Inter Press Service » Women’s Health Turning the World Downside Up Sat, 30 May 2015 01:41:02 +0000 en-US hourly 1 When Kenyan Children’s Lives Hang on a Drip Sat, 23 May 2015 17:06:44 +0000 Miriam Gathigah Prof Grace Irimu shows IPS a drip feed bag and a copy of Kenya’s ‘Basic Paediatric Protocols’ as she explains the importance of intravenous treatment in saving the lives of young children affected by acute watery diarrhoea. Credit: Miriam Gathigah/IPS

Prof Grace Irimu shows IPS a drip feed bag and a copy of Kenya’s ‘Basic Paediatric Protocols’ as she explains the importance of intravenous treatment in saving the lives of young children affected by acute watery diarrhoea. Credit: Miriam Gathigah/IPS

By Miriam Gathigah
NAIROBI, May 23 2015 (IPS)

Acute watery diarrhoea is a major killer of young children but misunderstanding over the benefits of fluid treatment is preventing many Kenyan parents from resorting to this life-saving technique and threatening to reverse the strides that the country has made in child health.

The 2014 Kenya Demographic and Health Survey, released in April this year, reports that the country’s under-five mortality rate fell to 52 deaths per 1,000 live births in 2014, down from the 74 deaths in 2008-09, but still far from the 32 per 1,000 live births targeted under the Millennium Development Goals (MDGs).“Parents must … understand that rapid fluid treatment is life-saving for children diagnosed with shock or poor blood circulation due to diarrhoea” – Prof Grace Irimu, Associate Professor of Paediatrics, University of Nairobi

The primary treatment for acute watery diarrhoea is rehydration, administered intravenously in the most severe cases of very young children suffering from shock after losing excessively high quantities of body fluids. A fluid bolus – or rapid liquid dose – delivered directly through an intravenous drip allows a much faster delivery than oral rehydration.

However, notes nurse Esther Mayaka at the Jamii Clinic in Mathare, Nairobi, “parents of children brought to hospital with acute watery diarrhoea are refusing to have them put on [drip] fluid treatment and this is a major concern because diarrhoea is a leading killer among children and giving fluids is still the main solution.”

She told IPS that the ongoing rains and floods in many parts of the country “have created a comeback for diseases like cholera whose most telling sign is watery diarrhoea which needs to be managed with fluids.”

In February this year, Kenya’s Director of Medical Services, Dr Nicholas Muraguri, issued a cholera outbreak alert following an increase in cases of acute watery diarrhoea in several counties, including Homa Bay, Migori and Nairobi.

According to Prof Grace Irimu, Associate Professor of Paediatrics at the University of Nairobi, the reluctance to resort to drip fluid treatment has arisen due to misunderstanding generated by a Fluid Expansion As Supportive Therapy (FEAST) study in 2011 to establish whether the bolus technique was the best practice to use among children diagnosed with shock.

The FEAST study, which was conducted among children in Kenya, Tanzania and Uganda, found that fluid boluses increased 48-hour mortality in critically-ill children with poor blood circulation or shock in these resource-limited settings in Africa, but Irimu told IPS that the study excluded diarrhoea and only studied illnesses associated with fever, such malaria and sepsis.

“Parents must therefore understand that rapid fluid treatment is life-saving for children diagnosed with shock or poor blood circulation due to diarrhoea,” she said.

The Kenya Paediatric Association is also trying to set the record straight and, in a statement shared with IPS, the association reiterated that “diarrhoea complicated by severe dehydration is one of the biggest killers of children globally.”

According to the paediatrics association, the FEAST study excluded children with diarrhoea and dehydration because “the value of giving fluids in this group is well known. Giving appropriate fluid therapy is essential.”

Prof Irimu told IPS that the FEAST study had led to a revision of the ‘Basic Paediatric Protocols’, Kenya’s national guidelines for paediatric care, and clauses that address the treatment of diarrhoea were also revised.

Previously, a child diagnosed with shock as a result of diarrhoea would be given fluids in three cycles, every 15 minutes depending on the response. Now, the child receives the fluids in two cycles and if there is no response, health providers are advised to proceed to slower fluid administration where the child is given the amount that the body needs, depending on the level of dehydration.

Meanwhile, the country continues to make strides in dealing with HIV/AIDS – another critical health issue covered by the MDGs – among children. Studies show that the number of children with HIV aged between 18 months and 14 years fell from 184,000 in 2007 to 104,000 in 2012, according to the most recent Kenya Aids Indicator Survey.

However, Prof Joseph Karanja, a reproductive health and HIV/AIDs expert in Nairobi, says that the country can still do better because “through available antiretroviral drugs as a preventive measure among HIV positive mothers, HIV transmission to the infant can be reduced to as low as one percent.”

Dr Pauline Samia, a paediatric neurologist and a board member of the Kenya Paediatric Association, says that there is also a commitment to address conditions that challenge the management of HIV among children such as epilepsy.

“Though research in this area is limited, an estimated 6.7 percent of children with HIV also have epilepsy, with at least 50 percent of children with HIV having central nervous system problems such as delayed development, behavioural challenges and convulsions,” she observes.

Regarding progress in other MDGs, some progress has been made in reducing the prevalence of underweight children less than five years of age, one of the goals set for eradicating extreme hunger and poverty.

The 2014 Kenya Demographic and Health Survey reports that not only has childhood malnutrition declined significantly, from 35 percent in 2008 to the current 26 percent, but the prevalence of underweight children also decreased from 16 percent in 2008 to 11 percent in 2014.

On the front of improving maternal health, the survey says that while maternal mortality remains high at 488 deaths in every 100,000 live births, in the past five years more than three in five births (61 percent) took place in healthcare facilities, a marked improvement compared with the 43 percent in 2008.

Edited by Phil Harris   

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The U.N. at 70: Time to Prioritise Human Rights for All, for Current and Future Generations Wed, 20 May 2015 13:23:26 +0000 Dr. Babatunde Osotimehin Babatunde Osotimehin, Executive Director of the United Nations Population Fund (UNFPA). Credit: UN Photo/Paulo Filgueiras

Babatunde Osotimehin, Executive Director of the United Nations Population Fund (UNFPA). Credit: UN Photo/Paulo Filgueiras

By Dr. Babatunde Osotimehin

Seventy years ago, with the founding of the United Nations, all nations reaffirmed their faith in fundamental human rights, in the dignity and worth of the human person, and in the equal rights of men and women and of nations large and small.

The commitment to fundamental human rights that was enshrined in the United Nations Charter and later in the Universal Declaration of Human Rights lives on today in many other treaties and agreements, including the Programme of Action of the 1994 International Conference on Population and Development.There is a wealth of indisputable evidence that when sexual and reproductive health is integrated into broader economic and social development initiatives, it can have a positive multiplier effect on sustainable development and the well-being of entire nations.

The Programme of Action (PoA) , endorsed by 179 governments, articulated a bold new vision about the relationships between population, development and individual well-being.

And it was remarkable in its recognition that reproductive health and rights, as well as women’s empowerment and gender equality, are the foundation for economic and social development.

The PoA is also rooted in principles of human rights and respect for national sovereignty and various religious and cultural backgrounds. It is also based on the human right of individuals and couples to freely determine the number of their children and to have the information and means to do so.

Since it began operations 46 years ago, and guided by the PoA since 1994, the United Nations Population Fund has promoted dignity and individual rights, including reproductive rights.

Reproductive rights encompass freedoms and entitlements involving civil, political, economic, social and cultural rights.

The right to decide the number and spacing of children is integral to reproductive rights and to other basic human rights, including the right to health, particularly sexual and reproductive health, the right to privacy, the right to equality and non-discrimination and the right to liberty and the security of person.

Reproductive rights rest not only on the recognition of the right of couples and individuals to plan their families, but also on the right to attain the highest standard of sexual and reproductive health.

The impact of the PoA has been nothing short of revolutionary for the hundreds of millions of women who have over the past 21 years gained the power and the means to avoid or delay a pregnancy.

The results of the rights-based approach to sexual and reproductive health, including voluntary family planning, have been extraordinary. Millions more women have become empowered to have fewer children and to start their families later in life, giving them the opportunity to complete their schooling, earn a better living and rise out of poverty.

And now there is a wealth of indisputable evidence that when sexual and reproductive health is integrated into broader economic and social development initiatives, it can have a positive multiplier effect on sustainable development and the well-being of entire nations.

Recent research shows that investments in the human capital of young people, partly by ensuring their right to health, including sexual and reproductive health, can help nations with large youth populations realize a demographic dividend.

The dividend can help lift millions of people out of poverty and bolster economic growth and national development. If sub-Saharan Africa realized a demographic dividend on a scale realized by East Asia in the 1980s and 1990s, the region could experience an economic miracle of its own.

The principles of equality, inalienable rights, and dignity embodied in the United Nations Charter, the Universal Declaration of Human Rights and the Programme of Action are relevant today, as the international community prepares to launch a 15-year global sustainable development initiative that builds on and advances the objectives of the Millennium Development Goals, which come to a close later this year.

The new Post-2015 Global Sustainable Development Agenda is founded on principles of equality, rights and dignity.

Upholding these principles and achieving each of the proposed 17 new Sustainable Development Goals require upholding reproductive rights and the right to health, including sexual and reproductive health.

Achieving the proposed goal to ensure healthy lives and promoting well-being for all at all ages, for example, depends in part on whether individuals have the power and the means to prevent unintended pregnancy or a sexually transmitted infection, including HIV.

Human rights have guided the United Nations along the path to sustainability since the Organisation’s inception in 1945. Rights, including reproductive rights, have guided UNFPA along that same path for decades.

As we observe the 70th anniversary of the United Nations and look forward to the post-2015 development agenda, we must prioritise the promotion and protection of human rights and dignity for every person, for current and future generations, to create the future we want.

Edited by Kitty Stapp

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Latin America Must Address Its Caregiving Crisis Tue, 19 May 2015 07:40:42 +0000 Fabiana Frayssinet A caregiver assists her elderly employer on a residential street in Buenos Aires, Argentina. Credit: Fabiana Frayssinet/IPS

A caregiver assists her elderly employer on a residential street in Buenos Aires, Argentina. Credit: Fabiana Frayssinet/IPS

By Fabiana Frayssinet
BUENOS AIRES, May 19 2015 (IPS)

As in the rest of the world, the care of children, the elderly and the disabled in Latin America has traditionally fallen to women, who add it to their numerous domestic and workplace tasks. A debate is now emerging in the region on the public policies that governments should adopt to give them a hand, while also helping their countries grow.

The challenges women face are reflected by the life of body therapist Alicia, from Argentina, who preferred not to give her last name. After raising three children and deciding to concentrate on her long-postponed dream of becoming a writer, she now finds herself caring for her nearly 99-year-old mother.

The elderly woman is in good health for her age, with almost no cognitive or motor difficulties. But time is implacable, and Alicia is starting to wonder how she will be able to afford a full-time nurse or caregiver.“In Latin America we’re facing what has been called the caregiving crisis. As life expectancy has improved, the population is ageing, which means there are more people in need of care.” -- Gimena de León

“I can see things changing in my mother’s condition. She can still get around pretty much on her own – she can take a bath, she moves around, but it’s getting harder and harder for her. And she’s becoming more and more forgetful,” said Alicia, who up to now has managed to juggle her work and job-related travelling thanks to the help of a cousin and a woman she pays as back-up support.

“But soon I’ll have to find another way to manage,” she added. “I won’t be able to leave her alone, like I do now, for a few hours. I have no idea how I’ll handle this. Time is running out and soon I’ll have to figure something out, if I want to be able to continue with my own life.”

According to Argentina’s national statistics and census institute, INEC, women dedicate twice as much time as men to caregiving: 6.4 hours a day compared to 3.4 hours. Among women who work outside the home, the average is 5.8 hours.

But given the new demographic makeup of the region, the situation could get worse, according to Gimena de León, a United Nations Development Programme (UNDP) Inclusive Development analyst.

“In Latin America we’re facing what has been called the caregiving crisis,” she told IPS. “As life expectancy has improved, the population is ageing, which means there are more people in need of care.”
“At the same time the proportion of the population able to provide care has shrunk, basically because of the massive influx of women in the labour market. That’s where the bottleneck occurs, between the caregiving needs presented by the current population structure and this drop in family caregiving capacity,” she added.

The International Labour Organisation (ILO) reports that 53 percent of working-age women in the region are in the labour market, and 70 percent of women between the ages of 20 and 40.

It also estimates that in 2050 the elderly will make up nearly one-fourth of the population of Latin America, due to an ageing process that is a new demographic phenomenon in this region of 600 million people.

Changes that according to René Mauricio Valdés, the UNDP resident representative in Argentina, “leave a kind of empty space,” which is more visible in the political agenda because up to now it was taken for granted that families – and women in particular – were in charge of caregiving.

The UNDP and organisations like the ILO and the United Nations Children’s Fund (UNICEF) are promoting a regional debate on the need for governments to design public policies aimed at achieving greater gender equality.

According to the UNDP, caregiving is the range of activities and relationships aimed at meeting the physical and emotional requirements of the segments of the population who are not self-sufficient – children, dependent older adults and people with disabilities.

In the region, the greatest progress has been made in Costa Rica, especially with respect to the care of children, and in Uruguay, where a “national caregiving system” has begun to be built for children between the ages of 0 and 3, people with disabilities and the elderly, with the additional aim of improving the working conditions of paid caregivers.

Other countries like Chile and Ecuador have also made progress, but with more piecemeal measures.

In Argentina the national programme of home-based care providers offers training to paid caregivers and provides home-based care services to poor families, through the public health system. But the waiting lists are long.

“The current policies don’t suffice to ease the burden of caregiving for families, and for women in particular, who are the ones doing the caregiving work to a much greater extent than men,” said De León.

“The distribution of time and resources is clearly unfair to women, and the state has to take a hand in this,” she said.

Solutions should emerge according to the specific characteristics of each country. Measures that are called for include longer maternity and paternity leave, more caregiving services for the elderly, more daycare centres for small children, flexibility to allow people to work from home, and more flexible work schedules.

But caregiving is still a relatively new issue in terms of public debate, and has been largely invisible for decision-makers, according to Fabián Repetto of the Argentine Centre for the Implementation of Public Policies Promoting Equity and Growth.

“The different things that would fit under the umbrella of a policy on caregiving were never given priority in the political sphere,” she told IPS.

Repetto believes the issue will begin to draw the interest of the political leadership “when it becomes more visible.”

The “economic argument” of those promoting this debate, the UNDP explains, is “the need to incorporate the female workforce in order to improve the productivity of countries and give households a better chance to pull out of poverty.”

In addition, it is necessary to improve “the human capital” of children, “whose educational levels will be strengthened with comprehensive care policies in stimulating settings.”

“What does that mean? That those children who receive early childhood development today, and who we give a boost with a caregiving policy, will be much more productive. And being much more productive as a society makes the country grow, and makes it possible to have better policies for older adults as well,” Repetto said.

Alicia prefers a “human” rather than economic argument.

“The idea is to respect the life of an elderly person, which sometimes for different reasons is hard to maintain. Respect for the dignity of the other, so they can live the best they can up to the last moment. For them to be cared for, and that doesn’t just mean changing their diapers, but that they are cared for as a human being.”

Edited by Estrella Gutiérrez/Translated by Stephanie Wildes

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Opinion: Let’s Talk Menstruation. Period. Thu, 14 May 2015 21:28:16 +0000 Chris Williams and Kersti Strandqvist Strengthening women’s positions, and giving them the opportunity to fully participate in society is necessary if we are to achieve the SDG targets. Credit: Farooq Ahmed/IPS

Strengthening women’s positions, and giving them the opportunity to fully participate in society is necessary if we are to achieve the SDG targets. Credit: Farooq Ahmed/IPS

By Chris Williams and Kersti Strandqvist
NEW YORK, May 14 2015 (IPS)

Every month, more than two billion women around the world menstruate, and yet the topic is still shrouded by a veil of silence. While some girls celebrate their period as the first step into womanhood, many girls in developing or emerging countries are shocked and ashamed of their monthly cycles.

Recent studies have found that over 70 percent of girls in India had no idea what was happening to them when they started their first period; 50 percent of girls in Iran believe that menstruation is a disease; and over 50 percent of girls in Ethiopia miss between one and four days of school per month due to menstruation.In every country, the veil of silence around menstruation contributes to discrimination that can hold women back in their personal lives and professional careers.

Even in the United States, where menstruation management is taught in schools and girls typically have access to the necessary resources and infrastructure, the topic remains a taboo, preferably not addressed in polite circles. Real-life examples abound.

In March, Instagram twice removed a photo of a fully clothed woman with two visible spots of blood, because it violated their ‘community guidelines.’ In January, tennis star Heather Watson shocked the world by ascribing her Australian open defeat to ‘girl things.’

In every country, the veil of silence around menstruation contributes to discrimination that can hold women back in their personal lives and professional careers.

It is time for the global community to break its silence on menstruation so that women and girls can discuss the topic without shame, and reap the rewards for their health, education and quality of life.

The taboo surrounding menstruation is a barrier to equal participation and opportunities for women. More importantly, this neglect of a woman’s need to manage their menstruation inside and outside the home is a violation of a host of human rights – in many countries, menstruating women are banned from praying, cooking, or sleeping near their family.

Current research shows that menstrual education in every country continues to provide girls with mixed messages; on the one hand it is a normal, natural event, however girls are also taught that it should be hidden.

This taboo on female development has also had unintended consequences for U.S. aid priorities – according to development experts, the U.S. government will remain reluctant to fund education initiatives in developing or emerging countries until there is a proven link between toilets in schools or menstrual management education to an improvement in attendance rates or performance in school.

The countdown has begun to the United Nations release of the Sustainable Development Goals, and women’s empowerment is expected to take center stage as a cross-cutting issue that will lift the development of society as a whole.

Strengthening women’s positions, and giving them the opportunity to fully participate in society is necessary if we are to achieve these targets.

The ambitious goal of ensuring equality for women and girls requires a multi-stakeholder approach, with collaboration from communities, government, U.N. agencies, private sector, academia, NGOs, media and others. It is time for all sectors to work together to ensure that menstruation is far higher on the development agenda.

By leveraging public-private partnerships, a unique combination of funding can ensure that market research from the private sector can efficiently contribute to the effectiveness of aid and investment.

This week, the global movement to break the silence on menstruation comes to the U.S. as Team SCA, an all-women crew of sailors participating in the round-the-world Volvo Ocean Race, docks in Newport, Rhode Island. The team is promoting the message of women’s empowerment.

With support from the Water Supply and Sanitation Collaborative Council (WSSCC), a U.N. body dedicated to achieving safe sanitation and hygiene for the most vulnerable through community-led approaches, Team SCA has participated in several menstrual hygiene management training sessions during the race.

Practical, sustainable change for women and girls can be achieved through research, innovation and education. Governments, community leaders, opinion leaders, and global citizens must speak out to change attitudes, upend customs that restrain menstruating women and girls, and promote basic education about periods.

Menstrual hygiene management is only the beginning but it is a critical first step… we need to break the silence across the female lifecycle, from puberty to menopause to old-age.

Eliminating these taboos is an international responsibility, and an opportunity for the U.S. to lead by example, by increasing awareness of this monthly global human rights violation, as well as holding an open and honest discussion about its own taboos.

Edited by Kitty Stapp

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Pregnancy and Childbirth Still Kill Too Many Women in Latin America Thu, 14 May 2015 17:01:16 +0000 Fabiana Frayssinet A grandmother with her daughter - a young mother - and other members of their family in Mbya Guaraní Iboty Ocara, an indigenous village in the province of Misiones in the northwest of Argentina. Indigenous people are among the most vulnerable groups in Latin America in terms of maternal mortality. Credit: Fabiana Frayssinet/IPS

A grandmother with her daughter - a young mother - and other members of their family in Mbya Guaraní Iboty Ocara, an indigenous village in the province of Misiones in the northwest of Argentina. Indigenous people are among the most vulnerable groups in Latin America in terms of maternal mortality. Credit: Fabiana Frayssinet/IPS

By Fabiana Frayssinet
BUENOS AIRES, May 14 2015 (IPS)

In spite of strides in social progress, Latin America’s maternal mortality rates remain unacceptable, and many of the deaths are avoidable, occurring partly because of neglect of the prescriptions provided by experts: preventive action and health promotion.

Juan Reichenbach, a regionally renowned Argentine expert on maternal and child health, has hands-on experience of the problem with mothers and their infants, as a paediatrician and the national director of Motherhood and Infancy (2008-2009).

“If I had to formulate a simple maxim, I would say: Tell me where you were born and I’ll tell you whether or not you will survive,” he said in an interview with IPS.

“The main agents of change are prevention and promotion,” said Reichenbach, who is now a professor at Universidad Nacional de La Plata, where he is chief resident and supervises junior resident doctors at a children’s hospital.“When you look at the basic causes of maternal deaths you don’t have to be highly intelligent to see that they are related to lack of access (to the health system) and to abortions, which are the main cause of maternal deaths in Argentina and in Latin America." -- Juan Reichenbach

“In other words, the health of mothers and their children needs to be treated as a fundamental right,” he said.

“Trends in Maternal Mortality: 1990-2013,” a United Nations report published in 2014, revealed that the maternal mortality rate fell by 40 percent in Latin America over the stated period.

In spite of this drop in the maternal mortality rate, 9,300 women lost their lives in the region in 2013 due to complications of pregnancy and childbirth, the report said.

On average, approximately 16 women die every day in Latin America and the Caribbean from maternity-related complications, according to April 2015 figures from the Pan-American Health Organisation (PAHO).

“When you look at the basic causes of maternal deaths you don’t have to be highly intelligent to see that they are related to lack of access (to the health system) and to abortions, which are the main cause of maternal deaths in Argentina and in Latin America,” Reichenbach said.

According to Bremen De Mucio, of PAHO’s Latin American Centre for Perinatology, Women and Reproductive Health (CLAP), “relevant and valuable” progress has been made, but the maternal mortality ratio remains at an “unacceptable” level.

The fifth Millennium Development Goal (MDG) for improving maternal health calls for reducing the 1990 maternal mortality ratio by three-quarters by the end of 2015, as well as providing universal access to reproductive health.

“Continuing to promote human development is the key. And this goes beyond the health sector alone. Effective work to improve the social determinants of health has more impact than isolated health interventions,” De Mucio told IPS.

Reichenbach, for his part, said: “We will only make progress towards achieving the MDGs by educating people about human dignity and the right to life, which are not quantifiable aims.”

The main risk factors for maternal fatalities in Latin America could be reduced “almost to zero,” according to De Mucio. These risk factors are hypertensive disorders of pregnancy, haemorrhage and infections.

According to PAHO, complications of pregnancy and childbirth are the main cause of death among women aged 20 to 34, and half of all maternal deaths are due to unsafe abortions, in a region where voluntary termination of pregnancy is illegal in the majority of countries.

“About 700,000 babies are born every year in Argentina, and there are an estimated 500,000 abortions. The number of abortions goes unrecognised and unexamined by the health system, and is the tip of the iceberg of maternal mortality,” Reichenbach said.

He said that 35 percent of maternal deaths in his country are preventable with, for instance, proper monitoring during pregnancy.

• Between 1990 and 2013, Latin American countries reduced maternal mortality by an average of 40 percent, much less than the MDG target of 75 percent by 2015. However, 11 countries managed to reduce the rate by more than the regional average: Uruguay (-67 percent), Peru (-64 percent), Bolivia (-61 percent), Chile and Honduras (-60), Dominican Republic (-57), Guatemala (-49), Mexico (-45), Ecuador (-44), and Brazil and Haiti (-43 percent).

• The countries with the lowest maternal mortality rates in the region are Uruguay (14 per 100,000 live births) and Chile (22 per 100,000 live births).

• The highest maternal mortality rate occurs in Haiti, with 380 deaths per 100,000 live births.

Source: Trends in Maternal Mortality: 1990-2013. Estimates by WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division.

Argentina’s national guidelines stipulate at least five health clinic check-ups for low-risk pregnancies, but in practice expectant mothers attend on average “less than 2.5 times, and the first visit is usually delayed. Some women arrive at a public hospital in a critical state when they are seven months pregnant,” Reichenbach said.

“Buying a computerised tomography scanner is not the solution; the real answer lies in adequate living conditions, education, employment, decent housing and access to health services,” he said. “Large maternity hospitals generally only intervene as a last resort to fix things after they have gone seriously wrong.”

In his view, the key is to take action at the primary level of health care, including providing an adequate sanitary environment and inclusion in a health system “that pays attention to patients’ daily problems,” reaches remote locations and conducts door-to-door visits in high-risk areas.

Serious cases should be detected promptly and referred to maternity facilities with essential obstetric and neonatal equipment, such as an operating theatre, blood bank, cardiopulmonary resuscitation apparatus and ambulances equipped to deliver emergency care.

Inter-disciplinary teams are needed where doctors are “just another member of the team,” alongside obstetricians, nurses, social workers and community health workers whose work is “much more closely linked to the local area and to people’s health,” he said.

Reichenbach said an “equitable” distribution of doctors is essential to serve marginalised populations, like indigenous peoples, who are “in the first ranks of the dispossessed,” and intra-regional migrants.

In Argentina, for example, there is one doctor per 80 inhabitants in Buenos Aires, while there is only one per 3,000 people in El Impenetrable, a vast forested region in the northern province of Chaco.

“If health is viewed as a right, it follows that every child, mother, teenager and elderly person – including the most impoverished – must be healthy, and that is not so difficult to achieve,” he said.

Health policies should address issues such as geographical remoteness, lack of infrastructure and cultural factors that prevent the spread of sexual and reproductive education.

“We are talking about pregnancy, but we also have to look at whether the pregnancy is wanted within the family, or whether it is an accident, caused by lack of information or by cultural factors, so that a 30-year-old mother ends up having seven or eight children,” he said.

Ariel Karolinski, a consultant for PAHO in Argentina, told IPS that for the past 20 years “the maternal mortality ratio has remained constant at about 40 per 100,000 live births,” although there are wide internal disparities.

However, between 2010 and 2012, for the first time Argentina achieved a fall in the maternal mortality rate with a “relative reduction of 22 percent,” he said.

Karolinski attributed this to programmes like Plan Nacer and Sumar, which expanded public health coverage for mothers and children and targeted the provinces with the worst health indicators, and to cash transfer schemes for pregnant women that are conditional on attending for prenatal check-ups and getting their children vaccinated.

Within Latin America, similar policies have allowed countries like Bolivia, Peru and Uruguay to reduce their maternal mortality rates by over 60 percent.

De Mucio stressed that in Bolivia and Peru there were “favourable repercussions from a pluricultural focus applied during pregnancy, childbirth and the postpartum period.” In Peru, additionally, large numbers of maternity waiting homes for women living far away from health centres have been set up.

Meanwhile, in Uruguay, changes in “the law on abortion (available up to the 12th week of gestation since 2012) have contributed to virtually eradicating deaths from this cause,” he said.

However, “it should not be forgotten that the economic boom” has contributed to improving living conditions, a change which is “directly related to the reduction of maternal mortality,” he concluded.

Edited by Estrella Gutiérrez/Translated by Valerie Dee

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Sri Lanka’s Development Goals Fall Short on Gender Equality Tue, 05 May 2015 21:53:55 +0000 Ranjit Perera In peacetime Sri Lanka, women still bear a heavy load in looking for jobs and tending to their families. Credit: Adithya Alles/IPS

In peacetime Sri Lanka, women still bear a heavy load in looking for jobs and tending to their families. Credit: Adithya Alles/IPS

By Ranjit Perera
COLOMBO, May 5 2015 (IPS)

When Rosy Senanayake, Sri Lanka’s minister of state for child affairs, addressed the U.N. Commission on Population and Development (CPD) in New York last month, she articulated both the successes and shortcomings of gender equality in a country which prided itself electing the world’s first female head of government: Mrs. Sirimavo Bandaranaike in July 1960.

After surviving a 26-year-long separatist war, which ended in 2009, Sri Lanka has been registering relatively strong economic growth, and also claiming successes in its battle against poverty and hunger."Women also bear primary responsibility for care work – which creates multiple and intersecting forms of discrimination that limits the opportunities for their full integration into the workforce.” -- Rosy Senanayake

As the U.N.’s Millennium Development Goals (MDGs) move towards their targeted deadline in December 2015, Sri Lanka says it has reduced poverty from 26.1 percent in 1990-1991 to 6.7 percent in 2012-2013 – achieving the target of cutting back extreme poverty by 50 percent far ahead of end 2015.

Still, it still lags behind in gender equality – even as 51.8 percent of the country’s total population (of 21.8 million) are women, with only 34 percent comprising its labour force.

Pointing out that Sri Lanka has enjoyed significant progress in its social and economic indicators, Senanayake told IPS, it is also one of the few countries in Asia that has a sex ratio favourable to women.

But Sri Lanka’s advancement, in light of changing demographics, will ultimately depend on its ability to enable women and young people to be active participants in the country’s post-2015 development agenda and the U.N.’s proposed Sustainable Development Goals (SDGs).

“This requires an increase in sustained investment targeted at gender equality and social protection,” she added.

Addressing a meeting in Colombo last week, visiting U.S. Secretary of State John Kerry praised the women of Sri Lanka for playing a critical role in helping the needy and the displaced.

“They’re encouraging people to build secure and prosperous neighbourhoods. They are supporting ex-combatants and survivors of sexual and gender-based violence, and they’re providing counseling and other social services. And these efforts are absolutely vital and we should all support them,” he said.

“But we also have to do more than that,” he noted.

“Here, as in every country, it’s crystal clear that for any society to thrive, women have to be in full control – they have to be full participants in the economics and in the political life. There is no excuse in the 21st century for discrimination or violence against women. Not now, and not ever,” Kerry added.

The country’s positive development goals are many and varied: Sri Lanka has almost achieved universal primary education; the proportion of pupils starting grade 1, who reach grade 5, is nearly 100 percent; the unemployment rate has declined to less than four percent: the maternal mortality rate has declined from 92 deaths per 100,000 live births in 1990 to 33.3 in 2010; and the literacy rate of 15- to 25-year-olds increased from 92.7 percent in 1996 to 97.8 percent in 2012, according to official figures released by the government.

U.N. Resident Coordinator in Colombo Subinay Nandy says since the end of the separatist war, “Sri Lanka has graduated from lower to middle income status.”

Still, despite strong health and education results, Sri Lanka struggles to provide gender equality in employment and political representation.

Referring to the MDG country report produced by the government, Nandy says, Sri Lanka, overall, is in a strong position. The good performance noted in the report has been sustained and Sri Lanka has already achieved many of the MDGs and is mostly on track to achieve the others, he said.

But the negatives are also many and varied.

The proportion of seats held by women in the national parliament “remains very low”; the number of HIV/AIDS cases, despite low prevalence, is gradually increasing; tuberculosis remains a public health problem; there has been an increase in the incidence of dengue fever; and Sri Lanka’s debt-services-to-exports ratio remains relatively high compared to other developing countries in the Asia-Pacific region.

The eight MDGs spelled out by the United Nations include eradicating extreme poverty and hunger; achieving universal primary education; promoting gender equality and empowering women; reducing child mortality; improving maternal health; combatting HIV/AIDS, malaria and other diseases; ensuring environmental sustainability and developing a global partnership for development.

The targeted date to achieve these goals is 2015.

Senanayake told the CPD unemployment amongst women is more than twice as high as unemployment amongst men, while women migrant workers and women in the plantation and export processing sectors bring in significant foreign exchange earnings to the country.

However, a majority of women who participate in the labour force do so in the informal sector.

“This leaves them vulnerable to exploitation and abuse during their course of employment. Women also bear primary responsibility for care work – which creates multiple and intersecting forms of discrimination that limits the opportunities for their full integration into the workforce,” she said.

Sri Lanka recognises that inclusive development rests on ensuring equality of opportunity in work.

“As such, we are firmly committed to making the necessary legal and structural investments to bolster a decent work agenda in marginalised sectors,” she noted.

These investments demand a broader discussion on the value of female participation in development.

This includes the availability and promotion of sexual and reproductive health and rights; robust mechanisms to prevent violence against women and girls; and strengthening measures to bring perpetrators of violence to justice.

These, she said, are critical in ensuring Sri Lanka’s ‘demographic dividend’ can be leveraged.

Meanwhile, the introduction of family planning services by the Family Planning Association was well integrated into maternal and child health services and later expanded to reduce the stigma surrounding contraception.

This strategy accounted for more than 80 percent decline in fertility, according to Senanayake.

Additionally, the government of Sri Lanka, through her Ministry, has introduced a scheme that provides a monthly nutritional supplement to all pregnant women in the country to reduce rates of anaemia, low birth weight and malnutrition – which affects both mother and baby.

Still, Sri Lanka faces the problem of unsafe abortions, unintended and teenage pregnancies, which pose significant challenges to the health and well-being of women and adolescents.

In this respect, she said, strengthening comprehensive reproductive education through school curriculum can help young people access accurate information on gender, sexuality, sexually transmitted infections including HIV and increase their awareness on the effective use of contraception.

Currently over 23.4 percent households are headed by women.

To combat these demographic pressures, Prime Minister Ranil Wickremesinghe has set up a National Committee on Female-Headed Households and a National Centre for Female Headed Households – enabling female heads of households to integrate into the workforce and access sustainable livelihoods.

Edited by Kitty Stapp

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Urban Slums a Death Trap for Poor Children Tue, 05 May 2015 18:08:55 +0000 Valentina Ieri Children on their way to school in Kibera, the largest slum in Nairobi. Credit: Save the Children

Children on their way to school in Kibera, the largest slum in Nairobi. Credit: Save the Children

By Valentina Ieri

It’s called the urban survival gap – fuelled by the growing inequality between rich and poor in both developing and developed countries – and it literally determines whether millions of infants will live or die before their fifth birthday.

Save the Children’s annual report on the State of the World’s Mothers 2015 ranks 179 countries and concludes that that “for babies born in the big city, it’s the survival of the richest.”

Speaking from the launch at U.N. Headquarters, Carolyn Miles, president and CEO of Save the Children, said that for the first time in history, more families are moving into cities to give their children a better life. But this shift from a rural to an urban society has increased disparities within cities.

“Our report reveals a devastating child survival divide between the haves and have-nots, telling a tale of two cities among urban communities around the world, including the United States,” Miles added.

The document estimates that 54 percent of the world’s population lives in urban areas, and by 2050 the concentration of people in cities will increase to 66 percent, especially in Asia and Africa.

The World Health Organisation (WHO) says that nearly a billion people live in urban slums, shantytowns, on sidewalks, under bridges and along railroad tracks.

Rizelle, 17, and her three-week-old baby. Rizelle lives in a squatted home under a bridge in San Dionisio, Indonesia. Photo credit: Save the Children

Rizelle, 17, and her three-week-old baby. Rizelle lives in a squatted home under a bridge in San Dionisio, Indonesia. Photo credit: Save the Children

While women living in cities may have easier access to primary health care, including hospitals, many governments have been unable to keep up with this rapid urban growth. One-third of all urban residents – over 860 million people – live in slums where they face lack of clean water and sanitation, alongside rampant malnutrition.

Miles said that despite the progress made on reducing urban under-five mortality around the world, the survival divide between rich and poor children in cities is growing even faster than that of poor children in rural areas.

In most of the developing nations surveyed, children living at the bottom 20 percent of the socioeconomic ladder are twice as likely to die as children in the richest 20 percent, and in some cities, the disparity is much higher.

Robert Clay, vice president of the health and nutrition at Save the Children, explained that urban poor are more transient, as they tend to have unsteady jobs and living situations. In rural areas, many people at least have land and food, and a stronger support system within the community.

“In urban areas this doesn’t exist. Urban cities are overcrowded by many ethnic groups living side by side so it’s a bit harder to bond, communicate and build trust. It’s the hidden population that is more problematic to reach,” Clay told IPS.

He said lack of data makes it harder for charities like Save the Children, or national and municipal governments, to access these marginalised communities.

The 10 developing countries with the largest child survival divide are Bangladesh, Cambodia, Ghana, Kenya, India, Madagascar, Nigeria, Peru, Rwanda and Vietnam.

Among the 10 worst wealthy capital cities for child survival, out of the 25 studied, Washington D.C. (U.S.) was number one, followed by Vienna (Austria), Bern (Switzerland), Warsaw (Poland), and Athens (Greece).

The river that runs through the Kroo Bay slum community in Sierra Leone. Credit: Save the Children

The river that runs through the Kroo Bay slum community in Sierra Leone. Credit: Save the Children

By looking at the mother’s index rankings of 2015, based on five criteria – maternal health, children’s well-being, educational status, economic status and women political status, Save the Children says that conditions for mothers and their children in the 10 bottom-ranked countries – all but two of them in West and Central Africa – are dramatic, as nations struggle to provide the basic infrastructure for the health and wellness of their citizens.

“On average, in these countries one woman out of 30 dies from pregnancy-related causes, and one child out of eight dies before his or her fifth birthday,” Miles said.

Globally, under-five mortality rates have declined, from 90 to 46 deaths per 1,000 live births. However, these numbers, says the organisation, mask the fact that child survival is strictly linked to family wealth, and miss addressing the conditions of poverty and unhealthy life of slums.  

Positively, the report has also uncovered some successful solutions found by governments to reduce maternal and infant mortality, and close the inequality gap between rich and poor children in their own countries. The most successful countries are Ethiopia (Addis Ababa), Egypt (Cairo), Guatemala (Guatemala City), Uganda (Kampala), Philippines (Manila) and Cambodia (Phnom Penh).

“Ethiopia, which recently had accelerated economic growth, managed to develop effective targeting policies, and provided accessible preventive and curative health care for poor mothers and children,” Clay said.

“[Ethiopia] should be a blueprint for other countries, which should bring access to communities in slums so that local people are not left behind,” he underlined, adding that hiring urban outreach workers who can go into the communities, speak the language of the people living there and understand their conditions and needs is vital.

Save the Children is calling on national governments worldwide to find new policies and plans to invest in a universal maternal and infant health care, develop cross-sectoral urban plans, and reduce urban disadvantages, and to increase the focus on the Sustainable Development Goals in the post-2015 development agenda, concluded Miles.

Edited by Kitty Stapp

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Q&A: “People Need to Be at the Centre of Development” Sat, 02 May 2015 20:58:17 +0000 Sandra Siagian Indonesian Vice President Jusuf Kalla and UNFPA Executive Director Dr. Babatunde Osotimehin discussed how Indonesia could harness its demographic dividend on the sidelines of the World Economic Forum on East Asia in Jakarta on Apr. 20. Credit: Courtesy of UNFPA Indonesia.

Indonesian Vice President Jusuf Kalla and UNFPA Executive Director Dr. Babatunde Osotimehin discussed how Indonesia could harness its demographic dividend on the sidelines of the World Economic Forum on East Asia in Jakarta on Apr. 20. Credit: Courtesy of UNFPA Indonesia.

By Sandra Siagian
JAKARATA, May 2 2015 (IPS)

In a populous archipelago nation like Indonesia, where 250 million live spread across some 17,500 islands, speaking over 300 languages, the question of development is a tricky one.

A lower-middle-income country with a poverty rate of 11.4 percent – with a further 65 million people living just below the poverty line – the government is forced to make tough choices between where to invest limited funds: education or health, job creation or infrastructure development?

A demographic dividend arises when a high ratio of working people relative to population size frees up resources for private and public investment in human and physical capital.
These issues are further complicated by the fact that over 62 percent of the population – about 153 million people – lives in rural areas, largely cut off from easy access to hospitals, schools and job markets outside of the agricultural sector. About 27 percent of this population, roughly 66.1 million people, are women of reproductive age.

In addition, Indonesia currently has the highest rate of working-age people that it has ever had, both in absolute numbers – with 157 million potential workers – and as a proportion of the total population – accounting for 66 percent of all Indonesians.

While this puts a huge strain on the government to provide jobs, it also offers the country a chance to reap the benefits of its demographic dividend, defined by the International Labour Organisation (ILO) as a period in which the rising number of working people relative to population size frees up resources for private and public investment in human and physical capital.

This, in turn, allows the country to achieve far higher rates of income per capita, thus boosting the national economy.

At the recently concluded World Economic Forum on East Asia, which ran from Apr. 19-21 in Indonesia’s capital, Jakarta, experts from around the world urged the country to capitalise on its demographic dividend by investing heavily in its own people.

Among the nearly 700 participants in the conference was the executive director of the United Nations Population Fund (UNFPA), former Nigerian Health Minister Dr. Babatunde Osotimehin, who stressed throughout his three-day visit that “people need to be at the centre of development.”

While this may seem a simple recipe, it bears repeating in Indonesia, where half of the population falls into the ‘youth’ category (15-24 years), a demographic that also has one of the highest unemployment rates in the country.

With Indonesia’s population set to increase by 19 percent, to about 293 million people by 2030, according to the UNFPA, the country would be well advised to heed the words of population experts.

In the midst of his whirlwind visit to Jakarta, Osotimehin sat down with IPS to discuss how Indonesia can harness the potential of its people, and to share some strategies on how the young democracy can optimise on changing population dynamics.

Excerpts from the interview follow.

Q: Where is Indonesia in terms of its demographic dividend?

A: Indonesia needs to take advantage of its demographic window of opportunity, which is expected to peak between 2020 and 2030. I think that there is the consciousness in Indonesia that this [demographic dividend] is an important national planning process, which they must invest in.

I believe that Indonesia has both the analytics and the political commitment, but I believe that going forward, we will have to encourage Indonesia to investment [strategically] for the demographic dividend to succeed.

Q: What kinds of investments need to be made?

A: Investments in health, youth education and employment need to be scaled up considerably. I think that social systems need strengthening – we need to address the issue of early marriage and make sure that girls are allowed to go to school, stay in school and reach maturity. We want to make sure that girls and women can make choices for themselves going forward, that is a key point.

Every young person must be taught about themselves and their bodies, and every woman needs to have access to voluntary family planning and sexual reproductive health services so that they are empowered to make choices. Having comprehensive sexuality education would ensure that we could reduce things like HIV infections, sexually transmitted infections and teenage pregnancies.

I think that within the educational framework we also want a situation where the curriculum is diversified so that we can encourage vocational training and entrepreneurship training. We need to be able to inspire small and medium-sized enterprises, which usually form the basis of a thriving economy.

Q: Why is it particularly important for Indonesia to focus on young people?

A: It’s important for Indonesia to invest in young people for many reasons. It gives a sense of belonging [for] a young person and it ensures that they can participate in national development. Young people will be part of the demographic transition and fertility reduction needs to include them. So really, they have to be part of the process.

Once you realise the potential of young people and they enter employment they are then able to save and earn, which in turn will help the economy grow.

Q: Is Indonesia moving in the right direction?

I think Indonesia has always had some of the necessary policies in place; they just need to be revitalised. New investments and political leadership have to come into it.

In the past, Indonesia was the leader in family planning after they implemented a national family planning programme in the 1970s. But it fell off the radar after Indonesia’s democratic transition in the 2000s, when family planning services were decentralised.

I think this new government is committed to bringing it back and I hear from discussions with various government leaders that this is something that they are paying close attention to.

Indonesia should also consider working with the private sector to help create decent jobs. Making sure that everybody, from the youth to the elderly, has social protection that provides basic [services] will be most important.

Edited by Kanya D’Almeida

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Unsafe Abortions Continue to Plague Kenya Sat, 02 May 2015 11:43:33 +0000 Robert Kibet By Robert Kibet
NAIROBI, May 2 2015 (IPS)

She is just 14, but Janida avoids eye contact with others, preferring to look down at the ground and nodding her head if someone tries to engage her in conversation.

Janida (not her real name) was once a sociable and playful child, but that was before she was sexually abused by her stepfather and giving birth to a baby who is now four months old.

Her days marked by trauma and depression, Janida is just one of many girl children in Kenya who have been abused and robbed of their childhood, leaving them emotionally scarred.

“The little girl [Janida] underwent both physical and mental torture,” Teresa Omondi, Deputy Executive Director and Head of Programmes at the Federation of Women Lawyers (FIDA) Kenya, told IPS. ”Her best option was to terminate the pregnancy rather than suffer the mental and physical torture, but she could not afford the cost of a safe abortion.”Many of the induced abortions taking place continue to be unsafe and complications are common” – Teresa Omondi, Federation of Women Lawyers (FIDA) Kenya

Under Article 26 (4) of the Kenyan constitution, “abortion is not permitted unless, in the opinion of a trained health professional, there is need for emergency treatment, or the life or health of the mother is in danger, or if permitted by any other written law.”

In September 2010, Kenya’s Ministry of Health released national guidelines on the medical management of rape or sexual violence – guidelines that allow for termination of pregnancy as an option in the case of conception, but require psychiatric evaluation and recommendation.

Then, in September 2012, the health ministry released standards and guidelines on the prevention and management of unsafe abortions to the extent allowed by Kenyan law, only to withdraw them three months later under unclear circumstances.

According to Omondi, “the law has not yet been fully put into operation and many providers have not been trained to provide safe abortion, meaning many of the induced abortions taking place continue to be unsafe and complications are common.”

The health ministry is responsible for doctors and nurses not being permitted to be trained on providing safe abortion, said Omondi, so “it is ridiculous that while Kenya’s Ministry of Health accepts that post-abortion care is a public health issue regarding numbers, practitioners have their hands tied.”

The issue of unsafe abortions in Kenya hit the headlines in September last year, when Jackson Namunya Tali, a 41-year-old nurse, was sentenced to death by the high court in Nairobi for murder, after the death of both Christine Atieno and her unborn baby in a botched illegal abortion.

Various inter-African meetings attended by Kenya have been held on reducing maternal mortality rates by providing safe abortions, with health ministers agreeing that statistics show that countries that do provide safe abortions have reduced their maternal mortality rates.

In a recent analysis, Saoyo Tabitha Griffith, Reproductive Health Rights Officer at FIDA and an advocate at the High Court of Kenya, said that despite Kenya having adopted a Constitution that affirms among others, women’s rights to reproductive health and access to safe abortion, Kenyan women continue to die from unsafe abortion – a preventable cause of maternal mortality.

For Dr Ong’ech John, a health specialist in Nairobi, perforated uteruses and intestines, heart and kidney failures, anaemia requiring blood transfusion as well as renal problems are just a few of the health complications arising from an abortion that goes wrong.

“Unsafe abortion complications are not just about removal of the products of conception that were not completely removed. One can evacuate but the perforated uterus has to be repaired, or you remove the uterus and it is rotten,” Dr Ong’ech told IPS.

“When the health ministry issued a directive in February this year instructing all health workers, whether from public, private or faith-based organisations, not to participate in any training on safe abortion practices and the use of the medication abortion, many questions were left unanswered,” said Omondi.

A highly respected Kenyan doctor, Dr John Nyamu, spent one year in prison in 2004 after his clinic was raided following the discovery of 15 foetuses on major roads together with planted documents from a hospital he had worked for but had since closed.

Speaking of his ordeal with Mary Fjerstand, a senior clinical advisor at Ipas, a global non-governmental organisation dedicated to ending preventable deaths and disabilities from unsafe abortion, Nyamu said that the publicity surrounding his imprisonment helped people to “realise the magnitude and consequences of unsafe abortion in Kenya; women were dying in great numbers. Before that, abortion was never spoken of in public.”

He went on to say that Kenya wants to achieve the Millennium Development Goal of a 75 percent reduction in maternal mortality, but that “it can’t be achieved if safe abortion is not available.”

A May 2014 World Health Organisation (WHO) updated fact sheet indicates that every day, approximately 800 women die worldwide from preventable causes related to pregnancy and childbirth, with 99 percent of all maternal deaths occurring in developing countries.

Edited by Phil Harris   

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Draconian Ban on Abortion in El Salvador Targeted by Global Campaign Thu, 30 Apr 2015 20:53:51 +0000 Edgardo Ayala One of her defence lawyers hugs Carmelina Pérez when an appeals court in eastern El Salvador declares her innocent of homicide, on Apr. 23. She had been sentenced to 30 years in prison in June 2014 after suffering a miscarriage. In El Salvador women, especially the poor, suffer from the penalisation of abortion under any circumstances. Credit: Edgardo Ayala/IPS

One of her defence lawyers hugs Carmelina Pérez when an appeals court in eastern El Salvador declares her innocent of homicide, on Apr. 23. She had been sentenced to 30 years in prison in June 2014 after suffering a miscarriage. In El Salvador women, especially the poor, suffer from the penalisation of abortion under any circumstances. Credit: Edgardo Ayala/IPS

By Edgardo Ayala
SAN SALVADOR, Apr 30 2015 (IPS)

International and local human rights groups are carrying out an intense global campaign to get El Salvador to modify its draconian law that criminalises abortion and provides for prison terms for women.

Doctors, fearing prosecution, often report poor women who end up in the public hospitals with complications from miscarriages, some of whom are sent to jail for supposedly undergoing illegal abortions.

There are currently 15 women in prison who were sentenced for alleged abortions after reported miscarriages. At least 129 women were prosecuted for abortions between 2000 and 2011, according to local organisations.

The campaign by Amnesty International and local human rights groups collected 300,000 signatures on a petition demanding a modification of El Salvador’s total ban on abortion.

This Central American country of 6.3 million people is one of the few nations in the world to ban abortion under any circumstances and penalise it with heavy jail terms.

The campaign was launched when a woman was freed by an appeals court. She had been found guilty of homicide and spent 15 months in prison.

Carmelina Pérez wept tears of joy when a judge declared her innocent on Apr. 23, after a hearing in a court in the eastern city of La Unión, the capital of the department of the same name.

“I’m happy, because I will be back with my son and with my family, free,” a still-handcuffed Pérez told IPS. She has a three-year-old son in her native Honduras.

Pérez, 21, was working as a domestic employee in the town of Concepción de Oriente, in La Unión, when she suffered a miscarriage. She ended up sentenced in June 2014 to 30 years in prison for homicide – a sentence that was overturned on appeal.

Of the 17 women imprisoned in similar cases since 1998, 15 are still in prison.

That was the year the legislature modified the penal code to make abortion illegal under all circumstances, even when the mother’s life is at risk, the fetus is deformed or unviable, or the pregnancy is the result of incest or rape.

Article 1 of the Salvadoran constitution was amended in January 1999 to protect the right to life from the moment of conception, making it even more difficult to reform the ban on abortion.

Carmen Guadalupe Vásquez, 25, was another one of the 17 women imprisoned, who are referred to by rights groups as “Las 17”. She had been sentenced to 25 years after being raped and suffering a miscarriage. She spent seven years in prison but was pardoned by the legislature in January 2015, after the Supreme Court recognised prosecutorial errors in her trial.

And in November 2014, 47-year-old Mirna Ramírez was released after serving out her 12-year sentence.

At least five other women have been accused and are in prison awaiting final sentencing.

Most of these women sought medical care in public hospitals after suffering miscarriages or stillbirths, but were reported by hospital staff fearful of being accused of practicing abortions. Many were handcuffed to the hospital bed and sent to prison directly, under police custody.

“The total ban on abortion is a violation of the human rights of girls and women in El Salvador, such as the rights to health, life and justice,” Amnesty International Americas director Erika Guevara said at an Apr. 22 forum in San Salvador.

Guevara added that El Salvador’s law on abortion “criminalises the country’s poorest women.”

Although there are no recent figures, a 2013 study carried out by the Agrupación Ciudadana por la Despenalización del Aborto (Citizens’ Coalition for the Decriminalisation of Abortion) found that 129 women were accused of abortion between 2000 and 2011.

Of this total, 49 were convicted – 23 for abortion and 26 for homicide in different degrees. In these cases, the prosecutor’s office argued that the fetuses were born alive and the mother was responsible for their death.

Of the 129 women accused, seven percent were illiterate, 40 percent had only a primary school education, 11.6 percent had a high school education and just 4.6 had made it to the university. And 51.1 percent of the accused had no income while 31.7 had small incomes.

In El Salvador, it is no secret that middle- and upper-class women have access to safe abortions in private clinics, and are neither reported by the doctors nor arrested and charged.

In its petition to modify the ban, Amnesty International demanded that El Salvador ensure access to safe and legal abortion in cases of rape or incest, where the woman’s health or life is at risk, and where the fetus is malformed or unlikely to survive.

Only the Vatican, Haiti, Nicaragua, Honduras, Surinam and Chile have total bans on abortion, although in Chile the legislature is studying a bill that would legalise therapeutic abortion (under the previously listed circumstances).

Delegates from Amnesty International, the Agrupación Ciudadana, and the Center for Reproductive Rights met on Apr. 22 with representatives of President Salvador Sánchez Cerén of the left-wing Farabundo Marti National Liberation Front, to demand a reform of the law and deliver the 300,000 signatures.

They also met with the presidents of the legislature and judiciary.

“There is at least a willingness to talk, we see a certain openness,” activist Paula Ávila with the Center for Reproductive Rights, an international organisation based in the United States, told IPS.

Ávila added that as women who have suffered these cases increasingly speak out and tell their stories, the state will have to accept the need to sit down and talk.

The Center, along with the Agrupación Ciudadana and the Feminist Collective for Local Development, demanded a response from the Salvadoran state to a communication sent on Apr. 20 by the Inter-American Human Rights Commission (IACHR) urging the state to recognise its responsibility in the death of “Manuela”.

Manuela – who never allowed her real name to be revealed – had a stillbirth, was erroneously accused of having an abortion, and was sentenced to 30 years in prison.

It was later discovered that she had lymphatic cancer, a disease that can cause miscarriages. She died in prison in 2010 without being treated for her cancer.

The IACHR has accepted the case and has given the Salvadoran state three months to respond with regard to its responsibility for her death.

The debate on the flexibilisation of the total ban on abortion is marked by the “machismo” of Salvadoran society and moralistic and religious overtones, with heavy pressure from Catholic Church leaders and evangelical churches that stands in the way of political changes.

But the release of Carmelina Pérez in La Unión has given rise to hope in similar cases.

For the first time, an appeals court judge dismissed the statement of the gynecologist who testified against the defendant. That decision was key in overturning her conviction.

Edited by Estrella Gutiérrez/Translated by Stephanie Wildes

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No Woman, No World Mon, 27 Apr 2015 22:00:12 +0000 Sean Buchanan By Sean Buchanan
LONDON, Apr 27 2015 (IPS)

Almost exactly two years ago, on the morning of Apr. 24, over 3,600 workers – 80 percent of them young women between the ages of 18 and 20 – refused to enter the Rana Plaza garment factory building in Dhaka, Bangladesh, because there were large ominous cracks in the walls. They were beaten with sticks and forced to enter.

Forty-five minutes later, the building collapsed, leaving 1,137 dead and over 2,500 injured – most of them women.

The Rana Plaza collapse is just one of a long series of workplace incidents around the world in which women have paid a high toll.

It is also one of the stories featured in the UN Women report Progress of the World’s Women 2015-2016: Transforming Economies, Realizing Rights, launched on Apr. 27.

All too often women fail to enjoy their rights because they are forced to fit into a ‘man’s world’, a world in which these rights are not at the heart of economies.
Coming 20 years after the Fourth World Conference on Women in Beijing, China, which drew up an agenda to advance gender equality, Progress of the World’s Women 2015-2016 notes that while progress has since been made, “in an era of unprecedented global wealth, millions of women are trapped in low paid, poor quality jobs, denied even basic levels of health care, and water and sanitation.”

At the same time, notes the report, financial globalisation, trade liberalisation, the ongoing privatisation of public services and the ever-expanding role of corporate interests in the development process have shifted power relations in ways that undermine the enjoyment of human rights and the building of sustainable livelihoods.

Against this backdrop, all too often women fail to enjoy their rights because they are forced to fit into a ‘man’s world’, a world in which these rights are not at the heart of economies.

What this means in real terms is that, for example, at global level women are paid on average 24 percent less than men, and for women with children the gaps are even wider. Women are clustered into a limited set of under-valued occupations – such as domestic work – and almost half of them are not entitled to the minimum wage.

Even when women succeed in the workplace, they encounter obstacles not generally faced by their male counterparts. For example, in the European Union, 75 percent of women in management and higher professional positions and 61 percent of women in service sector occupations have experienced some form of sexual harassment in the workplace in their lifetimes.

The report makes the link between economic policy-making and human rights, calling for a far-reaching new policy agenda that can transform economies and make women’s rights a reality by moving forward towards “an economy that truly works for women, for the benefit of all.”

The ultimate aim is to create a virtuous cycle through the generation of decent work and gender-responsive social protection and social services, alongside enabling macroeconomic policies that prioritise investment in human beings and the fulfilment of social objectives.

Today, “our public resources are not flowing in the directions where they are most needed: for example, to provide safe water and sanitation, quality health care, and decent child and elderly care services,” says UN Women Executive Director Phumzile Mlambo-Ngcuka. “Where there are no public services, the deficit is borne by women and girls.”

According to Mlambo-Ngcuka, “this is a care penalty that unfairly punishes women for stepping in when the State does not provide resources and it affects billions of women the world over. We need policies that make it possible for both women and men to care for their loved ones without having to forego their own economic security and independence,” she added.

The report agrees that paid work can be a foundation for substantive equality for women, but only when it is compatible with women’s and men’s shared responsibility for unpaid care work; when it gives women enough time for leisure and learning; when it provides earnings that are sufficient to maintain an adequate standard of living; and when women are treated with respect and dignity at work.

Yet, this type of employment remains scarce, and economic policies in all regions are struggling to generate enough decent jobs for those who need them. On top of that, the range of opportunities available to women is limited by pervasive gender stereotypes and discriminatory practices within both households and labour markets. As a result, the vast majority of women still work in insecure, informal employment.

The reality is that women also still carry the burden of unpaid work in the home, which has been aggravated in recent years by austerity policies and cut-backs. To build more equitable and sustainable economies which work for both women and men, warns the report, “more of the same will not do.”

At a time when the global community is defining the Sustainable Development Goals (SDGs) for the post-2015 era, the message from UN Women is that economic and social policies can contribute to the creation of stronger economies, and to more sustainable and more gender-equal societies, provided that they are designed and implemented with women’s rights at their centre.

Edited by Phil Harris    

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Sexual Violence in Conflict “The Contemporary Moral Issue” Says United Nations Fri, 17 Apr 2015 08:54:23 +0000 Valentina Ieri By Valentina Ieri

Impunity for perpetrators of sexual violence in war must end, said Zainab Hawa Bangura, the Special representative of the United Nations Secretary-General on sexual violence in conflict, who presented to the U.N. Security Council the Secretary-General’s 2015 report on the issue on April 15.

Speaking to the Council, Bangura said, “The history of war zone rape has been a history of denial. It is time to bring these crimes, and those who commit them, into the spotlight of international scrutiny.”

Calling on Council member states, Bangura remarked that sexual abuse is used in war as a tool to terrorise, displace victims and establish power, by state and non-state actors, as well as militia rebel groups.

Hamsatu Allamin, from the “Working Group on Women, Peace and Security”, a Nigerian NGO, urged the Council to find concrete solutions.

“Women’s meaningful participation in peace and security processes must be a core component of any effort to effectively reduce and address incidents of conflict-related sexual violence,” she said.

The U.N. report acknowledges for the first time the impacts of the “use of sexual rape as a war tactic upon women, girls, but also men and boys, by extremist armed groups – providing a list of 45 suspected parties – in countries such as Iraq, Mali, Nigeria, Somalia and Syria.”

The study, which analysed the situation in 19 war torn countries in Europe, Africa, Asia, South America and Middle East, described sexual violence as a “truly global crime”, coming in the form of abuse, sexual slavery, forced marriage, and nudity.

Sexual violence is also used as an instrument of discrimination against ethnic and religious minorities, the report noted. It highlighted the risks for LGBT individuals, which are targeted by armed groups which seek to impose social control and “morality”.

In a previous talk at the U.N. earlier in the week, Bangura told the press that including women into the peacebuilding and peacemaking framework would be a strong step forward in offering them the possibility to increase their power and role in conflict societies.

Progress is being made, Bangura explained, as in the past two years the international community has cooperated with the African Union, the International Conference of the Great Lakes Region, and will soon with the League of Arab States. Also a number of regional organizations have appointed envoys on women, peace and security.

Follow Valentina Ieri on Twitter @Valeieri


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Clean Cookstoves Could Change the Lives of Millions in Nepal Wed, 15 Apr 2015 22:28:18 +0000 Mallika Aryal In Nepal almost 22 million people are affected by indoor air pollution. Credit: Mallika Aryal/IPS

In Nepal almost 22 million people are affected by indoor air pollution. Credit: Mallika Aryal/IPS

By Mallika Aryal
PHARPING, Nepal, Apr 15 2015 (IPS)

When 26-year-old Laxmi married into the Archaya household in Chhaimale village, Pharping, south of Nepal’s capital Kathmandu, she didn’t think she would be spending half the day in the kitchen inhaling smoke from the stove.

“The smoke made me cough so much I couldn’t breathe. It was difficult to cook,” the young woman tells IPS.

“[Open] fires and traditional cookstoves and fuels is one of the world's most pressing health and environmental problems.” -- Global Alliance for Clean Cookstoves
At the time, the family was using a rudimentary cookstove, the kind that has been found to be inefficient, unsafe and unhealthy. These stoves release hazardous pollutants such as carbon monoxide, particulate matter and nitrous oxide, cause burns and sometimes disfigurement and put million of people – particularly women – at risk of severe health problems.

The toxic gases are known to create respiratory problems, pneumonia, blindness, heart diseases, cancer and even low birth rates. Every year 4.3 million premature deaths worldwide are attributed to indoor air pollution.

In Nepal almost 22 million people are affected by it.

Six months ago, Laxmi and her father-in-law realised that the women in their neighbourhood, a village of about 4,000 people, were getting their housework done faster and had free time to do other things.

When Laxmi’s father-in-law went to investigate, he found that they were using improved cookstoves and the family immediately decided to upgrade.

“I wanted to install improved cookstoves before, but I didn’t have an idea of how to go about it, or what organisations I could approach to ask for help,” Damodar Acharya, Laxmi’s father-in-law, tells IPS.

Fortunately for the Acharya family, the U.S.-based organisation Global Peace Foundation (GPF) had been working in the village and helping communities build mud-brick clean stoves with locally available materials.

Unlike traditional stoves, clean cookstoves have airtight chambers that prevent smoke from escaping into cramped kitchens. They also have small chimneys through which poisonous exhausts can exit the house.

“The [organisation] took 500 rupees [about five dollars] from us, but they did everything, including mixing raw materials, building the stove and teaching us how to clean them every few weeks,” Damodar Acharya explains.

According to Khila Ghale, of GPF-Nepal, the five-dollar fee includes “the labour charges of the stove master to build the stove, the cost of bricks, three or four types of rods, and the materials that make up the chimney.”

The entire cost of a two-hole mud brick stove ranges between 12 and 15 dollars. There is no government subsidy on improved cookstoves, so organisations like GPF help financially whenever they can.

However, the amount is still too much for most families in Nepal, where more than 75 percent of the population earns less than 1.25 dollars per day.

Ghale, who works directly with communities in raising awareness about the benefits of improved cookstoves, says in order to make them sustainable, it is important to monitor their use, talk to the communities about the benefits and challenges and make them aware that the stoves have to be properly maintained.

“The stove is sustainable but it has to be cleaned [and] repaired properly for long term use. It is unreasonable to expect it to work forever, but if maintained properly, it can be sustainable,” he says.

“If we can make families aware of the benefits, especially about the health benefits for women and children, the stoves [could] become an essential part of the household.”

According to the Global Alliance for Clean Cookstoves, over 80 percent of Nepali people use solid fuels such as wood and cow dung for cooking. In this country of 28 million, over 75 percent of households cook indoors, and 90 percent cook on open fires.

In January 2013 the government of Nepal announced clean cooking solutions for all by 2017. This initiative is in line with the United Nation Foundation’s Global Alliance for Clean Cookstoves project, which aims to adopt clean cooking solutions for 100 million households worldwide by 2020.

The Global Alliance claims, “[Open] fires and traditional cookstoves and fuels is one of the world’s most pressing health and environmental problems.”

Indeed, the World Health Organisation (WHO) has found that the three billion people worldwide who rely on solid fuels and indoor open fires for cooking suffer severe health impacts from the pollution. More men, women and children die each day as a result of exposure to indoor air pollution than die from malaria and tuberculosis.

A few weeks after the Acharya family built their clean cookstove, Laxmi’s neighbour Durga and her husband decided they also wanted one.

Durga Sharma tells IPS, “I have to cook early in the morning because I have two kids who go to school.” Using an improved cookstove has made her life easier, she says, and is keeping her family healthier.

Nepali women like Durga and Laxmi spend over five hours in the kitchen every day. Today, with improved cookstoves their cooking time is cut in half, and they have to use 50 percent less firewood.

In addition, they are much more environmentally-friendly than burning solid fuels.

According to the Intergovernmental Panel on Climate Change (IPCC) black carbon, which traditional cookstoves produce, is the second biggest climate pollutant after carbon dioxide.

The International Centre for Integrated Mountain Development (ICIMOD) Asia says accounts for 40 percent of black carbon, which is responsible for altering monsoon patterns, adversely impacting agriculture and damaging water supplies. Thus, experts say, implementing cleaner cooking solutions for millions of households worldwide will feed automatically into global goals to reduce carbon emissions.

Back in Chhaimale village, around midday, Laxmi and Durga have already finished their housework for the day, and have even had the time to run errands.

Both women want to use the extra time they have to do what they love: Durga hopes to sell sundried vegetables in the local market and Laxmi is thinking about joining evening classes to complete her Masters degree programme, options they would simply not have had before.

Edited by Kanya D’Almeida

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Women Still Struggling to Gain Equal Foothold in Nepal Tue, 07 Apr 2015 17:31:28 +0000 Renu Kshetry A woman remains pensive during a support group meeting for families of missing persons in the south-eastern Nepali town of Biratnagar. Credit: Amantha Perera/IPS

A woman remains pensive during a support group meeting for families of missing persons in the south-eastern Nepali town of Biratnagar. Credit: Amantha Perera/IPS

By Renu Kshetry
KATHMANDU, Apr 7 2015 (IPS)

Kali Sunar, 25, a resident of the Dumpada village in the remote Humla District in Far-West Nepal, lives a life that mirrors millions of her contemporaries.

From the minute she rises early in the morning until she finally rests her head at night, this rural woman’s chief concern is how to meet her family’s basic, daily needs.

"Women leaders have to rise above party lines if they really want to make a difference." -- Usha Kala Rai, a leader of the ruling Communist Party of Nepal (Unified Marxist Leninist)
Her small plot of arable land scarcely produces enough food to feed her family of six for three months out of the year. With few other options open to them, her husband and her brother travel to neighbouring India to work as labourers, like scores of others in this landlocked country of 27.5 million people.

“The money they send is not enough because more than half of it is spent on their travel back and forth,” Sunar tells IPS. “If only I could get some kind of work, it would be a huge relief.”

Roughly 23 million people, accounting for 85 percent of Nepal’s population, live in rural areas. Some 7.4 million of them are women of reproductive age. Many are uneducated – the female literacy rate is 57.4 percent, compared to 75 percent for men – and while this represents progress, experts say that until women in Nepal gain equal footing with their male counterparts, the lives of women like Sunar will remain stuck in a rut.

Nepal has signed a string of international treaties that promise gender parity – but many of these pledges have remained confined to the paper on which they were written.

The Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), which Nepal ratified in 1991, specifies for instance that states parties must take all necessary steps to prevent the exclusion of, or violence towards, women; sadly, this has not been a reality.

According to the Kathmandu-based Violence Against Women (VAW) Hackathon, an initiative to provide support to victims of abuse, gender-based violence is the leading cause of death among Nepali women aged 19 to 44 years – more than war, cancer or car accidents.

The organisation further estimates: “22 percent of women aged 15 to 49 have experienced physical violence at least once since age 15; 43 percent of women have experienced sexual harassment in the workplace; [and] between 5,000 and 12,000 girls and women are trafficked every year.”

Some 75 percent of these girls are under 18; the majority of them are sold into forced prostitution.

Rights activists say that the country also routinely flouts its commitment to eliminate gender discrimination in the workplace, in legal matters, and in numerous other civic, economic and social spheres.

Twenty-five-year-old Kali Sunar barely grows enough on her small plot of arable land to feed her family of six for three months out of the year. Credit: Renu Kshetry/IPS

Twenty-five-year-old Kali Sunar barely grows enough on her small plot of arable land to feed her family of six for three months out of the year. Credit: Renu Kshetry/IPS

Not only international treaties but domestic mechanisms, too, have failed to pull the brakes on sex discrimination and gender-based inequities.

A 2007 Interim Constitution, designed to ease Nepal’s transition from a constitutional monarchy to a federal republic, made provisions for women – as well as for other marginalised groups like Dalits (lower caste communities) Adivasis (indigenous and tribal groups), Madhesis (residents of the southern plains) and poor farmers and labourers – to be active political participants based on the principle of proportional inclusive representation.

These were all steps in the right direction, bolstered by the 2008 election of the Constituent Assembly (CA), which saw women occupying 33 percent of all seats in the 601-member parliament.

However, that number fell to 30 percent in the second election, held in 2013, the first after the CA failed to draft a new constitution. With only 11.53 percent of women in the cabinet, experts say there is an urgent need to increase the number of women at the decision-making level.

According to a monitoring report by the non-governmental organisation Saathi, which tracked progress on United Nations Security Council Resolution 1325 (UNSCR 1325) relating to women, peace and security, women’s participation in Nepal’s judiciary stands at an average of 2.3 percent, with 5.6 percent of women in the Supreme Court, 3.7 percent in the appellate courts, none in the special courts and 0.89 in the district courts.

Women’s representation in security agencies is even more worrisome, according to a 2012 study entitled ‘Changes in Nepalese Civil Services after the Adoption of Inclusive Policy and Reform Measures’: there are only 1.6 percent women in Nepal’s army, 3.7 percent in the armed police force and 5.7 percent in the regular police force.

Dismal numbers of female civil servants across a broad spectrum of service groups also spell trouble: women account for just 9.3 percent of civil servants in the education sector, 4.4 percent in the economic planning and statistics division, 4.9 percent in agricultural affairs, 2.2 percent in engineering and two percent in forestry.

Only in the health sector do women come anywhere close to their male counterparts, with 4,887 out of 13,936 positions, roughly 36 percent, occupied by women.

Still, even this number is low, considering the health indicators for women that could be improved by boosting women’s representation at higher levels of politics and government: according to the World Health Organisation (WHO), Nepal has a maternal mortality ratio (MMR) of 190 deaths per 100,000 live births. Only 15 percent of Nepali women have access to healthcare facilities.

Data from Nepal’s Central Bureau of Statistics (CBS) indicate that only 19.71 percent of all families exercise female ownership of land or housing, another reason why women continue to languish on the lowest rung of the social ladder with little ability to exercise their own independence.

Although Nepal’s female labour force participation rate is higher than many of its South Asian neighbours – 80 percent, compared to 36 percent in Bangladesh, 27 percent in India, 32 percent in Sri Lanka and 24 percent in Pakistan, according to the International Labour Oragnisation (ILO) – working women are burdened by social attitudes, which dictate that women undertake domestic labour as well as their other jobs.

“This makes it difficult for women to perform [in their chosen field] and have an impact,” explains Mahalaxmi Aryal, a member of the CA from the Nepali Congress.

Usha Kala Rai, a prominent women’s rights activist and politician, admits that the country has many legal grounds on which to address women’s issues, but says they are seldom utilised to their best effect.

“We completely lack the political will and the commitment to implement these legal provisions,” says Rai, a former member of the Constituent Assembly and leader of the ruling Communist Party of Nepal (Unified Marxist Leninist).

She calls for increased numbers of women in decision-making roles, but acknowledges that those who make it to the top generally come from the elite class, with the added privilege of having received a good education – thus they are not necessarily representative of women across the socio-economic spectrum.

She tells IPS she favours a system of proportional representation for all state bodies on the basis of the female share of Nepal’s population – 52 percent.

“Women leaders have to rise above party lines if they really want to make a difference,” she explains, citing the creation of the 2008 Women’s Caucus, comprised of all 197 women in the Constituent Assembly representing every major political party, to stand together for women’s rights irrespective of ideology.

However, pressure from male leaders meant that the second Constituent Assembly was unable to revive the Caucus, with the result that women no longer have a unified platform on which to voice their collective demands.

“Women politicians have been handpicked by their parties under the proportional representation (PR) [system], which makes them vulnerable to partisan politics,” political science professor Mukta Singh Lama tells IPS.

Until such a system is replaced with one that prioritises genuine inclusion of women at every level of the state, experts fear that Nepal’s women will not have an equal hand in the shaping of this country.

Edited by Kanya D’Almeida

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Curbing Tobacco Use – One Step Forward, Two Steps Back Thu, 02 Apr 2015 04:30:13 +0000 Diana Mendoza According to the World Health Organisation (WHO), there will be between 1.5 and 1.9 billion smokers worldwide in 2025. Credit: Marius Mellebye/CC-BY-2.0

According to the World Health Organisation (WHO), there will be between 1.5 and 1.9 billion smokers worldwide in 2025. Credit: Marius Mellebye/CC-BY-2.0

By Diana Mendoza
ABU DHABI, Apr 2 2015 (IPS)

The numbers are in, and there’s not much to celebrate: every year, about six million people die as a result of tobacco use, including 600,000 who succumb to the effects of second-hand smoke.

Whether consumed by smoking or through other means, tobacco is a deadly business, and while usage statistics vary drastically across countries, time periods and age-groups, one thing is plain to policy makers all over the world: tobacco is going to be a huge development challenge in the coming decade.

“In tobacco and smoking, we see death and disease. The tobacco industry sees a marketplace." -- Matthew Myers, president of the Campaign for Tobacco-Free Kids
According to the World Health Organisation (WHO), “Tobacco is the only legal drug that kills many of its users when used exactly as intended by manufacturers.” Smoking in particular, and other forms of tobacco use to a lesser degree, has been found to increase the risk of non-communicable diseases (NCDs), including chronic respiratory conditions, cardiovascular illnesses, and cancers of all stripes.

Already the global burden of NCDs is tremendous, accounting for the most number of deaths worldwide. Some 36 million die annually from NCDs, representing 63 percent of global deaths. Of these, more than 14 million people die prematurely, before the age of 70.

In a bid to stem this rampant loss of life, governments all over the world have signed numerous treaties and protocols, including the WHO Framework Convention on Tobacco Control (FCTC), which presently boasts 180 states parties covering 90 percent of the world’s population.

One of the convention’s goals is to achieve a 30-percent reduction in tobacco use among people aged 15 years and older by 2025.

By some calculations, the international community is moving slowly but surely towards this target. For instance, a new WHO study released last month found that in 2010 there were 3.9 billion non-smokers aged 15 years and over in WHO member states (or 78 percent of the population of 5.1 billion people over the age of 15).

The number of non-smokers is projected to rise to five billion (or 81 percent of the projected population of 6.1 billion people aged 15 and up) by 2025 if the current pace of tobacco cessation continues, the report said.

According to a study published last month by the UK-based medical journal, The Lancet, the prevalence of tobacco smoking among men fell in 125 out of 173 countries surveyed, and the smoking rate among women fell in 156 countries out of 178, in the 2000-2010 period.

But while these trends are positive, a closer look at the data shows that at current levels of progress, only 37 countries worldwide, or just 21 percent of all member states, stand ready to meet the Global Action Plan for the Prevention and Control of NCDs 2013-2020.

In fact, according to the WHO, there will be between 1.5 and 1.9 billion smokers worldwide in 2025, representing a potential health crisis of severe proportions.

Catching them young – killing them young?

Last month some 3,000 tobacco control advocates closed the 16th World Conference on Tobacco or Health (WCOTH) here in Abu Dhabi, capital of the United Arab Emirates (UAE), with appeals to world leaders to crack down on the tobacco industry’s campaign to lure young people into the habit.

Among other demands, activists and experts pressed governments to enforce bans on massive advertising campaigns, which many see as a gateway to what could become a lifetime of smoking.

In 2008, the WHO reported that 30 percent of young teens worldwide aged 13 to 16 smoke cigarettes, with between 80,000 and 100,000 children taking up the habit each day.

The organisation estimates that half of those who start smoking in their adolescent years will continue smoking for the next 15 to 20 years of their life, lending credibility to the widely held fear that when tobacco use starts young, life might also end young.

From the music and fashion industries to food and sports, the multi-billion-dollar tobacco industry is finding marketing and advertising opportunities to attract scores of potential young consumers, since their curiosity and tendency to experiment have long marked them as a key ‘target’ group.

“In tobacco and smoking, we see death and disease. The tobacco industry sees a marketplace,” said Matthew Myers, president of the Campaign for Tobacco-Free Kids, a leading US-based tobacco control campaign organisation.

In a statement released back in January, Myers alleged, “The tobacco industry spends 8.8 billion dollars a year – one million dollars an hour – on marketing, much of it in ways that make these products appealing and accessible to children.”

“They also use all means – legal and illegal – to sell their deadly products, deceive the public and policy makers by attempting to appear credible and trustworthy, and use lawyers, lobbyists, and public relations firms to undermine good government and the will of the people,” Myers said during the WCOTH last month.

From rock concerts to sporting events and from cafes to nightclubs, where young people of a higher income bracket typically socialise, cigarettes are readily available, making it difficult to avoid the pull of peer pressure.

Experts say young women, especially those who are economically independent, also fall into the category of an emerging market for the tobacco industry, as they seek fresh outlets for expressing their newfound freedom.

Myers cited Russia, where 25 percent of young women between 18 and 30 years old have taken up the habit, and China, where the equating of cigarette smoking with high fashion is evident in the country’s major cities like Beijing and Shanghai.

Neither Russia nor China is expected to meet the smoking component of the global NCD target by 2025.

Although Russia could witness a decrease in the number of smokers from 46.9 million in 2010 to 36.6 million in 2025, and China is slated to slash its smokers from 303.9 million in 2010 to 291 million in 2025, the rate of decrease in both countries is too low.

The situation is particularly dire in China, where an estimated 740 million suffer from exposure to second-hand smoke. The WHO estimates that 1.3 million die here each year from lung cancer, accounting for one-third of lung cancer-related deaths globally.

Judith Mackay, senior adviser of the World Lung Foundation, said Asian women in particular are being targeted by the industry because of the number of developing countries and fast-growing economies in the region with large young female populations.

“For developing countries in this region, the style of advertising in the 50s has come back – portraying smoking among young women as cool and sexy,” she said during a press conference in Abu Dhabi.

A 2010 report by the George Institute of Global Health stated that Asia and the Pacific were home to 30 percent of all smokers in the world, with India and China contributing hugely to these numbers.

In a bid to help member countries meet the smoking component of the NCD target, the WHO introduced a set of measures called MPOWER, encapsulating efforts to monitor tobacco use, protect people from tobacco smoke, offer help to those seeking to quit the habit, warn about the dangers of tobacco use, enforce bans on advertising, promotion and sponsorship, and raise taxes on tobacco products.

Such measures will not be easily implemented but as WHO Director-General Margaret Chan pointed out, “It’s going to be a tough fight but we should not give up until […] the tobacco industry goes out of business.”

Edited by Kanya D’Almeida

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Lesbians Receiving Unequal Treatment from Cuban Health Services Wed, 01 Apr 2015 07:41:50 +0000 Ivet Gonzalez Two women hugging at a Day Against Homophobia in Havana organised by the lesbian, gay, bisexual and transsexual (LGBT) community. Credit: Jorge Luis Baños/IPS

Two women hugging at a Day Against Homophobia in Havana organised by the lesbian, gay, bisexual and transsexual (LGBT) community. Credit: Jorge Luis Baños/IPS

By Ivet González
HAVANA, Apr 1 2015 (IPS)

In addition to other forms of discrimination, lesbian and bisexual women in Cuba face unequal treatment from public health services. Their specific sexual and reproductive health needs are ignored, and they are invisible in prevention and treatment campaigns for women.

Many lesbian and bisexual women are afraid of gynaecological instruments and procedures which they experience as particularly distasteful given their sexual orientation. Many are unaware of their risks of contracting sexually transmitted infections (STI) and postpone attending gynaecology appointments in order to avoid questions about their love life, activists and health experts told IPS.

Dayanis Tamayo, a 36-year-old education specialist who lives in Santiago de Cuba, 862 kilometres from Havana, feels that health professionals are judgmental when they discover that her partner is a woman. They make lesbophobic comments and give her disapproving looks.

“Sometimes I get by unnoticed because I don’t fit the stereotype of a butch lesbian, but otherwise I always feel judged,” said Tamayo, who is engaged in research at Universidad de Oriente.

Recent studies back up Tamayo’s statement, pointing to prejudice against lesbian and bisexual women among the country’s health personnel, and ignorance about their particular sexual health needs.

Cuban psychiatrist Ada Alfonso presented a report on “Salud, malestares y derechos sexuales de las lesbianas” (Lesbians’ sexual health, illnesses and rights) at the 2014 Cuban Day Against Homophobia. She said that when they go to see the doctor, these women are asked more about their sexual experiences than about their reason for seeking treatment.

“If we look at women’s health through the lenses of inequality, the gap between lesbians and heterosexuals in regard to health services has a lesbophobic subtext hidden behind the discourse on ‘social needs’,” said Alfonso, an expert with the National Centre for Sex Education (CENESEX).

In her view, social pressure on women who are not heterosexual, amounting to homophobia, causes various forms of psychological and sexual malaise.

Alfonso interviewed women in several of the island’s provinces. She found that ethical deficiencies in the system are leading women to postpone clinical tests until they can see a doctor who has been recommended, or a health professional sharing their own sexual orientation.

The women are particularly averse to gynaecological tests because of the instruments used and invasive procedures such as pelvic and vaginal examinations.

Gynaecology outpatient consultations total 925,549 a year, for a population of 4.7 million women aged over 15, according to the National Office of Statistics.

Personnel working in preventive screening services for cervical and uterine cancer told Alfonso that lesbian women tend to come forward for testing too late for any therapeutic action to be taken.

“We generally think that since we do not have sex with men, we are exempt from those risks, because the information campaigns in the media only portray heterosexual couples,” an accountant resident in the Diez de Octubre neighbourhood of Havana told IPS, requesting anonymity.

The 39-year-old accountant, who works in the state sector, has never had a Papanicolau (Pap) test, which involves collecting cells from the uterine cervix and checking them for abnormalities. The Pap test is recommended for women aged over 25 to prevent cervical and uterine cancer and in Cuba it is offered free to women every three years.

“Although I do know that it is important, I find it psychologically difficult to face this test because I feel so exposed, assaulted even, and I personally do not like penetration,” she said.

All Cubans enjoy health coverage by a local family clinic, which is responsible for reminding women when it is time for their next Pap test. However, many women put it off.

In 2013, a total of 765,822 Cuban women aged over 25 had a Pap test done, a take-up rate of 195.8 per 1,000 according to the most recent figures from the Cuban Annual Health Statistics.

All treatment in the Cuban health system is free of charge and is delivered without institutionalised discrimination. But prejudice against non heterosexual people continues to grow.

“Health personnel are part of society, and society rejects lesbians,” José Martínez, a medical doctor in the eastern province of Granma, told IPS.

According to Martínez, medical training in Cuba is too narrowly focused on a biological approach and makes hardly any reference to psychosocial determinants of health.

“When a lesbian woman goes to see a gynaecologist, the doctor will probably assume that she is at lower risk (of cervical or uterine cancer) because penetration is not involved in her relationship, because this is what they have been taught,” Martínez said.

Yenis Milanés, who has a degree in hygiene and epidemiology, told IPS that “medical students are not required to take a single course on sexuality” during their training.

Women who have intimate relations with women tend to have a low perception of their own risk, and seldom take protective measures during sex, Milanés and Martínez said.

They both collaborated in a 2013 study of 30 lesbian and bisexual women in the province of Granma, which found these women thought they were unlikely to acquire sexually transmitted infections.

Another study in 2014 by Martínez and Milanés confirmed that sexual and reproductive health programmes in Cuba generally do not include information about the risks of contracting STI and HIV/AIDS that specifically addresses lesbian women’s issues.

Lesbians receive less information about STI prevention than other population groups and they have fewer welcoming institutional spaces where they can socialise and discuss their problems, said the report, to which IPS had access.

The research study debunks the myth that engaging in lesbian sex avoids all infection risks, although these are indeed much lower than for other sexual behaviours.

Depending on the sexual practices of a same-sex lesbian couple, unprotected contact with exchange of vaginal secretions and menstrual blood can lead to infection with the HIV/AIDS and Herpes simplex viruses, bacterial vaginosis, gonorrhoea, syphilis, vaginal parasites and other diseases.

Women represented 18.5 percent of the 2,156 new HIV-positive cases diagnosed in Cuba in 2013, bringing the total number of people living with the virus to 16,400, according to the Ministry of Public Health.

Training health professionals to be sensitive to sexual diversity has been a long-established demand by groups of lesbian women supported by CENESEX in the provinces of Camagüey, Ciego de Ávila, Cienfuegos, Granma, La Habana, Santiago de Cuba, Trinidad and Villa Clara.

Through community activism, these groups are struggling for their rights to responsible enjoyment of sexual health, including equality of treatment in the health services and access to assisted reproduction technology.

Editado por Estrella Gutiérrez/Translated by Valerie Dee

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Opinion: Education as a Cornerstone for Women’s Empowerment Wed, 25 Mar 2015 22:32:24 +0000 Dr. Kirsten Stoebenau Girls who report that their domestic chores interfere with their schooling are three times more likely to drop out. Credit: Zofeen Ebrahim/IPS

Girls who report that their domestic chores interfere with their schooling are three times more likely to drop out. Credit: Zofeen Ebrahim/IPS

By Dr. Kirsten Stoebenau
WASHINGTON, Mar 25 2015 (IPS)

Earlier this month, the Barack Obama administration announced a new initiative designed to improve girls’ education around the world. Dubbed “Let Girls Learn,” the programme builds on current progress made, such as ensuring girls are enrolled in primary school at the same rates as boys, and is looking to expand opportunities for girls to complete their education.

The Obama administration’s leadership on this issue is commendable and incredibly important for moving global momentum on girls’ education forward.Without transforming gender norms that hold too many girls back and holding schools accountable for ensuring girls stay in school and can return to school, girls - and indeed entire communities - will be deprived of future leaders.

We know that keeping girls in school and providing them with a quality education that can prepare them for their future continues to pay dividends down the line, including better health outcomes and better financial stability for girls themselves, and also for their families and communities.

Research shows that girls with secondary school education are six times less likely to marry early compared to girls who have very little or no education. Additionally, each extra year of a mother’s education reduces the probability of infant mortality by as much as 10 per cent and each extra year of secondary schooling can increase a girl’s future earnings by 10 to 20 per cent.

But around the world, far too many girls face insurmountable barriers that often cause girls to drop out of school, ultimately preventing them from getting the quality education they deserve.

Recently, the International Center for Research on Women (ICRW) conducted research to assess the main causes of school drop out for girls in two districts of the West Nile sub-region of Uganda where only six girls for every ten boys are enrolled in secondary school, a ratio far below the national average.

A predominantly rural and impoverished region, West Nile, Uganda’s recent past has been characterized by war and conflict.

As such, poverty plays a huge role in girls’ inability to continue school. Of the girls who dropped out of school nearly 50 per cent listed financial reasons as the main reason they dropped out of school. Pregnancy was the second most common reason girls gave for leaving school.

While these factors are indeed eye-opening, our research found, however, that gender norms and beliefs about the roles of women as compared to men, were among the most significant determinants of school dropout for girls in West Nile.

Traditionally in West Nile, girls were taught to be subservient to the men to whom they ‘belonged’, first to their fathers and then later in life to their husbands. Despite significant social change that has taken place over the past number of decades,  deeply-rooted gender norms and expectations are carried from one generation to the next and have a profound impact on girls’ and their families’ expectations and hopes for girls futures, and girls’ determination and ability to finish – or drop out of –school.

For example, while most parents surveyed said they value girls’ and boys’ schooling equally, they acknowledge burdens at home, like chores and housework, fall on the girls in the family, rather than the boys. Consequently, girls who reported their domestic chores had interfered with their schooling in the past were three times more likely to drop out.

The domestic sphere remains solely a woman’s domain in the West Nile, and in the face of high adult mortality due to poverty, war, and HIV, girls who lost a parent were even more likely to have to take on a high household chore burden. This set of burdens often includes caring for younger siblings, which likely contributes to girls in the study reporting only starting school on average at the age of 8.25 years, more than two years past the intended starting age of six.

For girls who become pregnant while in school, dropout is almost inevitable. Only 4 per cent of girls who reported they had ever been pregnant were still enrolled in school. Pregnancy is often followed by a forced marriage and the accompanying expectation that a girl’s responsibilities should now shift from her education to caring for her child.

These data highlight just how many barriers girls face in continuing their education, with so many of those barriers finding deep roots in cultural norms that simply don’t value girls the way they value boys. And while this study was conducted in the West Nile region of Uganda, gender norms that continue to hold girls back are certainly not rare around the world.

In order to succeed in letting girls learn, governments, schools, communities and families must dismantle barriers for girls where they exist. Local governments and communities must ensure girls get off to a good start with their education, by disseminating information about existing policies for the age at start of school, because we know that when girls are enrolled in school on time and progress through each grade on schedule, they’re more likely to continue their education.

The education and health sectors must also work with local governments to introduce comprehensive sexuality education in schools to improve knowledge of and access to reproductive health services to help prevent pregnancy, which currently marks the end of a girl’s education in Uganda.

Additionally, we know that eight of ten girls who dropped out of school in West Nile, Uganda are eager to return to school if given the opportunity, but for the girls who dropped out due to pregnancy this is a near impossibility.

Re-entry and retention policies for pregnant girls and mothers who gave birth as children must be strengthened so that these girls do not miss out on the opportunity to break an intergenerational cycle of poverty, which is all the more likely for an adolescent single mother without a secondary education.

Education is, simply put, a cornerstone for women’s empowerment and subsequently for local and national development.

Without transforming gender norms that hold too many girls back and holding schools accountable for ensuring girls stay in school and can return to school, girls – and indeed entire communities – will be deprived of future leaders that could be instrumental in helping to combat poverty in the community, which could empower more girls for generations to come.

Edited by Kitty Stapp

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CSW 59 Wraps up as Delegates Look Towards 2016 Mon, 23 Mar 2015 15:50:34 +0000 Josh Butler UN Women Executive Director Phumzile Mlambo-Ngcuka speaks at the Commission on the Status of Women, which ended its 59th session in New York last week. Credit: UN Women/Ryan Brown

UN Women Executive Director Phumzile Mlambo-Ngcuka speaks at the Commission on the Status of Women, which ended its 59th session in New York last week. Credit: UN Women/Ryan Brown

By Josh Butler

The Commission on the Status of Women, one of the biggest events on the calendar for United Nations headquarters in New York City, is over for another year.

For two weeks, thousands of delegates, dignitaries, ambassadors, experts, and activists flooded the city, with more than 650 events, talks, briefings, meetings, presentations and panels all striving for the same goal – “50:50 by 2030,” said Secretary-General Ban Ki-moon of the CSW’s goal for gender equality within 15 years, at the official opening of the commission.

Soon-Young Yoon, U.N. Representative of the International Alliance of Women and Chair of the NGO Committee on the Status of Women, estimated more than 11,000 people took part in CSW 59.

“This was the largest feminist movement at the U.N. in New York, ever,” she told IPS.

“It was more than double the number we usually get.”

Yoon attributed the huge attendance to well-documented attempts to scale back women’s rights worldwide in the last year, including fundamentalist activities in the Middle East and Africa, the kidnapping of 270 Nigerian schoolgirls by Boko Haram, and a growing culture of hostility and harassment of women online.

“Against all this, the women’s movement has stepped up. The CSW is a pilgrimage for the international women’s movement,” she said.

The 59th session of the CSW was about reaffirming the world’s commitment to, and marking the anniversaries of, the 1995 Beijing Platform for Action and the 2000 Security Council Resolution 1325.

Rather than lay out any new bold agenda or fighting for political reforms, it was important to take stock of progress and assess what further action was necessary, said Christine Brautigam, Director of the Intergovernmental Support Division of U.N. Women.

“We were tasked with a comprehensive review of the Beijing platform, of how implementation stands. We’ve come up with good indications of how to move forward,” Brautigam told IPS on the final day of the meeting.

She said the Commission had “benefited tremendously” from an “unprecedented” amount of reporting by member states, with 167 countries preparing reports on how gender equality reforms had been implemented. Brautigam said through the immense preparatory work, member states had agreed CSW 59 would produce a “short, succinct political declaration” reaffirming the commitment to fulfilling the vision of the Beijing platform and achieving gender equality by 2030."I’ve always seen CSW as one of the most, if not the most, dynamic meetings on the U.N. calendar." - Liesl Gerntholtz, Women’s Rights Division at Human Rights Watch

There was not an expectation for lengthy negotiations, as we usually have, it was to pledge further action to accelerate gender equality, and ensure full implementation of the platform. The key outcome is that political outcome adopted on the first day,” she said.

The declaration features six points for action, calling for renewed focus on and faster progress toward the ideals set out in the Beijing platform. Member states called for strengthened laws and policies, greater support for institutional mechanisms striving for gender equality, transformation of discriminatory norms and gender stereotypes, greater investment to close resource gaps, strengthened accountability for the implementation of commitments; and enhanced capacity for data collection, monitoring and evaluation.

“This is a formidable basis for everyone, from governments to the U.N. system to civil society, to take action,” Brautigam said.

While reaffirming past commitments and analysing progress was the official aim of CSW, it was far from the only function of the fortnight of feminism. Liesl Gerntholtz, Executive Director of the Women’s Rights Division at Human Rights Watch, said the annual CSW has become an important meeting place for the sharing of ideas, energy and inspiration for women around the globe.

“The value of the CSW has shifted from negotiations and outcome documents, to being a space for civil society to engage with member states and with each other. There are fewer and fewer spaces where civil society can come together, and in this one place hordes of women’s rights organisations can come together and talk,” she told IPS.

“Networking is critical, and it has become the most valuable part of the conference. It’s a chance for the movement to meet and strategise, to make stronger alliances, and have very rich and interesting discussions about what the issues are.”

Gerntholtz said the inclusive nature of the CSW – where activists can mingle with ambassadors, where politicians share panels with academics and celebrities – fostered cross-pollination of ideas, and the sharing of concerns between social strata.

“I’ve been fascinated to watch people talking about forms of harassment we haven’t talked about before, like cyber harassment, women threatened with sexual violence on social media,” she said.

Brautigam echoed the sentiments, saying one of CSW’s most formidable strengths was as a meeting place for sharing of ideas.

“I’ve always seen CSW as one of the most, if not the most, dynamic meetings on the U.N. calendar. It is a prime marketplace of ideas and lessons learnt, for solidarity, and drawing strength for the work for the coming year. People get together, brainstorm and energise each other,” she said.

However, for all the energy, enthusiasm and excitement during the mammoth program, there are also criticisms. Gerntholtz said recent years have seen some member states hoping to roll back progress already carved out, to undo achievements made, and to break pledges for future reform.

“There have been concerns for a while over the value of CSW. There have been some attempts in recent years to push back on language in the Beijing platform, particularly on violence against women and reproductive rights,” she said.

“That remains a huge concern for this forum – every year, it opens up the possibility member states might try to undermine and dilute and change some of these really important rights women have fought to establish.”

Gerntholtz said 2014 saw such a push by representatives from Iran, Egypt, Vatican City and several African nations – a group she called “the Unholy Alliance.”

“In any other circumstances, they wouldn’t be talking to each other, but they caucus to dilute important women’s rights,” she said.

The CSW was also criticised from civil society groups. Ahead of the CSW, the Women’s Rights Caucus labelled the proposed political declaration as “a bland reaffirmation of existing commitments,” saying it “threatens a major step backward” for rights and equality.

“Governments cannot pick and choose when to respect, protect and fulfil the human rights of women and should not do so in this declaration,” it wrote in a statement.

On Friday, the CSW wrapped up after two weeks of meetings. UN Women Executive Director Phumzile Mlambo-Ngcuka called CSW 59 “a forceful, dynamic and forward-looking session.”

“We are all aware that there are no shortcuts to realising gender equality, the empowerment of women and the human rights of women and girls. Based on the road we have travelled, we know that there are more challenges ahead of us,” she said in remarks at the closing of CSW 59, where Brazil was elected Chair of the 60th session.

Already plans for action are being set out for next year’s session. Brautigam said gender equality through the lens of sustainable development would be the theme, with three major global conferences – the Conference on Financing for Development in Addis Abada, negotiations on the post-2015 development agenda and Sustainable Development Goals, and the Climate Change Conference in Paris – to shape, and be shaped by, the women’s rights movement.

“The priority next year is women’s empowerment and the link to sustainable development. Between now and then, many important milestones will be met. We’re trying to ensure gender equality will be at the core of those discussions,” she said.

Yoon also stressed how the outcomes of the three major conferences would influence the next CSW.

“The priority of sustainable development is very important, because gender equality is missing to some extent in the discussions around climate change and sustainability,” she said.

Yoon said CSW 60 would likely have much more substantive, concrete outcomes and action plans than this year’s conference, and hoped 2016 would tackle issues of violence against women.

“The CSW will decide its whole multi-year program of work, for the next four years. We need to stay focused on violence against women in its broader definition,” she said.

“Not just domestic violence, but things like sexual harassment, campus safety and sexual violence on campuses, and online safety. It is inexcusable we have not been able to put all our resources to fix this.”

“We are rescuing victims, chasing perpetrators, but not preventing these things from happening. We simply must do this, otherwise all that we want to accomplish will fall apart, because women are terrified to speak out.”

With the thousands of delegates, dignitaries, ambassadors, experts, and activists now heading home after an exhausting fortnight, the focus will be on implementing the ideas and actions inspired by the conference.

“I hope people can go home with renewed energy, that people can refine their strategies for holding governments accountable, and that they learnt a lot,” Gerntholtz said.

Follow Josh Butler on Twitter: @JoshButler

Edited by Roger Hamilton-Martin

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Palestinian Women Victims on Many Fronts Sat, 21 Mar 2015 10:17:44 +0000 Mel Frykberg Islam Iliwa lost her home and cleaning products business in Gaza following an Israeli bombardment. She is one of many single, divorced mothers struggling to survive under the siege. Credit: Mel Frykberg/IPS

Islam Iliwa lost her home and cleaning products business in Gaza following an Israeli bombardment. She is one of many single, divorced mothers struggling to survive under the siege. Credit: Mel Frykberg/IPS

By Mel Frykberg
GAZA CITY, Mar 21 2015 (IPS)

Israel’s siege of Gaza, aided and abetted by the Egyptians in the south, has aggravated the plight of Gazan women, and the Jewish state’s devastating military assault on the coastal territory over July and August 2014 exacerbated the situation.

In a resolution approved by the U.N. Commission on the Status of Women on Mar. 20, Israel’s ongoing occupation of Palestinian territory was blamed for “the grave situation of Palestinian women.”

The 45-member commission adopted the resolution – which was sponsored by Palestine and South Africa – by a vote of 27-2 with 13 abstentions. The United States and Israel voted against, while European Union members abstained.The collective suffering of Palestinian women extends beyond death and injury, with forcible displacement and surviving in overcrowded shelters with inadequate facilities, including inadequate clean drinking water and food, lack of privacy and hygiene issues.

“Women’s suffering doubled in the Gaza Strip in particular due to the consequences of Israel’s latest offensive, as they have been enduring hard and complicated living conditions,” said Gaza’s Palestinian Centre for Human Rights (PCHR) in a statement released on Mar. 8 to mark International Women’s Day.

“During the 50-day Israeli offensive, women were exposed to the risks of death or injury because of Israel’s excessive use of lethal force as well as Israel’s blatant violations of the principles of distinction and proportionality under customary international humanitarian law,” said PCHR.

During the war, 293 women were killed (18 percent of the civilian victims) and 2,114 wounded, with many sustaining permanent disabilities.

However, inherent cultural, religious and legal implications have also played a part in making life untenable for Gaza’s female population.

The world of 40-year-old Islam Iliwa from Zeitoun in Gaza City was shattered during a night of heavy bombardment last year during the war.

The divorced mother of three children, aged 10 to 16, lost nearly everything when an Israeli air strike destroyed her home and with it the business that she had worked so hard for years to build up.

Iliwa had been living in Dubai when she and her husband divorced, a move that makes it particularly hard for women to reintegrate into conservative Arab society.

The divorce was traumatic but Iliwa was determined to make a go of her life and moved back to Gaza in 2011 with the money she had saved up while working in Dubai.

Under Islamic law, the father would have been given automatic custody of their three children at their respective ages.

However, Iliwa decided she would pay her husband to sign custody of the children over to her as well as forfeit her rights to child support.

“I told him I would survive without him and make a good life for myself and my children,” Iliwa told IPS.

“On arriving back in Gaza, I poured my life savings of 20,000 dollars into a small business which sold cleaning materials,” she said.

“In a good month before the war I was able to earn about 2,400 dollars and my business was growing. However, my home and the little factory I built were both destroyed during the Israeli bombing attack. My son Muhammad was also injured,” recalled Iliwa, as she broke down and wept at the bitter memory.

Iliwa and her three children were forced to flee to a U.N. shelter, along with hundreds of thousands of other desperate Gazans.

When it was safe to leave the shelter, after a ceasefire had been reached, Iliwa and her children were destitute and homeless.

However, the plucky mother of three has been able to rent a new home and slowly rebuild her business with the help of Oxfam, even though she is now making a fraction of what she used to.

The collective suffering of Palestinian women extends beyond death and injury, with forcible displacement and surviving in overcrowded shelters with inadequate facilities, including inadequate clean drinking water and food, lack of privacy and hygiene issues.

A rise in domestic violence has aggravated the situation with women having little recourse to societal or legal support with many Palestinians believing that this is a private matter between spouses.

Under Palestinian law, the few men that are arrested for “honour killings” receive little jail time and women beaten by husbands would have to be hospitalised for at least 10 days before police would consider intervening.

According to PCHR’s documentation, 16 women were killed last year in different contexts related to gender-based violence.

Last year, U.N. Women in Palestine released a statement saying that they it was “seriously concerned” about the killings, highlighting that the “worrying increase in the rate of femicide demonstrated a widespread sense of impunity in killing women”.

A 2012 survey by the Palestinian Central Bureau of Statistics (PCBS) said that 37 percent of Palestinian women were subject to some form of violence at the hands of their husbands, with the highest rate in Gaza at 58.1 percent and the lowest in Ramallah at 14.1 percent.

Gaza’s Palestinian Centre for Democracy and Conflict Resolution (PCDCR) explained that the difficult economic circumstances, poverty and unemployment, were the reasons behind the spike in domestic violence.

“These factors reflect negatively on men’s psychological status. They became more stressed and angry as they can’t support their families financially, live in crowded conditions and have no privacy,” PCDCR told IPS.

“There has also been a reversal in gender roles where women accept low-paying jobs which men consider below their status as the head of families or single women/widows are forced to take on the breadwinner role.

“This has all fed into men’s feelings of inadequacy and to them taking their frustrations out on their female relatives,” PCDCR told IPS.

Edited by Phil Harris    

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Women in the Philippines at the Forefront of the Health Food Movement Fri, 20 Mar 2015 04:25:47 +0000 Diana Mendoza In the Philippines, 22 percent of children under the age of five are underweight, and 32 percent of children are stunted. Credit: Kara Santos/IPS

In the Philippines, 22 percent of children under the age of five are underweight, and 32 percent of children are stunted. Credit: Kara Santos/IPS

By Diana Mendoza
MANILA, Mar 20 2015 (IPS)

When Tinay Alterado’s team from ARUGAAN, an organisation of women healthcare advocates, visited Eastern Visayas, a region of the Philippines devastated by Typhoon Haiyan in November 2013, they noticed that the relief and rescue sites were flooded with donated milk formula, which nursing mothers were feeding to their babies in vast quantities.

Milk formula was one of the hundreds of relief items that streamed into the affected region in the aftermath of the strongest recorded storm to ever hit land.

“No one knows if GMOs are safe to eat, but there is mounting evidence that they pose dangers to human health." -- Angelina Galang, head of Consumer Rights for Safe Food (CRSF)
“We intervened because we knew from what we saw that we had to teach women how to breastfeed and how important it is for them, their babies and their families,” Alterado told IPS.

ARUGAAN, which in Filipino means to nurture or take care of someone, is a home centre organised by mostly poor, urban working mothers who care for babies up to three-and-a-half months old and advocate for healthy lifestyles, especially exclusive breastfeeding.

“We informed the women that they can and must breastfeed, and it should be for [up to] six months or even longer,” Alterado said.

Her group’s emergency response in the typhoon-affected areas took more time than planned, as they had to teach women how to induce milk from their breasts through a process called ‘lactation massage’ and how to store the milk for their babies’ next meal.

Alterado said her colleagues have doubled their efforts to spread awareness on this crucial aspect of motherhood, which is not ingrained in the country’s culture. Few people connect the act of breastfeeding with its associated economic and environmental benefits, such as reducing trash or easing a family’s financial woes.

In a country where 22 percent of children under the age of five are underweight, and 32 percent of children are stunted, women’s role in fighting hunger and malnutrition cannot be underestimated.

According to the United Nations Children’s Fund (UNICEF), “An overreliance on rice, low levels of breastfeeding and […] recurring natural hazards, connected to and amplified by […] poverty, means that children do not eat enough” in this archipelago nation of just over 100 million people.

The U.N. Food and Agriculture Organisation (FAO) estimates that the Philippines is devastated by an average of 20 typhoons every year that severely damage crops and farmlands, adding another layer to the thorny question of how to solve the country’s food issues.

Last year, the Philippines joined a list of some 63 developing countries to meet the Millennium Development Goal (MDG) target of halving the number of hungry people ahead of the 2015 deadline. Still, the country has one of the highest malnutrition rates in the world, contributing to Asia-Pacific’s dubious distinction of being home to 553 million malnourished people as of 2014.

As government officials and international development organisations struggle to come to terms with these numbers against the backdrop of impending natural disasters, women across the Philippines are already leading the way on efforts to combat hunger and ease the burden of malnutrition.

Ancient wisdom to tackle modern lifestyles

Alterado’s crusade is no different from that of Angelina Galang who heads Consumer Rights for Safe Food (CRSF), a coalition of organisations pushing for consumers’ right to know, choose, and have access to safe and healthy food.

For Galang, the struggle starts at home. When her grandchildren visit every weekend, she doesn’t serve them the usual soda, junk food or take-out pizza favored by so many young people. Instead, she gives them fruits and healthy, home-cooked snacks like boiled bananas.

She said the children didn’t like it at first but after many months, they have become used to weekend visits with their grandma that do not feature Coke and hot dogs. “Hopefully, they will learn and adopt that kind of lifestyle as they grow up,” she told IPS.

Galang said teaching the ‘fast food generation’ about the right kinds and quantities of food is a challenge, especially since many young people are taken in by corporations’ attractive marketing tactics.

But the problems do not end there. CRSF is also challenging the Philippine government to conduct better research on genetically modified crops and to label food products that are known to have genetically modified organisms (GMOs), which alter the genetic makeup of crops to enhance their appearance, nutrient content and growth.

“No one knows if GMO foods are safe to eat, but there is mounting evidence that they pose dangers to human health,” Galang asserted.

“Consumers are the guinea pigs of GMOs,” she said, adding that eight GMO crops have been approved by the Philippine government for propagation and 63 for importation.

The movement against genetically modified crops recently coalesced around the government’s attempts to plant the genetically engineered ‘golden rice’, a strand fortified with beta-carotene that the body converts to Vitamin A.

The government claimed its experiment was designed to address the country’s massive Vitamin A deficiency, which affects 1.7 million children under the age of five and roughly 500,000 pregnant and nursing mothers, according to the Philippines-based International Rice Research Institute (IRRI).

Activists and concerned citizens say that GMOs will worsen hunger, kill diversification and possibly contaminate other crops. Women like Galang also contend that until long-term, comprehensive studies are done, “It is better to eat and buy local, unprocessed and organic foods.”

Educating the youth

Experts say the first step in the health food movement is to educate children on the importance of eating local and organic.

Camille Genuino, a member of the Negrense Volunteers for Change Foundation based in Bacolod City, is witnessing this first hand. Her four-year-old child, who attends a daycare centre, is learning how to plant herbs and make pasta and pizza from the fresh produce harvested from their little plot.

“Educating children and exposing them to the benefits of farming is good parenting,” said Genuino, whose non-governmental advocacy group produces the nutritious Mingo powder – an instant formula that turns into a rich porridge when mixed with water – which is distributed in disaster-stricken areas.

Her child’s daycare centre is based in Quezon City, a poor, urban area located close to a waste disposal facility where residents have installed farms on their roofs so they can grow their own food. The centre conducts regular feeding programmes for 80 to 100 children in the area.

It is a humble effort in the greater scheme of things, but similar initiatives across the Philippines suggest a growing movement, led largely by women, is at the forefront of sparking changes in the food and nutrition sector.

Monina Geaga, who heads Kasarian-Kalayaan, Inc. (SARILAYA), a group of grassroots women’s organisations, believes that independent efforts to ensure a family’s nutrition can go a long way.

“People should know how to plant vegetables – like tomatoes, eggplant, pepper and string beans – in pots, and recycle containers for planting,” she said. “This would at least ensure where your food comes from because you source your meals from your own garden.”

More than 200 farmer-members of SARILAYA – mostly across Luzon, one of the three major islands in the Philippines – practice organic agriculture, believing it to be the best guarantee of their families’ health in the era of processed foods, GMOs and synthetic products.

Geaga said Filipino women, including the ones staying at home and raising their children, are at the forefront of these consumer and environment advocacy efforts.

Citing studies by the Food and Nutrition Research Institute and the University of the Philippines, she pointed out that poor families spend 70 percent more on purchasing infant formulas than other needs in the household and that youth in the 16-20 age-group consume fast food products heavy in fat, cholesterol and sodium on a daily basis.

Such statistics are not just numbers on a page – they are the reason scores of women across the Philippines are doubling up as scientists, farmers and activists so that they and their families can be a little healthier, and perhaps live a little longer.

Edited by Kanya D’Almeida

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