By Jo Baker
LONDON, Jan 7 2016 (IPS)

It is a grim fact that prisoners in most countries suffer from poorer health than non-prisoners, and that their right to health is not always protected. But for certain groups these rights can be even more elusive. Such is the case for women.

Jo Baker

For me, this was starkly illustrated during a visit to the clinic of a large women’s jail in the southern Philippines. Here, a very thin woman lay curled and still on a narrow wooden bench. Her hands were cradling her taut, bloated stomach, her eyes tightly closed. The nurse explained that she was an addict, arrested while heavily pregnant for drug possession (a sentence that keeps the country’s women’s jails lamentably stocked), and that her baby had died days earlier in a government hospital because of a condition related to her drug use, after a complicated labour. Being understaffed and short on medicine and beds in the prison, the best treatment she could offer the woman on her return, as she faced her withdrawal, post-labour pain, grief, separation from family, and possible years awaiting trial, were paracetamol, kind words and a bench. Hers would be a particular and gendered kind of purgatory.

In speaking with imprisoned women and healthcare practitioners across five countries, our research team commonly found harmful responses and barriers to healthcare that existed because the inmates were women. These included women who were imprisoned in Jordan while recovering from brutal gender-based violence (including honour crimes and rape), without adequate treatment or rehabilitation; women who prepared for and recovered from childbirth in dirty rooms with little more than substandard prison rations, water and soap; and women who were isolated and punished because of attempts to self-harm or commit suicide. “One girl used the edge of a seafood shell on her wrists,” recounted an inmate in the Philippines. “They scolded her. If you want to die, go ahead, do it now!”

These responses are of course unlikely to be particular only to these countries.

International standards (including the Bangkok Rules) now recognize that because women commonly face certain risk factors and backgrounds, they require a gender-specific framework for healthcare. More women than men suffer from particular diseases, including HIV, hepatitis and some cancers. They have differing sexual and reproductive health (SRH) needs, including those relating for example, to birth, abortion and the menopause. They are more susceptible to particular mental health problems. Studies have found self-harm in prison to be up to ten times higher among women than among men, and suicide to also be proportionally higher. This list goes on.

Women (especially those in conflict with the law) are also, crucially, more likely to have been victims of sustained gender-based violence and sexual abuse. Yet prisons, which are increasingly taking in women, are rarely equipped to respond to these forms of trauma. As I was told quietly by one prison healthcare worker, gesturing to a courtyard of around 20 women. “Almost all the women here are mothers, and a lot have maltreatment and molestation in their histories. I can look around and count more than ten women who have been raped. Some have been prostituted by their families. Then drug use comes in and makes it a vicious cycle.”

These and other cultural factors lead to a different sense of shame, which can also work as a barrier to healthcare. For example inmates in Jordan, Zambia and the Philippines told me that they often avoided reporting urinary tract infections and SRH problems to male health staff. Yet some prisons for women don’t employ female doctors, and these issues remain unrecognized, and sometimes debilitating.

My research findings with DIGNITY (see our comparative study here) therefore stress the urgent need for every prison and place of detention to follow a framework for healthcare that is gender-responsive and trauma-informed – one that treats women’s specific health needs, and trains staff accordingly. In just a few facilities did we find gestures towards this.

But not all gender-sensitive health responses are medical. The traditional prison model – designed as a harsh criminal justice response to violent men – remains the basis for many institutions detaining groups that are neither violent, nor male. In the facilities where women told me of harsh disciplinary structures, negative relationships between staff and inmates, and their isolation from caring relationships, they tended to report very low morale, forms of depression, and other signs of serious struggle, such as self harm and hunger strike. This was markedly different in facilities (such the one described here in Albania) that connected the women with the outside community – particularly their children – and gave them tools to cope, learn, communicate and prepare for the future.

Meanwhile, exercise is known to be important to health and morale, and is a right of prisoners under international law (see the Mandela Rules). Yet only in one of five countries, the Philippines, were detained women encouraged and able to exercise every day. In the other countries, exercise and sports facilities of some kind were common only in prisons for men.

Many of our findings on health fell in line with those observed by the former UN Special Rapporteur on Violence Against Women in her 2013 report on women’s incarceration, and they indicated clear and harmful examples of discrimination. Yet in reviewing issues raised by UN treaty body reports, we found women’s health to largely be a gap: UN experts are not giving this area consideration.

The human rights of these women entitle them to better, and must be championed, internationally and in their own countries. As once said by Dostoevsky, society must be judged by the way that it treats its prisoners. Or rather, and as told to me by one mother and survivor of domestic violence, sentenced to life in a Zambian prison: “If you’ve offended, certain things you must accept. But I don’t deserve to pass through some of these things. I came to prison healthy. I’m not intending to leave sick.”

(End)

Excerpt:

A Ugandan marriage ceremony known as ‘kuhingira’ at which the groom pays a ‘bride price’. The country’s Supreme Court has now ruled that refunding them if the marriage breaks up is unconstitutional. Credit: Wambi Michael/IPS

By Wambi Michael
KAMPALA, Aug 7 2015 (IPS)

After years of a protracted battle against Uganda’s “bride price” practice, the country’s Supreme Court this week ruled that husbands can no longer demand that it be returned in the event of dissolution of a customary marriage but has stopped short of declaring the practice itself unconstitutional.

In a country in which most marriages are customary, women’s rights activists have hailed the decision as a step in the right direction for greater equality in the marriage relationship but had hoped that the court would rule the bride price – or dowry – itself unconstitutional.

In Uganda, the bride price is the gift that is given as a token of appreciation by grooms to the families of their brides. Traditionally, it takes the forms of cows or goats, besides money, and some tribes have recently been demanding articles such as sofas and refrigerators among others.

The legal battle over “bride prices” started back in 2007 when MIFUMI, a non-governmental women’s rights organisation based in Kampala, filed a petition to Uganda’s Constitutional Court, seeking to have them declared unconstitutional.“Refund of the bride price connotes that a woman is on loan and can be returned and money recovered. This compromises the dignity of a woman" – Uganda’s Chief Justice Bert Katureebe

MIFUMI, whose work revolves around the protection of women and children experiencing violence and other forms of abuse, argues that if women are empowered they can rise above many of the cultural traditions, such as bride price, that hold them back, blocking their potential contribution to development.

The MIFUMI petition argued that the demand for and payment of bride price by the groom to the parents of the bride, as practised by many communities in Uganda, gives rise to conditions of inequality during marriage contrary to the country’s constitutional provisions which guarantee that men and women be accorded equal rights in marriage and its dissolution.

In 2010, however, the Constitutional Court ruled that the bride price was constitutional, with just one judge, Amos Twinomujuni (who has since died) dissenting, arguing that the main issue at stake was women’s equality and that the bride price was a source of domestic violence.

Undeterred, MIFUMI decided to appeal to the country’s Supreme Court and finally, in a 6-1 decision, the judges have ruled that the act of refunding the bride price is contrary to the country’s constitution regarding equality in contracting marriage, during marriage and in its dissolution.

Lead Justice Jotham Tumwesigye observed that it was unfair for the parents of the woman to be asked to refund the bride price after years of marriage and that it in any case it was unlikely that the parents of the bride would have kept anything involved in the bride price on hand for refunding.

Justice Tumwesigye further argued that one effect of the bride’s parents no longer having bride price goods or cash to refund could force a married woman into a situation of marital abuse for fear that her parents would be in trouble owing to their inability to refund the bride price.

Uganda’s Chief Justice Bert Katureebe, one of the six judges, ruled that “refund of the bride price connotes that a woman is on loan and can be returned and money recovered. This compromises the dignity of a woman.”

The judges of the Supreme Court unanimously agreed that referring to bridal gifts as bride price reduces its significance to a mere market value.

Solomy Awiidi, a legal officer with MIFUMI told IPS after the judgment that she was happy that ruling had partly struck off some of the cultural practice that has held women hostage in abusive marriages.

She said much as MIFUMI had wanted the whole issue of bride price totally abolished, the fact that court had ruled against refund was something to celebrate after 15 years of struggle against the practice.

“There are fathers and brothers of brides facing civil suit because they failed to return the bride price, while thousand if not millions of women across the country who have been abused because of failure to refund the bride price. This ruling will liberate many of them,” said Awiidi.

Kampala-based human rights lawyer Ladislaus Rwakafuzi, who has been the principal lawyer for the MIFUMI petition, told IPS: “We have not got everything we wanted but at least we know that people will start being cautious paying too much when they know there is going to be no refund when there is failure of the marriage.”

Rita Achiro, Executive Director of the Uganda Women’s Network (UWONET), told IPS that the ruling has shown that women of Uganda can use courts of law to fight against laws that oppress them.

Achiro also challenged the Ugandan government and Parliament to come up with a law to enforce the court decision, saying that demand for refund of the bride price will continue if government and Parliament do not enact a law criminalising bride price refunds.

She said there were precedents in which Ugandan courts had nullified laws discriminating against women but Parliament and government had failed to enact the laws needed enforce the judgments.

Achiro cited the March 2004 Constitutional Court ruling that struck down ten sections of the Divorce Law on the grounds that they contravened a clause in the constitution that guaranteed women and men equal rights.

Uganda’s Divorce Law had previously allowed men to leave their wives in cases of adultery, while women were not granted the same right because they had to prove their husbands guilty not only of adultery but also of a range of crimes including bigamy, sodomy, rape and desertion.

A panel of five constitutional judges unanimously upheld the view that grounds for divorce must apply equally to all parties in a marriage.  Women activists had hailed the judgment as a landmark ruling that would bring equality of the sexes but, eleven year later, no law has yet been enacted to enforce the ruling.

Edited by Phil Harris    

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