanghai with 23 million and Mexico City, Mumbai and San Paulo each with approximately 21 million.

In addition to internal movements within nations, international migration across countries and regions has also increased markedly over the past decades. A half-century ago 77 million or nearly 3 percent of world population were immigrants, meaning they live in a place different from their place of birth. That figure has tripled to 232 million, representing slightly more than 3 percent of world population.

While most of the international migration is lawful, increasing numbers of men, women and children are choosing due to circumstance and desire to immigrate outside legal channels.

And while precise figures of migrants unlawfully resident are difficult to establish, the total number worldwide is estimated at least 50 million.

The numbers of refugees have also increased substantially during the recent past. At mid-20th century, an estimated one million people remained uprooted following the world war.

In the early 1990s the number of refugees peaked at around 18 million. Latest estimates put the global number of refugees at 16.7 million and growing.

Also, the total number of people forced to flee their homes due to conflict, which includes refugees, asylum seekers and internal displaced persons, has reached 51.2 million, the first time it has exceeded 50 million since the World War II.

From the above discussion, most would probably agree that while some aspects of world population are clearly better today than 70 years ago, others are not necessarily better and still others are decidedly worse.

Lower mortality rates and people living longer lives are certainly welcomed improvements. Men and women having the ability to decide more easily and freely the number, spacing and timing of births has also been an advance.

The logical consequence of lower mortality and fertility is population aging, a remarkable achievement that will, however, require major societal adjustments.

The scale of refugees and internally displaced person is plainly worse than a half century ago. The growing numbers and difficult circumstances of those fleeing their homes are unlikely to improve in the near future given the increasing political upheaval, ongoing civil conflicts and deteriorating economic conditions in many parts of the world.

Finally, the unprecedented growth of world population – the most rapid in human history –added about 5 billion more people since the mid 20th century.

This extraordinary demographic growth continues to pose serious challenges for humanity, including food production, pollution, global warming, water shortages, environmental degradation, crowding, reduced biodiversity and socio-economic development.

The recent declines in world population growth provide some indication of future demographic stabilisation or peaking, perhaps as early as the close of the 21st century.

At that time, would population is expected to be about 10 billion, 2.5 billion more than today or four times as many people as were living on the planet when the United Nations was founded.

Edited by Kitty Stapp

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Analysis: Collaboration Key for a Clean Indiahttp://www.ipsnews.net/2015/02/analysis-collaboration-key-for-a-clean-india/?utm_source=rss&utm_medium=rss&utm_campaign=analysis-collaboration-key-for-a-clean-india http://www.ipsnews.net/2015/02/analysis-collaboration-key-for-a-clean-india/#comments Tue, 24 Feb 2015 19:07:32 +0000 Neeraj Jain http://www.ipsnews.net/?p=139323 Sanitation infrastructure in India’s sprawling slums remains a massive challenge. Credit: Malini Shankar/IPS

Sanitation infrastructure in India’s sprawling slums remains a massive challenge. Credit: Malini Shankar/IPS

By Neeraj Jain
NEW DELHI, Feb 24 2015 (IPS)

Prime Minister Narendra Modi’s call to action for a 100 percent Open Defecation Free (ODF) India by 2019 was announced as part of the Swachh Bharat Mission (SBM) or Clean India Campaign last year.

With 60 percent of all those practising open defecation globally residing in India, this task is particularly crucial, yet also challenging.We need to think how we are going to engage and influence the behaviour of such a massive audience. It probably requires the most ambitious behaviour change campaign ever attempted in the history of any nation.

Inadequate waste management leads to the contamination of water sources, contributing to diarrhoeal diseases that claim the lives of 186,000 children every single year.

With nowhere safe to go to the toilet, women and girls are often put in a vulnerable position as they seek somewhere private to relieve themselves.

A lack of adequate sanitation also has a substantial impact on economic development, with money repeatedly being lost due to workers being sick or taking time off to care for sick family members, not to mention the cost of medical treatment.

So is the 2019 target actually achievable?

It may sound like a tall order but we won’t know until we try. We need to look at the ways to make it work – implement this seemingly ambitious plan in an effective manner to make the target achievable. Not just admit defeat before we start.

The recent pace of the activities under the SBM suggests that India would become clean by 2070. To achieve the target around 50,000 toilets need to be built every day, without compromising on quality.

So it’s high time that we stop focussing on the problems and start discussing possible solutions.

With this in mind, WaterAid India organised an India WASH Summit in New Delhi last week. It was the first of its kind and was aimed at devising solutions to India’s sanitation crisis and shaping future collaboration to achieve Swachh Bharat’s ambitious target of a toilet for every household by Oct. 2, 2019. 

This landmark event, organised in partnership with the Ministry of Drinking Water & Sanitation and Ministry of Urban Development, brought together the government, the private sector and civil society groups working to make clean India a reality.

The summit concluded with the creation of a concrete set of recommendations to be shared with the government of India to help in the effective implementation of the SBM across a number of themes including behaviour, equity and inclusion, gender, water security, institutional transformation, technology, research, and convergence of nutrition, health and education.

Collaboration emerged as a key theme at the summit, both within the sector as well as with organisations focussing on nutrition, health and education. Participants at the summit stressed the importance of capacity building and the need for effective monitoring.

It was agreed that sanitation should be acknowledged as a basic human right. To ensure success in getting sanitation for all, programmes need to be equitable and inclusive and should include behaviour change at its core.

Previous initiatives have taught us that just building toilets is not enough. To stimulate demand for toilets, hygiene education and collective initiatives are key.

We need to think how we are going to engage and influence the behaviour of such a massive audience. It probably requires the most ambitious behaviour change campaign ever attempted in the history of any nation.

The overall budget of the programme (rural as well as urban) as estimated by the government is almost Rs. 3 lakh crores (50 billion dollars).

I believe that answers to all hurdles identified above do exist but the entire WASH (water, sanitation and hygiene) sector need to come together to find the most suitable answers as well as the most effective ways to implement it, in record time.

WaterAid has been working in the WASH sector in India since 1986 and is committed to supporting the government of India in realising the ambitious but much needed goal of making India open defecation free by Mahatma Gandhi’s 150th birth anniversary in October 2019.

Edited by Kitty Stapp

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“HeForShe” Campaign Moves to the Next Stagehttp://www.ipsnews.net/2015/02/heforshe-campaign-moves-to-the-next-stage/?utm_source=rss&utm_medium=rss&utm_campaign=heforshe-campaign-moves-to-the-next-stage http://www.ipsnews.net/2015/02/heforshe-campaign-moves-to-the-next-stage/#comments Tue, 17 Feb 2015 23:25:02 +0000 Josh Butler http://www.ipsnews.net/?p=139228 Emma Watson launching the HeForShe IMPACT 10x10x10 Initiative at the end of January in Davos for UN Women. Credit: UN Women/Celeste Sloman

Emma Watson launching the HeForShe IMPACT 10x10x10 Initiative at the end of January in Davos for UN Women. Credit: UN Women/Celeste Sloman

By Josh Butler
UNITED NATIONS, Feb 17 2015 (IPS)

It launched in a blaze of social media glory with a viral speech that rocketed around the world, and five months on from the launch of U.N. Women’s groundbreaking HeForShe campaign, the real work is well underway.

The campaign, designed to recruit men and boys as key players in the gender equality movement, burst into life in September 2014 with a passionate speech from British actress Emma Watson on the floor of the United Nations in New York City.

The Harry Potter star’s speech has since been seen by millions around the globe, as the HeForShe launch and Watson’s remarks went viral worldwide.

“I have realised that fighting for women’s rights has too often become synonymous with man-hating. If there is one thing I know for certain, it is that this has to stop,” she said at the U.N.

“It is time that we all see gender as a spectrum instead of two sets of opposing ideals… How can we effect change in the world when only half of it is invited or feel welcome to participate in the conversation?”

HeForShe asks men to stand up for women’s rights and gender equality, to address inequality and discrimination faced by women worldwide. The overarching goal is gender equality by 2030.

U.N. Women presented a campaign update to the U.N. on February 9, outlining its accomplishments so far: billions of media impressions; millions of dollars donated; over 200,000 men pledging their support to the movement; and the new “Impact 10x10x10” program to bring on governments, universities and corporations as partners, recently launched at the World Economic Forum in Davos. “I think it’s attainable, but it’s a question of political will. Will people with power exercise that power? Even though it looks bleak now, I believe women’s equality is coming.” -- Terry O’Neill, President of the National Organisation for Women

“Once men start questioning the dynamics of gender inequality, men take responsibility for changing them, alongside women,” the U.N. Women briefing heard.

Elizabeth Nyamayaro, senior advisor at U.N. Women and head of the HeForShe campaign, called it a “rallying call” and “solidarity movement for gender equality.”

“We need to shift the way things have been done. A new approach was needed, there is a need for men to be part of this dialogue,” she told IPS.

“This is something that can’t just be for women alone to solve. It’s about men recognizing this is their struggle too.”

Just five months old, HeForShe is arguably already one of the most well recognised gender equality campaigns to ever exist, but women’s groups hold mixed opinions on the goals, ideology and value of the movement.

Liesl Gerntholtz, Executive Director of the Women’s Rights Division at Human Rights Watch, told IPS she was concerned that, ironically, men were seemingly being valued more than women in this gender equality campaign.

“The concern is that it is very easy for women’s voices to be usurped. That in shifting the focus to men, you run the risk of making women invisible again,” Gerntholtz said.

“There needs to be a conscious effort to keep women’s voices front and centre of these campaigns.”

She spoke of attending women’s rights conferences and summits where the entire panel of speakers were men, without a single female voice.

“Even in the U.N., with explicit decisions to look for gender parity in a discussion, I’ve been to events and panels that are all men. [HeForShe] might run the risk of replicating these risks of inequality and disempowerment,” Gerntholtz said.

Terry O’Neill, President of the National Organisation for Women, said HeForShe was a good starting point but was not the miracle cure for gender equality.

“The campaign does not address all the aspects of equality that need to be addressed. It simply says, feminism is good for men and for women, and that’s indisputable,” she told IPS.

“I think it’s attainable, but it’s a question of political will. Will people with power exercise that power? Even though it looks bleak now, I believe women’s equality is coming.”

Gerntholtz was skeptical of HeForShe’s broad goal “to end gender inequality by 2030,” as outlined by said UN Women Executive Director Phumzile Mlambo-Ngcuka.

“What are the indicators of gender equality that we are talking about? Is it access to education, participation in government and the corporate sector, a reduction in the number of women experiencing violence? The difficulty in an aim like that is it is very vague,” Gerntholtz said.

“It is important, what we use as markers on the road. It is an ambitious goal.”

When asked by IPS what indicators HeForShe would measure when assessing gender equality, Nyamayaro did not point to any specific examples.

“We’re looking for parity across every single level of society, whether in the home, workplace or community,” she said.

“We’re looking for lasting, concrete change… action from the grassroots, bottom up.”

Nyamayaro pointed out the Impact 10x10x10 project as HeForShe’s next substantial action, where she hoped meaningful change could be accomplished.

A one-year pilot initiative, the project will “engage governments, corporations and universities as instruments of change positioned within some of the communities that most need to address deficiencies in women’s empowerment and gender equality,” according to a release from U.N. Women.

“Each sector will identify approaches for addressing gender inequality, and pilot test the effectiveness of these interventions,” the release continues.

Nyamayaro said 10x10x10 would be a key part of HeForShe’s upcoming agenda, with further plans to be unveiled on International Women’s Day in March and a big one-year anniversary celebration in September.

“A lot needs to be done at the government and corporate level, and in terms of universities, with half the world’s population under 30 and the amount of violence on college campuses, we thought we could really do something there,” she said.

While Gerntholtz made clear her reservations over HeForShe, she said she generally supported the campaign’s goals.

“The women’s movement has been moving towards understanding that we need to include men and boys in the solution. We can’t just see them as perpetrators of violence, but as partners in eradicating violence,” she said.

“Using Emma Watson helps popularise feminism and makes it a legitimate choice for young men. It’s important she reaches the next generation, who will hopefully take leadership roles.”

O’Neill said the National Organisation for Women looked forward to tracking the progress of HeForShe.

“It’s really all hands on deck. We need all the help we can get,” she said.

“We need the U.N. to be loud and strong for women’s equality. HeForShe is one part of what’s needed, but it isn’t the be all and end all.”

Follow Josh on Twitter @joshbutler

Edited by Roger Hamilton-Martin

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Millennium Development Goals: A Mixed Report Card for Indiahttp://www.ipsnews.net/2015/02/millennium-development-goals-a-mixed-report-card-for-india/?utm_source=rss&utm_medium=rss&utm_campaign=millennium-development-goals-a-mixed-report-card-for-india http://www.ipsnews.net/2015/02/millennium-development-goals-a-mixed-report-card-for-india/#comments Sat, 14 Feb 2015 13:12:08 +0000 Neeta Lal http://www.ipsnews.net/?p=139191 India is home to one-fourth of the world’s poor. Credit: Neeta Lal/IPS

India is home to one-fourth of the world’s poor. Credit: Neeta Lal/IPS

By Neeta Lal
NEW DELHI, Feb 14 2015 (IPS)

Despite being one of the world’s fastest expanding economies, projected to clock seven-percent GDP growth in 2017, India – a nation of 1.2 billion – is trailing behind on many vital social development indices while also hosting one-fourth of the world’s poor.

While the United Nations prepares to wrap up a decade-and-a-half of poverty alleviation efforts, framed through the lens of the Millennium Development Goals (MDGs), by the end of this year, the international community has its eyes on the future.

"A focus on accelerating sustainable, inclusive and balanced growth is key to poverty eradication." -- Ranjana Kumari, director of the Delhi-based non-profit Centre for Social Research (CSR)
The coming development era will be centred on sustainability, driven by targets set out in the Sustainable Development Goals (SDGs). Home to one-sixth of the world’s population, India’s actions will determine to a great extent global efforts to lift millions out of destitution in the coming years.

Experts say its patchy progress on the MDGs offers some insights into how the country will both assist and hold back global development efforts in the post-2015 era.

Earlier this month the U.N. released a report lauding India’s efforts to half the number of poor people living within its borders to the current 270 million since the country joined hands with 189 U.N. member states to draft the MDGs 15 years ago.

While making strides in poverty reduction, India is also on track to achieve gender parity at the primary, secondary and tertiary levels on the education front by the year’s end though it lags significantly on the goal of empowering its women.

“The proportion of women working in decent jobs outside agriculture remains low; their participation in the overall labour force is also low and declining in rural areas; women in farming are constrained by lack of land ownership; and women are poorly represented in parliament,” the U.N. report stated.

The report recommends a continued emphasis on increasing both growth and social spending. However, experts point out this will be a significant challenge against the backdrop of India’s new Hindu nationalist government slashing social sector spending by about 30 percent in the supplementary budget.

Wretched poverty persists

The allocation for the National Rural Employment Guarantee Act (NREGA), an initiative to provide employment to all adult members of poor Indian families for five dollars per day, is now the lowest it has been in five years.

Despite robust economic growth, scenes of destitution are visible all throughout India, a nation of 1.2 billion people. Credit: Neeta Lal/IPS

Despite robust economic growth, scenes of destitution are visible all throughout India, a nation of 1.2 billion people. Credit: Neeta Lal/IPS

By the end of last year, state governments had reported a drop of 45-percent in funds allocated by the Centre, from 240 billion to 130 billion rupees (3.8 million to 2.1 million dollars) – the sharpest decline since the scheme’s inception in 2005.

India needs to balance its economic growth while tackling poverty as the latter can considerably erode the progress achieved from high GDP numbers, say economists.

“Removing poverty is clearly the most important of the goals as it has clear linkages to the other MDGs,” Delhi-based economist Parvati Singhal, a visiting professor at Jawaharlal Nehru University, told IPS.

“It needs to be central to the post-2015 development agenda. Higher income resulting from growth is the best panacea for poverty […],” Singhal elaborated.

According to Sabyasachi Kar, associate professor at the Institute of Economic Growth, with the University of Delhi, a major reason for continuing poverty in India is the country’s below-par industrial growth, which scuppers job creation.

“Programmes like NREGA and food-for-work programmes are at best safety nets that will keep people from starving. We need robust growth in the industrial and manufacturing sectors to generate employment and alleviate poverty while raising incomes permanently.

“Effective domestic resource mobilisation and incentivising the private sector to invest in sustainable green technologies will also help to tackle poverty,” the economist added.

Though Asia’s third largest economy has shown good progress in achieving its poverty reduction target, the malaise has ironically become more visible.

The sight of homeless construction workers, beggars, rag pickers, child labourers – the ensemble cast of India’s apparently prospering megacities – reflects its harsh underbelly.

According to a report entitled ‘Effects of Poverty in India: Between Injustice and Exclusion’, “The spectacular growth of cities has made poverty in India more visible and palpable through its famous slums.”

U.N. data shows that 93 million people in India live in slums, including 50 percent of the population in its capital, New Delhi.

Meanwhile, the megacity of Mumbai, home to 19 million, hosts nine millions slum-dwellers, up from six million just 10 years ago.

Dharavi, the second largest slum in Asia, is located in central Mumbai and is home to between 800,000 and one million people, crammed into just 2.39 square kilometres of space.

Investing in women and children: crucial for development

Public health in India is also an area of concern, with the country trailing in the realms of infant and child mortality as well as maternal health.

According to the World Bank India accounts for 21 percent of deaths among children below five years of age. Its maternal mortality ratio (MMR) – the number of women who die during pregnancy, delivery or in the first 42 hours of a termination per 100,000 live births – is 190. Countries like Ecuador and Guatemala fare better than India, with MMRs of 87 and 140 respectively.

Addressing these issues will be a considerable challenge as India is home to 472 million children or about 20 percent of the world’s child population, while nearly 50 percent of its population is comprised of women.

Health activists are advocating for greater capital investment in public health. India currently spends an abysmal one percent of its GDP on health, half the sum allocated by neighbouring China.

Even Russia and Brazil, two other nations in the BRICS association of emerging economies of which India is a part, invest 3.5 percent of their respective GDPs on health.

“A focus on accelerating sustainable, inclusive and balanced growth is key to poverty eradication,” Ranjana Kumari, director of the Delhi-based non-profit Centre for Social Research (CSR), told IPS.

The activist feels that growth and development should not only be measured in GDP terms but also in terms of per capita income and per capita spending.

“Right now, there is inequitable distribution of wealth in India. Money is concentrated in the hands of a few while the masses struggle to get two square meals a day. This inequity needs to be addressed as there’s no conflict in the growth of social justice and GDP growth; both ought to work in tandem for success.”

Speaking at the launch of the U.N. report on India last week, Shamshad Akhtar, under-secretary-general of the U.N., advocated for a new sustainable agriculture-based green revolution, which could contribute to ending hunger not only in India but across South Asia at large.

With eight percent of India’s population engaged in agriculture, amounting to some 95.8 million people, sustainable development will be impossible without lifting India’s farmers out of poverty, researchers contend.

Edited by Kanya D’Almeida

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Cancer Locks a Deadly Grip on Africa, Yet It’s Barely Noticedhttp://www.ipsnews.net/2015/02/cancer-locks-a-deadly-grip-on-africa-yet-its-barely-noticed/?utm_source=rss&utm_medium=rss&utm_campaign=cancer-locks-a-deadly-grip-on-africa-yet-its-barely-noticed http://www.ipsnews.net/2015/02/cancer-locks-a-deadly-grip-on-africa-yet-its-barely-noticed/#comments Fri, 13 Feb 2015 01:31:02 +0000 Jeffrey Moyo http://www.ipsnews.net/?p=139139 Many specialist doctors and nurses in Africa are migrating to greener pastures, leaving cancer patients with few options. Credit: Jeffrey Moyo/IPS

Many specialist doctors and nurses in Africa are migrating to greener pastures, leaving cancer patients with few options. Credit: Jeffrey Moyo/IPS

By Jeffrey Moyo
HARARE, Feb 13 2015 (IPS)

Hidden by the struggles to defeat Ebola, malaria and drug-resistant tuberculosis, a silent killer has been moving across the African continent, superseding infections of HIV and AIDS.

World Cancer Day commemorated on Feb. 4 may have come and gone, but the spread of cancer in Africa has been worrying global health organisations and experts year round. The continent, they fear, is ill-prepared for another health crisis of enormous proportions.

By 2020, according to the World Health Organisation (WHO), approximately 16 million new cases of cancer are anticipated worldwide, with 70 percent of them in developing countries. Africa and Asia are not spared.“Africa is at a crossroads in the face of rising cancer cases, with the disease proving to be more deadly than HIV/AIDS and it is worsening at a time when the continent faces a serious shortage of cancer specialists,” Menzisi Thabane, private oncologist in South Africa’s Eastern Cape Province

“Africa is at a crossroads in the face of rising cancer cases, with the disease proving to be more deadly than HIV/AIDS and it is worsening at a time when the continent faces a serious shortage of cancer specialists,” Menzisi Thabane, a private oncologist in South Africa’s Eastern Cape Province, told IPS.

“Africa and its leaders have failed to recognise cancer as a high-priority health problem despite millions of people succumbing to the disease,” added Thabane.

Most of Africa’s 2,000 plus languages have no word for cancer. The common perception in both developing and developed countries is that it is a disease of the wealthy world, where high-fat, processed-food diets, alcohol, smoking and sedentary lifestyles fuel tumour growth.

While many cancers are linked to unhealthy diets and smoking, a large number – particularly in Africa – are caused by infections like hepatitis B and C which can lead to liver cancer and the human papillomavirus (HPV) that causes almost all cervical cancers.

An HPV vaccine treatment costs 350 dollars for three doses over six months in most sub-Saharan African countries, whereas in Zimbabwe radiotherapy costs between 3,000 and 4,000 dollars for a whole session.

A study published in 2011 found that since 1980 new cervical cancer case numbers and deaths dropped substantially in rich countries, but increased dramatically in Africa and other poor regions. Overall, 76 percent of new cervical cancer cases are in developing regions, and sub-Saharan Africa already has 22 percent of all cervical cancer cases worldwide.

According to Zimbabwe’s Ministry of Health and Child Care, the country only has four oncologists catering to over 7,000 cancer patients nationwide. “The shortage of cancer doctors stands as an impediment to comprehensive treatment and care for cancer patients here,” Dr Prosper Chonzi, director of Health Services in the Zimbabwean capital, Harare, told IPS.

The shortage of cancer specialists is also seen in West Africa.

Last year, The Vanguard, a Nigerian newspaper, reported that there were an estimated 60 oncologists serving over 300 million people in the West African sub-region with fewer than 20 oncologists serving 160 million Nigerians. Ghana has only seven for 24 million people, Burkina Faso two and Cote D’Ivoire just one. Sierra Leone has more than six million people and no cancer doctors.

Across the continent in Kenya, cancer accounts for approximately 18,000 deaths annually, with up to 60 percent of fatalities occurring among people who are in the most productive years of their life. Men are most commonly diagnosed with prostate or oesophageal cancer, and women are most frequently affected by breast and cervical cancer.

Zimbabwe’s health activists blame the absence of cancer education for the upsurge of fatal cases in the African nation. “Very few people, including government, consider cancer a real threat to the health delivery system,” Agnes Matutu, director of the Zimbabwe Cancer Alliance, an anti-cancer lobby group here, told IPS.

Melody Hamandishe, a retired government nutritionist, told IPS she blamed imported genetically modified foods. This contributes to cancer, she said, as does the abuse of alcohol, often causing liver cancer.

In Zambia, anti-cancer activists accuse the government of not prioritising the fight against the disease. “People are perishing in huge numbers because of cancer here in Zambia while government is seized with fighting HIV/AIDS,” Kitana Phiri, a cervical cancer survivor, now a devoted anti-cancer activist based in the Zambian capital, Lusaka, told IPS.

In Tanzania, cancer is also wreaking havoc. A January 2014 report by the Ocean Road Cancer Institute (ORCI), the only specialised facility for cancer treatment in this east African nation, said there are 100 new patients in every 100,000 population out of the country’s population of 45 million.

Finally, in Namibia, uranium workers were reported to have elevated rates of cancers and other illnesses after working in one of Africa’s largest mines.

Rio Tinto’s Rössing uranium mine extracts millions of tonnes of rock a year for the mineral. “Most workers stated that they are not informed about their health conditions and do not know if they have been exposed to radiation or not. Some workers said they consulted a private doctor to get a second opinion,” say researchers at Earthlife Namibia and the Labour Resource and Research Institute who collaborated in a study.

“The older workers all said they know miners dying of cancers and other illnesses. Many of these are now retired and many have already died of cancers,” says the study report.

Cancer is not beyond us in terms of cancer control and reducing the impact of the disease, declared the Cancer Association of South Africa (CANSA) on World Cancer Day this year.

“The global cancer epidemic is huge and set to rise,” said Elize Jourbert, head of CANSA. “In South Africa, more than 100 000 are diagnosed annually. This day helps us spread the word and raise the profile of cancer”.

Under the tagline ‘Not beyond us’, World Cancer Day in South Africa focused on taking a positive and proactive approach to the fight against cancer, highlighting that solutions do exist regarding cancer care and early detection and that they are within reach.

Meanwhile, Ellen Awuah-Darko, the 75-year-old founder of the Accra-based Jead Foundation for breast cancer, says it was her personal experience of finding a breast lump and ending up paying tens of thousands of dollars to be treated in the United States that made her start to push for change.

“In America I had to put down 70,000 dollars before they’d even talk to me,” she said in an interview with Reuters. “I was lucky, I could afford it after my husband died and left me money, but I thought ‘why should I get treatment when others can’t’.”

Now, every Wednesday, Awuah-Darko goes with healthcare workers into communities in the Eastern Region of Ghana to offer women a simple breast examination and show them how to check themselves.

“Early detection can save your life,” she said. “I want everybody to know that. It’s not something people should be ashamed of or embarrassed about.”

Edited by Lisa Vives/Phil Harris    

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OPINION: The Plight of Women and Girls in Zambezi’s Floodshttp://www.ipsnews.net/2015/02/opinion-the-plight-of-women-and-girls-in-zambezis-floods/?utm_source=rss&utm_medium=rss&utm_campaign=opinion-the-plight-of-women-and-girls-in-zambezis-floods http://www.ipsnews.net/2015/02/opinion-the-plight-of-women-and-girls-in-zambezis-floods/#comments Mon, 02 Feb 2015 18:53:12 +0000 Dr. Julitta Onabanjo and Michael Charles http://www.ipsnews.net/?p=138974 Flooding in Malawi. Courtesy of the Malawi Red Cross Society

Flooding in Malawi. Courtesy of the Malawi Red Cross Society

By Julitta Onabanjo and Michael Charles
UNITED NATIONS, Feb 2 2015 (IPS)

The flooding of the Zambezi River has had devastating consequences for three countries in Southern Africa. The three worst affected countries are Malawi, Mozambique and Zimbabwe. 

Livestock has drowned, crops have been submerged or washed away and infrastructure has been badly damaged.Imagine being a pregnant woman airlifted from the floodplains and placed in a camp with no midwives, no sterilised equipment nor medical supplies to ensure a safe delivery.

Worse still, hundreds of lives have been lost – and the dignity of women and girls is on the line.

In Malawi, an estimated 638,000 people have been affected and the president has declared a state of disaster. About 174,000 people have been displaced in three of the worst affected districts out of 15 districts hit by floods.

A total of 79 deaths have been reported and about 153 people are still missing. Data disaggregated by age and sex are not readily available, however, it is estimated that about 330,000 of the 638,000 displaced people in the camps are women and close to 108,000 are young people.

The situation is also critical in Zimbabwe. According to preliminary assessments, approximately 6,000 people (1,200 households) have been affected, of which 2,500 people from 500 households are in urgent need of assistance. An estimated 40-50 per cent will be women or girls. More than ten people have drowned while many more have been injured, displaced and left homeless.

In Mozambique, almost all 11 provinces have experienced extensive rainfall. The central province of Zambézia was the worst hit – a bridge connecting central and northern Mozambique was destroyed by the floods in Mocuba district. Niassa and Nampula provinces were also seriously affected.

These three provinces are already among the poorest in the country, and for the most vulnerable – women, girls and children – the impact of flooding can be devastating.

Around 120,000 people from 24,000 families have been affected. The death toll due to flooding, lightning and houses collapsing has risen to 64, while more than 50,000 people from 12,000 families are in need of shelter. Others have fled to neighbouring Malawi. At least 700 out of an estimated 2500 people have been repatriated to date.

Mozambique has a recent history of recurrent floods. UNFPA is supporting the government and other partners to scale up efforts to safeguard the dignity of women and girls. This includes the positioning of reproductive health kits, hygiene kits and promoting gender-based violence prevention.

Flooding in Mozambique. Courtesy of UNFPA

Flooding in Mozambique. Courtesy of UNFPA

Health and reproductive health needs

As with most humanitarian situations, women, girls and children are usually the worst affected. In Mozambique, for example, close to 1,000 orphans and over 100 pregnant women and girls require urgent attention.

Imagine being a pregnant woman airlifted from the floodplains and placed in a camp with no midwives, no sterilised equipment nor medical supplies to ensure a safe delivery. This is a scenario that countless pregnant women are facing.

In addition to efforts by partners to address the food and infrastructural security needs of the people, women and girls are particularly vulnerable to exploitation and erosion of dignity, and deserve adequate attention.

In Malawi, about 315 visibly pregnant women were identified in the three worst affected districts. Between Jan. 10 and 24, 88 deliveries were recorded by 62 camps in the worst affected districts. Twenty-four of these deliveries were among adolescents aged between 15 and 19 years, as reported from Phalombe, where fertility rates and teenage pregnancies are generally high.

Malawi floods. Some of the pregnant women receiving dignity kits at Somba camp in T A Bwananyambi, Mangochi. Courtesy of UNFPA

Malawi floods. Some of the pregnant women receiving dignity kits at Somba camp in T A Bwananyambi, Mangochi. Courtesy of UNFPA

Women living in camps for displaced people are fearful of gender-based violence, including rape and other types of sexual abuse. Several cases of gender-based violence have already been reported. In one of the districts, a total of 124 cases were brought to the attention of authorities.

The design of the camps and the positioning of toilets are said to be contributing to these cases. A woman from Bangula camp said: “The toilets are far away from where we are sleeping. We are afraid to walk to the toilets at night for fear of being raped. If the toilets could be located close by, this could assist us.”

Personal dignity and hygiene is a major challenge for women and young people, especially for adolescent girls. A teenager from Tchereni camp in Malawi said: “I lost everything during the floods. My biggest challenge is how to manage my menstrual cycle.”

It has been reported that women and girls are sharing sanitary materials, which seriously compromises their health and dignity.

Urgent action

In order to address the  sexual and reproductive health needs of affected populations, UNFPA Malawi has recruited and deployed full time Reproductive Health and Gender Coordinators to support the authorities with the management of SRH/HIV and gender-based violence (GBV) issues in the camps.

UNFPA has also distributed pre-positioned Reproductive Health kits as well as drugs and medical equipment to cater for clean deliveries, including by Caesarean section, and related complications of pregnancy and child birth in six districts and two central hospitals in the flood-affected areas.

Over 300 prepositioned dignity kits were distributed and 2,000 more have been procured, over half of which have already been distributed to women of child-bearing age in some of the most affected districts to allow the women to continue to live with dignity in their state of crisis.

The International Federation of Red Cross and Red Crescent Societies (IFRC) has launched an emergency appeal for CHF 2,7 million to assist Malawi Red Cross to step up emergency response activities, including a detailed needs assessment of the affected regions, the procurement of non-food items, the procurement and distribution of shelter materials, and the provision of water and sanitation services.

A similar process was applied for Mozambique and Zimbabwe, with the aim of saving more lives by providing immediate assistance to those in need.

But as partners working together to address the numerous problems that confront the affected populations – and warnings of more risks of flooding – we cannot neglect the plight of women and girls.

In humanitarian situations especially, the dignity and reproductive health and rights of women and girls deserves our full attention.

Edited by Kitty Stapp

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Dying in Childbirth Still a National Trend in Zimbabwehttp://www.ipsnews.net/2015/01/dying-in-childbirth-still-a-national-trend-in-zimbabwe/?utm_source=rss&utm_medium=rss&utm_campaign=dying-in-childbirth-still-a-national-trend-in-zimbabwe http://www.ipsnews.net/2015/01/dying-in-childbirth-still-a-national-trend-in-zimbabwe/#comments Fri, 30 Jan 2015 19:15:33 +0000 Jeffrey Moyo http://www.ipsnews.net/?p=138935 Zimbabwe struggles to contain maternity deaths. Here in this southern African nation, the number of women dying in childbirth continues to rise. Credit: Jeffrey Moyo/ IPS

Zimbabwe struggles to contain maternity deaths. Here in this southern African nation, the number of women dying in childbirth continues to rise. Credit: Jeffrey Moyo/ IPS

By Jeffrey Moyo
HARARE, Jan 30 2015 (IPS)

For 47-year-old Albert Mangwendere from Mutoko, a district 143 kilometres east of Harare, the Zimbabwean capital, transporting his three pregnant wives using a wheelbarrow to a local clinic has become routine, with his wives delivering babies one after the other.

But these routines have not always been a source of joy for Mangwendere.

“Over the past twenty years, I have been ferrying my pregnant wives to a local clinic using a wheelbarrow because I have no (full size) scotch cart and we have lost 12 babies in total while traveling to the clinic,” Mangwendere told IPS.

Mangwendere’s case typifies the deepening maternity crisis in this Southern African nation.An estimated 3,000 women die every year in Zimbabwe during childbirth and at least 1.23 percent of gross domestic product (GDP) is lost annually due to maternal complications – United Nations issue paper on 'Maternal Mortality in Zimbabwe', 2013

An estimated 3,000 women die every year in Zimbabwe during childbirth and at least 1.23 percent of gross domestic product (GDP) is lost annually due to maternal complications, according to Maternal Mortality in Zimbabwe, a United Nations issue paper released in 2013.

In fact, the United Nations found that maternal mortality worsened by 28 percent between 1990 and 2010. The major causes were bacterial infection, uterine rupture (scar from a previous caesarean section tearing during an attempt at birth), renal and cardiac failure, as well as hyperemesis gravidarum (condition characterised by severe nausea, vomiting and weight loss during pregnancy).

This year, the government has allocated 301 million dollars to the health sector for a country of 13.5 million, according to the local NewsDay publication, which concluded: “This is to say that the government intends to spend on average just over 22 dollars on an individual this year. Compare this with 650 dollars for South Africa, 90 dollars for Botswana, 390 dollars for Botswana and 200 dollars for Angola.”

On top of a barely adequate public transportation system, user fees for delivering pregnant women that are charged in healthcare centres are also at fault, say civil society activists.

“In 2012, the government crafted and adopted a policy that saw user fees for maternity services being scrapped,” Catherine Mukwapati, director of the Youth Dialogue Action Network, a grassroots organisation, told IPS.

“But despite this policy, some facilities still charge indirect service fees, which is scaring away many pregnant women from hospitals and clinics, leaving them in the hands of less skilled midwives.”

Zimbabwe’s local authority clinics say they have resisted scrapping maternity fees despite the official directive, claiming that they are not reimbursed as promised by the government.

28-year-old Chipo Shumba pictured here holds her only child after she lost six others while giving birth over the past few years, a crisis health experts in Zimbabwe say is on the rise. Credit: Jeffrey Moyo/IPS

28-year-old Chipo Shumba pictured here holds her only child after she lost six others while giving birth over the past few years, a crisis health experts in Zimbabwe say is on the rise. Credit: Jeffrey Moyo/IPS

“Council clinics have no choice but to charge the council-subsidised 25 dollars for maternity since they haven’t received money from government,” Harare city director of health services, Stanley Mungofa, told IPS.

The actual cost of providing maternity services in council clinics has been pegged at 152 dollars, Mungofa said. At public hospitals like Parirenyatwa in Harare, the cost of a normal delivery is 150 dollars while a caesarean section costs as much as 450 dollars.

In a bid to lower the high maternity fees of public hospitals and council clinics, a group of donors pledged 435 million dollars for the nation’s health system for the period 2011-2015. The fund – the so-called Health Transition Fund – was led by the health ministry and managed by the U.N. Children’s Fund (UNICEF).

Importantly, the Health Transition Fund is helping to retain skilled workers by raising low wages. Underpaid doctors make up a large part of the country’s “brain drain” and there are now just 1.6 doctors for every 10,000 people.

Maternal fees may not apply in Zimbabwe’s countryside, where many like Mangwendere and his wives live, but other obstacles present an equally insurmountable barrier to obtaining care. Clinics and referral hospitals are often far away from people needing help, a major cause of maternity deaths there.

Finally, the tentacles of systemic corruption have reached into the health care systems. According to Transparency International, one local hospital was found to be charging mothers-to-be five dollars every time they screamed while giving birth.

A staggering 62 percent of Zimbabweans reported having paid a bribe in the previous year, the group stated in its 2013 report on global corruption.

Zimbabwe’s health sector was one of the best in sub-Saharan Africa in the 1980s, but it nearly collapsed when an economic crisis caused hyper-inflation of more than 230 million percent in 2008. Over the following years, chronic under-investment made a bad situation worse.

The increase in maternal mortality is being witnessed despite the U.N. Millennium Development Goal (MDG) for maternal health, under which countries should reduce the maternal mortality ratio by three-quarters between 1990 and 2015.

A 2012 status report on the MDGs asserted that Zimbabwe was unlikely to meet its mandate of reducing the maternal mortality ratio to 174 per 100,000 live births.

In research conducted in 2013 to address causes of maternal death, Zimbabwe’s Ministry of Health and Child Care blamed excessive bleeding after childbirth and unsafe abortion as the major causes of death, although no information was provided to back the claim.

“Statistics on maternal deaths often leave out sad realities of these similar deaths in unreachable remote areas where pregnant women and infants die daily without these cases being recorded anywhere,” said Helen Watungwa, a midwife at a council clinic in Gweru, the capital of the Midlands province, 222 kilometres outside the capital.

“But in any case, with the limited resources we have as nurses, we are doing all we can to save lives both of delivering mothers and infants,” Watungwa told IPS.

“It is truly a miracle that we continue to survive a series of pregnancies while battling to give birth often on the way to the clinic, bleeding heavily without any skilled persons to attend to us, with only our husband tottering with each one of us to the village healthcare centre using a wheelbarrow,” 28-year-old Mavis Handa, one of Mangwendere’s wives, told IPS.

Edited by Lisa Vives/Phil Harris    

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Dumped, Abandoned, Abused: Women in India’s Mental Health Institutionshttp://www.ipsnews.net/2015/01/dumped-abandoned-abused-women-in-indias-mental-health-institutions/?utm_source=rss&utm_medium=rss&utm_campaign=dumped-abandoned-abused-women-in-indias-mental-health-institutions http://www.ipsnews.net/2015/01/dumped-abandoned-abused-women-in-indias-mental-health-institutions/#comments Fri, 30 Jan 2015 05:08:44 +0000 Shai Venkatraman http://www.ipsnews.net/?p=138927 Women in India’s mental health institutions often face systematic abuse that includes detention, neglect and violence. Credit: Shazia Yousuf/IPS

Women in India’s mental health institutions often face systematic abuse that includes detention, neglect and violence. Credit: Shazia Yousuf/IPS

By Shai Venkatraman
MUMBAI, Jan 30 2015 (IPS)

Following the birth of her third child, Delhi-based entrepreneur Smita* found herself feeling “disconnected and depressed”, often for days at a stretch. “Much later I was told it was severe post-partum depression but at the time it wasn’t properly diagnosed,” she told IPS.

“My marriage was in trouble and after my symptoms showed no signs of going away, my husband was keen on a divorce, which I was resisting.”

“The nurses were unkind and cruel. I remember one time when my entire body was hurting the nurse jabbed me with an injection without even checking what the problem was.” -- Smita, a former resident of an Indian mental health institution
After a therapy session, Smita was diagnosed as bi-polar, a mental disorder characterised by periods of elevated highs and lows. “No one suggested seeking a second opinion and my parents and husband stuck to that label.”

One day after she suffered a particularly severe panic attack, Smita found 10 policemen outside her door. “I was taken to a prominent mental hospital in Delhi where doctors sedated me without examination. When I surfaced after a week I found that my wallet and phone had been taken away.”

All pleas to speak to her husband and parents went unheeded.

It was the beginning of a nightmare that lasted nearly two months, much of it spent in solitary confinement. “The nurses were unkind and cruel. I remember one time when my entire body was hurting the nurse jabbed me with an injection without even checking what the problem was.”

On one occasion, when she stopped eating in protest after she was refused a phone call, she was dragged around the ward. “There were women there who told me they had been abused and molested by the staff.”

Not all the women languishing in these institutions even qualified as having mental health problems; some had simply been put there because they were having affairs, or were embroiled in property disputes with their families.

Days after she was discharged her husband filed for a divorce on the grounds that Smita was mentally unstable.

“I realised then that my husband was building up his case so he would get custody of the kids.”

Isolated and afraid, Smita did not find the strength or support to fight back. Her husband won full custody and left India with the children soon after. “My doctor says I am fine and I am not on any medication but I still carry the stigma. I have no access to my kids and I no longer trust my parents,” she told IPS.

Smita’s story points to the extent of violence women face inside mental health institutions in India. The scale was highlighted in a recent Human Rights Watch (HRW) report, ‘Treated Worse than Animals’, which said women often face systematic abuse that includes detention, neglect and violence.

Ratnaboli Ray, who has been active in the field of mental health rights in the state of West Bengal for nearly 20 years, says on average one in three women are admitted into such institutions for no reason at all. Ray is the founder of Anjali, a group that is active in three mental institutions in the state.

“Under the law all you need is a psychiatrist who is willing to certify someone as mentally ill for the person to be institutionalised,” Ray told IPS. “Many families use this as a ploy to deprive women of money, property or family life. Once they are inside those walls they become citizen-less, they lose their rights.“

Ray points to the story of Neeti who was in her early 20s when she was admitted because she said she heard voices. “When we met her she was close to 40 and fully recovered, but her family did not want her back because there were property interests involved.”

With the help of the NGO Anjali, Neeti fought for and won access to her share of family property and was able to leave the institution.

Those on the inside endure conditions that are inhumane.

“There is hardly any air or light. Unlike the male patients who are allowed some mobility within the premises, women are herded together like cattle,” says Ray. In many hospitals women are not given underclothes or sanitary pads.

Sexual abuse is rampant. “Because it is away from public space and there is an assumed lack of legitimacy in what they say, such complaints are nullified as they are ‘mad’,” adds Ray.

Unwanted pregnancies and forced abortions impact their mental or physical health. They languish for years, uncared for and unattended.

“One can’t help but notice the stark contrast between the male and female wards,” points out Vaishnavi Jaikumar, founder of The Banyan, an NGO that offers support services to the mentally ill in Chennai, capital of the south Indian state of Tamil Nadu.

“You will find wives and mothers coming to visit male patients with food and fresh sets of clothes, while the women’s wards are empty.” Experts also say discharge rates are much lower when it comes to women.

The indifference towards patients is evident not just in institutions, but also at the policy level, with mental health occupying a low rung on the ladder of India’s public health system.

According to a WHO report the government spends just 0.06 percent of its health budget on mental health. Health ministry figures claim that six to seven percent of Indians suffer from psychosocial disabilities, but there is just one psychiatrist for every 343,000 people.

That ratio falls even further for psychologists, with just one trained professional for every million people in India.

Furthermore, the country has just 43 state-run mental hospitals, representing a massive deficit for a population of 1.2 billion people. With the District Mental Health Programme (DMHP) present in just 123 of India’s 650 districts, according to HRW, the forecast for those living with mental conditions is bleak.

“Behind that lack of priority is the story of how policymakers themselves stigmatise,” contends Ray. “The government itself thinks [the cause] is not worthy enough to invest money in. Unless mental health is mainstreamed with the public health system it will remain in a ghetto.”

Depression is twice as common in woman as compared to men and experts say that factors like poverty, gender discrimination and sexual violence make women far more vulnerable to mental health issues and subsequent ill-treatment in poorly run institutions.

Gopikumar of The Banyan advocates for creative solutions that are scientific and humane like Housing First in Canada, which reaches out to both the homeless and mentally ill. The Banyan is presently experimenting with community-based care models funded by the Bill and Melinda Gates Foundation and the Canadian government.

“Our model looks at housing and inclusivity as a tool for community integration,” says Gopikumar. “The poorest in the world are people with disabilities and most of them are women. They are victims of poverty on account of both caste and gender discrimination and its time we open our eyes to the problem.”

*Name changed upon request

Edited by Kanya D’Almeida

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Conflict-Related Displacement: A Huge Development Challenge for Indiahttp://www.ipsnews.net/2015/01/conflict-related-displacement-a-huge-development-challenge-for-india/?utm_source=rss&utm_medium=rss&utm_campaign=conflict-related-displacement-a-huge-development-challenge-for-india http://www.ipsnews.net/2015/01/conflict-related-displacement-a-huge-development-challenge-for-india/#comments Thu, 29 Jan 2015 09:19:53 +0000 Priyanka Borpujari http://www.ipsnews.net/?p=138896 In Serfanguri relief camp in Kokrajhar, several tents were erected, but they were inadequate to properly house the roughly 2,000 people who had arrived there on Dec. 23, 2014. This single tent houses 25 women and children. Credit: Priyanka Borpujari/IPS

In Serfanguri relief camp in Kokrajhar, several tents were erected, but they were inadequate to properly house the roughly 2,000 people who had arrived there on Dec. 23, 2014. This single tent houses 25 women and children. Credit: Priyanka Borpujari/IPS

By Priyanka Borpujari
KOKRAJHAR, India, Jan 29 2015 (IPS)

The tarpaulin sheet, when stretched and tied to bamboo poles, is about the length and breadth of a large SUV. Yet, about 25 women and children have been sleeping beneath these makeshift shelters at several relief camps across Kokrajhar, a district in the north-eastern Indian state of Assam.

The inhabitants of these camps – about 240,000 of them across three other districts of Assam – fled from their homes after 81 people were killed in what now seems like a well-planned attack.

The Asian Centre for Human Rights says the situation is reaching a full-blown humanitarian crisis, representing one of the largest conflict-related waves of displacement in India.

It has turned a mirror on India’s inability to meet the Millennium Development Goals (MDGs), and suggests that continued violence across the country will pose a major challenge to meeting the basic development needs of a massive population.

Hunger is constant in the refugee camps, with meagre rations of rice, lentils, cooking oil and salt falling short of most families’ basic needs. Women are forced to walk long distances to fetch firewood for woodstoves. Credit: Priyanka Borpujari/IPS

Hunger is constant in the refugee camps, with meagre rations of rice, lentils, cooking oil and salt falling short of most families’ basic needs. Women are forced to walk long distances to fetch firewood for woodstoves. Credit: Priyanka Borpujari/IPS

Appalling conditions

On the evening of Dec. 23, several villages inhabited by the Adivasi community were allegedly attacked by the armed Songbijit faction of the National Democratic Front of Bodoland (NDFB), which has been seeking an independent state for the Bodo people in Assam.

The attacks took place in areas already marked out as Bodoland Territorial Authority Districts (BTAD), governed by the Bodoland Territorial Council (BTC).

But the Adivasi community that resides here comprises several indigenous groups who came to Assam from central India, back in 150 AD, while hundreds were also forcibly brought to the state by the British to work in tea gardens.

Clashes between the Adivasi and Bodo communities in 1996 and 1998 – during which an estimated 100 to 200 people were killed – still bring up nightmares for those who survived.

This child, a resident of the Serfanguri camp, is suffering from a skin infection. His mother says they are yet to receive medicines from the National Rural Health Mission (NRHM). Credit: Priyanka Borpujari/IPS

This child, a resident of the Serfanguri camp, is suffering from a skin infection. His mother says they are yet to receive medicines from the National Rural Health Mission (NRHM). Credit: Priyanka Borpujari/IPS

It explains why the majority of those displaced and taking shelter in some 118 camps are unwilling to return to their homes.

But while the tent cities might seem like a safer option in the short term, conditions here are deplorable, and the government is keen to relocate the temporary refugees to a more permanent location soon.

The relief camp set up at Serfanguri village in Kokrajhar lacks all basic water and sanitation facilities deemed necessary for survival. A single tent in such a camp houses 25 women and children.

“The men sleep in another tent, or stay awake at night in turns, to guard us. It is only because of the cold that we somehow manage to pull through the night in such a crowded space,” explains Maino Soren from Ulghutu village, where four houses were burned to the ground, forcing residents to run for their lives carrying whatever they could on their backs.

Now, she tells IPS, there is a serious lack of basic necessities like blankets to help them weather the winter.

Missing MDG targets

In a country that is home to 1.2 billion people, accounting for 17 percent of the world’s population, recurring violence and subsequent displacement put a huge strain on limited state resources.

Time after time both the local and the central government find themselves confronted with refugee populations that point to gaping holes in the country’s development track record.

With food in limited supply and fish being a staple part of the Assamese diet, it is common to see women and even children fishing in the marshy swamps that line the edge of the refugee camps, no matter how muddy or dirty the water might be. Credit: Priyanka Borpujari/IPS

With food in limited supply and fish being a staple part of the Assamese diet, it is common to see women and even children fishing in the marshy swamps that line the edge of the refugee camps, no matter how muddy or dirty the water might be. Credit: Priyanka Borpujari/IPS

Outside their hastily erected tents in Kokrajhar, underweight and visibly undernourished children trade biscuits for balls of ‘jaggery’ (palm sugar) and rice.

Girls as young as seven years old carry pots of water on their heads from tube wells to their camps, staggering under the weight of the containers. Others lend a hand to their mothers washing pots and pans.

The scenes testify to India’s stunted progress towards meeting the MDGs, a set of poverty eradication targets set by the United Nations, whose timeframe expires this year.

One of the goals – that India would reduce its portion of underweight children to 26 percent by 2015 – is unlikely to be reached. The most recent available data, gathered in 2005-2006, found the number of underweight children to be 40 percent of the child population.

Similarly, while the District Information System on Education (DISE) data shows that the country has achieved nearly 100 percent primary education for children aged six to ten years, events like the ones in Assam prevent children from continuing education, even if they might be enrolled in schools.

According to Anjuman Ara Begum, a social activist who has studied conditions in relief camps all across the country and contributed to reports by the Internal Displacement Monitoring Centre (IDMC), “Children from relief camps are allowed to take new admission into nearby public schools, but there is no provision to feed the extra mouths during the mid-day meals. So children drop out from schools altogether and their education is impacted.”

Furthermore, in the Balagaon and Jolaisuri villages, where camps have been set up to provide relief to Adivasi and Bodo people respectively, there were reports of the deaths of a few infants upon arrival.

Most people attributed their deaths to the cold, but it was clear upon visiting the camps that no special nutritional care for lactating mothers and pregnant women was available.

This little boy is one of hundreds whose schooling has been interrupted due to violence. The local administration is attempting to evict refugees from the camps, most of which are housed in school compounds, but little is being done to ensure the educational rights of displaced children. Credit: Priyanka Borpujari/IPS

This little boy is one of hundreds whose schooling has been interrupted due to violence. The local administration is attempting to evict refugees from the camps, most of which are housed in school compounds, but little is being done to ensure the educational rights of displaced children. Credit: Priyanka Borpujari/IPS

Bleak forecast for maternal and child health

Such a scenario is not specific to Assam. All over India, violence and conflict seriously compromise maternal and child health, issues that are high on the agenda of the MDGs.

In central and eastern India alone, some 22 million women reside in conflict-prone areas, where access to health facilities is compounded by the presence of armed groups and security personnel.

This is turn complicates India’s efforts to reduce the maternal mortality ratio from 230 deaths per 100,000 live births to its target of 100 deaths per 100,000 births.

It also means that India is likely to miss the target of lowering the infant mortality rate (IMR) by 13 points, and the under-five mortality rate by five points by 2015.

Scenes like this are not uncommon at relief camps inhabited by the Bodo community. Many families have accepted that they will have a long wait before returning to their homes, or before their children resume schooling. Credit: Priyanka Borpujari/IPS

Scenes like this are not uncommon at relief camps inhabited by the Bodo community. Many families have accepted that they will have a long wait before returning to their homes, or before their children resume schooling. Credit: Priyanka Borpujari/IPS

According to a recent report by Save the Children, ‘State of the World’s Mothers 2014’, India is one of the worst performers in South Asia, reporting the world’s highest number of under-five deaths in 2012, and counting some 1.4 million deaths of under-five children.

Nutrition plays a major role in the mortality rate, a fact that gets thrown into high relief at times of violence and displacement.

IDPs from the latest wave of conflict in Assam are struggling to make do with the minimal provisions offered to them by the state.

“While only rice, lentils, cooking oil and salt are provided, there is no provision for firewood or utensils, and hence the burden of keeping the family alive falls on the woman,” says Begum, adding that women often face multiple hurdles in situations of displacement.

With an average of just four small structures with black tarpaulin sheets erected as toilets in the periphery of relief camps that house hundreds of people, the basic act of relieving oneself becomes a matter of great concern for the women.

“Men can go anywhere, any time, with just a mug of water. But for us women, it means that we have to plan ahead when we have to relieve ourselves,” said one woman at a camp in Lalachor village.

It is a microcosmic reflection of the troubles faced by 636 million people across India who lack access to toilets, despite numerous commitments on paper to improve the sanitation situation in the country.

As the international community moves towards an era of sustainable development, India will need to lay plans for tackling ethnic violence that threatens to destabilize its hard-won development gains.

Edited by Kanya D’Almeida

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When Ignorance Is Deadly: Pacific Women Dying From Lack of Breast Cancer Awarenesshttp://www.ipsnews.net/2015/01/when-ignorance-is-deadly-pacific-women-dying-from-lack-of-breast-cancer-awareness/?utm_source=rss&utm_medium=rss&utm_campaign=when-ignorance-is-deadly-pacific-women-dying-from-lack-of-breast-cancer-awareness http://www.ipsnews.net/2015/01/when-ignorance-is-deadly-pacific-women-dying-from-lack-of-breast-cancer-awareness/#comments Wed, 28 Jan 2015 04:15:08 +0000 Catherine Wilson http://www.ipsnews.net/?p=138872 Local women's NGO, Vois Blong Mere, campaigns for women's rights in Honiara, capital of the Solomon Islands. Credit: Catherine Wilson/IPS

Local women's NGO, Vois Blong Mere, campaigns for women's rights in Honiara, capital of the Solomon Islands. Credit: Catherine Wilson/IPS

By Catherine Wilson
SYDNEY, Jan 28 2015 (IPS)

Women now face a better chance of surviving breast cancer in the Solomon Islands, a developing island state in the southwest Pacific Ocean, following the recent acquisition of the country’s first mammogram machine.

But just a week ahead of World Cancer Day, celebrated globally on Feb. 4, many say that the benefit of having advanced medical technology, in a country where mortality occurs in 59 percent of women diagnosed with cancer, depends on improving the serious knowledge deficit of the disease in the country.

"While cancer is included on the NCD [non-communicable diseases] list, very little attention and resources are specifically addressing women and breast cancer awareness." -- Dr. Sylvia Defensor, senior radiologist at the Ministry of Health and Medical Services in Fiji
“Breast cancer is a health issue that women are concerned about in the Solomon Islands, but adequate awareness of it among women is not really prioritised,” Bernadette Usua, who works for the local non-governmental organisation, Vois Blong Mere (Voice of Women), in the capital, Honiara, told IPS.

Rachel, a young 24-year-old woman living with her two children, aged three and five years, in one of the country’s many rural villages, did not know what breast cancer was when she detected a lump in her breast in August 2013.

But the lump grew larger prompting her to travel to Honiara several months later to see a doctor.

“She went to the central hospital and was advised to have her left breast removed, but due to the little knowledge that she and her husband had about what it would be like, both were afraid of the surgery,” Bernadette Usua, who is Rachel’s cousin, recounted.

“So they just left the hospital without any medication or other assistance, and went home,” she continued.

Rachel tried traditional medicine available in her village, but the cancer and pain became more aggressive. Usua remembers next seeing her cousin in July of last year.

“She was sitting on her bed night and day with extreme pain, unable to lie down and sleep. But she was still brave as she nursed herself, washed herself and cooked for her children. She cried and prayed until she passed away in September,” Usua recalled.

Breast cancer is the most common cancer in women worldwide and in the Solomon Islands, where it accounted for 92 of more than 200 diagnosed cases in 2012. But its incidence in the developing world, where 50 percent of cases and 58 percent of fatalities occur, is rapidly rising.

Low survival rates of around 40 percent in low-income countries, compared to more than 80 percent in North America, are due mainly to late discovery of the disease in patients and limited diagnosis and treatment offered by under-resourced health centres.

Last year Annals of Global Health revealed that of 281 cancer cases identified in women in the Solomon Islands in 2012, 165 did not survive, while in Papua New Guinea and Fiji fatalities occurred in 2,889 of 4,457, and 418 of 795 diagnosed cases, respectively.

Insufficient public knowledge about the disease is an issue across the region.

“Currently public health education and promotion is focussing heavily on the control of NCDs [non-communicable diseases] as a whole. While cancer is included on the NCD list, very little attention and resources are specifically addressing women and breast cancer awareness,” said Dr. Sylvia Defensor, senior radiologist at the Ministry of Health and Medical Services in Fiji, a Pacific Island state home to over 880,000 people.

In the Solomon Islands, mammograms, or x-rays of the breast, will now be free to all female citizens who comprise about 49 percent of the population of more than 550,000. This is after installation of digital mammography equipment, funded by the national First Lady’s Charity, in Honiara’s National Referral Hospital.

Dr. Douglas Pikacha, general surgeon at the hospital, explained that mammograms were vital to early detection of breast disease and the saving of women’s lives through early treatment, such as surgery and chemotherapy.

Mammography is considered the most effective form of breast cancer screening by the World Health Organisation (WHO), with some evidence that it can reduce subsequent loss of life by an estimated 20 percent, especially in women aged 50-70 years.

But with more than 80 percent of the population residing in rural areas and spread over more than 900 different islands, Josephine Teakeni, president of Vois Blong Mere, is deeply concerned about the fate of many women who are located far from the main health facilities in the capital. An estimated 73 percent of doctors and all medical specialists in the country are based at the National Referral Hospital.

She says that reliable breast cancer screening and diagnosis is urgently needed in provincial hospitals if the mortality rate is to be reduced. Most patients must travel an average of 240 kilometres to reach the National Referral Hospital, commonly by ferry or motorised canoe, given the prohibitive expense of internal air services.

There is also a critical shortage of health care workers in the country with 0.21 doctors per 1,000 people and Teakeni claims that “while waiting for an operation the delay can result in full advancement of the cancer and death.”

However, there is a further challenge with almost half of all women diagnosed with breast cancer refusing a mastectomy, which involves the partial or entire surgical removal of affected breasts, even though it may result in the patient’s recovery, the Ministry of Health reports.

“Many prefer traditional treatment to mastectomy because they believe it is more womanly to have their breast than to live without it,” Pikacha said.

The high risk of cancer mortality is another factor impacting gender inequality in the Pacific Island state where entrenched cultural attitudes and widespread gender violence, experienced by 64 percent of women and girls, hinders improvement of their social and economic status.

Teakeni believes that an urgent priority is dramatically improving “awareness among women about the signs and symptoms of breast cancer, and even simple tests that women can do themselves, such as checking the breast for lumps while having a shower,” as well as the importance and impact of medical treatment.

Still, the installation of the new mammogram machine gives women on this island something, however small, to celebrate.

Edited by Kanya D’Almeida

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Battle Heats Up Over Legalisation of Sex Work in Indiahttp://www.ipsnews.net/2015/01/battle-heats-up-over-legalisation-of-sex-work-in-india/?utm_source=rss&utm_medium=rss&utm_campaign=battle-heats-up-over-legalisation-of-sex-work-in-india http://www.ipsnews.net/2015/01/battle-heats-up-over-legalisation-of-sex-work-in-india/#comments Fri, 16 Jan 2015 14:10:38 +0000 Neeta Lal http://www.ipsnews.net/?p=138679 The view from a red-light district in India, where some three million sex workers are caught in the middle of a debate on legalisation. Credit: bengarrison/CC-BY-SA-2.0

The view from a red-light district in India, where some three million sex workers are caught in the middle of a debate on legalisation. Credit: bengarrison/CC-BY-SA-2.0

By Neeta Lal
NEW DELHI, Jan 16 2015 (IPS)

Thirty-six-year-old Chameli Devi, a sex worker operating out of New Delhi’s G.B. Road – Asia’s largest red-light district, housing an estimated 12,000 of India’s three million sex workers – is an unhappy woman these days.

A contentious debate over the sex trade in India, following a call for legalisation by the National Commission for Women (NCW) – a state-run body that advises the government on women-related policy matters – has Devi worried.

“In wealthier countries, many women genuinely choose this trade due to better income prospects and opportunities. But in India, every woman who enters this trade has invariably been coerced into it by a trafficker, her family or her husband." -- Sarita, a 43-year-old sex worker in New Delhi
She feels that merely issuing licences or permits to people of her ilk will not lead to the improvement of the unhealthy and, at times, dangerous conditions under which commercialised prostitution functions.

According to U.N. reports, about 70 percent of sex workers in India are abused by their clients and the police. Abuse, say activists, is often under-reported by sex workers due to a lack of knowledge of their basic rights.

“Most of us don’t take to the flesh trade out of choice but are sold by criminal mafias to brothels. The move to regulate our business will only end up giving immunity to the pimps and brothels to buy or sell poor women like us while increasing trafficking of young women and children,” Devi told IPS.

A recent study conducted by the Indian philanthropic non-profit Dasra found that roughly half of trafficking victims are adolescent girls, while the average age of sex workers has dropped from 14-16, to 10-14, “because young girls are believed to have a lower risk of carrying a sexually transmitted disease”.

“Most victims come from rural areas, over 70 percent are illiterate, and almost half reported that their families earned just about one dollar [per day],” the report stated.

Other studies have found that most sex workers in India are form the lower castes, communities that are routinely subjected to violence and exploitation in a highly stratified society.

It is unsurprising, then, that scores of women trapped in the trade remain highly opposed to legalization.

Sarita, 43, another sex worker, feels that while there may be a sound argument for legalisation in richer countries like the USA, or even China, such a system is ill-suited to India.

“In wealthier countries, many women genuinely choose this trade due to better income prospects and opportunities. But in India, every woman who enters this trade has invariably been coerced into it by a trafficker, her family or her husband,” she asserted. “So the dynamics of our society are very different.”

Curbing the flourishing sex trade

A 2014 study, ‘Economics Behind Forced Labour Trafficking’, spearheaded by Indian Nobel Peace Prize-winner Kailash Satyarthi, contains some of the most up-to-date data on the flourishing sex trade.

“The figures are shocking…In India alone, the money generated through [the] sex trade so far stands at a whopping 343 billion dollars. Research confirms that several agencies such as traffickers, brothel owners, money lenders, law enforcement officials, lawyers, judiciary and to a certain level even the victims of CSE (commercial sexual exploitation) eventually receive money for participation,” Satyarthi said in the study.

According to a 2009 United Nations report, sex trafficking is the commonest form of human trafficking in the world, making it the largest slave trade; about 79 percent of all human trafficking is for sex work and it is the fastest growing criminal industry globally.

Countries that have legalised prostitution are not much better off. The Netherlands, which legalised prostitution in 2000, continues to grapple with human traffickers smuggling women into the country’s brothels, point out non-profits working in the area.

With the legalisation debate gaining traction, public opinion in India is also splintered over the issue. Those who favour the move feel that it will whittle down harassment, legal intimidation, entrapment and exploitation of sex workers.

NCW Chairperson Lalitha Kumaramangalam, who set the ball rolling with her suggestion that the trade be brought under state control last month, feels that such a step will ensure better living conditions for women engaged in commercial sex work.

She contends it will reducing trafficking of both girls and women and improve the health conditions of sex workers who are presently forced to serve clients in unhygienic conditions and without condoms, which has caused HIV and other sexually transmitted diseases to spread.

In fact health care experts extend some of the strongest arguments in favour of legalising prostitution, or regulating it. They feel that the rapid spread of HIV/AIDS across the world, especially in Asia and Africa, can be checked by bringing the business under the state umbrella as this will help health workers to better educate those in the trade about condom usage and basic hygiene.

Safer sex work or a massive bureaucracy?

Opponents of legalisation, however, are wary of the consequences of adding layers of regulation to India’s massive bureaucracy. They fear that government intervention could trigger harassment of the very people it seeks to protect.

“Legalising prostitution is legalising the profiteers of the sex-industry and their customers,” Ranjana Kumari, director for the New Delhi-based think tank Centre for Social Research, told IPS.

“It means rape of poor, lower-caste women with impunity. Not only that, it will make India a world magnet for sex trafficking and sex tourism.”

Donna M. Hughes, professor of Women’s Studies at the University of Rhode Island, writes in her essay ‘Prostitution: Causes and Solutions’ that legalisation does not reduce prostitution or trafficking.

“In fact,” she writes, “both activities increase because men can legally buy sex acts, and pimps and brothel keepers can legally sell and profit from them … In the Netherlands, since legalisation, there has been an increase in the use of children in prostitution.”

Activists working with sex workers are also deeply divided over the issue. While Dr S. Jana, who launched the 65,000-strong sex workers’ forum — Durbar Mahila Samanwaya Committee — based out of the eastern Indian state of West Bengal, has supported the legalisation call, others fear that it will further embolden traffickers and the prostitution mafia.

“Indian law and government policies have failed to protect sex workers due to the loopholes in law which makes them vulnerable to abuse. If the trade is legalised, the situation will worsen,” Meena Seshu, a feminist activist and founder of SANGRAM, a voluntary organisation working in the field of HIV control based in Sangli, a city in the western state of Maharashtra, told IPS.

Legalisation, adds the activist, could also scupper attempts by many women’s organisations and NGOs to rehabilitate women and children forced into prostitution.

“The state should formulate policies and schemes for the rehabilitation of sex workers who are coming out of this commercial sexual exploitation. This will offer a better solution to this complex problem,” Seshu contends.

Edited by Kanya D’Almeida

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Humanity’s Future: Below Replacement Fertility?http://www.ipsnews.net/2015/01/humanitys-future-below-replacement-fertility/?utm_source=rss&utm_medium=rss&utm_campaign=humanitys-future-below-replacement-fertility http://www.ipsnews.net/2015/01/humanitys-future-below-replacement-fertility/#comments Thu, 15 Jan 2015 19:51:42 +0000 Joseph Chamie http://www.ipsnews.net/?p=138669 A mother and her three children, part of the indigenous Hmong group, in Sin Chai, northwestern Viet Nam. The general trend in world fertility rates shows they are in decline - due to a combination of factors, including economic development and the improved social role of women. Credit: UN Photo/Kibae Park

A mother and her three children, part of the indigenous Hmong group, in Sin Chai, northwestern Viet Nam. The general trend in world fertility rates shows they are in decline - due to a combination of factors, including economic development and the improved social role of women. Credit: UN Photo/Kibae Park

By Joseph Chamie
UNITED NATIONS, Jan 15 2015 (IPS)

Is below replacement level fertility the future for humanity? The answer to this seemingly simple question regarding human reproduction is not only of considerable demographic concern, but also has enormous social, economic and environmental consequences for the planet.

Aside from a global mortality catastrophe, the future size of the world’s population is determined basically by the number of children women bear. If the average number of births per woman remains more than about two, world population continues to increase.

However, if women on average have less than two births, then world population eventually decreases. A fertility rate of 2.1 births per woman under low mortality conditions is the replacement level, which over time results in population stabilisation.

Throughout most of human history women bore many children. In addition to offsetting high rates of infant and child mortality, a large number of children provided valuable assistance, needed labour and personal meaning to rural households as well as old-age support to parents.

At the beginning of the 20th century average global fertility was still about six births per woman. By 1950 world fertility had declined slightly to five births per woman, with less than a handful of countries having rates below the replacement level (Figure 1).

Source: United Nations Population Division

Source: United Nations Population Division

At that time, most of the largest countries, such as Brazil, China, Egypt, India, Mexico, Nigeria, Pakistan, and Turkey, had rates of six or more births per woman. In addition, 29 countries, including Afghanistan, Algeria, Dominican Republic, Ethiopia, Guatemala, Iran, Iraq, Kenya, Libya, Rwanda, Philippines, Saudi Arabia, Somalia, Syria and Yemen, had average fertility rates of seven or more births per woman.

As a result of the high fertility rates and comparatively low death rates, world population grew very rapidly during the 20th century, especially in the second half. World population nearly quadrupled during the past century, an unprecedented demographic phenomenon, increasing from 1.6 to 6.1 billion.

Also during the past 50 years, historic declines in fertility rates occurred, resulting in a halving of the world’s average rate to 2.5 births per woman. Those remarkable fertility declines are unequivocal and widespread, with lower rates in virtually every country.

In 1950, 101 countries, or 44 percent of world population, had a fertility rate of six or more births per woman. Today 12 countries – with all but two in sub-Saharan Africa, representing five percent of world population – have a fertility rate of six or more births per woman.

In addition, the transition from high fertility to below replacement levels took place in all European countries as well as in Australia, Canada, Japan, New Zealand and the United States. The transition to below replacement fertility also occurred across a broad and diverse range of developing countries, including Brazil, China, Costa Rica, Iran, Lebanon, South Korea, Singapore, Thailand, Tunisia and Vietnam. In sum, 75 countries, or close to half of the world’s population, are experiencing fertility rates below the replacement level (Figure 1).

With regard to future fertility levels, two key questions stand out. First, will countries with below replacement fertility remain at those levels? And second, in the coming decades will the remaining 126 countries also end up with below replacement fertility?

While future fertility rebounds cannot be ruled out, the general pattern over the last five decades has been unmistakable: once fertility falls below the replacement level, it tends to stay there. That trend has especially been the case for the many countries where fertility has fallen below 1.6 births per woman, such as Canada, Germany, Hungary, Italy, Japan, South Korea and Russia.

Some countries consider sustained below replacement fertility as a threat to their economies and societies and have attempted to return to at least the replacement level through various pro-natalist policies, programmes and incentives, including reduced taxes, subsidised care for children and bonuses. However, such government attempts have by and large not achieved their objectives.

The forces that brought about declines in fertility to historic lows are widely recognised and include lower mortality rates, increased urbanisation, widespread education, improvements in the status of women, availability of modern contraceptives and delayed marriage and childbearing.

Other important factors include the costs of childrearing, employment and economic independence of women, divorce and separation, the decline of marriage, co-habitation, childless lifestyles and the need to save for longer years of retirement and elder care. Those forces and factors are likely to continue and become increasingly widespread globally.

According to United Nations medium-variant population projections, by mid-century the number of countries with below replacement fertility is expected to nearly double, reaching 139 countries (Figure 1). Together those countries will account for 75 percent of the world’s population at that time.

Some of the populous countries expected to fall below the replacement fertility level by 2050 include Bangladesh, India, Indonesia, Mexico, South Africa and Turkey. Looking further into the future, below replacement fertility is expected in 184 countries by the end of the century, with the global fertility rate falling below two births per woman (Figure 1).

It is certainly difficult to imagine rapid transitions to low fertility in today’s high-fertility countries, such as Chad, Mali, Niger and Nigeria, where average rates are more than six births per woman. However, rapid transitions from high to low fertility levels have happened in diverse social, economic and political settings.

With social and economic development, including those forces favouring low fertility, and the changing lifestyles of women and men, the transition to below replacement fertility in nearly all the remaining countries with high birth rates may well occur in the coming decades of the 21st century.

Edited by Kitty Stapp

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Groups Push Obama to Clarify U.S. Abortion Funding for Wartime Rapehttp://www.ipsnews.net/2014/12/groups-push-obama-to-clarify-u-s-abortion-funding-for-wartime-rape/?utm_source=rss&utm_medium=rss&utm_campaign=groups-push-obama-to-clarify-u-s-abortion-funding-for-wartime-rape http://www.ipsnews.net/2014/12/groups-push-obama-to-clarify-u-s-abortion-funding-for-wartime-rape/#comments Wed, 10 Dec 2014 00:49:17 +0000 Carey L. Biron http://www.ipsnews.net/?p=138188 Survivors at a workshop in Pader, northern Uganda. Thousands of women were raped during Uganda’s civil war but there have been few government efforts to assist them. Credit: Rosebell Kagumire/IPS

Survivors at a workshop in Pader, northern Uganda. Thousands of women were raped during Uganda’s civil war but there have been few government efforts to assist them. Credit: Rosebell Kagumire/IPS

By Carey L. Biron
WASHINGTON, Dec 10 2014 (IPS)

Nearly two dozen health, advocacy and faith groups are calling on President Barack Obama to take executive action clarifying that U.S. assistance can be used to fund abortion services for women and girls raped in the context of war and conflict.

The groups gathered Tuesday outside of the White House to draw attention to what they say is an ongoing misreading by politicians as well as humanitarian groups of four-decade-old legislation. That law, known as the Helms Amendment, specifies women’s health services that can be supported by U.S. overseas funding."We want to prevent these acts but also, when that violence does occur, to make sure that organisations and government agencies are providing the necessary post-rape care, including legal and social services, as well as mental and physical health services. Abortion services need to be part of that package.” -- Serra Sippel

This mis-interpretation, advocates warn, results in ongoing mental suffering, social disgrace and even additional abuse for women who have been raped.

“For over 40 years, the Helms Amendment has been applied as a complete ban on abortion care in U.S.-funded global health programmes – with no exceptions,” Purnima Mane, the president of Pathfinder International, a group that works on global sexual health issues, said in comments sent to IPS.

“The result is that Pathfinder and other U.S. government-funded agencies are unable to provide critical abortion care services to those at risk even under circumstances upheld by U.S. law and clearly allowable under the Helms Amendment. With the stroke of a pen, President Obama can change the outcome for many of these women and start to reverse more than four decades of neglect of their basic human rights and harm to their health.”

Advocates say such an executive action would be in line with both the law and broader public opinion. Indeed, on the face of it, the Helms Amendment seems to be quite clear.

The amendment bans U.S. funding from being used to “pay for the performance of abortion as a method of family planning” or to “motivate or coerce any person to practice abortions.” While the law does not specifically bar U.S. assistance being used for abortion services in the case of rape, critics have long noted that this has been the impact since the start.

“No U.S. administration has ever implemented this correctly, in terms of making exemptions in certain instances,” Serra Sippel, the president of the Center for Health and Gender Equity (CHANGE) and a key organiser of Tuesday’s demonstration, told IPS.

“This comes down to politics and the political environment in Washington. But what we need is for the president to take leadership and direct USAID” – the federal government’s main foreign assistance agency – “and the State Department to say the U.S. government is taking a stand and supporting access to abortion in these cases.”

Misinterpretation, self-censorship

Abortion has been, and remains, one of the most divisive issues in U.S. politics. By many metrics, this polarisation has only worsened with time.

This came to the cultural and political forefront in 1973, when the U.S. Supreme Court ruled in a landmark decision that a state law banning abortion (except to save the mother’s life) was unconstitutional. The ruling resulted in a lasting moral outrage among broad sections of the U.S. public, though polls suggest that a majority of those in the United States support services following rape, incest or when a mother’s life is at risk.

The Helms Amendment was among the first legislative responses to the court’s ruling, passed just months later. Since then, the amendment has resulted in a discontinuation of U.S. assistance for all abortion services in other countries.

It is important to note that these procedures remain legal in the United States, as well as in many of the countries in which U.S.-funded entities, including government departments, are operating. Humanitarian groups often feel they cannot even make abortion-related information available to women, including those raped during conflict – even if the Helms Amendment doesn’t specifically proscribe doing so.

“These restrictions, collectively, have resulted in a perception that U.S. foreign policy on abortion is more onerous than the actual law … [leading to] a pervasive atmosphere of confusion, misunderstanding and inhibition around other abortion-related activities beyond direct services,” analysis published last year by the Guttmacher Institute, a sexual health-focused think tank here, reports.

“Wittingly or unwittingly, both NGOs and U.S. officials have been transgressors and victims alike in the misinterpretation and misapplication of U.S. anti-abortion law … whether through misinterpretation or self-censorship, NGOs are needlessly refraining from providing abortion counseling or referrals.”

Global statistics on conflict-time rapes and resulting pregnancies are hard to come by. Human Rights Watch points to 2004 research carried out in Liberia, where rape was used as a weapon of war, suggesting that around 15 percent of wartime rapes led to pregnancy.

“Human rights practitioners and public health officials from Bosnia, the Democratic Republic of Congo, Colombia, and other countries at war, have collected evidence from conflict rape survivors showing both that pregnancy happens and that it has devastating consequences for women and girls,” Liesl Gerntholtz, the executive director of a Human Rights Watch’s women’s rights division, wrote Tuesday.

“They are left to continue unwanted pregnancies and bear children they often cannot care for and who are daily reminders of the brutal attacks they suffered. This, in turn, makes these children more vulnerable to stigmatization, abuse, and abandonment.”

Global acknowledgment

On Tuesday, the groups participating in the White House demonstration also called on President Obama to clarify that the Helms Amendment does not apply to pregnancies resulting from incest or if the mother’s life is at risk. Yet the focus of the calls remains on rape in the context of war and conflict.

Advocates say public consciousness on this issue has risen significantly over the past year and a half. To a great extent, this has been driven by the conflict in Syria and the rise of the Islamic State, as well as the ongoing violence in the Democratic Republic of the Congo (DRC), and the centrality of sexual violence in each of these.

“We know that rape has been used as a weapon of war throughout history. What’s new is the attention from governments and advocates over the past 18 months,” CHANGE’s Sippel says.

“The prevention of violence cannot stand alone. We want to prevent these acts but also, when that violence does occur, to make sure that organisations and government agencies are providing the necessary post-rape care, including legal and social services, as well as mental and physical health services. Abortion services need to be part of that package.”

The United States has been a strong global advocate against sexual violence in recent years, including with regard to conflict situations. President Obama has created the first U.S. action plan on women’s role in peace-building, a White House strategy on gender-based violence, among other actions.

Advocates say that clarifying the Helms Amendment would be the next logical step. Although the White House was unable to comment for this story, organisers of Tuesday’s rally say President Obama’s aides did meet with advocates working on sexual violence in Colombia, the DRC and elsewhere.

Edited by Kitty Stapp

The writer can be reached at cbiron@ips.org

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OPINION: Stand in Solidarity with Courageous Women’s Human Rights Defendershttp://www.ipsnews.net/2014/12/opinion-stand-in-solidarity-with-courageous-womens-human-rights-defenders/?utm_source=rss&utm_medium=rss&utm_campaign=opinion-stand-in-solidarity-with-courageous-womens-human-rights-defenders http://www.ipsnews.net/2014/12/opinion-stand-in-solidarity-with-courageous-womens-human-rights-defenders/#comments Tue, 02 Dec 2014 22:35:29 +0000 Zeid Raad Al Hussein http://www.ipsnews.net/?p=138061

Zeid Ra’ad Al Hussein is the United Nations High Commissioner for Human Rights and has extensive experience in international diplomacy and the protection of human rights.

By Zeid Ra'ad Al Hussein
UNITED NATIONS, Dec 2 2014 (IPS)

Almost two decades ago, in Beijing, 189 countries made a commitment to achieve equality for women, in practice and in law, so that all women could at last fully enjoy their rights and freedoms as equal human beings.

They adopted a comprehensive and ambitious plan to guarantee women the same rights as men to be educated and develop their potential. The same rights as men to choose their profession. The same rights to lead communities and nations, and make choices about their own lives without fear of violence or reprisal.

Credit: OHCHR

Credit: OHCHR

No longer would hundreds of thousands of women die every year in childbirth because of health care policies and systems that neglected their care. No longer would women earn considerably less than men. No longer would discriminatory laws govern marriage, land, property and inheritance.

In the years that followed, the world has witnessed tremendous progress: the number of women in the work force has increased; there is almost gender parity in schooling at the primary level; the maternal mortality ratio declined by almost 50 percent; and more women are in leadership positions.

Importantly, governments talk about women’s rights as human rights and women’s rights and gender equality are acknowledged as legitimate and indispensable goals.

However, the world is still far from the vision articulated in Beijing. Approximately one in three women throughout the world will experience physical and/or sexual violence in their lifetime. Less than a quarter of parliamentarians in the world are women.Attacks against women who stand up to demand their human rights and individuals who advocate for gender equality are often designed to keep women in their “place.” In some areas of the world, women who participate in public demonstrations are told to go home to take care of their children.

In over 50 countries there is no legal protection for women against domestic violence. Almost 300,000 women and girls died in 2013 from causes related to pregnancy and childbirth. Approximately one in three married women aged 20 to 24 were child brides.

In many parts of the world, women and girls cannot make decisions on their most private matters – sexuality, marriage, children. Girls and women who pursue their own life choices are still murdered by their own families in the dishonourable practice of so-called honour killings.

All of our societies remain affected by stereotypes based on the inferiority of women which often denigrate, humiliate and sexualise them.

Today we have the responsibility to protect the progress made in the past 20 years and address the remaining challenges. In doing so, we must recognise the vital role of women who defend human rights, often at great risk to themselves and their families precisely because they are viewed as stepping outside socially prescriptive gender stereotypes.

We must recognise the role of all people, women and men, who publicly call for gender equality and often, as a result, find themselves the victim of archaic and patriarchal, but powerful, threats to their reputations, their work and even their lives.

These extraordinary individuals – women’s human rights defenders – operate in hostile environments, where arguments of cultural relativism are common and often against the background of the rise of extremist, misogynistic groups, which threaten to dismantle the gains of the past.

Attacks against women who stand up to demand their human rights and individuals who advocate for gender equality are often designed to keep women in their “place.” In some areas of the world, women who participate in public demonstrations are told to go home to take care of their children.

Consider the recent example of a newspaper publishing naked photos of a woman, claiming she was a well-known activist – an attack designed to shame this defender into silence. In other places, when women claim their right to affordable modern methods of contraception, they are labelled as prostitutes in smear campaigns seeking to undermine their credibility.

Online attacks against those who speak for women’s human rights and gender equality by so-called “trolls” – who threaten heinous crimes – are increasingly reported.

These attacks have a common thread – they rely on gender stereotypes and deeply entrenched discriminatory social norms in an attempt to silence those who challenge the age old system of gender inequality. However, these defenders will not be silenced, and we must stand in solidarity with them against these cowardly attacks.

This is why my office has decided to launch a campaign to pay tribute to women and men who defy stereotypes and fight for women’s human rights. The campaign runs from Human Rights Day, Dec. 10 this year, to International Women’s Day, Mar. 8, 2015. We encourage everyone to join the ranks of these strong and inspiring advocates, on social media (#reflect2protect) and on the ground.

As we approach the 20-year anniversary of Beijing, discrimination and violence against women, and the stereotypes that confine them into narrowly fixed roles must end. Women have the right to make their own decisions about their lives and their bodies.

Guaranteeing and implementing these rights are non-negotiable obligations of all states. Women human rights defenders were instrumental in securing the ambitious programme laid out in Beijing. Their work, their activism and their courage deserve our recognition, our support and our respect.

Edited by Kitty Stapp

 

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OPINION: All Family Planning Should Be Voluntary, Safe and Fully Informedhttp://www.ipsnews.net/2014/11/opinion-all-family-planning-should-be-voluntary-safe-and-fully-informed/?utm_source=rss&utm_medium=rss&utm_campaign=opinion-all-family-planning-should-be-voluntary-safe-and-fully-informed http://www.ipsnews.net/2014/11/opinion-all-family-planning-should-be-voluntary-safe-and-fully-informed/#comments Wed, 26 Nov 2014 23:10:52 +0000 Dr. Babatunde Osotimehin http://www.ipsnews.net/?p=137986

Dr. Babatunde Osotimehin is the Executive Director of UNFPA, the United Nations Population Fund.

By Dr. Babatunde Osotimehin
UNITED NATIONS, Nov 26 2014 (IPS)

The tragic deaths and injuries of women following sterilisation in the Indian state of Chhattisgarh have sparked global media coverage and public concern and outrage.

Now we must ensure that such a tragedy never occurs again.

Dr. Babatunde Osotimehin. Credit: UNFPA

Dr. Babatunde Osotimehin. Credit: UNFPA

The women underwent surgery went with the best intentions – hoping they were doing the right thing for themselves and their families.

Now their husbands, children and parents are left to live without them, reeling with deep sadness, shock and mourning.

The only way to respond to such a tragedy is with compassion and constructive action, with a focus on human rights and human dignity.

Every person has the right to health. And this includes sexual and reproductive health—for safe motherhood, for preventing and treating HIV and other sexually transmitted infections, and for family planning.

Taking a human rights-based approach to family planning means protecting the health and the ability of women and men to make their own free and fully informed choices.

All family planning services should be of quality, freely chosen with full information and consent, amongst a full range of modern contraceptive methods, without any form of coercion or incentives.

The world agreed on these principles 20 years ago in Cairo at the International Conference on Population and Development.

Governments also agreed on the goals to achieve universal education and reproductive health by 2015, to reduce child and maternal mortality, and to promote gender equality and the empowerment of women.As we mourn the loss of the women who died in India, we must make sure that no more women suffer such a fate.

The Cairo Conference shifted the focus away from human numbers to human beings and our rights and choices.

Family planning is a means for individuals to voluntarily control their own bodies, their fertility and their futures.

Research and experience show that when given information and access to family planning, women and men choose to have the number of children they want. Most of the time, they choose smaller families. And this has benefits that extend beyond the family to the community and nation.

Family planning is one of the best investments a country can make. And taking a holistic and rights-based approach is essential to sustainable development.

We know that it is important to tackle harmful norms that discriminate against women and girls. This means, first of all, providing quality public education, and making sure that girls stay in school.

Second, we must empower women to participate in decisions of their families, communities and nations.

Third, we must reduce child mortality so parents have confidence their children will survive to adulthood.

And fourth, we must ensure every woman’s and man’s ability to plan their family and enjoy reproductive health and rights.

As we mourn the loss of the women who died in India, we must make sure that no more women suffer such a fate.

The organisation that I lead, UNFPA, the United Nations Population Fund, supports a human rights-based approach to family planning, and efforts to ensure safe motherhood, promote gender equality and end violence against women and girls.

In all of these areas, India has taken positive steps forward. One such step is the development of appropriate clinical standards for delivering family planning and sterilisation services.

When performed according to appropriate clinical standards with full, free and informed consent, amongst a full range of contraceptive options, sterilisation is safe, effective and ethical. It is an important option for women and couples.

Yet much work remains to be done in every country in the world to ensure universal sexual and reproductive health and reproductive rights.

The recent events in India highlight the need for improved monitoring and service provision, with the participation of community members and civil society, to ensure that policies are implemented, and to guarantee that services meet national and international standards.

Already the prime minister has quickly initiated investigations, a medical team was sent to the site, and a judicial commission was appointed by the state government to investigate the deaths of the women. I commend them for this immediate response.

Several people, including the doctor who conducted the surgeries and the owner of the firm that produced the suspected medicines, have been arrested. There is every hope that those responsible will be held accountable.

There is also hope that the government will take further measures to restore public confidence in its family planning programs as it upholds the human rights, choices and dignity of women and men.

Any laws, procedures or protocols that might have allowed or contributed to the deaths and other human rights violations should be reformed or changed to prevent recurrences.

As the world’s largest democracy, India is home to more than 1.2 billion people and recognised as a global leader in medicine, science and technology.

Given its leadership and expertise, India can ensure that family planning programmes meet, or exceed, clinical and human rights standards throughout the country.

UNFPA and many partners stand ready to support such an effort.

Edited by Kitty Stapp

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Survivors of Sexual Violence Face Increased Riskshttp://www.ipsnews.net/2014/11/survivors-of-sexual-violence-face-increased-risks/?utm_source=rss&utm_medium=rss&utm_campaign=survivors-of-sexual-violence-face-increased-risks http://www.ipsnews.net/2014/11/survivors-of-sexual-violence-face-increased-risks/#comments Tue, 25 Nov 2014 19:10:55 +0000 Lyndal Rowlands http://www.ipsnews.net/?p=137954 Students at Columbia University carry mattresses on the Carry That Weight National Day of Action to show their support for survivors of sexual assault. Credit: Warren Heller

Students at Columbia University carry mattresses on the Carry That Weight National Day of Action to show their support for survivors of sexual assault. Credit: Warren Heller

By Lyndal Rowlands
UNITED NATIONS, Nov 25 2014 (IPS)

“A recurring nightmare for me is I’m trying to tell someone something and they are not listening. I’m yelling at the top of my lungs and it feels like there is a glass wall between us.”

Jasmin Enriquez is a two-time survivor of rape. Like two-thirds of rape survivors, Enriquez knew her rapists. The first was her boyfriend when she was a high school senior, the second a fellow student she had been seeing at college."What I hear from women is that they are told to shut up: they are told to shut up during it, they are told to shut up after it, and they are told by some institutions to continue keeping their mouths shut." -- Dr. Dana Sinopoli

“[The nightmare] shows how I’ve always felt that even as someone coming forward as a survivor, as soon as I start giving details to some people, they instantly start to shut it down. As in, you’re being crazy or hyperemotional, instead of taking it as one whole piece and looking at it holistically,” Enriquez told IPS.

Women who have experienced gender-based violence are at a significantly increased risk of developing a mental disorder, such as post-traumatic stress disorder, anxiety or depression, within one to three years after the assault.

Enriquez explains, “People don’t seem to understand that after being sexually assaulted, it’s something that you have to live with the rest of your life.

“Most of the time there is an incredible amount of anxiety or depression or other mental health issues that people just don’t understand,” she says. “It’s been five years since I was sexually assaulted and I still live through the trauma.”

A special Lancet series published Friday says that one in three women have experienced physical or sexual violence from their partner.

Researcher Dr. Susan Rees from the University of New South Wales told IPS that there is strong evidence that if you are exposed to gender-based violence, you are at a much higher risk for the onset of post-traumatic stress disorder (PTSD), anxiety and depression as well as attempted suicide.

Rees’ research into the connection between gender-based violence and mental disorders has shown that women who have been assaulted are significantly more likely to experience a mental disorder in their lifetime.

Women who have experienced one form of gender-based violence have a 57 percent chance of developing a mental disorder compared with only 28 percent of women who have not experienced gender-based violence. Significantly, 89 percent of women who have experienced gender-based violence three to four times will develop a mental disorder.

It is important for survivors of assault to get early support to help prevent the onset of an associated mental disorder, Rees said.

However, experiencing sexual assault can be confusing, especially for young women and girls, and this may prevent them from getting early intervention.

Enriquez explains that she didn’t initially realise the connection between her response to the trauma of sexual violence and the symptoms she was experiencing.

“I’ve recently been very jumpy, kind of always tense and I get startled easy, I didn’t understand why that was happening and it was very frustrating.”

Enriquez’ fiancé, who is not the person who assaulted her, used to jump out at her or play games to surprise her, and she found this really upsetting,

“I didn’t understand that it was related to me being sexually assaulted until probably my senior year of college. I feel like if I had been educated about what normal symptoms are of PTSD, I would have known that there was more to it and that it was a normal piece of it.”

Community attitudes affect prevalence

Community attitudes towards women, including strong patriarchal attitudes, power imbalance and gender inequality contribute to the prevalence of violence against women, said Rees.

“It makes sense that if you change attitudes then you can change prevalence, you can reduce the risk for women,” she said.

This is what Enriquez aims to do with her organisation Only With Consent. Together with her fiancé, Enriquez speaks with students to raise awareness and change young people’s attitudes towards sexual assault.

“I definitely think that there’s a gender piece that goes with both the mental health and the sexual assault and that it ties back to any time a woman expresses an emotion of being angry or upset we immediately call her out for being irrational or emotional.” Enriquez told IPS.

“If the majority of survivors who are speaking out are women, and they are expressing these feelings of being upset or being angry, or being really hurt, or any of those feelings, we discredit what they are saying, because we see them as irrational creatures,” Enriquez said.

Psychologist Dr. Dana Sinopoli told IPS that it is also important to consider how gender-based violence affects men, especially men who experience childhood sexual assault. She said that this should involve addressing gender stereotypes such as that men are aggressive or impulsive.

As Carry That Weight explains on its website:

“People of all gender identities can experience and be affected by sexual and domestic violence—women are not the only survivors just as men are not the only perpetrators. We strive to challenge narrow and inaccurate representations of what assault looks like and also acknowledge that these forms of violence disproportionately affect women, transgender, gender nonconforming, and disabled people.”

Sinopoli added however that changing community attitudes towards women was an important part of addressing gender-based violence.

“Consistently what I hear from women is that they are told to shut up, they are told to shut up during it, they are told to shut up after it, and they are told by some institutions to continue keeping their mouths shut.

“That is what we can link to the depression and the anxiety and a lot of the re-experiencing and retriggering that is so central to PTSD,” Sinopoli said.

Sinopoli added that “the way that society reacts, to someone who discloses or is struggling, is so important.

“The more that people speak up the more that we will actually see a decline in such significant psychological symptoms.”

Early intervention can help

When helping someone who has experienced violence, Rees said that it is important that friends and family reassure the victim that it “it is never acceptable to be hit, or to be treated violently or to be raped.”

Unfortunately, population studies show that women who have experienced gender-based violence are also at increased risk of experiencing it again in their lifetime.

“This might be the case because often men target women who are vulnerable, so if she has a mental disorder or trauma as a result of an early childhood adversity, she may be more likely to be targeted by men who in a sense benefit from powerlessness, inequality and fear.”

She said that warning bells that a relationship is unhealthy include controlling, jealous behaviour such as telling you who you should socialise with, or getting jealous because you are doing better than he is at university.

“Often women think that’s because he cares about me, he’s worried about me and that why he wants to know where I am all the time,”

But this type of behaviour should actually be seen as a warning of future emotional and perhaps physical abuse, Rees said.

Rees said that the reasons women don’t leave violent relationships are complex,

“She may be suffering depression. She may not have the economic resources to leave. She may worry about the children, and rightly so, because often people end up homeless, and she also may know that she’s at high risk of retaliation from the perpetrator if she leaves.”

Rees also explained that it is important for health practitioners to receive training so they can be confident to ask about domestic violence and respond appropriately.

She added that primary health care responses need to be integrated with community-based services to ensure that survivors have access to help that is sensitive to the complex impact of sexual violence.

Edited by Kitty Stapp

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Pakistan’s Paraplegics Learning to Stand on their Own Feethttp://www.ipsnews.net/2014/11/pakistans-paraplegics-learning-to-stand-on-their-own-feet/?utm_source=rss&utm_medium=rss&utm_campaign=pakistans-paraplegics-learning-to-stand-on-their-own-feet http://www.ipsnews.net/2014/11/pakistans-paraplegics-learning-to-stand-on-their-own-feet/#comments Mon, 24 Nov 2014 13:34:03 +0000 Ashfaq Yusufzai http://www.ipsnews.net/?p=137914 Over 2,000 paraplegic women have received treatment and training at the Paraplegic Centre of Peshawar, in northern Pakistan, enabling them to earn a living despite being confined to a wheelchair. Credit: Ashfaq Yusufzai/IPS

Over 2,000 paraplegic women have received treatment and training at the Paraplegic Centre of Peshawar, in northern Pakistan, enabling them to earn a living despite being confined to a wheelchair. Credit: Ashfaq Yusufzai/IPS

By Ashfaq Yusufzai
PESHAWAR, Pakistan , Nov 24 2014 (IPS)

When a stray bullet fired by Taliban militants became lodged in her spine last August, 22-year-old Shakira Bibi gave up all hopes of ever leading a normal life.

Though her family rushed her to the Hayatabad Medical Complex in Peshawar, capital city of Pakistan’s northern-most Khyber Pakhtunkhwa (KP) province, doctors told the young girl that she would be forever bed-ridden.

Bibi fell into a deep depression, convinced that her family would cast her aside due to her disability. Worse, she feared that she would not be able to care for her daughter, particularly since her husband had succumbed to tuberculosis in 2012, making her the sole breadwinner for her family.

“All credit goes to the Paraplegic Centre of Peshawar (PPC), which enabled me to become a working man. Otherwise, my family would have starved to death." -- 40-year-old Muhammad Shahid, a victim of spinal damage
In the end, however, all her worries were for naught.

Today Bibi, a resident of the war-torn North Waziristan Agency, part of Pakistan’s Federally Administered Tribal Areas (FATA), is a successful seamstress and embroiderer, and is skillfully managing the affairs of her small family.

She says it is all thanks to the Paraplegic Centre of Peshawar (PPC), the only one of its kind in Pakistan, where she is currently undergoing intensive physiotherapy. Already Bibi is showing signs of recovery, but this is not the only thing that is making her happy.

“Her real joy is her craft, which she learned here at the Centre,” Bibi’s mother, Zar Lakhta, tells IPS. “We are no longer concerned about her future.”

According to PPC’s chief executive officer, Syed Muhammad Ilyas, the majority of those who suffer injury to their spinal cords remain immobile for life, unable to work and fated to be a burden on loved ones.

“Breaking a bone or two is one thing,” Ilyas tells IPS. “Breaking one’s back or neck is another story altogether.

“Unlike any other bone in our body, the spine, or back bone, not only keeps our body straight and tall, it also protects the delicate nervous tissue called the spinal cord, which serves as a link between our body and the brain,” he asserts.

If this link is severed, a person can literally become a prisoner in their own body, losing bowel and bladder control, as well as the use of their legs. The physical aspect of such an injury alone is enough to plunge a patient into the deepest despair; but there is yet another tragic twist to the story.

“Believe it or not about 80 percent of our patients are the only bread winners of their respective families,” Ilyas explains, “while more then 90 percent live below the poverty line [of less than two dollars a day].”

As a result, finding employment for paraplegics is just as vital as offering physical therapy that might help them regain the use of their lower bodies.

“This is why we have employed experts who teach tailoring, computer sills, dress-making, glass painting and embroidery to our patients,” Ilyas says.

Most families travel between 100 and 400 km to reach the Centre, but their efforts are always rewarded. In addition to skills training, the PPC offers individual and group counseling sessions, all part of a holistic treatment programme aimed at helping patients find dignity and self-worth, to be able to function on their own after being discharged from the PPC.

This has certainly been the case for 40-year-old Muhammad Shahid, who suffered a backbone injury in the Swat district of the Khyber Pakhtunkhwa province back in 2008.

“I was sent to the PPC, after surgery in a government-run hospital, where I learnt embroidery,” he tells IPS. “Now I am working in my home and earn about 300 dollars a month, which I use to educate and feed my two sons and daughter.”

“All credit goes to the PPC, which enabled me to become a working man. Otherwise, my family would have starved to death,” he tells IPS over the phone from his hometown in the Swat Valley.

The PPC was established in 1979 by the International Committee of the Red Cross (ICRC) to provide free treatment to those wounded in the 1979-1989 Soviet War in Afghanistan. Later, the KP government took control of the facility, opening it up to locals in the tribal areas.

The Centre has been a godsend for the thousands who have sustained injuries in crossfire between militants and government forces, who since 2001 have been battling for control of Pakistan’s mountainous regions that border Afghanistan.

Director-general of health services for Khyber Pakhtunkhwa, Dr. Waheed Burki, says more than 40,000 people, including 5,000 security personnel and 3,500 civilians, have been killed since 2005 alone. A further 10,000 have been injured.

Burki says about 90 percent of those who frequent the PPC were injured in war-related incidents.

But Amirzeb Khan, a physiotherapist at the Centre, says that the patients are not all victims of violence. Some have sustained injuries from road traffic accidents and small firearms, while others suffered spinal cord damage as a result of falls from rooftops, trees and electricity poles.

“The majority of the patients are between 20 and 30 years old, which means they fall into the ‘most productive’ age-group,” Khan tells IPS.

Many of these young people come to the Centre fearing the worst; yet almost all leave as productive members of society, armed with the skills necessary to make a living despite being confined to a wheelchair.

Those with minor injuries have even learned how to walk again.

“About 3,000 of our patients are now prospering,” Khan adds. “Of these, roughly 2,000 are women.”

In a country where the average annual income is 1,250 dollars, according to government data, the cost of treating spinal injuries is far greater than most families can afford. In places like the United States and Europe, experts tell IPS, rehabilitating such a patient could run up a bill touching a million dollars.

By offering their services for free, and developing low-cost technologies and equipment, the PPC has closed a yawning health divide in a vastly unequal country, at least for paraplegics.

An administrator named Ziaur Rehman tells IPS that plans are afoot to turn the PPC into a ‘Centre of Excellence’ for patients with spinal cord injuries from all over the country and the region over the next five years.

The hope is to create a multiplier effect, whereby those who receive training here will take their newly acquired skills and pass them on to their respective communities.

A living example of this is 24-year-old Shaheen Begum, who now runs her own embroidery centre in the Hangu district of KP. Immobilised by a back injury in 2011, she underwent rigorous physical therapy at the Centre, while also learning computer skills and fabric painting.

“Now I am imparting these skills to women in my neighbourhood and my children are in good schools,” she tells IPS happily.

Edited by Kanya D’Almeida

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AIDS Is No. 1 Killer of African Teenagershttp://www.ipsnews.net/2014/11/africa-aids-is-no-1-killer-of-teenagers/?utm_source=rss&utm_medium=rss&utm_campaign=africa-aids-is-no-1-killer-of-teenagers http://www.ipsnews.net/2014/11/africa-aids-is-no-1-killer-of-teenagers/#comments Fri, 21 Nov 2014 12:02:19 +0000 Sam Olukoya http://www.ipsnews.net/?p=137909 As AIDS becomes the leading cause of death of adolescents in Africa, empowering youth – especially girls - to make safe life choices and avoid HIV is crucial. Credit: Mercedes Sayagues

As AIDS becomes the leading cause of death of adolescents in Africa, empowering youth – especially girls - to make safe life choices and avoid HIV is crucial. Credit: Mercedes Sayagues

By Sam Olukoya
LAGOS, Nigeria, Nov 21 2014 (IPS)

Two years ago, Shola* was kicked out of the family house in Abeokuta, in southwestern Nigeria, after testing HIV-positive at age 13. He was living with his father, his stepmother and their seven children.

“The stepmother insisted that Shola must go because he is likely to infect her children,” Tayo Akinpelu, programme director of Youth’s Future Savers Initiative, told IPS.

SNAPSHOT: ADOLESCENTS WITH HIV IN TANZANIA
In Tanzania, alarmingly, HIV prevalence has not decreased among adolescents aged 15-19 between 2007 and 2012.
An estimated 165,000 adolescents live with HIV, of whom 97,000 girls and 68,000 boys. Some were born with HIV and others contracted it as children or teens.
To better understand their needs, the Tanzania Commission for AIDS conducted a survey of HIV positive teenagers aged 15-19 in seven regions.
Among its findings:

• Four in ten were sexually active, mostly with a regular partner.
• Just a little more than half reported using condoms at last sex.
• A third reported they had experienced sexual violence. Few had discussed the abuse with friends or relatives or reported it to authorities.
• Just over one-third were aware of family planning and child protection services
The study urges delivering information about child protection and sexual and reproductive health services to teens living with HIV so they can make safe life choices and access care and support.
National HIV prevalence is five percent, according to UNAIDS.
Akinpelu turned to Shola’s mother, who had remarried. But she refused, arguing that his father should be responsible for their son.

“Shola felt as an outcast,” says Akinpelu. Eventually, Shola’s grandparents took him in.

HIV among teenagers is devastating families in Nigeria and elsewhere in Africa, where AIDS has become the leading cause of death among adolescents.

“This is absolutely unacceptable,” says Craig McClure, chief of HIV programmes with the United Nations Children’s Fund (UNICEF), in New York. “What’s more, AIDS-related deaths are decreasing for all age groups except adolescents.”

The global AIDS death toll fell by 30 percent between 2005 and 2012 but increased by 50 percent among adolescents, says a UNICEF report.

Fear of seeking help

One reason for this shocking teen death toll, says Dr. Arjan de Wagt, chief of HIV/AIDS with UNICEF in Abuja, is the low number of adolescents on antiretroviral treatment (ART).

Of the 3.1 million Nigerians living with HIV, half are under 24 years. But only two out of ten HIV positive youth over 15 and just one out of ten under 15 received the lifesaving drugs in 2013, de Wagt told IPS.

Rejection by family and society, as happened to Shola, or fear of rejection, prevents adolescents from seeking help.

“Many HIV positive adolescents are dying in silence because they are too ashamed to access treatment,”’ Blessing Uju, a Lagos-based youth counsellor, told IPS.

“The shame is even bigger for the girls. In Nigeria, if you are HIV positive, the impression is that you are a commercial sex worker,” she says.

Sally* did not tell her parents or siblings when she tested HIV positive four years ago, at age 19.

“At the family level, there is a lot of stigma,” she told IPS.

Although aware of the danger of not taking her medication regularly, Sally often skipped it to avoid being seen with pills at home.

“As a young person, you need a confidant. If you are not strong, you might end up taking your life,” she says.

Teenagers need family help to stay on ART, says Akinpelu.

Shola’s grandparents would normally cook the first meal for the day in the afternoon until Akinpelu explained to them that the pills can cause nausea on an empty stomach and Shola needed a hearty meal earlier.

Uju says that treatment fatigue hits adolescents hard. “Some say they prefer to die than to continue taking their drugs,” she says.

adolescents_graph_unaids

High death toll

Of the 2.1 million adolescents living with HIV worldwide in 2012, more than 80 per cent are in sub-Saharan Africa, according to the United Nations Joint Programme on HIV/AIDS (UNAIDS).

Malawi, with 93,000 HIV positive teenagers, has 6,900 annual AIDS-related adolescent deaths.

The death toll is linked to late diagnosis and starting ART too late, explains Judith Sherman, of UNICEF in Lilongwe.

Malawi’s policy is that all children seen in health facilities should be offered an HIV test. “Unfortunately, this does not happen routinely,” she says.

FAST FACTS

AIDS DEATHS AMONG ADOLESCENTS IN 2013


• South Africa 11,000
• Tanzania 10,000
• Ethiopia 7,900
• Kenya 7,800
• Zimbabwe 6,500
• Uganda 6,300
• Malawi 5,600
• Zambia 4,400
• Mozambique 3,900
• Rwanda 1,200
• Lesotho 1,200

Teenagers’ adherence to ART is lower than adults, says Sherman, “for a range of reasons like treatment fatigue, depression, fear of stigma, denial and unstable family relationships.”

Tanzania’s estimated 165,000 adolescents living with HIV face similar challenges as their peers in Nigeria and Malawi. (see sidebar)

Allison Jenkins, chief of HIV/AIDS with UNICEF in Tanzania, says that one effective way to help teenagers are clubs.

“Teen clubs improve adherence to treatment, especially among members who attend regularly,” she told IPS.

HIV among teen girls

Alarmingly, adolescent HIV prevalence is highly gendered, with teen girls showing infection rates that UNAIDS calls ”unacceptably high”.

Teen girls aged 15-19 in Mozambique have a prevalence of seven per cent, more than double the boys of the same age. Botswana presents a similar scenario.

Lucy Attah, of the Lagos-based Women and Children Living with HIV & AIDS, blames poverty.

“Girls have to trade sex for money to sustain themselves,” she says. “The pressure for money is higher in the cities where teenage girls compete to get the best mobile phones and clothes.”

Adolescents become sexually active, try drugs and alcohol, feel invulnerable, and experience the social and economic pressures of becoming an adult. HIV and the lack of youth-friendly health services compound the problem, says the UNICEF report.

 “We must do more and do it well, focusing on sub-Saharan Africa and on adolescent girls, where the heaviest burden lies,” says McClure.

*names changed to protect privacy

Edited by Mercedes Sayagues

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