“My body my decision,” reads a slogan written on the back of an activist during a march in Lima in 2019. Credit: Walter Hupiú / IPS

By Mariela Jara
LIMA, Sep 27 2024 (IPS)

The struggle for women’s right to decide in Latin America and the Caribbean, for their access to legal, safe and free abortion continues in the region, with some countries fully criminalising it, others with severe regulations, and a few guaranteeing better conditions, while threats of regression persist.

This Saturday 28 September marks, as every year, the Global Day of Action for Access to Safe and Legal Abortion, launched in 1990, at the 5th Latin American and Caribbean Feminist Meeting, held in Argentina.

Since then, the international day of action for safe abortion has been nurtured by the agreements reached at the Cairo Conference on Population and Development in 1994, which recognised sexual and reproductive rights as part of human rights, and by the mandates of Human Rights Committees demanding that countries decriminalise abortion and protect the rights of girls, adolescents and women.

“This is a historic struggle of the feminist movement. We have made progress in the recognition of women’s human rights in the region, but those related to sexual and reproductive rights and abortion continue to be polarising; however, we have no doubt that they must be integrated into our rights as a whole”.“We have seen the great influence of right-wing fundamentalist religious groups in countries where abortion is criminalised and in others where it is barely advancing on the grounds of risk to the woman's life, malformations and danger to health”: Aidé García.

So said Aidé García, director of the non-governmental organisation Catholic Women for the Right to Decide in Mexico and former director of the organisation’s Latin American network, present in 10 countries.

The activist spoke to IPS from New York, where this September she takes part in several meetings in the framework of the High-Level Segment of the 79th General Assembly of the United Nations and the Summit of the Future.

About 51% of the more than 660 million people in Latin America and the Caribbean are women. This population faces diverse gender inequalities, according to a joint report by the Economic Commission for Latin America and the Caribbean (ECLAC) and UN Women in 2023.

The report claims that three out of every 10 women in the region live in poverty; one out of every 10 has experienced violence and, in addition, the maternal mortality rate is 87.6 per 100,000 live births.

In this context, preventing women who freely decide from terminating a pregnancy or persecuting and criminalising them for doing so, aggravates the violation of their human rights, with the connivance between the prevailing patriarchy, the Catholic Church and now even more of evangelical denominations.

A study by the Guttmacher Institute revealed that in 2010-2014 there were 6.5 million induced abortions in the region. When these are performed in unsafe conditions due to legal barriers or lack of economic resources, they cause many deaths and harm women’s overall health.

The other side of the coin is forced maternity.

Aidé García, Mexican social worker and women’s and human rights activist, former coordinator of the Latin American and Caribbean network Catholics for the Right to Decide. Credit: Courtesy of Aidé García

A scenario with gaps

“There is great inequality in Latin America and the Caribbean on the issue of abortion,” said García, who is a social worker and feminist with vast experience in contributing to debates on this issue in Mexico and in international forums.

“We have seen the great influence of right-wing fundamentalist religious groups in countries where abortion is criminalised and in others where it is barely advancing on the grounds of risk to the woman’s life, malformations and danger to health,” she said.

Among the 10 countries or territories where abortion is fully criminalised are Belize, El Salvador, Haiti, Jamaica, Honduras, Nicaragua, Dominican Republic and Suriname.

Cuba was the first to fully decriminalise voluntary termination of pregnancy in the region, in 1965, followed by Guyana in 1995. Then, in this century, Uruguay, Argentina, Colombia and Mexico, first in 13 states and then at the federal level.

In most, legislation regulates it only under the restricted grounds – and in many cases full of obstacles to its implementation – of rape, health and risk to the pregnant woman’s life, non-consensual artificial insemination, and foetal malformations incompatible with life.

The most favourable frameworks are in Colombia, where abortion is legalised during the first 24 weeks of gestation, Argentina and Guyana, where it is legal up to 14 weeks, Uruguay and Mexico, with up to 12 weeks, and Cuba during the first quarter.

The color green has spread from Argentina to other Latin American countries, to demand the right of women and feminist movements to legal and safe abortion. Credit: Walter Hupiú / IPS

These legal loopholes for access to abortion also reflect the resistance to recognising women’s right to voluntarily terminate a pregnancy.

“We are fighting for respect for the autonomy and the possibility that women and people with gestational capacity have to decide about our reproduction. We demand the recognition of the moral authority that is ours, because from a Judeo-Christian culture where the religious sphere often intervenes, women who make decisions about sexuality are blamed”, said García.

She drew attention to political, religious and economic interest groups in the region that seek to preserve a fundamentalist tradition that denies women decision-making and public and political participation.

“It has to do with a patriarchal and misogynist sense of the role that we are assigned in society, and that is a great struggle that we have in feminism because at the end of the day, it is about the control of our bodies”, she stressed.

Women and feminist movements in Latin America are fighting to spread throughout the region the tide of green scarves, which emerged in Argentina, with which they fill the streets in several demonstrations a year and which symbolise the struggle for the right to legal and safe abortion.

Brenda Álvarez, a feminist lawyer from Peru, director of the organization Proyecta Igualdad, which follows cases of women criminalized for the crime of abortion. Image: Courtesy of Brenda Álvarez

Criminalised and persecuted

Brenda Álvarez is a lawyer and president of Proyecta Igualdad, a non-governmental organisation in Peru, which through its Green Justice line provides legal counsel to prevent criminalisation in the care of obstetric emergencies related to abortion, a dramatic and little known reality in the country.

With 33 million people, the South American country is one of the most restrictive in the recognition of women’s reproductive rights. Since 1924, abortion has been criminalised, except for therapeutic reasons, when the life of the pregnant woman is in danger or there is a risk of serious and permanent damage to her health.

The struggles of feminists and women’s movements in recent decades to decriminalise abortion have come up against the opposition of conservatives linked to Catholic and evangelical religious groups, to the point that, although therapeutic abortion celebrated its 100th anniversary in 2024, the protocol for its implementation is barely 10 years old, and with limitations.

“In the midst of the pandemic, we learned of the case of Diana Aleman, a Venezuelan irregular migrant who died in a public hospital due to the criminalisation of abortion and the harassment she experienced. As we followed the case, we realised it was not the only one, that more people were experiencing this situation and were being prosecuted,” Álvarez told IPS at her office in Lima.

She said that women who go to health facilities for an obstetric emergency related to abortion are poor and vulnerable, uninformed of their rights, and in these circumstances face state violence.

“It is not only poor medical care or harassment at the time of service, but also dealing in the emergency room with interrogations by the police, the prosecutor’s office, even with samples taken by representatives of the Institute of Forensic Medicine, as was the case of a teenager a few weeks ago who arrived unconscious with pneumonia and septic shock. That’s how they wanted to take her statement,” she revealed.

In 2020-2021 they carried out the Being Born with Uterus study, which states that each year more than 184 police reports for abortion and more than 633 of prosecutorial investigations are filed in Peru. “It was alarming, even cases of therapeutic abortion that are not punishable were prosecuted, we found 55; and we found sentences including adolescents,” she explained.

Health personnel report obstetric emergencies if they suspect abortions under the questionable article 30 of the General Health Law No. 26842, and “the authorities are ready to respond as if there were no serious crimes to prosecute in the country”. Álvarez explained that the guarantee of due process is not fulfilled and that these are illegal processes.

“This is problematic because often the only evidence that ends in a conviction for abortion is the statement taken from women, girls and adolescents in health services in a context of coercion and absolute lack of legal protection,” she denounced.

Among the impacts of the criminalisation of abortion on women’s lives, she mentioned the loss of employment and mental health opportunities, the uncertainty that having a criminal record entails for the possibility of finding a job, the cost of going to the justice system “even when the legal defence is ex officio, which, we have seen, is not effective and part of the conviction system”.

In addition to the urgency of decriminalising abortion, she said there is a need to promote citizen empowerment by creating tools so that women can know and exercise their rights when they go to a hospital with an obstetric emergency. In this regard, her organisation has developed outreach and awareness-raising materials.

A feminist activist with the sign “I want my uterus free” during the 13th Latin American and Caribbean Feminist Meeting held in Lima. Credit: Mariela Jara / IPS

Improving the law and risks in the region

Twelve years ago, Uruguay passed the law on the Voluntary Interruption of Pregnancy up to 12 weeks of gestation, an important step forward in the region and the result of a long struggle by women and feminists for the legalisation of abortion. The law also established grounds for abortion in cases of serious health risk to the woman, rape and malformations incompatible with life outside the womb.

Soledad Gonzales, a political scientist specialising in gender issues, told IPS from Montevideo that there is a need to work for a new law that would remove the persistent restrictions.

In practice, this means barriers to the exercise of the right, such as the interdisciplinary board that evaluates the woman’s request, the appointment she must undergo to inform her of alternatives, and the five-day waiting period after which she either ratifies her will to end the pregnancy or not, in order to proceed according to her decision.

“A new law is in order. For example, women do not always realise they are pregnant after three months. They end up having abortions clandestinely, having started the abortion legally,” she said.

Gonzales said that the chances for this proposal, on which women’s and feminist organisations agree, will depend on the results of the Uruguayan general elections on 30 October.

García, from Catholic Women for the Right to Decide, also said that the risks of setbacks in women’s reproductive rights, such as the freedom to decide about their bodies and access to abortion in safe and free conditions, depends on the positions of governments, whether they are conservative or progressive.

“This is part of the historical struggle that leads us to never lower our guard,” she said.

Young women from the Brazilian state of Bahia attend an informational campaign which also hands out menstrual hygiene products. Poverty and the lack of adequate information on this subject affect millions of girls, adolescents and adult women. CREDIT: Government of Bahia

By Humberto Márquez
CARACAS, May 26 2023 (IPS)

Menstrual hygiene management is elusive for millions of poor women and girls in Latin America, who suffer because their living conditions make it difficult or impossible for them to access resources and services that could make menstruation a simple normal part of life.

“When my period comes, I miss class for three or four days. My family can’t afford to buy the sanitary napkins that my sister and I need. We use cloths for the blood, although they give me an uncomfortable rash,” says Omaira*, a 15-year-old high school student.

From her low-income neighborhood of Brisas del Sur, in Ciudad Guayana, 500 kilometers southeast of Caracas, she speaks to IPS by phone: “We can’t buy pills to relieve our pain either. And my period is irregular, it doesn’t come every month, but there are no medical services here for me to go and treat that.”

In Venezuela, “one in four women does not have menstrual hygiene products and they improvise unhygienic alternatives, such as old clothes, cloths, cardboard or toilet paper to make pads that function as sanitary napkins,” activist Natasha Saturno, with the Solidarity Action NGO, tells IPS.

“The big problem with these improvised products is that they can cause, at best, discomfort and embarrassment, and at worst, infections that compromise their health,” says Saturno, director of enforceability of rights at the NGO that conducts health assistance and documentation programs and surveys.

Campaigns that adult and young women have carried out in Mexico and Colombia demanding the right to menstrual health managed to get the authorities to eliminate the value added tax on essential feminine hygiene products. CREDIT: Nora Hinojo/UN Mexico

Universal problem, comprehensive approach

Is this a local, focalized problem? Not at all: “On any given day, more than 300 million women worldwide are menstruating.  In total, an estimated 500 million lack access to menstrual products and adequate facilities for menstrual hygiene management (MHM),” states a World Bank study.

“Today more than ever we need to bring visibility to the situation of women and girls who do not have access to and education about menstrual hygiene. Communication makes the difference,” said Hugo González, representative of the United Nations Population Fund (UNFPA) in Peru.

UNFPA says there is broad agreement on what girls and women need for good menstrual health, and argues that comprehensive approaches that combine education with infrastructure and with products and efforts to combat stigma are most successful in achieving good menstrual health and hygiene.

The essential elements are: safe, acceptable, and reliable supplies to manage menstruation; privacy for changing the materials; safe and private washing facilities; and information to make appropriate decisions.

UNFPA’s theme this year for international Menstrual Hygiene Day, which is celebrated every May 28, is “Making menstruation a normal fact of life by 2030”, the target date for compliance with the Sustainable Development Goals (SDGs) adopted by the international community at the United Nations.

United Nations Population Fund workers prepare packages of menstrual hygiene items for women from poor communities in Central America. The cost of some of these products makes them unaffordable for many families. CREDIT: UNFPA

The pink tax

Nine out of 31 countries in the region consider menstrual hygiene products essential, which makes them exempt from value added tax or reduced VAT, according to the study “Sexist Taxes in Latin America” ​​by Germany’s Friedrich Ebert Foundation.

After a “Tax-free Menstruation” campaign, in 2018 Colombia became the first country in the Americas to eliminate VAT – 16 percent – on menstrual hygiene products. Its neighbor Venezuela still charges 16 percent VAT, and Argentina, Chile, the Dominican Republic and Uruguay charge VAT between 18 and 22 percent on such products.

Colombia was joined by Ecuador, Guyana, Jamaica, Mexico – where street demonstrations were held against charging VAT on menstrual products – Suriname and Trinidad and Tobago. Other countries have reduced VAT, such as Costa Rica, Panama, Paraguay and Peru, while in Brazil VAT differs between states and averages 7 percent.

The so-called “pink tax” obviously affects the price of menstrual hygiene products such as disposable and reusable sanitary pads and menstrual cups, which becomes especially burdensome in countries with high inflation and depreciated currencies, such as Argentina and Venezuela.

According to the average price of the cheapest brands, ten disposable sanitary pads can cost just under a dollar in Mexico, 1.50 dollar in Argentina or Brazil, 1.60 dollar in Colombia, Peru or Venezuela, and almost two dollars in Costa Rica.

“It’s an important problem,” Saturno points out, “in a country like Venezuela, where the majority of the population lives in poverty and the minimum wage – although it has been increased with some stipends – is still just five dollars a month.”

Adult women, young women and girls participate in a session to share information and experiences organized by the Colombian association Menstruating Princesses, which emphasizes the importance of education to combat taboos and make menstruation a normal, stress-free experience. CREDIT: Menstruating Princesses

Hostile environment, scarce education

“If you often can’t buy sanitary pads, that’s the smallest problem. The worst thing is the shame you feel if you go to work and the cloth fails to keep your clothes free of blood, or if you catch an infection,” Nancy *, who at the age of 45 has been an informal sector worker in numerous occupations and trades in Caracas, told IPS.“Poverty causes women and adolescent girls to miss days of secondary school or work because they do not have the supplies they need when they menstruate. It becomes a vicious circle, because their academic or work performance is affected, hindering their chances of developing their full potential and earning a better income.” -- Natasha Saturno

The mother of four young people lives in Gramoven, a poor neighborhood in the northwest of the capital. Her two unmarried daughters, ages 18 and 22, have had experiences similar to Nancy’s on their way to school, in the neighborhood, on the bus, and on the subway.

“The thing is, the period is not seen as something natural, boys and men see it as something dirty, at work they sometimes do not understand that if you are in pain you have to stay at home,” said Nancy. “And when you work for yourself, you have to go out no matter what, because if you don’t go out, no money comes in.”

Saturno says that “poverty causes women and adolescent girls to miss days of secondary school or work because they do not have the supplies they need when they menstruate.”

“It becomes a vicious circle, because their academic or work performance is affected, hindering their chances of developing their full potential and earning a better income,” she adds.

But the problem “goes far beyond materials, it does not end just because someone obtains the products; it includes education and decent working conditions for women,” psychologist Carolina Ramírez, who runs the educational NGO Menstruating Princesses in the Colombian city of Medellín, tells IPS.

For this reason, “we do not use the term ‘menstrual poverty’ and speak instead of menstrual dignity, vindicating the need for society, schools, workplaces and States to promote education about menstruation and combat illiteracy in that area,” says Ramírez.

To illustrate, she mentions the widespread rejection of using tampons and cups “because of the old taboo that the vulva shouldn’t be touched, that the vagina shouldn’t be looked at,” in addition to the fact that many areas and communities in Latin American countries not only lack spaces or tools to sterilize products but often do not have clean water.

A concern raised by both Saturno and Ramírez is the great vulnerability of migrant women in the region – which has received a flood of six million people from Venezuela over the last 10 years, for example – in terms of menstrual and general health, as well as safety.

Another worrying issue is women in most Latin American prisons, which are unable to provide adequate menstrual hygiene, since they do not have access to disposable products or the possibility to sterilize reusable supplies.

Throughout the region, “greater efforts are required to break down taboos that violate fundamental rights to health, education, work, and freedom of movement, so that menstruation can be a stress-free human experience,” Ramírez says.

*Names have been changed to protect the privacy of the interviewees.

Excerpt:

Yomira Cuadros faced motherhood at an early age, as well as the obstacles of a sexist society like Peru’s, regarding her reproductive decisions. In the apartment where she lives with her family in Lima, she expresses faith in the future, now that she has finally started attending university, after having two children as a result of unplanned pregnancies. CREDIT: Mariela Jara/IPS

By Mariela Jara
LIMA, Nov 18 2022 (IPS)

No woman in Peru should have to die, have her physical or mental health affected, be treated as a criminal or have an unwanted pregnancy because she does not have access to abortion, said Dr. Rocío Gutiérrez, an obstetrician who is the deputy director of the Manuela Ramos Movement, a non-governmental feminist center that works for gender rights in this South American country.

In this Andean nation of 33 million people, abortion is illegal even in cases of rape or fetal malformation. It is only legal for two therapeutic reasons: to save the life of the pregnant woman or to prevent a serious and permanent health problem.

Peru thus goes against the current of the advances achieved by the “green wave”. Green is the color that symbolizes the changes that the women’s rights movement has achieved in the legislation of neighboring countries such as Uruguay, Colombia, Argentina and some states in Mexico, where early abortion has been decriminalized. These countries have joined the ranks of Cuba, where it has been legal for decades."I didn't tell my parents because they are very Catholic and would have forced me to go through with the pregnancy, they always instilled in me that abortion was a bad thing. But I started to think about how pregnancy would change my life and I didn't feel capable of raising a child at that moment." -- Fatima Guevara

But Latin America remains one of the most punitive regions in terms of abortion, with several countries that do not recognize women’s right to make decisions about their pregnancies under any circumstances. In El Salvador, Honduras, Nicaragua, the Dominican Republic and Haiti it is illegal under all circumstances, and in some cases draconian penalties are handed down.

In the case of Costa Rica, Guatemala, Peru and Venezuela, meanwhile, abortion is allowed under very few conditions, while there are more circumstances under which it is legal in Bolivia, Brazil, Chile and Ecuador.

“In Peru an estimated 50,000 women a year are treated for abortion-related complications in public health facilities,” Dr. Gutiérrez told IPS. “This is not the total number of abortions in the country, but rather the number of women who reach public health services due to emergencies or complications.”

The obstetrician spoke to IPS from Buenos Aires, where she participated in the XV Regional Conference on Women, held Nov. 7-11 in the Argentine capital.

Gutiérrez explained that the cases attended are just the tip of the iceberg, because for every abortion complicated by hemorrhage or infection treated at a health center, at least seven have been performed that did not present difficulties.

Multiplying by seven the 50,000 cases treated due to complications provides the shocking figure of 350,000 unsafe clandestine abortions performed annually in Peru.

The doctor regretted the lack of official statistics about a phenomenon that affects the lives and rights of women “irreversibly, with damage to health, and death.”

Gutiérrez said that another of the major impacts is the criminalization of women who undergo abortions, due to mistreatment by health personnel who not only judge and blame them, but also report them to the police.

Obstetrician Rocío Gutiérrez (C), deputy director of the feminist Manuela Ramos Movement, stands with two fellow activists holding green scarves – representing the struggle for reproductive rights – during the XV Regional Conference on Women held this month in the city of Buenos Aires. CREDIT: Courtesy of Rocío Gutiérrez

Under article 30 of Peru’s General Health Law, No. 26842, a physician who attends a case of presumed illegal abortion is required to file a police report.

Gutiérrez also referred to the fact that unwanted pregnancies have numerous consequences for the lives of women, especially girls and adolescents, in a sexist country like Peru, where women often do not have the right to make decisions on their sexuality and reproductive health.

Healing the wounds of unwanted motherhood

By the age of 19, Yomira Cuadros was already the mother of two children. She did not plan either of the pregnancies and only went ahead with them because of pressure from her partner.

In 2020, according to official data, 8.3 percent of adolescents between the ages of 15 and 19 were already mothers or had become pregnant in Peru.

Cuadros, whose parents are both physicians and who lives in a middle-class family, said she never imagined that her life would turn out so differently than what she had planned.

“The first time was because I didn’t know about contraceptives, I was 17 years old. The second time the birth control method failed and I thought about getting an abortion, but I couldn’t do it,” Cuadros told IPS.

At the time, she was in a relationship with an older boyfriend on whom she felt very emotionally dependent. “I had made a decision (to terminate the pregnancy), but he didn’t want to, he told me not to, the pressure was like blackmail and out of fear I went ahead with the pregnancy,” she said.

Making that decision under coercion hurt her mental health. Today, at the age of 26, she reflects on the importance of women being guaranteed the conditions to freely decide whether they want to be mothers or not.

Peruvian activists go topless to demand the right to legal abortion, during a demonstration in the streets of the capital on Mar. 8, 2018. CREDIT: Mariela Jara/IPS

In her case, although she had the support of her mother to get a safe abortion, the power of her then-partner over her was stronger.

“Becoming a mother when you haven’t planned to is a shock, you feel so alone, it is very difficult. I didn’t feel that motherhood was something beautiful and I didn’t want to experience the same thing with my second pregnancy, so I considered terminating it,” she said.

Finding herself in that unwanted situation, she fell into a deep depression and was on medication, and is still in therapy today.

“I went from being a teenager to an adult with responsibilities that I never imagined. It’s as if I have never really gone through the proper mourning process because of everything I had to take on, and I know that it will continue to affect me because I will never stop being a mother,” she said.

She clarified that “it’s not that I don’t want to be a mother or that I hate my children,” and added that “as I continue to learn to cope, I will get better, it’s just that it wasn’t the right time.”

She and her two children, ages nine and seven, live with her parents and brother in an apartment in the municipality of Pueblo Libre, in the Peruvian capital. She has enrolled at university to study psychology and accepts the fact that she will only see her dreams come true little by little.

“Things are not how I thought they would be, but it’s okay,” she remarked with a newfound confidence that she is proud of.

Gutiérrez said more than 60 percent of women in Peru have an unplanned pregnancy at some point in their lives, and argued that the government’s family planning policies fall far short.

The National Institute of Statistics and Informatics reported that the total fertility rate in Peru in 2021 would have been 1.3 children on average if all unwanted births had been prevented, compared to the actual rate of 2.0 children – almost 54 percent higher than the desired fertility rate.

“There are a set of factors that lead to unwanted pregnancies, such as the lack of comprehensive sex education in schools, and the lack of birth control methods and timely family planning for women in all their diversity, which worsened during the pandemic. And of course, the correlate is access to legal and safe abortion,” said Gutiérrez.

She lamented that little or no progress has been made in Peru in relation to the exercise of sexual and reproductive rights, including access to safe and free legal abortion, despite the struggle of feminist organizations and movements in the country that have been demanding decriminalization in cases of rape, artificial insemination without consent, non-consensual egg transfer, or malformations incompatible with life.

University student Fátima Guevara decided to terminate an unwanted pregnancy when she was 19 years old. Four years later, she is sure that it was the right decision, in terms of her plans for her life. The young woman told her story at a friend’s home, where she was able to talk about it openly, in Lima, Peru. CREDIT: Mariela Jara/IPS

The obscurity of illegal abortion

The obscurity surrounding abortion led Fátima Guevara, when she faced an unwanted pregnancy at the age of 19, to decide to use Misoprostol, a safe medication that is included in the methods accepted by the World Health Organization for the termination of pregnancies.

“I didn’t tell my parents because they are very Catholic and would have forced me to go through with the pregnancy, they always instilled in me that abortion was a bad thing. But I started to think about how pregnancy would change my life and I didn’t feel capable of raising a child at that moment,” she told IPS in a meeting at a friend’s home in Lima.

She said that she and her partner lacked adequate information and obtained the medication through a third party, but that she used it incorrectly. She turned to her brother who took her to have an ultrasound first. “Hearing the fetal heartbeat shook me, it made me feel guilty, but I followed through with my decision,” she added.

After receiving proper instructions, she was able to complete the abortion. And today, at the age of 23, about to finish her psychology degree, she has no doubt that it was the right thing to do.

Participants in the 2015 New York March for Gender Equality and Women's Rights. Credit: UN Photo/Devra Berkowitz.

By Tharanga Yakupitiyage
NEW YORK, Jan 20 2017 (IPS)

Just one day after the inauguration of President-elect Donald Trump, hundreds of thousands of women are expected to attend one of the largest demonstrations in history for gender equality.

Starting out as a social media post by a handful of concerned women, the Women’s March on Washington quickly transformed, amassing over 400 supporting organisations representing a range of issues including affordable and accessible healthcare, gender-based violence, and racial equality.

“It’s a great show of strength and solidarity about how much women’s rights matter—and women’s rights don’t always take the front page headlines,” Nisha Varia, Advocacy Director of Human Rights Watch’s Women’s Rights Division told IPS.

Despite the variety of agendas being put forth for the march, the underlying message is that women’s rights are human rights, Executive Director of Amnesty International USA Margaret Huang told IPS.

“All people must be treated equally and with respect to their rights, no matter who is in positions of authority and who has been elected,” she said.

Organisers and partners have stressed that the march is not anti-Trump, but rather is one that is concerned about the current and future state of women’s rights.

“It’s not just about one President or one candidate, there’s a much bigger banner that we are marching for…our rights should not be subject to the whims of an election,” Kelly Baden, Center for Reproductive Rights’ Interim Senior Director of U.S. Policy and Advocacy told IPS.

“It’s about women, not Trump,” she continued.

The rhetoric used during the election is among the concerns for marchers as it reflects a troubling future for women’s rights.

During his campaign, President-elect Trump made a series of sexist remarks from calling Fox News host Megyn Kelly a “bimbo” to footage showing him boasting of sexual assault. Though Trump downplayed his remarks as “locker room talk,” his rhetoric is now being reflected in more practical terms through cabinet nominations.

Huang pointed to nominee for Attorney-General Jeff Sessions who has a long and problematic record on women’s rights including voting against the reauthorisation of the Violence Against Women Act, rejecting anti-discrimination protections for lesbian, gay, bisexual and transgender (LGBT) people, and opposing the Lilly Ledbetter Fair Pay Act of 2009 which addresses pay discrimination.

During her confirmation hearing, Nominee for Secretary of Education Betsy DeVos wouldn’t say if she would uphold title IX which requires universities to act on sexual assault on campuses.

According to the National Sexual Violence Resource Center, one in five women and one in 16 men are sexually assaulted while in college.

The new administration has also recently announced cuts to the Department of Justice’s Violence Against Women Grants, which distribute funds to organisations working to end sexual assault and domestic violence.

“There is no question that we’re going to have some challenges in terms of increasing protections for women’s rights over the next few years,” said Huang to IPS.

Meanwhile, Varia pointed to other hard fought gains that risk being overturned including the Affordable Care Act (ACA). The ACA, which U.S. Congress is currently working to repeal, provides health coverage to almost 20 million Americans by prohibiting insurers from denying insurance plans due to pre-existing conditions and by providing subsidies to low-income families to purchase coverage.

If repealed, access to reproductive services such as contraception and even information will become limited. The health system also risks returning to a time when many insurance plans considered pregnancy a pre-existing condition, barring women from getting full or any coverage.

“Denying women access to the types of insurers or availability of clinics that can help them get pre-natal checks and can help them control their fertility by having access to contraception—these are all the type of holistic care that needs to be made available,” Varia said.

The U.S. is one of the few countries in the world where the number of women dying as a result of child birth is increasing, Varia noted.

In Texas, maternal mortality rates jumped from 18.8 deaths per 100,000 live births in 2010 to 35.8 deaths in 2014, the majority of whom were Hispanic and African-American women. This constitutes the highest maternal mortality rate in the developed world, closer in numbers to Mexico and Egypt than Italy and Japan, according to World Bank statistics.

A UN Working Group also expressed their dismay over restrictive health legislation, adding that the U.S. is falling behind international standards.

Though the ACA repeal and potential defunding of Planned Parenthood, another key reproductive services provider, threatens all women, some communities are especially in danger.

Francis Madi, a marcher and Long Island Regional Outreach Associate for the New York Immigration Coalition, told IPS that immigrant and undocumented immigrant women face additional barriers in accessing health care.

Most state and federal forms of coverage such as the ACA prohibits providing government-subsidised insurance to anyone who cannot prove a legal immigration status. Even for those who can, insurance is still hard or too expensive to acquire, making programs like Planned Parenthood essential.

“I can’t even do my job as an organiser asking for immigrant rights if I’m not able to access the services I need to live here,” Madi told IPS.

Madi highlighted the opportunity the march brings in working together through a range of issues and identities.

“I’m going because as a woman and an immigrant and an undocumented immigrant as well…it’s very important to attend this march to show we can work together on our issues,” she told IPS.

“If we don’t organize with each other, we can’t really achieve true change,” she continued.

In its policy platform, organisers of the Women’s March on Washington also stressed the importance of diversity, inclusion and intersectionality in women’s rights.

“Our liberation is bound in each other’s,” they said.

This includes not only women in the U.S., but across the world.

“There’s definitely going to be an international voice in this, not just U.S. activists,” Huang told IPS.

Marching alongside women in Washington D.C. on January 21^st will be women in nearly 60 other countries participating in sister marches from Argentina to Saudi Arabia to Australia.

“Women are concerned that a loss of a champion in the U.S. government will have significant impacts in other countries,” Huang said. Of particular concern is the reinstatement of the “global gag rule” which stipulates that foreign organisations receiving any U.S. family planning funding cannot provide information or perform abortions, even with funding from other sources. The U.S. does not fund these services itself.

The policy not only restricts basic right to speech, but analysis shows that it has harmed the health of low-income women by limiting access to family planning services.

The US Agency for International Development (USAID) is the world’s largest family planning bilateral donor.

Though the march is important symbolic act of solidarity, it is just the first step.

“We are also part of a bigger movement—we need to come together and be in solidarity on Saturday and then we need to keep doing the hard work [during[ the long days and months and years of organising that we have ahead of us,” Baden said.

Melody Kemp/IPS

By Lyndal Rowlands
UNITED NATIONS, Jul 7 2016 (IPS)

From forced sterilisation to sexual abuse, young women and men with disabilities are much more likely to have their sexual and reproductive health rights violated than other people.

However despite the increased risks they face, young people with disabilities are also much less likely to get the sexual health education that they need.

Sometimes this is because well-meaning caregivers fail to realise the sexual desires and needs of people with disabilities, Malin Kvitvaer who works for the Swedish Association for Sexuality Education (RFSU) told IPS.

“They see only the deafness and forget that there is a young person there too,” said Kvitvaer who works on a special project aimed at improving sexual education in sign language and is herself deaf.

Parents and caregivers can forget that young people with disabilities also have questions about their bodies and thinks about sex, just like any other teenager, said Kvitvaer.

Even where young people with disabilities do have access to sexual health education, it can be incomplete or inadequate due to access barriers, Kvitvaer added.

“There are many instances where the teacher, not being fluent in sign language, does not know how to teach sexuality education in sign language and either teaches a very compromised version, or skips it altogether,” she said.

Communication barriers can have an even greater impact, when abusers take advantage of the fact that it is harder for young Deaf people to report abuse.

“In the history of the Deaf community there is a history of young Deaf girls – boys too, but mostly girls – who were subjected to sexual abuse by the adult men around them, such as teachers, Deaf priests and so on.”

“Many times they also knew that the girls’ families did not speak Sign language and so they wouldn’t be able to tell (their families) about the abuse,” said Kvitvaer who was also the Swedish youth delegate to the United Nations in 2011.

We Decide, a new initiative launched last month by the UN Population Fund (UNFPA) aims to address the gaps in sexual and reproductive health services, education and information which disproportionately effect young people with disabilities.

Leyla Sharafi. Gender and youth specialist at UNFPA told IPS that adolescents and youth around the world struggle to access appropriate sexual and reproductive health services and that for young people with disabilities the barriers are even greater.

“Young people with disabilities are at higher risk of experiencing sexual violence and face greater barriers when accessing sexual and reproductive health services and education,” Sharafi told IPS.

“UNFPA and the We Decide program is advocating that all young people with disabilities enjoy their human rights, including living a life free of violence and discrimination.”

Sharafi added that the program was designed in collaboration with young people with disabilities, taking into consideration their wants and needs.

To this end, Kvitvaer notes that sexual education should not just focus on the negative aspects of sex, but also the positive aspects.

“I also think it is important to not only focus on problems that sex can cause – such as unwanted pregnancies, STDs, but also that sex is a good thing when consensual and that is just as ok to want to have sex, as it is to not want to have sex.”

This week marks the 10-year anniversary of the UN Convention on the Rights of Persons with Disabilities (CRPD) which Sharafi notes “is one of the only conventions that explicitly talks about access to sexual and reproductive health.”

A hearing in the Inter-American Court of Human Rights to follow up on compliance with its ruling that Costa Rica’s ban on in vitro fertilisation violates a number of rights. Credit: Inter-American Court of Human Rights

By Diego Arguedas Ortiz
SAN JOSE, Sep 15 2015 (IPS)

After banning in vitro fertilisation for 15 years and failing to comply with an Inter-American Court of Human Rights ruling for nearly three years, Costa Rica will finally once again allow the procedure for couples and women on their own.

On Sept. 10, centre-left President Luis Guillermo Solís issued a decree ordering compliance with the Inter-American Court’s 2012 verdict against the ban fomented by conservative sectors. The president ordered that measures be taken to overcome judicial and legislative barriers erected against compliance with the Court judgment.

“This was discriminatory,” lawyer Hubert May, the representative of several of the 12 couples who brought the legal action against the ban before the Court, told IPS. “The ban only affected those who couldn’t afford to carry out the procedure abroad, or those who weren’t willing to mortgage their homes or take out loans to fulfill their longing (for a child of their own).”

In November 2012, the Court ruled that the ban on in vitro fertilisation (IVF) violated the rights to privacy, liberty, personal integrity and sexual health, the right to form a family, the right to be free from discrimination, and the right to have access to technological progress. It gave Costa Rica six months to legalise the procedure.

But opposition from conservative sectors blocked compliance and hurt Costa Rica’s image in terms of international law.

Solís’s decree regulates IVF and puts the public health system in charge of the procedure, thus ensuring access for lower-income couples.

May said the decree “solves the problem of discrimination” by paving the way for the social security institute, the CCSS, to provide IVF as part of its regular health services.

IVF is a reproductive technology in which an egg is removed from a woman and joined with a sperm cell from a man in a test tube (in vitro). The resulting embryo is implanted in the woman’s uterus.

In its 2012 ruling, the Court stated that Costa Rica was the only country in the world to expressly outlaw IVF, a measure that directly affected local women and couples. In Latin America the procedure was first used in 1984, in Argentina.

One of the women affected by the ban was Gretel Artavia Murillo, who with her then husband ran up debt in an attempt to have a baby in the late 1990s.

Her now ex-husband, Miguel Mejías, declared before the Court that he had mortgaged his home and spent all his savings for the couple to undergo in vitro fertilisation in Costa Rica, but before they were able to do so, the practice was declared illegal.

IVF was first regulated in Costa Rica in 1995, but was banned in March 2000 by the constitutional chamber of the Supreme Court.

Five of the seven magistrates on the constitutional chamber argued that the law violated the right to life, which began “at conception, when a person is already a person…a living being, with the right to be protected by the legal system.”

Artavia and Mejía, along with 11 other couples, brought the case to the Inter-American Commission on Human Rights in 2001, and a decade later it reached the Inter-American Court. The Commission and the Court are the Organisation of American States (OAS) autonomous human rights institutions.

On Sep. 10 Costa Rican President Luis Guillermo Solís signed a decree making IVF legal after it was banned for 15 years. Credit: Casa Presidencial

A year later, the Court, which is based in the Costa Rican capital, San José, and whose rulings cannot be appealed and are theoretically binding, handed down its verdict.

“The constitutional chamber’s view was not shared by the Court, which considered that protection of life began with the implantation of a fertilised egg in the uterus,” said May.

May and other experts on the case said the position taken by Costa Rica’s highest court responded to the extremely conservative views of the leadership of the Catholic Church, and of other Christian faiths with growing influence in the country.

This Central American nation of 4.7 million people considers itself a standard-bearer of human rights in international forums. But the question of IVF tarnished that image when the conservative sectors took up opposition to it as a cause.

The debate in the legislature on a law to regulate IVF stalled for over two years, due to resistance by evangelical and conservative lawmakers.

In a Sep. 3 public hearing by the Court on compliance with the 2012 ruling, the executive branch said it planned to regulate the procedure by means of a decree, which civil society organisations saw as a reasonable solution to the stalemate over the new law.

“We know that in the legislature there is no way to forge ahead on key issues, such as practically anything to do with sexual and reproductive rights,” Larissa Arroyo, a lawyer who specialises in these rights, told IPS.

Arroyo pointed out that with regard to an issue like IVF, time is of the essence, given that a woman’s childbearing years are limited. She noted that “almost all of the victims lost their chance” to have children using the technique.

In the week between the public hearing and the signing of the presidential decree, the government consulted Costa Rica’s College of Physicians and the CCSS. While both backed the decree, the CCSS clarified that it preferred a law and warned that it would need additional funding, because each fertility treatment costs around 40,000 dollars.

The decree limits the number of fertilised eggs to be implanted to two.

In the same week, the legislative debate became further bogged down. While one group of legislators tried to expedite approval of the law to regulate IVF, another group continued to oppose the procedure as an attack on human life at its origin, likening it to the Jewish holocaust.

“The extermination camps of Nazi Germany are in the Costa Rica of today, the Costa Rica of the Solís administration,” evangelical legislator Gonzalo Ramírez, of the conservative Costa Rican Renewal Party, even said at one point.

Given that outlook and the impasse in the legislature, organisations like the Centre for Justice and International Law (CEJIL) celebrated the decree which offers “universal access” to IVF and “respect for the principle of equality.”

However, CEJIL programme director for Central America and Mexico Marcia Aguiluz recommended waiting until IVF is actually being implemented.

“The decree lives up to the requirements, but it is just a first step,” said Aguiluz, who is from Costa Rica. “Until the practice starts being carried out, we can’t say there has been compliance.”

Lawyers for the presidency said the decree is equipped to withstand legal challenges.

The 2012 ruling is the second handed down against Costa Rica in the history of the Court. The previous one was in 2004, when the Court found that the conviction of journalist Mauricio Herrera by a Costa Rican court on charges of defamation of a diplomat violated free speech, and ordered that the country enact new legislation on freedom of expression.

Edited by Estrella Gutiérrez/Translated by Stephanie Wildes

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

By Dr. Babatunde Osotimehin
UNITED NATIONS, May 20 2015 (IPS)

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

Excerpt:

Contraceptives on sale at a store in Sanaa, Yemen. Credit: Rebecca Murray/IPS

By Joseph Chamie
NEW YORK, Oct 1 2014 (IPS)

For most of human history, reproductive rights essentially meant men and women accepting the number, timing and spacing of their children, as well as possible childlessness. All this changed radically in the second half of the 20th century with the introduction of new medical technologies aimed at both preventing and assisting human reproduction.

Those technologies ushered in historic changes in reproductive rights and behaviour that continue to reverberate around the world, giving rise to increasingly complex theological, ethical and legal concerns that need to be addressed.New reproductive technologies have given rise to serious theological, ethical and legal concerns that have not been satisfactorily addressed.

Up until around the middle of the past century, reproductive rights were limited. The available birth control methods were rhythm, coitus interruptus (withdrawal), condoms and for some, the diaphragm.

Those methods in too many instances were unreliable and not considered user friendly. Also, while induced abortion has been practiced for ages, it was a drastic, dangerous and largely unlawful medical procedure.

In 1960, the oral contraceptive pill was introduced, dramatically transforming women’s reproductive rights and behaviour. In addition to the pill, modern methods of family planning, including the intra uterine device (IUD), injectables, implants, emergency contraceptive pills and sterilisation, have given women and men effective control over procreation.

Modern contraceptives have contributed to major changes in sexual behaviour and marriage. Women empowered with modern contraception can choose without the fear of pregnancy whether to have sexual relationships, enabling them to postpone childbearing or avoid it altogether.

And instead of marriage, cohabitation has become increasingly prevalent among many young couples, especially in industrialised countries.

The use of modern contraceptives also facilitated a rapid decline in family size worldwide. Between 1950 and the close of the 20th century, the world’s total fertility rate fell from five children per woman to nearly half that level.

Every major region of the world experienced fertility declines during that half century, with the greatest occurring in Asia and Latin America and the smallest in Africa.

With improved medical techniques, changing social norms and grassroots movements, induced abortion also became increasingly legalised globally. Although some remain strongly opposed to induced abortion, nearly all industrialised countries have passed laws ensuring a woman’s right to abortion.

Also at the 1994 International Conference on Population and Development (ICPD), 179 governments indicated their commitment to prevent unsafe abortion and in circumstances where abortion is not against the law, such abortion should be made safe.

Reproductive rights to terminate a pregnancy, however, have also led to excess female fetus abortions. Particularly widespread in China and India, their sex ratios at birth of 117 and 111 boys per 100 girls are blatantly higher than the typical sex ratio at birth of around 106.

Consequently, the numbers of young “surplus males” unable to find brides are more than 35 million in China and 25 million in India.

The introduction in 1970 of in vitro fertilisation (IVF) – fertilisation in a laboratory by mixing sperm with eggs surgically removed from an ovary followed by uterine implantation – radically altered the basic evolutionary process of human reproduction.

IVF provides childless couples the right and means to have biological children. It is estimated that more than five million IVF babies have followed since the birth of the first “test-tube baby” in 1978.

However, IVF has also raised ethical concerns. In addition to creating a pregnancy through “artificial” means, IVF has become a massive commercial industry prone to serious abuses and exploitation of vulnerable couples in the desire to make profits from childbearing.

IVF also permits gestational surrogacy, which extends reproductive rights to same-sex couples. In contrast to traditional surrogacy, where the surrogate is the actual mother, gestational surrogacy allows the surrogate to be unrelated to the baby with the egg coming from the intended mother or donor.

While those who are childless have a right to have biological children, gestational surrogacy raises challenging ethical questions, such as the exploitation of poor women, as well as complex legal issues, especially when transactions cross international borders.

In 1997, the cloning – or propagation by self-replication rather than through sexual reproduction – of the first mammal, Dolly the sheep, was achieved. The birth of Dolly was a major reproductive development.

Following the cloning of Dolly, scores of other animals, including fish, mice, cows, horses, dogs and monkeys, have been successfully cloned. These developments suggest that in the near future some humans may wish to assert their reproductive rights to be cloned, again raising serious theological, ethical and legal questions.

Among the transhumanist reproductive technologies imagined in the more distant future, one that stands out is ectogenesis, or the development of a fetus outside the human womb in an artificial uterus.

While ectogenesis may expand the extent of fetal viability, free women from childbearing and expand reproductive rights, it poses serious, unexplored medical, ethical and legal issues.

During the past half-century remarkable technological progress has been made in human reproduction. As a result of this medical progress, women and men have acquired wide-ranging reproductive rights and technologies to determine the number, timing and spacing of their children and to overcome childlessness with biological offspring.

The new reproductive technologies, however, have also given rise to serious theological, ethical and legal concerns that have not been satisfactorily addressed. Anticipated future medical breakthroughs in human reproduction make it even more imperative for the international community of nations to address the growing challenges and concerns regarding reproductive technologies and rights.

Edited by Kitty Stapp

Excerpt:

Millions of women in Pakistan do not have access to family planning services. Credit: Zofeen Ebrahim/IPS

By Thalif Deen
UNITED NATIONS, Sep 19 2014 (IPS)

The U.N.’s post-2015 development agenda has been described as the most far-reaching and comprehensive development-related endeavour ever undertaken by the world body.

But where does population, family planning and sexual and reproductive health rights (SRHR) fit into the proposed 17 Sustainable Development Goals (SDGs), which are an integral part of that development agenda?"We must continue to fight until every individual, everywhere on this planet, is given the opportunity to live a healthy and sexual reproductive life." -- Purnima Mane, head of Pathfinder International

Of the 17, Goal 3 is aimed at “ensuring healthy lives and promoting well-being for all at all ages,” while Goal 5 calls for gender equality and the “empowerment of all women and girls.”

But when the General Assembly adopts the final list of SDGs in September 2015, how many of the proposed goals will survive and how many will fall by the wayside?

Meanwhile, SRHR will also be a key item on the agenda of a special session of the General Assembly next week commemorating the 20-year-old Programme of Action (PoA) adopted at the landmark International Conference on Population and Development (ICPD) in Cairo in 1994.

In an interview with IPS, Dr. Babatunde Osotimehin, executive director of the U.N. Population Fund (UNFPA) said, “Twenty years ago, we were able to secure commitments from governments on various aspects of poverty reduction, but more importantly the empowerment of women and girs and young people, including their reproductive rights.

“But the battle is not over,” he said.

“Today, we are on the cusp of a new development agenda, and we, as custodians of this agenda, need to locate it within the conversation of sustainable development – a people-centred agenda based on human rights is the only feasible way of achieving sustainable development,” he declared.

Purnima Mane, president and chief executive officer of Pathfinder International, told IPS, “We are delighted the final set of [proposed] SDGs contains four critical targets on SRHR: three under the health goal and one under the gender goal.”

The inclusion of a commitment to universal access to sexual and reproductive health care services, including family planning, information and education, and the integration of reproductive health into national strategies and programmes, is necessary and long overdue, she said.

“But we have not reached the finish line yet,” cautioned Mane, who oversees an annual budget of over 100 million dollars for sexual and reproductive health programmes in more than 20 developing countries.

The SDGs still need to be adopted by the General Assembly, “and we must all continue to raise our voices to ensure these SRHR targets are intact when the final version is approved,” she added.

Mane said civil society is disappointed these targets are not as ambitious or rights-based as they should be.

“And translating the written commitment into actionable steps remains a major challenge and is frequently met with resistance. We must retain our focus on these issues,” she said.

Sivananthi Thanenthiran, executive director of the Malaysia-based Asian-Pacific Resource & Research Centre for Women (ARROW) working across 17 countries in the region, told IPS it is ideal to have SRHR captured both under the gender goal as well as the health goal.

The advantages of being part of the gender goal is that the rights aspects can be more strategically addressed – because this is the area where universal commitment has been lagging – the issues of early marriage, gender-based violence, harmful practices – all of which have an impact on the sexual and reproductive health of women, she pointed out.

“The advantages of being part of the health goal is that interventions to reduce maternal mortality, increase access to contraception, reduce sexually transmitted diseases, including HIV/AIDS, are part and parcel of sound national health policies,” Thanenthiran said.

It would be useful for governments to learn from the Millennium Development Goals (MDGs) process and ensure that the new goals are not implemented in silos, she added. “Public health concerns should be addressed with a clear gender and rights framework.”

Maria Jose Alcala, director of the secretariat of the High-Level Task Force for ICPD, told IPS what so many governments and stakeholders around the world called for throughout the negotiations was simply to affirm all human rights for all individuals – and that includes SRHR.

The international community has an historic opportunity– and obligation — to move the global agenda forward, and go beyond just reaffirming agreements of 20 years ago as if the world hasn’t changed,and as if knowledge and society hasn’t evolved, she noted.

“We know, based on ample research and evidence, based on the experiences of countries around the world, as well as just plain common sense, that we will never achieve poverty eradication, equality, social justice, and sustainable development if these fundamental human rights and freedoms are sidelined or traded-off in U.N. negotiations,” Jose Alcala said.

Sexual and reproductive health and rights are a must and prerequisite for the post-2015 agenda “if we are to really leave nobody behind this time around,” she declared.

Mane told IPS, “As the head of Pathfinder, I will actively, passionately, and strongly advocate for SRHR and family planning to be recognised and aggressively pursued in the post-2015 development agenda.”

She said access to SRHR is a fundamental human right. “We must continue to fight until every individual, everywhere on this planet, is given the opportunity to live a healthy and sexual reproductive life. ”

Asked about the successes and failures of ICPD, Thanenthiran told IPS there is a need to recognise the progress so far: maternal mortality ratios and infant mortality rates have decreased, access to contraception has improved and life expectancy increased.

However, much remains to be accomplished, she added. “It is apparent from all recent reports and data that SRHR issues worldwide are issues of socio-economic inequality.”

In every country in the world, she noted, women who are poorer, less educated, or belong to marginalised groups (indigenous, disabled, ethnic minorities) suffer from undesirable sexual and reproductive health outcomes.

Compared to their better educated and wealthier sister citizens, these women and girls are more likely to have less access to contraception, have pregnancies at younger ages, have more frequent pregnancies, have more unintended pregnancies, be less able to protect themselves from HIV and other sexual transmitted diseases, suffer from poor maternal health, die in childbirth and suffer from fistula and uterine prolapse.

Hence the sexual and reproductive health and rights agenda is also the equality agenda of this century, she added.

“Governments must commit to reducing these inequalities and carry these learnings from ICPD at 20 into the post-2015 development agenda,” Thanenthiran said.

Edited by Kitty Stapp

The writer can be contacted at thalifdeen@aol.com

A basket of condoms is passed around during International Women’s Day in Manila. Credit: Kara Santos/IPS

By Thalif Deen
UNITED NATIONS, Jul 10 2014 (IPS)

As the United Nations continues negotiations on a new set of Sustainable Development Goals (SDGs) for its post-2015 development agenda, population experts are hoping reproductive health will be given significant recognition in the final line-up of the goals later this year.

At the same time, an upcoming Special Session of the General Assembly in mid-September may further strengthen reproductive rights and the right to universal family planning."Advocates are rallying to ensure that SRHR remains as central to the next set of goals as it is to women's lives." -- Gina Sarfaty

Gina Sarfaty of the Washington-based Population Action International (PAI) told IPS, “We are at a critical juncture for sexual and reproductive health and rights (SRHR).”

As the conversation around the next set of SDGs begins to heat up, she said, “Advocates are rallying to ensure that SRHR remains as central to the next set of goals as it is to women’s lives.

“The stakes are high, and the need for action is paramount,” cautioned Sarfaty, a Geographic Information Systems (GIS) specialist and research associate at PAI.

World population, currently at over 7.2 billion, is projected to increase by 3.7 billion people by 2100. Much of this growth will occur in developing countries, with 64 percent concentrated in just 10 countries, according to PAI.

In eight of these nations – Nigeria, Tanzania, Democratic Republic of Congo, Niger, Uganda, Ethiopia, Kenya and Zambia – an important driver of population growth is persistently high fertility.

The remaining two countries accounting for the world’s increase – India and the United States – are those with already large populations and high net migration.

The ongoing negotiations for SDGs take place against the run-up to the upcoming special session of the General Assembly commemorating the 20th anniversary of the 1994 landmark International Conference on Population and Development (ICPD) in Cairo.

The special session, to be attended by several heads of state, is scheduled to take place Sep. 22 during the 69th session of the General Assembly.

Dr. Babatunde Osotimehin, under-secretary-general and executive director of the U.N. Population Fund (UNFPA), told IPS the principles set at the ICPD in 1994 are as relevant today as they were 20 years ago.

“But we need to act strong and fast to realise the Cairo vision and achieve universal access to sexual and reproductive health and reproductive rights, including family planning,” he added.

The special session presents the perfect opportunity for governments, at the highest level, to recommit to its success and to renew their political support for actions required to fully achieve the goals and objectives of its Programme of Action and achieve sustainable development, he said.

This will also place the Cairo principles firmly in the post-2015 development agenda, said Dr. Osotimehin, a former Nigerian minister of health.

Purnima Mane, president and chief executive officer of Pathfinder International, told IPS the September meeting represents an opportunity for world leaders to assess progress made over the past 20 years against the goals and strategies developed in 1994, identify any remaining gaps in performance that require increased attention and investment, and realign their efforts moving forward.

“This is a very important session for all of us working on sexual and reproductive health since it provides a critical forum for reaffirming and unifying international commitment to ICPD goals and for making an added push to do more on areas and in countries where we are lagging,” she said.

Asked why there wasn’t a follow-up international conference, perhaps an ICPD+20 on the lines of the Rio+20 environment conference in 2012, Mane said the Cairo Programme of Action developed a very forward-looking agenda and set the bar high for the international community 20 years ago.

She said its goals are still relevant and actionable, and the agenda is unfortunately not yet finished.

“My sense is that having a follow-up conference in such an environment was seen as neither strategic nor a good use of resources,” Mane said.

The upcoming special session “is intended to heighten focus on the goals established in the 1994 Programme of Action, stimulate discussion around what we will do to complete the unfinished agenda, re-engage on commitments already made and also push for more.

“I would hope the upcoming U.N. session will highlight the need to include sexual and reproductive health and rights upfront as a core component of the Sustainable Development Goals as the Open Working Group continues to develop its proposal,” said Mane, who oversees sexual and reproductive health programmes in more than 20 developing nations on an annual budget of over 100 million dollars.

Asked about the current status of world population growth, PAI’s Sarfaty told IPS that despite the fact that mortality has declined substantially, women in sub-Saharan Africa currently have more than five children on average, representing a modest decrease from the average of 6.5 children they had in the 1950s.

Compared to Latin America and Asia, she said, a slower pace of fertility decline has characterised sub-Saharan Africa, with stalls and even reversals along the way.

Of 22 countries where recent survey data is available, 10 are transitioning towards lower childbearing while 12 are currently experiencing fertility stalls.

“Therefore, the expectation that fertility will steadily decline in Africa, as the U.N. projects, will not hold without concerted policy and programme effort,” she warned.

The polar opposite fertility scenario is happening in the high income countries with low levels of fertility.

It is estimated that 48 percent of the world’s population lives in countries where women have fewer than 2.1 children on average in their lifetimes, she pointed out.

While fertility rates in these countries may be below replacement level, their need for family planning does not disappear, she declared.

Sarfaty said family planning use continued in Iran, for example, after the government discontinued its funding of family planning programmes in an attempt to encourage higher birth rates.

In addition to being ineffective, restricting access to family planning also restricts the right of a woman to determine her family size, she added.

Meanwhile, in a report released Thursday, the United Nations said the world’s population is increasingly urban, with more than half living in urban areas today and another 2.5 billion expected by 2050.

With nearly 38 million people, Tokyo tops U.N.’s ranking of most populous cities followed by Delhi, Shanghai, Mexico City, Sao Paulo and Mumbai.

The largest urban growth will take place in India, China and Nigeria: three countries accounting for 37 per cent of the projected growth of the world’s urban population between 2014 and 2050.

By 2050, India is projected to add 404 million urban dwellers, China 292 million and Nigeria 212 million.

Excerpt:

Emily Deng hopes she will deliver her baby safely at Juba 3 POC camp, South Sudan. Dr. Julitta Onabanjo, regional director of United Nations Population Fund (UNFPA) East and Southern Africa Region, says humanitarian crises are reproductive health disasters, especially because pregnancy-related deaths tend to soar during this period. Courtesy: United Nations Population Fund

By Julitta Onabanjo
JUBA, May 19 2014 (IPS)

As with many conflicts and other humanitarian emergencies around the world, those who suffer the most are women, young girls and children. The current terrible crisis in South Sudan is no exception. 

When I visited the country recently, I met women and girls, some with babies strapped on their backs, living in very poor conditions in protection camps within United Nations bases in the capital city of Juba. Walking through the camps, I also met young people, many of whom are now seeing their dreams of a better life being shattered by the violent conflict.

Many shared their stories freely with me. What is clear is that the jubilant songs sung during the country’s independence only a few years ago have now been replaced by the voices of agony and anguish of families torn apart by the violence as well as the protracted political crisis since the early 1990s.

In a report released on May, 8 the U.N. Mission in South Sudan (UNMISS) noted that the “conflict has exacerbated the vulnerability of women and children in South Sudan to sexual violence.”  Sexual and gender-based violence is not new in South Sudan – but the scale has been exponential due to the conflict and the absence of protection for the most vulnerable, who are women and children. We all know that cases of gender-based violence are under-reported during times of peace, and much more so in conflict situations. Yet even one case of sexual violence is one too many.

In far flung camps, there are reports of rapists targeting women and girls as they attempt to fetch firewood, look for food or fetch water for their families. Some have been killed as a result and many are too afraid to report their violation.

Worse still, the ability of survivors of sexual violence to receive services during the precarious situation has severely diminished. Consequently, most incidents of sexual violence could not be reported to health actors, nor documented or verified through medical reports, says the UNMISS report.

And that is not all. Humanitarian crises are reproductive health disasters, especially because pregnancy-related deaths tend to soar during this period.

A South Sudanese woman receives a reproductive health kit after delivering her baby. Courtesy: United Nations Population Fund

South Sudan has the world’s worst maternal mortality ratio of 2,054 deaths per 100,000 live births.  Prior to the crisis, the country’s fertility rate was nearly seven children per woman. It is estimated that 80,000 pregnant women living in affected areas (and thus 2,800 births every month) will require care by the end of December 2014.

Furthermore, an estimated 12,000 women will likely experience complications and require care, while 4,000 births are likely to require emergency Caesarean sections. Without adequate care, this number could increase considerably.

As a result of the crisis, two thirds of the health facilities in the areas affected by the conflict are reportedly closed or operating at limited capacity. In Jonglei, Upper Nile and Unity states, the state hospitals that usually provide emergency obstetric care services are not functional. Alternative facilities at the periphery have either been looted or destroyed and/or health staff members have fled due to insecurity.

There are very few skilled birth attendants or equipment available for comprehensive obstetric care. Pregnant women, who are cut off from basic services and healthcare, are therefore particularly vulnerable in this conflict situation.

But amidst the crisis there is considerable resilience and hope. At one U.N. Population Fund (UNFPA)-supported makeshift maternity tent I had the privilege to visit, I was humbled to meet international voluntary midwives who were working with minimum resources to ensure mothers could deliver their children safely.

As a woman and as a mother, I was moved to tears by the smile on a young woman’s face as she breastfed her newborn baby for the first time, in a  makeshift tent. It is our collective humanity that must prevail and make a difference in the lives of the women of South Sudan. We can’t afford to abandon them and leave them to their own devices.

There is an urgent need to support government and other actors to accelerate the provision of lifesaving maternal and neonatal health information and services, without which many pregnant women and their babies are at high risk of death or disability. We also need to address the gender-based violence taking place during this conflict, despite the challenge of reporting experienced by many survivors.

The world cannot afford to ignore what is going in South Sudan. It is a humanitarian tragedy unfolding right in front of our eyes.

Our hope is that the upcoming meeting of donors in Oslo will be able to generate the necessary resources to address the care and dignity of South Sudanese women and girls. We also hope that constructive political dialogue among all actors will speedily return the country to a path of peace that is desperately needed RIGHT NOW.

While the need to promote peace and security for overall development is urgent, ensuring care and dignity for each and every woman and young girl, those most affected in crisis situations, is equally urgent.

The innocent eyes of those women and girls I saw in the protection of civilian sites are on all of us. The question is, how long will we keep them on the edge?

Excerpt:

A Kopal gender sensitisation meeting in Uttarkashi district, India, ranked the fourth most dangerous country in the world for women. Credit: Nitin Jugran Bahuguna/IPS

By Jonathan Rozen
UNITED NATIONS, May 7 2014 (IPS)

As the U.N. focuses on refining its Post-2015 Development Agenda, divisions surrounding issues of population and development continue to plague consensus on a universal way forward.

“People have to be at the centre of development,” Dr. Babatunde Osotimehin, executive director of the U.N. Population Fund (UNFPA), told IPS. “I think we are beginning to see a greater commitment [of governments] to deliver on gender parity, girls rights, issues of gender-based violence and girls education.”“I don’t think that many of these big problems are going to be resolved by exchanging documents and meeting at conferences. It’s going to be what we do on the ground." -- UN Women Executive Director Phumzile Mlambo-Ngcuka

Following the 2014 U.N. Commission on Population and Development (CPD), an annual gathering where member states, non-governmental organisations (NGOs) and other members of civil society discuss and define goals on population and development, serious divisions emerged regarding issues of sexual health, sexual education and gender.

“The balance of this resolution remains heavily skewed towards peculiar interests of certain developed countries, as evidenced by undue emphasis on selected rights over the real development priorities,” said Fr. Justin Wylie, attaché for the Permanent Observer Mission of the Holy See to the U.N., on Apr. 12, following the adoption of the CPD outcome resolution.

“I refer in particular to the heavy focus on sexual or reproductive mores,” he said.

The sentiment that particular issues had a negative effect on the conduct of the conference was also expressed by member states with views in support of U.N. priorities.

“We were disappointed that certain contentious issues remained the focus of the conference at the expense of discussing more productive topics to improve the health of global populations,” Nicolas Doire, spokesperson for the Canadian Department of Foreign Affairs, Trade and Development (DFAIT), told IPS.

While UNFPA may not agree with the views of everyone at the CPD, the agency does understand the political nature of such conferences and the need for inclusive, plural dialogue in adopting the platform on population and development.

“The issue of sexuality, the issue of sexual reproductive health and [reproductive] rights evokes all kinds of things … apart from the politics,” Osotimehin told IPS. “We’ve always had conservatism around our issues.

“If we don’t bring people together in order to construct an action platform that brings all of the groups together, we are not likely to achieve the adoption,” he said.

For Dr. Osotimehin, a human rights-based agenda is essential because it was the foundation for the 1994 International Conference on Population and Development (ICPD) in Cairo. That being said, he also recognises that over the last 20 years, the world has changed.

“Today there are more non-state actors and some of the countries are more vocal than they were before, so we are dealing with a new set of constituencies,” he said. “But if you don’t address rights … you are not going to make the kind of progress we want to see and match the investments.”

Many girls in rural areas of Pakistan say they dropped out of primary school either because there were no secondary schools in their villages, or because they were not within safe walking distance. Credit: Farooq Ahmed/IPS

Linking population and development

The U.N. Programme of Action of the ICPD Beyond report, released on Feb. 12, outlined the progress made on issues of population and development since the 1994 Cairo Conference.

A primary finding of the report was that where girls have the power make choices in their lives, from reproductive rights to education, they can add significantly to the economic capacity and development of their country.

That is why UNFPA has identified inequality as the primary impediment to developmental goals and defined the adolescent girl as the “face of development.”

“Imagine that you can give her the education she needs to protect her rights … ensure that she can access contraception when she needs to, ensure that she can get good quality jobs, ensure that she can marry when she wants to marry, ensure that she can participate politically. Then, you just changed the world,” Osotimehin told IPS.

This is not to say that ground level cultural needs are not recognised. It is important to engage in dialogue with communities, he said, in order to understand what they need, not only what their needs are believed to be.

Taking action

The U.N. has identified the imperative for direct action on population issues in addressing the associated developmental problems.

“I don’t think that many of these big problems are going to be resolved by exchanging documents and meeting at conferences. It’s going to be what we do on the ground,” Phumzile Mlambo-Ngcuka, U.N. under-secretary-general and the executive director of U.N. Women, told IPS. “Activism, activism, activism.”

With this is mind, international conferences do provide legitimacy from which actors can work.

“It does help activists on the ground when something has been agreed to [in the conferences], because there is something to hang onto. So you also want those victories. But I think that we must not fool ourselves and think that [with a piece of paper], the problems have been solved,” Mlambo-Ngcuka said.

Beyond 2015

Looking to the ICPD conference in September, the key work ahead will be to reduce divisions and promote implementation.

“The fact that we have a document and that everybody has signed it does not mean that the problem has gone away. Those that feel they have lost will not necessarily implement what is there because it has been agreed to,” Mlambo-Ngcuka told IPS.

Moving the agenda’s focus away from controversial issues to incorporate the range of connections population issues have on development is one strategy UNFPA and other members of the international community are looking at.

“Integration should be big in the next development agenda,” Osotimehin told IPS. “We need to create linkages between one thing and the next … so were actually driving a development agenda.”

“We are focused on building consensus around initiatives that are proven to have the greatest impact,” said Doire.

The importance of a dynamic approaching to developmental challenges is central to the U.N. strategy as it works to build an agenda that includes contested subject matter.

“We need to bring all of the issues to bear when we talk about [population], so that it doesn’t get caught up in the old debates and questions,” Kathy Calvin, president and chief executive officer of the U.N. Foundation, told IPS. “It’s about your country’s economy [and] your country’s environment.”

At the Women Deliver conference in Kuala Lumpur, advocates shared strategies for breaking religious taboos on reproductive rights. Credit: Stella Paul/IPS

By Stella Paul
KUALA LUMPUR, May 31 2013 (IPS)

Liberian journalist Mae Azango says she spent a year living “like a bat, going from tree to tree” with her daughter in order to escape religious fanatics who were threatening to kill her for exposing the practice of female genital mutilation in her home country last year.

A senior reporter at the local FrontPage Africa publication, Azango told IPS that although the Liberian government signed a treaty in 2012 promising its citizens the right to information, it continues to hold back data on sexual and reproductive health and rights from journalists.

“With every story that I write, I take a great risk,” she says, adding that she is entirely dependent on “secret sources” within the government to gather information, since very little is shared in the public domain.

Her woes found echo among hundreds of women and health experts gathered in the Malaysian capital of Kuala Lumpur for the third annual Women Deliver global forum that ended Thursday.

Hailing from different corners of the globe, participants at the conference had no trouble identifying common goals: breaking taboos surrounding sex education and creating a safe climate for advocates, health professionals and educators to spread awareness on safe sex and family planning.

In Morocco, a country of 32 million people, schools are banned from offering sex education to young people because parliamentarians believe it to be an “evil concept, designed to promote promiscuity,” sexual and reproductive advocate Amina Lemrini told IPS.

She says progress on improving sexual health services in her country has been particularly slow due to taboos introduced by religious leaders.

With a government unwilling to challenge clerics, the job of providing crucial health services falls entirely on the shoulders of civil society, who are then threatened for their efforts.

Lemrini says she does not know a single reproductive rights activist who has not been threatened, yet the government offers them no protection.

Their distress has been recognised by leading experts in the field, including the executive director of the United Nations Population Fund (UNFPA), Babatunde Osotimehin, who told IPS that religious fundamentalism is a “indeed a worry” when it comes to progress on sexual health.

Still, he urged activists to continue their work, adding, “Fundamentalism exists in all societies and all religions – what matters is how we communicate our message.”

He believes that if more people are made aware of their rights and choices, they will not hesitate to defy archaic laws and so-called “cultural taboos.”

“The average person on the street does not want a situation where death comes calling every day for reasons that can be prevented,” he stressed.

Indeed, even a cursory glance at global statistics is enough to make a strong case for the need for better communication: according to the UNFPA, nearly 800 women die every single day as a result of pregnancy-related complications; in a year, that number is closer to 350,000 deaths, of which 99 percent occur in developing countries.

Sex-selective abortions and neglect of newborn baby girls have resulted in an estimated 134 million “missing” women worldwide.

Doing a wide sweep of global data, the UNFPA estimates that “millions of girls” practice unsafe sex and lack information on contraceptives. Osotimehin recently wrote that an “unmet need for family planning exists among 33 percent of girls between 15 and 19 years old…in Ethiopia, 38 percent in Bolivia, 42 percent in Nepal, 52 percent in Haiti and 62 percent in Ghana.”

Nyaradzayi Gumbonzvanda, head of the Young Women’s Christian Association (YWCA), told IPS that giving up on communication about sexual and reproductive health and rights was not an option.

“We need an operative environment for those who are discussing this issue,” she said. “We need to protect the media — this isn’t a choice. Governments must scale up the level of cooperation with the media and provide supportive legal backup where it is not yet available.”

Gumbonzvanda thinks that citizen journalism could be an effective way to mitigate the risk posed by fundamentalists, not only by amplifying the voices of those who often go unheard, but also by empowering common citizens to take action.

Nowhere was the power of citizen journalism more evident than during the revolution in Egypt in 2011, where blogs, tweets, and Facebook posts replaced TV channels, newspapers and radio stations in reaching millions of people.

Today, as Egyptians struggle against the conservative policies of the ruling Muslim Brotherhood, that network of citizen journalists has turned its attention to reproductive health and safe sex, topics that are frowned upon by Islamists.

Ahmed Awadalla, sexual and gender-based violence officer for Africa and Middle East Refugee Assistance (AMERA), told IPS that anyone discussing the issue risks detention, arrest, harassment and imprisonment.

As a result, the number of bloggers increases every day, as citizens and advocates flee to cyberspace in search of safe forums to share information and ideas.

“When I blog about the sexual rights of women I break two rules,” Awadalla said. “First, by speaking about a forbidden issue and secondly by speaking as a man, who is not supposed to take the side of women.” Though he faces harsh repercussions, nothing will persuade him to give up his advocacy.

But even while citizens innovate new ideas to get around the deadly threats of engaging in sex education, experts say governments must not be let off the hook for failing to provide these basic services.

Governments in Asia, Africa and Latin America must be held accountable by foreign funders, says Agnes Callamard, executive director of the London-based ‘Article 19’, an organisation dedicated to freedom of expression.

“Every government has committed to spending a certain amount of the funding they receive (on sexual health),” she said, so tracking aid flows could pressure governments to improve their track records on information sharing.

In fact, when the Mexico-based Grupo de Información en Reproducción Elegida (GIRE) started to track aid supposed to be allocated to providing information on sexual and reproductive health in 2011, “we found that nearly a million dollars were missing,” said GIRE Information Rights Advocate Alma Luz Beltrán y Puga. “We sued the government over that.  If the same tracking is done the world over, it can lead to greater accountability.”

According to a study done by the World Health Organisation (WHO), developed countries donated nearly 6.4 billion dollars to help provide access and information on reproductive health in developing countries. It is now up to civil society to ensure that money is responsibly allocated.

View outside a U.N.-supported family clinic in Khovd aimag, Mongolia, providing immunisation and child care. Credit: UN Photo/Eskinder Debebe

By Thalif Deen
UNITED NATIONS, Nov 14 2012 (IPS)

Since the 1966 International Covenant on Economic, Social and Cultural Rights, the United Nations has consistently maintained that family planning is a basic human right to be exercised by all – not just the wealthy and otherwise privileged.

The right of individuals to decide on the number of children they bear has been enshrined in at least seven other key treaties and U.N. declarations: the proclamation of the international human rights conference in 1968, the 1969 General Assembly resolution on Social Progress and Development and the 1979 Convention on Women’s Rights (CEDAW).

And over the last three decades, family planning has also been reaffirmed in the Children’s Rights Convention of 1989, the Vienna Programme of Action on Human Rights in 1993, the Programme of Action of the 1994 International Conference on Population and Development (ICPD) and the Beijing Platform of Action in 1995.

Dr. Babatunde Osotimehin, executive director of the New York-based U.N. Population Fund (UNFPA), is unequivocal in his strong advocacy of family planning.

“Family planning is not a privilege, but a right,” he told IPS. “Yet, too many women and men are denied this human right.”

The latest 2012 UNFPA report released Wednesday says the huge unmet need for family planning persists, “despite international agreements and human rights treaties that promote individuals’ rights to make their own decisions about when and how often to have children”.

An estimated 222 million women lack access to reliable, high-quality family planning services, information and supplies, putting them at risk of unintended pregnancies.

The report notes that even in developed countries, there are high levels of unintended pregnancies, especially among adolescents, the poor and ethnic minorities.

Dr. Osotimehin points out that family planning has a positive multiplier effect on development.

“Not only does the ability for a couple to choose when and how many children to have help lift nations out of poverty, but it is also one of the most effective means of empowering women,” he told IPS.

He argues that women who use contraception are generally healthier, better educated, more empowered in their households and communities and more economically productive.

And women’s increased labour-force participation boosts nation’s economies, he adds.

Titled, “The State of World Population 2012: By Choice, Not By Chance: Family Planning, Human Rights and Development”, the report says voluntary family planning should be available to all – because it is a universal human right.

Shortages of contraceptives are only one reason why millions of people are still unable to exercise their right to family planning.

Access to family planning may also be restricted by other factors, including
poverty, negative social pressures, gender inequality and discrimination.

Still, the report finds that financial resources for family planning have declined and contraceptive use has remained mostly steady.

In 2010, there was a shortfall of about 500 million dollars in expected contributions from donor countries to sexual and reproductive health services in developing countries.

Contraceptive prevalence has increased globally by just 0.1 percent per year over the last few years.

At the London Summit on Family Planning last July, donor countries and Foundations together pledged about 2.6 billion dollars to make family planning available to 120 million women in developing countries with unmet needs by 2020.

Developing countries themselves pledged two billion dollars.

But still, an additional 4.1 billion dollars is necessary each year to meet the unmet needs for family planning of all 222 million women who would use family planning but currently lack access to it, according to the UNFPA report.

“This investment would save lives by preventing unintended pregnancies and unsafe abortions,” it says.

However, money is just one part of the solution, the report points out.

Failing to meet the sexual and reproductive health needs of adolescents and young people in Malawi, for example, contributed to high rates of unintended pregnancy and HIV, the report said.

In the United States, the report showed that teenage motherhood reduces a girl’s chances of obtaining a high school diploma by up to 10 percent.

To ensure that every person’s right to family planning is realised, the report calls on governments and leaders to take or reinforce a rights-based approach to family planning; secure an emphasis on family planning in the global sustainable development agenda that will follow the Millennium Development Goals in 2015; ensure equality by focusing on specific excluded groups; and raise funds to invest fully in family planning.

“The law has many gaps, and satisfies no one,” says activist Martha Aguñín. Credit: Hacelosvaler.org

By Raúl Pierri
MONTEVIDEO, Oct 18 2012 (IPS)

The Uruguayan Congress passed a law Wednesday decriminalising abortion, making it one of the few countries in the region where abortion is allowed in cases other than rape, incest, malformation of the fetus or danger to the mother’s life. But activists who backed the bill are not pleased with modifications introduced in the final version.

“We see this law as minimal; it is not what we were hoping for,” Martha Aguñín, spokeswoman for Mujer y Salud en Uruguay (MYSU – Women and Health in Uruguay), told IPS.

“It has many gaps, and satisfies no one,” added Aguñín, whose non-governmental organisation is leading the campaign “Legal Abortion – Uruguay; They are your rights, demand that they be respected!”

The law decriminalises abortion in the first trimester of pregnancy. But it will only be permitted in cases in which the pregnant woman complies with certain requisites.

Under the bill approved by the Senate Wednesday, which is set to be signed into law by President José Mujica, the woman seeking an abortion must first explain to a doctor the “economic, social, family or age difficulties that in her view stand in the way of continuing the pregnancy.”

The doctor will immediately refer her to an interdisciplinary panel made up of at least three professionals: a gynaecologist, psychologist and social worker.

The panel will advise her on the content of the law, the risks posed by the procedure, and the alternatives to abortion, and she will be given five days to mull it over.

If she doesn’t change her mind after the five-day waiting period, she will be allowed to have an abortion, without any further necessary steps, in one of the country’s health clinics or hospitals.

But Aguñín criticised this system, saying the panels would act in practice as a sort of “tribunal” or court.

“When women make a decision of this kind, we don’t need to be instructed to reflect on it, because we already do that in a conscious, adult, responsible manner,” she said.

“We have the right to decide when and how we will have children, and how many, without having to go in front of a tribunal that orders us to think about it for five days,” she said.

The activist explained that the new abortion law was not the one civil society groups wanted, but was the only one possible, as it was the result of negotiations and concessions made by the lawmakers of the left-wing Broad Front coalition, which has governed Uruguay since 2005, who have a majority in Congress.

A similar attempt failed in 2008, when the legislature approved a law on “the defence of sexual and reproductive health” but President Tabaré Vázquez (2005-2010), the leader of the Broad Front at the time, vetoed the articles that legalised abortion.

Vázquez, a prominent oncologist, argued at the time that abortion was “a social ill that must be avoided,” and said the bill could not deny “the reality of the existence of human life in the gestational state.”

But this time around, President Mujica has said he will not interfere and will sign the bill.

After a debate that dragged on for over 10 hours, the law was approved with the votes of 16 Broad Front senators and one senator of the centre-right National Party, in the 31-member Senate. The Chamber of Deputies had already passed the bill.

The new law, in practice

MYSU also expressed doubts about the implementation of the new law, given the shortcomings of the Uruguayan health system.

“We have found that women who live in some places in the interior, like Río Branco (a small town in the northeast of the country), do not have access to the services or the referral teams on sexual and reproductive health. They have to travel 80 km to receive attention and advice” in a larger city, said Aguñín.

“The system does not offer the conditions, under these urgent timeframes, for women to have an abortion in safe conditions,” she contended.

But Ana Labandera, president of the organisation Iniciativas Sanitarias (Health Initiatives), made up of health professionals who support the new law, was more upbeat.

“It is a law that can be perfected,” she told IPS. “It has a few problems, but it is a big stride anyway towards guaranteeing the rights of women, and allowing them to complete their decision process about having an abortion within the integrated national health system.”

With regard to the implementation of the law, Labandera said there are now trained professionals in different parts of the country, thanks to articles of the 2008 law on sexual and reproductive health that were not vetoed by Vázquez.

“These services are starting to function, or are already functioning, and this will clearly make it possible for the professionals to become qualified to deal with the entire process involved in abortion cases,” she said.

“The platform, the infrastructure, has already been put in place so that this law can be a complementary part of the services that are already provided,” she added.

The international human rights group Médicos del Mundo (Doctors of the World) celebrated the new law, describing it as a “positive precedent” for all of Latin America.

In a statement, the organisation said the law was a step forward for women’s health, from a regional perspective, and added that it would closely follow its implementation.

Abortion had been legalised in Uruguay in 1934, during a time of new liberal ideas. But that change provoked controversy, and in 1938, abortion was made a crime under the penal code. Since then there have been eight unsuccessful attempts at reforming the law, the last of them in 2008.

It is estimated that more than 30,000 abortions a year are practiced in this South American country of 3.3 million people. Of every 10 pregnancies, three or four are interrupted, Labandera said.

According to figures provided by MYSU, the highest rates of abortion are in Latin America and Africa, where the practice is highly restricted in nearly every country, and where many women have unplanned pregnancies.

In this hemisphere, abortion on request is currently only legal in Cuba, Canada, the United States, Puerto Rico, three countries of the French Antilles, French Guiana, Guyana and Barbados. And in 2007, the Mexico City government made abortion legal in the capital.

In the rest of heavily Catholic Latin America, it is only allowed under narrow circumstances, such as cases of rape, incest, a malformed fetus or danger to the mother’s life. And in Nicaragua it is illegal under any conditions.

In a survey carried out in June by Radar, a Uruguayan polling firm, 51 percent of respondents said they were in favour of decriminalising abortion, 42 percent said they were opposed, and the rest did not express an opinion.

The Public Health Ministry reported that between 2007 and 2011, there were no deaths resulting from illegal abortions, although civil society organisations express doubts over that claim.

So far this year, two women, ages 28 and 32, died in public hospitals as a result of complications caused by medical abortion brought on by misoprostol, a drug used to treat ulcers that also causes early abortion.

When Philippines President Benigno Aquino III delivered his annual state of the union address in July, he appealed to the country’s lawmakers to break a  deadlock on progressive birth control laws in this predominantly Catholic nation.

An estimated 15 Filipina women currently die from pregnancy-related complications every day – up from a daily average of 11 a decade ago – and many of these are teenagers from among the urban and rural poor, according to a government survey.

In the decade after the law was originally proposed, unintended pregnancies have risen by 54 percent, according to the government’s ‘Family Health Survey-2011.’  The bill seeks to addresses this situation by offering contraceptive options, reproductive health care and sex education in schools.

According to the survey, the maternal mortality rate (MMR) reached 221 deaths for every 10,000 live births during the 2006 – 2010 period, marking a 36 percent increase from the 162 deaths during the 2000 – 2005 period.

In early August, the President’s allies in the House of Representatives had occasion to cheer as lawmakers in the Congress voted to end the fractious debate that had trapped ‘The Responsible Parenthood, Reproductive Health and Population Development Act’ in a Lower House parliamentary committee.

But, as the reproductive health (RH) bill makes its way through the Senate and the House for amendments, its sponsors face filibustering by a vocal minority trying to delay passage of the bill before Oct. 15 when the term of the current Congress expires.

“The anti-RH forces know that at the moment the pro-RH forces are likely to have the majority, so their strategy is to prolong the parliamentary process,” Congressman Walden Bello of the Citizens Action Party told IPS in an interview.

“Once we get to mid-October, it will be very difficult to muster quorums to take up legislation since most members of the House will be busy campaigning for reelection (for next May’s election),” Bello said.

According to Bello, the strategy of the vocal minority – about 120 members in the 285-strong Lower House –  is to leverage the political influence that the Catholic Church wields in this archipelago of 96.5 million people.

“The anti-RH forces hope that some of the pro-RH forces will waver and decide against voting for the bill for fear that the Catholic Church hierarchy will tell their Catholic constituents to vote against them,” Bello said.

The clout of the Church is playing out in the  Jesuit-run Ateneo de Manila University where some 190 academics supporting the RH bill have been threatened with heresy proceedings, according to local media.

“The first principle of canon law is that we don’t allow teaching that is against the official teachings of the Church,” Bishop Leonardo Medroso told a local radio station in an interview. “If there is somebody who is giving instructions against the teachings of the Church, then they have to be investigated immediately.”

The Church has also backed street protests against the controversial bill and one “people power” gathering drew an estimated 10,000 people in the capital.

Arguments trotted out against the bill at such meetings include loss of family values in a ‘contraceptive society’ and state interference in what is seen by many as a religious domain.

“The RH bill has become a political question because of the role of the Church in opposing it,” says Harry Roque, professor of constitutional law at the University of the Philippines. “The influence of the Church is ever persuasive.”

“But the reality is that we need this bill,” Roque said in a telephone interview from Manila. “It is important for the President to do what is right. He is deeply committed to supporting this bill.”

To do otherwise would expose the Aquino administration to charges of  being remiss in meeting United Nation’s Millennium Development Goal (MDG)  of slashing by three-quarters the maternal mortality ratio (MMR) by 2015 against what it was in 1990.

Local women’s rights groups and U.N. agencies monitoring the country’s progress in meeting MDG 5 (one of eight goals) relating to maternal health and reducing the MMR hold that the Philippines is likely to miss the target.

“The first RH bill, which was proposed in the Upper and Lower House in 2001, was meant to “respond to the various RH problems in an integrated and rights-based fashion,” says Junice L. Demeterio-Melgar, executive director of Likhaan, a centre for women’s rights and health that is backed by a national network of grassroots activists.

“It specifically wanted to call attention to existing but essentially tabooed issues like adolescent RH, post-abortion care and sex education,” Demetrio-Melgar said.

“A law was needed to mainstream the integrated health and rights-based approach, as well as to override the devolution of the Philippines healthcare system,” she told IPS. “The bill was meant to institutionalise the department of health’s RH programmes.”

The non-passage of the bill has adversely affected lingering poverty in a country  where nearly 20 percent live below the U.N.’s 1.25 dollars-a-day poverty line.

“The richest women want 1.9 children and have two; the poorest women want four children but have six,” says Demeterio-Melgar. “Unintended fertility keeps families poor and families with more than three children have difficulty feeding their children and sending them to school.”

From a wooden, weather-beaten building on the edge of this border town, Mahn Mahn charts dangerous missions deep Myanmar (also Burma) for the 2,000-odd health workers under his wing.

These tours, through the mine-infested stretches of eastern Myanmar, include supplying basic maternity kits for pregnant women from the country’s ethnic minorities.

Beneficiaries of these humanitarian forays by the Back Pack Health Worker Team (BPHWT), the non-profit group that Mahn Mahn is secretary of, include the Karen, Karenni, Mon and Shan communities.

In staying its course, this group, which began its mission over a decade ago, implies that little has changed on the ground despite ceasefire agreements signed over the past 10 months between the reformist government of President Thein Sein and armed ethnic groups.

The communities affected by the decades-long conflict on the mountainous, jungle terrain of the Thai-Myanmar border are highly vulnerable. Human rights groups estimate that the fighting has rendered 500,000 villagers as internally displaced persons (IDPs).

“If you want to know about the impact of the conflicts, start with maternal mortality (MM) along eastern Burma – the worst in the country,” says Mahn Mahn, the 48-year-old medic from the Karen ethnic minority. “One in 12 pregnant women risks dying because of complications.”

His words are echoed by other international and local public health organisations working along the Thai-Myanmar border. In eastern Myanmar, MM rates have hovered between 721 and 1,200 per 100,000 live births compared to Myanmar’s national average of 240 per 100,000 live births.

These MM rates “dwarf the rates in Thailand (44 deaths for 100,000 live births), leaving women in eastern Burma with the worst pregnancy outcomes anywhere in Asia,” noted a report released this February by the Global Health Access Programme (GHAP), a U.S. non-governmental organisation.

The report, ‘Separated by Borders, United by Need’, describes the reproductive health crisis as a “public health emergency.” The absence of skilled birth attendants, lack of access to contraception, limited health information and absence of health clinics within easy reach have fuelled such deaths at childbirth, it said.

Too many women dying of complications arising from unsafe abortions and post-partum haemorrhage also expose the level of human rights violations perpetrated by Myanmar’s military during its armed campaigns against ethnic rebel groups.

The government’s official policies in the conflict zones work to deny healthcare to the ethnic minorities and prevent international humanitarian organisations from stepping in.

“We have documented that the experience of human rights violations is correlated with negative health outcomes,” says Jen Leigh, field director for GHAP. “Households that have experienced forced displacement have higher odds of infant and child death, child malnutrition and failure to use contraception.”

In a region where, according to surveys, some 18 percent of women of reproductive age are malnourished, stories of MM cases come as no surprise.

“From the information I gathered, attending trainings with midwives or health workers from our partner organisations, it appears like everybody knows somebody who died of pregnancy-related complications,” Leigh said in an IPS interview.

Little wonder why the Mae Tao clinic in Mae Sot, run by the legendary Dr. Cynthia Maung, has become a magnet for pregnant women along the border. Its reproductive health team delivers between 3 -15 babies daily as part of a free service.

Last year saw the clinic assisting a record 3,033 live births, up from the previous year’s 2,758 live births.

Close to half of the women who gave birth at the clinic came from across the border, following antenatal care they had received from Dr. Cynthia, an ethnic Karen who has won six international awards for her humanitarian work at the clinic since 1989.

But deep in the conflict zones, where the guns have gone silent, women have no choice, no hope for clinical care when giving birth. “Between 80 to 90 percent deliveries are at home with untrained midwives,” says Dr. Cynthia, as she is known here. “Only four percent have access to emergency care in a clinic.”

“There is a need for more trained birth attendants in those areas,” she told IPS. “They could save lives if they know safe birth techniques and be supplied with birth-kits. Even cutting an umbilical cord properly is a matter of life and death.”

Dr. Cynthia’s clinic has helped the BPHWT train women from remote areas about safe birthing practices. Over 800 local women have been given training trained and supplied with sterilisation equipment, gloves and razor blades to cut umbilical cords.

“The communities have begun to depend on our trained birth attendants,” says Mahn Mahn. “We are helping women who are unable to make it to the Mae Tao clinic or the few other clinics in the ethnic areas.”

He expects this local variant of a mobile health service to continue. After all, the BPHWT, which has 95 teams that fan out across the rugged terrain with health supplies slung behind their back, handles other health emergencies too, such as aiding landmine victims.

“It is going to be a long time before the ceasefires become meaningful for communities along the border,” Mahn Mahn notes. “Let’s say it will be so when the MM rates come down.”

Cricket star Kumar Sangakkara promoting HIV/AIDS awareness. Credit: UNFPA

By Feizal Samath
COLOMBO, Jul 16 2012 (IPS)

Sri Lanka has long enjoyed a low 0.1 percent HIV prevalence but, as the number of fresh infections rises steadily, experts are calling for a change in the country’s archaic laws that make sex work illegal and criminalises homosexual activity. 

David Bridger, country coordinator for UNAIDS in Sri Lanka and the Maldives, is among those who believe that stigma and discrimination combined with insensitive laws are fueling a slow but steady increase in the number new HIV infections.

“We have one part of government trying to reach people at high risk with targeted prevention efforts and another part of the government arresting people and driving them away from those very services,” Bridger tells IPS.

Bridger said the contradicting approach “does not make sense from a public health point of view and makes prevention more costly and less effective.”

Harischandra Yakandawala, programme manager at Sarvodaya, a non-governmental organisation (NGO) that works with the Global Fund for AIDS, TB and Malaria (GFATM), says Sri Lankan society still refuses to acknowledge HIV/AIDS as an issue.

“It is a culturally taboo subject (sexual issues) to speak about and we have serious difficulties in a situation where high-risk behaviour is widespread,” he said.  

Sarah Soysa from Y-Peer, an international youth network promoted by the United Nations Population Fund (UNFPA), notes: “Boys  simply refuse to wear condoms during sexual intercourse and are more concerned about their partners taking ‘the morning after pill’ to avoid pregnancies.”

Citing official figures, she said Sri Lanka now has some 40,000 teenage pregnancies and 1,000 abortions a day, mostly involving young women.

In the first quarter of the current year there were 40 new cases of HIV compared to 32 and 27 in the first quarters of 2011 and 2010 respectively, according to the National STD/AIDS Control Programme (NSACP).

At the end of 2011, 20.2 percent of HIV cases were in the 20-29 age group, while 37.6 percent of the cases were from the 30-39 age group.

There are an estimated 41,000 commercial sex workers (CSWs) and 30,000 men who have sex with men MSMs) in Sri Lanka, a country of 22 million people.  

“In the past two years new infections are seen to be rising among those below 24 years, and 50 percent of them are MSMs,” says NSACP director Nimal Edirisinghe.

His department plans to purchase 50,000 sachets of lubricants and distribute it among MSMs because anal sex tends to leave injuries that can increase the risk of infections.

But, the biggest hurdle for groups working in HIV/AIDS prevention is the laws against homosexuality and prostitution framed during British colonial times, criminalising ‘carnal intercourse against the order of nature’ and ‘gross indecency’ respectively.

Last month ‘Equal Ground’, a rights group that campaigns for equal rights for people with different sexual orientations and gender identities, petitioned the government to repeal sections 365 and 365A of the penal code, relevant to homosexuality and prostitution and dating back to 1883.

“The criminalisation of same sex relationships and the resultant cultural and social stigmas attached to homosexuality,” said the petition, leads to “all forms of discrimination, marginalisation and violence, resulting in mental health issues, low self-esteem and internalised homophobia.”

“Consensual sex between adults should not be policed by the state nor should it be grounds for criminalisation,” the petition said.

“We work a lot with female sex workers and have many problems with the police and law enforcement authorities,” says H. A. Lakshman, executive director of Community Strength Development Foundation (CSDF), an NGO.

Lakshman, who has been working for the past 19 years with CSWs and employs some of them, said: “We try to provide sex workers with alternate livelihood avenues in the hope that they would eventually move away from sex work.”

For CSDF the biggest challenge is that 20 percent of CSWs who are also injectible drug users pay for their fixes – about Sri Lankan rupees 2,000 (15 dollars) a day – from their earnings.  

“They are careless about the use of condoms,” said Lakshman whose organisation is currently in touch with 6,000 sex workers and distributes 125,000 condoms a month as partner to GFATM and UNFPA. 

“Over the years we have distributed millions of condoms,” he said. The CSDF maintains a drop-in centre at its Colombo office where the women can avail of counselling, help, and even stay overnight.

“Our work has seen a reduction in drug use, pregnancies and abortions while condom use has increased,” he said. “We now also find fewer infections among this group.”

Sarvodaya’s Yakandawala says that lately CSWs have moved from working in brothels to visiting homes and hotels, contacting clients over mobile phones.

Between 100,000 to 150,000 people are estimated to use the services of sex workers – both women and men – per day.

Bridger at UNAIDS says there is an urgent need for policy debate and discussion on reproductive rights and sexual health. “Bad laws should not be allowed to stand in the way of effective HIV responses,” he said.

A condom ad in Hanoi. Credit: Natalie Callaghan

By Helen Clark
HANOI, Vietnam, Jul 15 2012 (IPS)

Conservative attitudes toward women die hard in Vietnam, as seen in the country’s worsening sex ratio at birth (SRB). Yet, social mores have relaxed sufficiently for women to tune in to late night TV talk shows to learn about the acceptability of one-night stands.

For city girls at least, this represents a radical swing away from a culture where sex before marriage is taboo and sex within marriage a “mission”, as one women’s magazine editor put it.

Yet, in this ‘Year of the Dragon’, considered auspicious to beget male children, there is concern that the SRB may widen further, with more couples than usual resorting to illegal sex-selective abortions.

Deputy health minister Nguyen Viet Tien said recently that Vietnam’s SRB stands at 112:100 (boys to girls) and is still climbing. In the northern Hung Yen province, it is as high as 131:100 said Tien, with one commune in the province recording a hugely distorted 257:100 ratio.

Sex-selective abortions are common after the second or third pregnancies. Vietnam has a two-child policy and, although it is not as strictly enforced as in China, government officials and others are liable to sanctions or fines if they cross the limit.

Vietnam’s national gender strategies are ‘progressive’ and generally in line with the United Nation’s millennium development goals for gender equality.

The main legislative body, the National Assembly, has 24.4 percent female representation for the 2011 – 2016 period. On the other hand, there are only two women in the 22-member cabinet and one woman in the 14-person communist party politburo.

According to TV producer Bui Thi Huyen Nga, career women are the main demographic of the talk show she produces, the ‘The Late Night Show’ that appears twice a week on the government-owned VTV3 channel. It features discussions about sex outside marriage and casual relationships.

“Most Vietnamese say a ‘party girl’ is a bad girl. But we (the TV show’s demographic) think it’s normal. After a stressful week she wants release and goes to the bar and makes friends,” she told IPS.

“Almost all Vietnamese think sex is too taboo  a subject so we shouldn’t talk about it. Vietnamese women want to have fun, that’s all. We think it’s normal in modern life,” she added.

Le Hoang, anchor on the show – and well-known filmmaker, author and columnist – is regarded as divisive and blunt. Recently he made ‘Hot Boy Noi Loan’, a hit film about a rent boy (gay prostitute) in Saigon that was released nationally with few cuts and shown  to overseas audiences too.

Ten years ago, he made ‘Bar Girl’ about dancers and hostesses in Ho Chi Minh City (HCMC) about girls regarded as “bad”.

“However, most are from the poor rural areas who come to the city in the hope of making more money. We should understand about those kinds of girl because they’re just victims,” he tells IPS.

But he sees a big difference in the way city girls can, and do, behave and their countryside counterparts. “The girl who lives in the city has a lot more freedom in sex,” he says. “Countryside girls have fewer options and they choose (make decisions) far too quickly.”

Hoang points to the number of Vietnamese girls who marry older Korean, Chinese or Taiwanese men after brief interviews in the hope of a better life.

Despite the leaps that Vietnam has made out of poverty, “you cannot believe the figures. Seventy percent of people are still farmers. And farmers have very little money.”

Anubha Gupta, a qualitative researcher with the market research company Cimigo based in HCMC, has spent six years studying numerous subjects in Vietnam, including attitudes to sex and contraception. She thinks Vietnam is like other developing, still-patriarchal societies.

But she believes that Vietnam is also changing fast and may soon overtake much of the region and South Asia in terms of equality.

“If you look at other aspects (of gender relations), socially or in a working environment, you don’t see disrespect. Men and women can talk to each other without problems,” she tells IPS.

Of sex and contraception, “there’s a lot of social… almost stigma” but though women may be afraid of rude comments when buying the morning after pill, it is freely and easily available.

Not everyone agrees. My Linh, 23, a Korean language student at the HCMC University of Science and Humanities, says that though she thinks more sex articles in women’s magazines is a good idea, she is against sex before marriage – at least for herself.

“Firstly Vietnamese society doesn’t support this idea. Most men want to have sex with their girlfriends but they also want to marry a virgin.”

Hoang tells in halting English: “In western culture it’s (living together) ok. In Vietnam…in the city it’s ok. In rural areas it’s not.”

My Linh thinks women who live with their boyfriends should be careful since a breakup might make marriage with someone else difficult. “It’s very hard to make the men think different.”

Population pressure in Pakistan. Credit: M. Fahim Siddiqi/IPS

By Zofeen Ebrahim
KARACHI, Pakistan, Jul 11 2012 (IPS)

“No scalpel, no stitch and no rest needed,” guarantees Dr. Ghulam Shabbir Sudhayao, referring to the surgical procedure called vasectomy – the least popular method of birth control around the world, including Pakistan.

“People confuse vasectomy with castration (surgical removal of the testicles) and that scares them away,” Sudhayao, who works for the government’s population welfare department, tells IPS.

Vasectomy involves a minor procedure to snip the sperm ducts.  Sudhayao himself resorted to the method when he decided that his family was complete. “We had two daughters and wished for a son, and the third  time, my wife delivered twin boys.”

“Compared to vasectomy, tubaligation (tying a woman’s fallopian tubes) is a complex surgical operation and is done under general anaesthesia,” says Sudhayo, explaining why he did not ask his wife to get herself sterilised.

Sudhayao says he has carried out over 6,000 of these minimally invasive, “ten minute” surgeries performed under local anaesthesia in the last 20 years.

But, Sudhayao is frustrated that the 2,000 social mobilisers working for the department are unable to meet their quotas. “We get no more that 80 to 90 clients in a month though the operation is  free and the patient gets Pakistani rupees 500 (five dollars) for nutrition, and the introducer can collect 1.59 dollars as incentive money.”

Over the last two decades, Sudhayao has trained 18 other doctors to perform this simple operation, but few of them are interested in promoting it.

“Despite being trained to spread the message, they say they are scared of being ridiculed in the community. To popularise this method, we need to use the electronic media, the quickest way to get the message across,” says Sudhayao.

Interestingly, men from the low economic strata appear to be quicker to realise the benefits of this procedure.

Syed Jeal Shah, 42, a biology teacher in a government school in Khairpur, underwent vasectomy after he had 10 children. “Things were getting out of hand. We could not afford to feed so many mouths on my meagre salary.”

While his operation was carried out eight years ago, he is still the butt of friends’ jokes that centre around impotency. “My colleagues say family planning (FP) is a woman’s problem,” says Shah.

“Men don’t think FP is their problem,” says Sherhshah Syed, former president of the Society of Obstetricians & Gynaecologists of Pakistan and currently president of the Pakistan National Forum on Women’s Health.

Syed says vasectomy is associated with impotency. Men find the subject embarrassing and often seek advice from clerics, most of whom are opposed to birth control.

But with Pakistan’s population expanding rapidly and family planning  methods focused on women alone failing, population experts are taking a second look at vasectomy as a means of birth control.

Pakistan’s population stands at 180 million, and with each woman bearing four children on average the projections are that the population could cross  450 million by 2050.

Studies by the Islamabad-based Research and Development Solutions (RADS), in collaboration with United States Agency for International Development, show six million Pakistani couples needing contraception annually while the public sector covers just 33 percent of them.

Dr. Ayesha Khan who heads RADS tells IPS that “some 53 percent of these couples buy FP services, while 15 percent access them through non-governmental organisations.”

According to the Population Reference Bureau (PRB), a Washington D.C.-  based research organisation that monitors population trends around the world, Pakistani women ususally think about FP only after they have had five or more children.

“Women are often required to have large families to improve their social standing and ensure their economic survival,” says Tewodros Melesse, director general of International Planned Parenthood Foundation.

“In many countries girls marry at a very young age, become pregnant too early and out of necessity  drop education to take care of their young family,” Melesse said in an interview with IPS.  In Pakistan, he added, only 22 percent of married women of reproductive age use a modern contraceptive method.

Farid Midhet, a demographer and founder of the Safe Motherhood Alliance cites “illiteracy, in particular female illiteracy”, and bad governance as the two main reasons why family planning programmes have never worked in Pakistan.

“Contraceptive use works as part of an enlightened and educated culture where women have some autonomy,” he told IPS.

Over the years the emphasis and pressure to bring down the number of babies has fallen on women, a majority of whom are illiterate and not empowered to take decisions concerning family size.

“The numbers for both male sterilisation (0.33 percent of all contraception) and condom use reflect the gender power imbalance – women bear a disproportionate burden when it comes to pregnancy prevention,” says Melesse.

“We need to proactively engage men as clients, as partners and as change agents in the sexual and reproductive health programme in Pakistan,” emphasizes Melesse.

“Religious prohibition and husband opposition are the main reasons identified for non-use of contraception in Pakistan so we need to engage with religious leaders to increase access to sexual and reproductive health services among most conservative communities in Pakistan,” Melisse said.

The case of Abdul Ghaffar Khosa, 55, who teaches in a madrassah (religious seminary) in Nawabshah, Sindh province, typifies the difficulties as well as the potential of roping in the clerics.

Khosa says there are different schools of thought in Islam regarding family planning and that while it remains a controversial issue he has set an example by undergoing the procedure himself about eight years ago.

But Khosa accepted vasectomy only after begetting 22 children from two wives. “In between pregnancies, my wives were miscarrying and they were getting weaker – I was scared of losing them.”

Khosa waited three years, to make sure that the procedure had not impaired his sexual functioning, before recommending it to friends and relatives. He has even referred several of his fellow clerics to Sudhayao.

Kathmandu's entertainment joints hire minor girls. Credit: Naresh Newar/IPS

By Naresh Newar
KATHMANDU, Jul 8 2012 (IPS)

Almost unnoticed, Nepal’s burgeoning adult entertainment industry has been drawing young girls away from being trafficked across the border to the fleshpots of India’s big cities.

Rights activists are worried that the issue of internal trafficking has not received the kind of legislative attention that resulted in laws, passed in 2007, to prevent and punish trafficking of young girls across Nepal’s borders by prostitution rings.

The result, they tell IPS, is that internal trafficking for the domestic entertainment industry is dismissed as an issue of exploitation rather than being treated as the more serious crime of trafficking for prostitution.

“Trafficking is happening right here in the country and not just to Mumbai or New Delhi of India,” says education specialist Helen Sherpa from World Education’s Asia division, which is working to combat child exploitation  through awareness programmes.

Although there are no government studies on cross-border  trafficking, a 2001 report by the International Labour Organisation estimated that around 12,000 Nepalese girls were being trafficked annually to India for prostitution.

Sherpa said that young girls from impoverished families are now being lured into working in the massage parlours and sleazy ‘cabin restaurants’ of Kathmandu and other cities with false offers of respectable jobs in the big hotels.

Cabin restaurants, massage parlours and dance bars make up the core of the entertainment industry, and a large number of them are known to be fronts for prostitution rackets.

There are also lodges, ‘bhatti pasals’ (small street eateries serving alcohol), and the ‘dohori’ (Nepali folk song and music) restaurants in the urban centres and along highways that are known to solicit clients.

An estimated 6,000-7,000 girls and women currently work in cabin restaurants, 3,000-4,000 in the dance bars, about 900 in the dohori restaurants and an equal number in the massage parlours, adding up to about 15,000 girls and women in a rapidly growing industry.

In Kathmandu alone there are an estimated 11,000 to 13,000 girls and women in the entertainment business, according to ‘Trafficking and Exploitation in the Entertainment and Sex Industries in Nepal,’ a handbook prepared for decision makers by the Terres des homes Foundation (TDH) in 2010.

Many activists consider the handbook an important source of information and guidance for government agencies and leaders dealing with trafficking. But the country has a long way to go in implementing its recommendations and steps.

“Internal trafficking has not been dealt with effectively in Nepal. It has been hinted at and peripherally addressed without researched information,” expert on trafficking Nandita Baruah tells IPS.

“But it is emerging as a critical concern today,” said Baruah who heads the ‘Combating Trafficking in Persons Programme’ of the Asia Foundation in Nepal.

Baruah explains that authorities and development agencies address internal trafficking as an issue of  child sexual exploitation in the entertainment industry  rather than one of  trafficking for  prostitution.

Nationwide there are approximately 32,000 sex workers with about half of them minors under 16 years of age, according to the government’s National Centre for STD/AIDS.

Activists believe that half of these sex workers were lured by traffickers while the other half chose to enter the trade to escape desperate poverty. Many of them were as young as 12 to 14 years old when they were internally trafficked to Kathmandu, as told to IPS by sex workers who wished to remain anonymous.

“I was 13 when I arrived in Kathmandu to join a job at a hotel but I was taken straight to a massage parlour. I had never seen such a place before,” said Sita Tamang (name changed). Tamang said that the massage parlour employers treated her well, initially.

After a week, she was told what the job really entailed. “I was shocked and I cried a lot in the beginning as I was very scared and then other girls consoled me saying that it wasn’t dangerous as they had been through the same thing and they got used to it,” said Tamang.

Tamang, now 18, says she never went back home and does not want to face her poor farmer parents. When she sees very young girls being brought in,  she is reminded of her own  past and feels bad , but  is powerless to do anything about it.

“Sometimes we fight with the owners when they bring in young girls. Once I had a physical fight with an owner over a very young girl and he let her go only after I threatened to have it reported in the newspapers,” said another masseur who started work when only 14.

She called the girl’s parents in Makwanpur district, 200 km from Kathmandu, and asked them to take their daughter home. “I screamed at them at the bus stop as I was reminded of my own past,” she said.

Cases of sex workers being sensitive and strong enough to prevent the recruitment of minors are rare. The general trend in the entertainment industry is for sex work victims to turn into traffickers themselves in a self-perpetuating system.

Studies by TDH show that entertainment workers are also primary procurers of girls for the industry and are paid for it.  Often, according to TDH studies, girls and women are not allowed to leave work until they find a replacement or repay debts by providing fresh recruits from their villages.

So far, the only action taken by the government has been in the shape of  occasional raids on entertainment establishments, though anti-trafficking laws are never invoked, activists say.

A major legal loophole is that Nepal has no law against prostitution and the girls, if arrested, are booked for disturbing the peace or obscenity. Usually, they are locked up for 24 hours and fined, but quickly return to work.

The girls earn about 100 dollars per month as salaries in the entertainment joints with the owners skimming off the bulk of the profits. Yet, many prefer that to the grinding poverty of Nepal’s rural villages.

According to TDH studies, a quarter of the establishments where the girls work bring in 10,000 dollars per month while at least half make about 4,000 dollars a month – considerable sums in impoverished Nepal.

“The severity of such crimes has not been measured and this is why the supply of girls has been easy,” said Asia Foundation’s Baruah.

She added that there is a need to conceptually clarify both the difference and the overlap between sexual exploitation and trafficking and then make a case for it within the criminal justice system.

“People have to first accept that internal trafficking is happening and the government has to acknowledge that this is a huge problem that needs more focused attention,” she explained.

On May 18, some 800 women in Sri Lanka’s northern region will hold Hindu religious ceremonies for the welfare of thier husbands who disappeared or surrendered to the military as it moved in to mop up nearly three decades of armed Tamil separatism.

“These women continue to live in hope even though many of those Tamil men may have died in the last days of the fighting,” says Shreen Abdul Saroor, a prominent rights activist working with conflict-affected women in northern Sri Lanka.

“On the other hand, even if they do acknowledge that their men have died, they don’t want to be known as widows as that could result in them being seen in a negative light in the community,” Saroor explained to IPS. “They prefer to be known as single women or as women heading households.”

Traditionally, Hindus consider widows to be inauspicious and the religion does not favour remarriage. Tamils, who form 12 percent of Sri Lanka’s 20 million population, mostly follow Hinduism while Sinhalese, who make up 74 percent of the population, are predominantly Buddhist.

According to government estimates, the ethnic conflict has widowed 59,000 women, the bulk of them in the Tamil-dominated north and east.

With rehabilitation tardy and options to earn money few, many women have been compelled to resort to sex work to earn a livelihood and provide for their families.

“We try to wean them away from sex work but they say they have no choice,” says an activist asking not to be named for fear of reprisal. “We provide the women with condoms and give advice on contraception as protection.”

The government is selective about permitting non-governmental organisations (NGOs) to work in the north. Only NGOs involved in development work – housing, livelihood development and infrastructure – are allowed in, while those that raise awareness on issues like peace, trauma or women’s rights are discouraged.

“The moment you say you are from an NGO, there are issues,” says Saroor who is founder of the Northern Mannar Women’s Development Federation and the Mannar Women for Human Rights and Democracy.

Saroor, one of four winners of the first ‘N-PEACE’ award, instituted by the United Nations Development Programme last year, says abuse of girl children is now a major problem in the north and with 26 cases recorded in the last three months alone. Many more cases go unreported.

The N-PEACE (Engage for Peace, Equality, Access, Community and Empowerment) strategy supports women in leading community recovery and peace building in the networked countries of Nepal, Indonesia, Sri Lanka and Timor-Leste.

There is concern that the atmosphere of uncertainty, caused by lack of resources, broken families and the absence of responsible males, has impacted the security of young girls.

“In one case, a nine-year-old was abused. Women say they are scared to leave their homes fearing for the safety of their children. So how do we provide them a livelihood?” Saroor asked.

The problems of women in northern Sri Lanka are enormous with their inability to speak out a major hurdle in the post-conflict healing process.

“They have no opportunity to tell their stories,” says Shanthi Sachithanandam, executive director of the Viluthu Centre for Human Resource Development that works with conflict-affected women. “There is an urgent need for counselling.”

The government has repeatedly denied charges by Western countries and international human rights groups that large numbers of civilians were killed in crossfire and aerial bombing in the months leading to May 2009.

Journalists were not permitted into the war zone and NGOs and humanitarian agencies asked to leave, with the result that there are no independent versions of what may have happened in the killing fields of the north.

In March, the Geneva-based U.N. Human Rights Council passed a United States-proposed resolution calling for implementation of recommendations made by Sri Lanka’s Lessons Learnt and Reconciliation Commission (LLRC) as a measure of accountability.

The LLRC, appointed by the government to look into issues relating to the conflict from February 2002 to May 2009, called for a probe into allegations of deliberate attacks on civilians and the prosecution of those responsible.

Rights groups working with war widows and mothers who lost their loved ones, fear repercussions if they dare to speak out publicly on sensitive issues.

When Seela (not her real name) spoke to reporters some weeks ago about a northern village where women have turned to sex work en masse, she and other members of her organisation received threats.

“These women are very vulnerable. We are very concerned about their plight and want to help them liberate themselves from this trap but there is not much we can do without support from the state,” she told IPS.

Seela said the lack of awareness of birth control methods has led to illegitimate babies being born and reports of spread of HIV/AIDS and other sexually transmitted diseases.

Visaka Dharmadasa, founder and chair of the association of war affected women and parents of soldiers missing in action, said a clearer picture would emerge when a survey being conducted by her organisation is completed in June.

“No comprehensive study has been done on the software issues (fate of the missing and trauma) in the north and the east. Only the hardware (infrastructure and development) is being addressed,” she said.

“Widows of (government) soldiers are better off economically than widows in the north and the east, but in both cases social and psychosocial issues have not been tackled. These are major challenges,” Dharmadasa said.

According to Sachithanandam rehabilitation in the north has been difficult with loans for livelihood development and empowerment failing to reach the intended beneficiaries.

“Multilateral agencies say women are key to post-war reconstruction. But the women are confined to the house because of young children,” said Sachithanandam. “Small loans given for goat-rearing or poultry-raising vanish when the animals die and the women are back to square one.”

That, says Saroor, is the point when women look at sex work as an option.

The LLRC report drew attention to the plight of Tamil widows. “Their lives are often lonely and insecure, and they are treated as a symbol of bad omen in their own social circles.”

Problems start with the definition of widowhood. While widows elsewhere in the country have marriage certificates to prove marital status, women in the north are unable to produce documents because of the destruction of official records during the war.

Military spokesman Brig. Ruwan Wanigasooriya told IPS that of 11,995 suspected rebel cadres who surrendered in May 2009, with 10,874 have been rehabilitated and reintegrated into civilian life.

Another 852 are in detention with investigations continuing or undergoing rehabilitation ahead of release while 13 had died of natural causes, the spokesman said.

Social activists say that attempts to rehabilitate sex workers in this former monarchy call for special efforts to uplift the Badi, a Hindu caste that has for centuries been associated with entertainment and prostitution.

Badi sex workers await rehabilitation. Credit: Naresh Newar/IPS

Sabitri Nepali was initiated into the traditional vocation of the Badis before she turned 14. Now, at 30, she is baffled by the changes taking place in a country struggling to climb out of a feudal past and transform into a modern, democratic republic.

“My family has survived on this trade for generations. My mother was a sex worker and I continued with the family profession. It was normal for us,” Sabitri tells IPS in this remote village in Kailali district, 700 km west of Kathmandu.

Badis, estimated to number 50,000, live in the western districts of Nepal but find work in the towns and cities of Nepal and neighbouring India, including Kathmandu, Mumbai and New Delhi.

Four years ago the Nepal government banned the Badis from pursuing their traditional occupation after it came under pressure from local communities fearing that the districts where there were Badi concentrations were turning into red light areas.

But, the government made no move to implement the ban, with the result that local communities formed monitoring groups backed by vigilantes that used violent methods to compel the Badis to give up their sole means of livelihood.

“We defied the ban and continued with our traditional occupation. How could we survive without incomes? Think about our children,” says Kalpana Badi,35, who like many others uses a surname that readily identifies her caste and her profession.

The word ‘badi’ is a corruption of the Sanskrit word ‘vadyabadak’, meaning one who plays a musical instrument, and suggests a degradation in the status of the caste over time.

South Asia’s rigid caste system once defined the occupation that people could engage in and Badis formed one group that has been unable to find its way out of an unfortunate position on the social ladder. “We didn’t want to continue with prostitution but the government has failed to fulfill its promises of rehabilitation,” says Bishal Nepali, husband of a Badi sex worker.

The government did announce a package that included housing, income generation activities and scholarships for Badi children, but these were never implemented.

“This has been a very frustrating process. We don’t know why the government has been so indifferent. The Badis are in a desperate situation,” says Uma Badi, a prominent activist and one of a handful of college-educated Badi women.

“Most Badis are uneducated and have no farms or livestock,” Uma explained.

Badis were denied citizenship until 2005 when the Supreme Court ordered the government to grant it to them and also extend financial support.

According to a study published in 1992 by Thomas Cox, an anthropologist then attached to Kathmandu’s Tribhuvan University, Badi girls “from early childhood, know, and generally accept the fact, that a life of prostitution awaits them.”

Badi girls, the study said, do not get married and commonly bear the children of their clients.

Cox recorded that upper caste Nepali society gives little encouragement to Badi girls to pursue other professions and those among them who enter public schools are “often severely harassed by high caste students.”

Two decades after Cox’s study, the Badis, as members of an ‘untouchable’ Dalit (meaning broken people) caste, are still not permitted use of the village water pump or well and their situation may have worsened.

In Muda village, many Badi girls and women have fled their homes fearing the Muda Anugaman Toli Samiti (a vigilante group) whose members have been accused of beating up Badis and their clients.

Badis are not allowed to run legitimate businesses. “People fear to buy anything from my shop because they fear the villagers,” says Dinesh Nepali, a Badi male who runs a small shop selling cigarettes, vegetables and soft drinks. “How can we survive like this?”

Badi activists are aware that they are prime targets for the United Nations Millennium Development Goals that deal with women’s rights, education and poverty, and that their uplift calls for extraordinary and determined initiatives.

“A handful of non-government organisations and donor agencies have been supporting the empowerment of Badi women, but that is not sustainable. Projects come and go but only government support can provide a long-term solution,” says Uma.

There were hopes that the abolition of the monarchy in favour of republican democracy, at the end of the bloody 1996-2006 civil war, would bring positive changes to the lives of the Badis, but Nepal is still coping with political instability.

“I have met three different prime ministers in the past few years,” said Uma. “They promise support but forget us as soon as we head back to our villages.”

In 2007, Badi activists threatened to march naked through Kathmandu to embarrass the government into implementing the court-ordered rehabilitation, but that brought nothing except more promises.

The local monitoring committees – that are backed by the vigilantes – admit that the government has failed in its promise to help the rehabilitation of the Badis.

“We are trying to help the Badi women start new dignified lives but we do admit that there are no viable alternatives,” says Riddha Bhandari, a leader of Muda’s monitoring group. “The government needs to act now.”

Bhandari denied that the Muda committee was out to destroy the Badis, but said there were worries over adverse influences on non-Badi girls and the possible spread of HIV/AIDS.

The Earth's capacity to meet human needs is finite, and depends on lifestyle choices and associated consumption. Credit: John Snape/CC BY 2.0

By Thalif Deen
UNITED NATIONS, May 1 2012 (IPS)

Just before the 1992 Earth Summit in Rio de Janeiro, some of the industrial nations, and specifically the United States, were lambasted for their obscenely high consumption of the world’s finite resources, including food, water and energy.

The world was being gradually destroyed, environmentalists warned, by unsustainable consumption.

Hitting back at critics, then U.S. president George H.W. Bush famously declared: “The American way of life is not up for negotiations. Period.”

The message, a pre-emptive diplomatic strike by the United States, reverberated throughout the summit of world leaders, whose plan of action for the 21st century virtually skirted the hot political issue.

Now, 20 years later, the United Nations will once again focus on population, consumption and the environment at the U.N. Conference on Sustainable Development (also known as Rio+20) in mid-June in Brazil.

The upcoming summit will adopt a new plan of action for a greener economy and a sustainable future.

A new 134-page study, released on the eve of the summit, and titled “People and the Planet“, highlights the rapid and widespread changes in the world’s population and the unprecedented levels of consumption that are threatening the well being of the planet.

Authored by the Royal Society, a 352-year-old institution described as a fellowship of the world’s most eminent scientists, the study says the Earth’s capacity to meet human needs is finite.

But how the limits are approached depends on lifestyle choices and associated consumption – and these depend on what is used, and how, and what is regarded as essential for human wellbeing.

The members of the Royal Society’s glorious past include some of the world’s illustrious scientists and thinkers of a bygone era, the likes of Isaac Newton, Charles Darwin, James Watson and Albert Einstein.

Presenting the report on behalf of the Royal Society, Nobel Laureate Sir John Sulston told reporters Tuesday there is a strong link between population, consumption and the environment.

The unsustainable consumption of the world’s most developed and emerging economies must be urgently reduced, he said.

A child born in the developed world, he pointed out, consumes 30 to 50 times as much water as one born in the developing world.

The increase in “material consumption”, he said, involved food, water, energy and minerals.

And as the report points out, “these resources are the most basic needs for survival, and in some parts of the world even these basic needs are not being met for some people.”

By contrast, high levels of material consumption seen in many parts of the world “may lead eventually to loss of well being for the consumer, and, in an inequitable world with finite resources, also result in the deprivation of others.”

The 21st century is a critical period for people and the planet, says the study, pointing out that the global population, which reached 7.0 billion during 2011, will reach between eight and 11 billion by 2050.

“Human impact on the Earth raises serious concerns, and in the richest parts of the world per capita material consumption is far above the level that can be sustained for everyone in a population of seven billion or more.”

This is in stark contrast to the world’s 1.3 billion poorest people, who need to consume more in order to be raised out of extreme poverty.

The study also says that population and consumption are both important: the combination of increasing global population and increasing overall material consumption has implications for a finite planet.

As both continue to rise, signs of unwanted impacts and feedback (such as climate change reducing crop yields in some areas) and of irreversible changes (such as the increased rate of species extinction) are “growing alarmingly”.

“The relationship between population, consumption and the environment is not straightforward, as the natural environment and human socio- economic systems are complex in their own right.”

Demographic change is driven by economic development, social and cultural factors as well as environmental change. A transition from high to low birth and death rates has occurred in various cultures, in widely different socioeconomic settings, and at different rates, the study adds.

And countries such as Iran and South Korea have moved through the phases of this transition much more rapidly than Europe or North America.

This has brought with it challenges different from those that were experienced by the more developed countries as they reached the late stages of the transition.

Developing countries will be building the equivalent of a city of a million people every five days from now to 2050, the study predicts.

And the continuing and rapid growth of the urban population is having a marked bearing on lifestyle and behaviour: how and what they consume, how many children they have, the type of employment they undertake.

Urban planning is essential to avoid the spread of slums, which are highly deleterious to the welfare of individuals and societies, the study notes.

In a series of recommendations, the study calls on the international community to bring the 1.3 billion people living on less than 1.25 dollars per day out of absolute poverty, and reduce the inequality that persists in the world today.

Additionally, the most developed and the emerging economies must stabilise and then reduce material consumption levels through dramatic improvements in resource use efficiency, including reducing waste; investment in sustainable resources, technologies and infrastructures; and systematically decoupling economic activity from environmental impact.

Also, reproductive health and voluntary family planning programmes urgently require political leadership and financial commitment, both nationally and internationally.

Population and the environment should not be considered as two separate issues, the study says.

“Demographic changes, and the influences on them, should be factored into economic and environmental debate and planning at international meetings, such as the Rio+20 Conference on Sustainable Development and subsequent meetings,” it says.

Also, governments should realise the potential of urbanisation to reduce material consumption and environmental impact through efficiency measures.

And in order to meet previously agreed goals for universal education, policy makers in countries with low school attendance need to work with international funders and organisations, such as U.N. Educational, Scientific and Cultural Organisation (UNESCO), the U.N. Population Fund (UNFPA), the U.N. children’s agency UNICEF, the International Monetary Fund (IMF), World Bank and Education for All.

By Thalif Deen
UNITED NATIONS, Apr 30 2012 (IPS)

The U.N. Population Fund (UNFPA) rightly believes the road to Rio goes via Cairo – and that sustainable development and population are inextricably linked.

Michael Herrmann Credit: Courtesy of UNFPA

So when the U.N. Conference on Sustainable Development (also known as the Rio+20 summit) takes place in Brazil in June, a strong underlying theme will be the human factor, as spelled out in the Programme of Action adopted at the 1994 International Conference on Population and Development (ICPD) in the Egyptian capital.

“Development has to serve people, and a sustainable development agenda must consider people,” says Michael Herrmann, economics adviser with UNFPA, and member of the U.N. Lead Economist Network.

An agenda that does not take account of people – their numbers, locations and age structures, as well as their living conditions, ambitions and opportunities – “misses the raison d’etre of sustainable development.”

In an interview with IPS, he pointed out that “for sustainable development, it quite simply matters how many people we are, where we live, how we live and what we want from life.”

“Sustainable development demands greener and more inclusive economic growth, which encourages sustainable production and consumption, and rights-based policies which address population dynamics,” said Herrmann, who once co-authored some of the flagship reports of the U.N. Conference on Trade and Development (UNCTAD) and is currently responsible for economic and demographic analysis at UNFPA.

Excerpts from the interview follow.

Q: What is the impact of rising population on the environment? A: Last year the world population surpassed the seven billion mark and by mid-century it will have grown to over nine billion. By 2050, we will add about as many people to the planet as inhabited the planet as recently as 1950.

More people will need more water, food and energy, more clothing, housing and infrastructure, and more health and education, amongst others. Meeting these needs will require not only a more balanced distribution of economic resources, but also higher levels of economic output, and this will lead to mounting pressures on all natural resources.

Q: How best can these challenges be met? A: The dual challenge of improving the well-being of a large and growing population, while promoting the sustainable use of essential natural resources, calls for a two-pronged approach. In accordance, the 1992 Earth Summit in Rio de Janeiro, Brazil, and the 1994 ICPD in Cairo have emphasised the need to shift towards sustainable production and consumption – which is the hallmark of the green economy – and appropriate policies to address demographic changes.

Contrary to common perceptions, we can address population dynamics, and we can address population dynamics through human-centred and rights-based policies. Whether the world population will grow to over nine billion by mid-century and stabilise at around 10 billion by the end of the century, or whether it will grow to well over 10 billion by mid-century and to about 16 billion by the end of the century, depends on today’s policies.

Demography is not destiny. The difference between these two population projections of the United Nations is half a child per woman, on average. Individual choices and opportunities culminate in population dynamics, and population dynamics can be addressed by enlarging, not restricting, individual choices and opportunities.

Q: What does this entail? A: This requires universal access to sexual and reproductive health, investment in education beyond the primary level, the empowerment of women, and a more active involvement of youth.

Together, these measures will not only help improve the quality of life of people – by reducing infant, child and maternal mortality, arresting the spread of communicable diseases and reducing unintended pregnancies of young women – but will also contribute to lower fertility and slow population growth.

Q: How much of the focus should be on population growth? A: It would be wrong to focus on population growth and neglect other demographic trends, including migration and urbanisation, which can be strong positive drivers for most sustainable development. However, to seize the benefits and address the challenges that come with demographic change, countries must systematically plan for demographic change using population data and projections.

Q: Will population be one of the key elements in the plan of action – formally called the outcome document – to be adopted by world leaders in Rio in June? A: For sustainable development it quite simply matters how many people we are, where we live, how we live and what we want from life.

Not to recognise the challenges that come with demographic change in the new outcome document would be a missed opportunity, and a step back from pervious political declarations. Not to outline rights-based policies to address population dynamics would leave undesirable room for misinterpretations.

To highlight demographic challenges is not the same as calling for population controls. Countries can address population dynamics through rights-based policies by encouraging sexual and reproductive health and rights, education, empowerment and participation; and they can address demographic challenges by systematically using population data and projections to inform rural, urban and national development strategies and policies.

Excerpt:

Primary school in Goroka Credit: Catherine Wilson/IPS

By Catherine Wilson
GOROKA, Papua New Guinea , Apr 29 2012 (IPS)

Sexual harassment of school-going girls is one factor that may prevent this Pacific island nation from achieving the Millennium Development Goal (MDG) of eliminating gender disparity in education by 2015.

Papua New Guinea (PNG)’s new free education policy has dramatically increased school enrolment, and a gross enrolment rate of 80 percent is within reach by 2015. But the third of the United Nations’ eight MDGs, that pertaining to girls’ education, remains elusive on current trends.

While PNG’s constitution promotes equal participation by men and women in national development, political, cultural, social and infrastructural factors inhibit retention of girls within the school system, reflecting a wider lack of women in the formal workforce, governance and decision-making roles.

The United Nations Development Programme rates the nation at 153 out of 187 countries, with a gender inequality index of 0.674. The education department reports the average educational attainment of girls is grade 10 and, for boys, grade 12, the final year of secondary school.

However, the nation’s cultural and social diversity means there is geographical variance.

In the Autonomous Region of Bougainville, where matrilineal societies are prevalent, there are 16,821 male and 16,120 female school students. In the Eastern Highlands Province, the literacy rate for males is 51 percent compared to 36.5 percent for females.

There were 7,127 male and 5,872 female students in primary level grade three in 2009. In grade 12, the number of female students, 180, was less than half the male enrolment of 494.

In the highlands, where most people practice subsistence agriculture and the average cash income is low, girls can be particularly disadvantaged, especially if there are no local schools.

“The (poor) state of school infrastructure, particularly in rural areas, is a significant hindrance to the achievement of equitable education outcomes,” said Arnold Kukari, leader of the universal basic education research programme at the National Research Institute.

Betty Hinamunimo, field officer with Care International, a non-government organisation (NGO) which works in partnership with the education department, said factors impeding girls’ education included “distance and cultural and social barriers, such as the fear families have of sending girls to urban centres where their safety is not guaranteed.”

Girls in PNG are at high risk of domestic and sexual violence, sexual harassment in schools, commercial exploitation and HIV, which pose serious threats to their health and education.

Ume Wainetti at the Family Sexual Violence Action Centre (FSVAC) said, “When FSVAC conducted the study on violence against children in 2005, young girls in rural schools said they get harassed by teachers and by male students, especially when they are going to school or going home.”

Wainetti said many of the young girls interviewed by FSVAC, an NGO based in the capital of Port Moresby, were already mothers.

Cultural and social barriers to education include the burden placed on girls of family care, domestic responsibilities and customary marriage, which can occur from 12 years. The International Centre for Research on Women (ICRW) estimates that a third of girls in the developing world are married before 18 years and begin child-bearing before 20 years.

The education department’s gender equity strategic plan (2009-2014) stresses the need to develop gender mainstreaming activities in schools and train all staff in gender sensitisation and sexual violence awareness.

Philip Afuti, president of the PNG teachers’ association, Eastern Highlands, and head teacher of North Goroka primary school, is committed to gender equality. Eighty percent of teachers are female, while the school has 630 male and 523 female students.

“We want to see the girls have an equal opportunity as boys in the education system,” Afuti declared. “They should be able to build this nation in partnership. We want to see that. PNG will only develop when both males and females are educated.”

This year, the national government rolled out a free and subsidised education policy, which has impacted female enrolment. Students attending elementary prep to grade 10 at secondary school do not have to pay tuition fees while those in grades 11 and 12 pay only 25 percent of fees.

“We have increased the numbers of females enrolling,” Afuti verified. “Some who left a few years ago have also come back.”

But there is a limit to the expansion of the education system.

“The government has taken a bold step to abolish school fees at the basic education level, thus addressing a critical access barrier, enabling more children to be enrolled and complete a full cycle of education,” Kukari explained.

“However,” Kukari said, “at this juncture, the education system does not have the absorptive capacity to accommodate all children wanting to enrol and to provide a sufficient number of teachers to ensure that children are provided with a quality education as well.”

There are also inadequate mechanisms of support for school-going girls suffering from sexual abuse. “If there are avenues for redress to such offences, these are not made known to students and parents,” Wainetti said.

“It is unfortunate that many teachers will not do anything about these abuses until the parents of the girl or boy turn up at the school to beat up the students who have been harassing their child,” Wainetti said.

The ICRW advocates that educated girls ‘who become healthy, productive and empowered adults are a force for positive social, economic and political change.”

Betty Hinamunimo agrees that, in rural communities, women working as literacy teachers are being valued more in the community and respected, and as role models they are contributing to changes in community attitudes and greater support for educating daughters.

“There is no doubt that PNG’s health, economic and social indicators will improve if there are more educated and professionally qualified women,” Kukari concurred. “They would make a very big difference in government, business, the private sector, public service and many other areas.”

By Aline Jenckel
UNITED NATIONS, Apr 28 2012 (IPS)

With a whopping 40 percent of Ghana’s population under the age of 24, the government’s ability to foster their development and include them in the country’s development are critical to the country’s future.

Samuel Kissi, executive coordinator of Curious Minds, a youth advocacy organisation in Ghana that works to promote a development agenda for youth. Credit: Courtesy of UNFPA

But although governments are verbally committed to the idea that the youth are the country’s future, they need “to actually make commitments to invest in young people”, says Samuel Kissi, executive director of Curious Minds, a Ghanaian media-based youth advocacy organisation.

“We want to push decision makers and politicians to move beyond only saying that young people are the future of the nation,” Kissi elaborates. He and other youth leaders spoke about poverty reduction and youth rights at a side event of the Commission on Population and Development at the United Nations last week.

“We try to explore opportunities for young people to get engaged,” explains Kissi. But all too often, certain policies, such as those regarding sexual and reproductive rights, are not implemented due to a lack of funding because they’re not included in the country’s development plans, he adds.

Kissi spoke with IPS correspondent Aline Jenckel about Curious Minds and how the organisation is trying to help young people not only understand the country’s development process and strategies but also engage in them.

Excerpts from the interview follow.

Q: Which youth issues does your advocacy organisation Curious Minds cover and how do you carry out your work? A: On our radio program, which is broadcast across the country, we talk about development issues, sexual and reproductive health and rights, poverty reduction and education, including sexual education.

We look at it from a youth perspective. Once the national budget is released every year, we look at it from an apolitical point of view, evaluate which commitments concerning young people have been put in from last year and how much has been implemented.

We also do community outreach and talk about everything related directly or indirectly to young people’s comprehensive development, including HIV and AIDS.

Q: With the global population growing so rapidly, the development of sexual and reproductive health and rights is more relevant than ever. What are the main problems regarding this issue in Ghana, and what factors, such as bad policies, might contribute to these problems? A: The problems in Ghana are not due to bad policies. There is a comprehensive adolescent sexual and reproductive policy, but it may not have been translated directly into implementation.

Therefore there are gaps in the reach of services, so not all young people are fully educated in sexual and reproductive health. If they are, it is still not enough to reduce their vulnerability because they are hungry or unsheltered, and someone takes advantage of that.

The high unemployment rate in Ghana also puts young people into vulnerable positions.

Q: Which other partners help educate the younger generation on sexual and reproductive health? A: There’s a strong coalition between the government and the civil society. There is also help from religious institutions, although previously they were not allowing the distribution of condoms.

Nevertheless, the major media outlets of the country took on these issues and gained expertise, so now when they report about it in newspapers or on the radio, they do so from a more informed perspective. They are actually able to educate the population.

Q: There has been some controversy due to statements by Pope Benedict XVI concerning sexual issues, such as a prohibition on birth control. As many Ghanaians are Christian, how did these statements affect your country? A: The Catholic church is big in Ghana, but I would not go as far as saying that these statements had a significant impact on occurrences in the country and definitely not on policies. If you take the help facilities owned by the Catholic Church in Ghana, they now provide youth friendly services.

I am not quite sure if the Pope would be excited to hear this, but we made some progress in making the religious institutions understand that this is going beyond their understanding of how it should be, because there’s a real need in the communities, as young people are sexually active.

Q: What do young people in Ghana think about Kofi Anna’s run for the presidency? A: It was unexpected that he would run for president, especially in the previous election, which he didn’t win. I don’t think that it’s going to happen, but if he did I’m sure many young people would be excited about it.

However, I think it is important that he play the role he’s playing now, bringing peace to problematic parts of the world as best as he can. I hope he can inspire more politicians back home, so that they aspire to the high standards he sets.

Excerpt:

By Mathilde Bagneres and - -
UNITED NATIONS, Apr 28 2012 (IPS)

Young people aged 15-24 make up a quarter of sexually active individuals, yet they comprise half of new sexually transmitted infections (STIs) infections each year.

Oriana Lopez Uribe, Mexican youth activist for sexual and reproductive health services and information. Credit: Mathilde Bagneres/IPS

At the same time, 75,000 children under the age of 18 lack health insurance and nearly 30,000 people aged 18-24 are uninsured, according to the U.S. Census Bureau.

Compared to the rest of the industrialised world, American teens are less likely to use contraception and have less access to reproductive health services and sex education. These factors help explain why the U.S. has the highest teen pregnancy rate of the industrialised world.

Oriana Lopez Uribe of Mexico began her activism as a volunteer with Mexfam, the Mexican Planned Parenthood Association, where she developed strategies for sexual and reproductive health services and information for youth.

She is currently a program officer at Balance, which promotes sexual and reproductive health services for young people and women at the national, regional and international levels.

IPS correspondent Mathilde Bagneres spoke with Oriana Lopez Uribe about her commitment to sexual and reproductive rights for young people.

Q: Can you tell me more about your work and about the presentation you gave during the commission on population and development at the United Nations (U.N.)? A: I have been an advocate for sexual and reproductive rights for 13 years.

I came to the U.N. to advocate for sexual and reproductive rights. Later, in two panels related to access to comprehensive sexual and reproductive health services, I spoke about the national experience and some of the barriers that young people have to tackle to access health services.

We still have not a very enabling environment for communicating about sexuality issues with our parents. The obligation for parental consent is a barrier for young people because if your family is not very open to sexuality, then it will be very difficult to tell them that you need to go to sexual and reproductive health services.

Lack of confidentiality is also a big issue. There is a lot of discrimination and especially with young and adolescent girls. If they are not married, everyone expects them not to have sexuality.

Due to all this discrimination, health providers have bad attitudes when young women come to their services. They don’t give them the service, or they lecture them about how they should behave. After such treatment, girls are not coming back.

In Mexico, we have specific laws and norms about giving adolescents access to sexual and reproductive health services. But the health providers don’t know the laws. They don’t know that it is their obligation to provide the service. There is a real need to train and inform those health care providers.

Q: What concrete measures and actions could be taken to promote sexual and reproductive rights for young people? Can you share a successful experience? A: One NGO had a successful experience. They built a program to help rural and indigenous adolescents and young women. Those clinics work in the community – they are not outsiders. People working in the clinics are coming from the community; they are really working within the community.

They also provide a space for young people to express themselves, to dance, to paint; so it is not just about diseases. It is a whole program for youth and not just healing services.

The clinics are also integrated clinics, so you can go there and you can get many services such as STI prevention, contraception. You have everything you need in one place. Even some other health related topics like nutrition, psychological help.

The government supported this program, and it was taken into more and more rural areas and marginalised parts of the country with the same components: lots of participation, community work.

Of course, it still needs to be improved, but I think it is a very good experience because it shows how much youth participation needs to be taken in account to develop policies and for the implementation of those policies, the evaluation, the monitoring and at all levels. Youth participation is crucial.

Q: What is the situation regarding sexual and reproductive rights in Mexico and, more particularly, norms regarding abortion? A: Mexico has different states so it is complicated. In general, in Mexico abortion is against the law, but there are some exceptions.

In every state, if the pregnancy is due to rape, you can have a legal abortion or at least that’s what the law says, or if the woman has gynaecological problems, some health issues, if there is a death risk, she can have an abortion.

In certain states you can also have a legal abortion for economic reasons. In Mexico City, without any reason, you can ask for an abortion during the first trimester.

The law says that if you’re a minor, you don’t have to come with your parents – it can be an adult that you trust. But the reality is that the health providers, to protect themselves, don’t think about the teenager in front of them. They ask for parental consent or a legal guardian’s consent, which makes it really hard for young girls because there is still a lot of stigma and discrimination around abortions. It’s very hard to change that.

The ideal would be to say, “She is the one that knows better.” If that pregnancy is not wanted, we need to start trusting women. They know what’s best for them.

Q: What are the greatest sexual health challenges that young people face nowadays? A: Everyone has to start believing, seeing and acknowledging that adolescents and young people have rights. We need to start giving them the ability to make their own choices. We, young people, are able to make decisions.

There is a lot of negativity surrounding and associated with youth – immaturity, drug use, bad sexuality, promiscuity.

I think it is very disempowering to think that an adolescent is a child. We need to stop protecting young people and start empowering them. We need to make them believe in themselves and boost their self- esteem and their capacity to make choices.

Excerpt:

By Thalif Deen
UNITED NATIONS, Apr 25 2012 (IPS)

The United Nations, which has remained focused on the world’s political and military hotspots, has turned its attention to the bigger socioeconomic issues facing adolescents and youth, including poverty, sexual abuse, female genital mutilation and lack of reproductive health care.

“This generation of youth is the largest in history,” Secretary- General Ban Ki-moon told a meeting of the 47-member U.N. Commission on Population and Development (CPD), which concludes Friday.

“And even more important, this generation of youth is shaping history,” he said, in an oblique reference to the role played by youth in political uprisings in the Middle East and North Africa, including Tunisia, Libya, Yemen, Bahrain, Egypt and Syria.

The theme of the weeklong CPD meeting is “National Experience in Population Matters: Adolescents and Youth”.

Out of a growing world population of over seven billion, about 1.2 billion have been identified as adolescents and youth, according to the United Nations. And of this 1.2 billion under the age of 20, about 300 million live in “grinding poverty”, says Dr Babatunde Osotimehin, executive director of the U.N. Population Fund (UNFPA).

Expressing concern over the well-being of adolescent girls, he said the leading cause of death was complications from pregnancy and childbirth.

“They need our protection and our help,” he told delegates.

Dr. Osotimehin said his agency was harnessing the power of technology, utilising mobile phones to help midwives and bringing participants together over Skype.

The youth on “the other side of the digital divide” was being harnessed through Facebook and Twitter.

“Those efforts are essential to young people’s sexual and reproductive health, “as awareness can spell the difference between life and death.”

The secretary-general had an equally distressing message when he pointed out that upto 60 percent of sexual assaults involved girls under the age of 16, and more than three million girls worldwide were at risk of female genital mutilation every year.

“Sixteen million adolescent girls become mothers every year, and every day, more than 2,000 young people contract HIV,” Ban said.

More than 100 million adolescents were not in school, and over 75 million young people were unemployed.

“We have a collective responsibility to drive these numbers down,” he added.

Turning to the youth delegations at the meeting, the secretary-general said: “Welcome. This is your United Nations.”

As part of the African Union, the 13 members of the Southern African Development Community (SADC), have said they will continue to commit themselves to implement the 2009-2019 Decade for Youth Empowerment and Sustainable Development to address the growing challenges facing youth.

The members of the SADC include Botswana, Democratic Republic of Congo, Lesotho, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Swaziland, Tanzania, Zambia and Zimbabwe.

Speaking on behalf of SADC, Ambassador Ismael Gaspar Martins of Angola said: “We must accelerate the training of youth for sustainable development and the promotion of youth volunteering,”

Dr. Sugiri Syarief, chair of Indonesia’s National Population and Family Planning Board, pointed out that it is critically important for member states to discuss ways of effectively addressing the many challenges confronting youth.

And since 2005, Indonesia has allocated 20 percent of its national budget on education, and the government is developing a scheme to ensure 12 years of compulsory education.

Indonesia will also host an International Youth Forum in December in the island of Bali.

Speaking at a Global Colloquium of University Presidents at New York’s Columbia University last month, the secretary-general spoke of the growing power exercised by the world’s younger generation in an age of high speed technology and the information super highway.

“To unleash the power of young people, we need to partner with them. This is what the United Nations is trying to do,” he added, announcing his decision to appoint a U.N. Special Adviser on Youth.

The secretary-general said the United Nations is developing an action plan for the coming years.

“We want to work with youth on major issues affecting them, including joblessness, political inclusion, human rights and sexual health,” he said.

“I mention this because, when we talk about youth, we have to look beyond demographics to why young people are so powerful. Youth are often the first to stand against injustice. Youth is a time of idealism. Young people are a force for transformation.”

He also said that young people are using social networking to drastically alter power dynamics.

And young people are using Facebook and Twitter to organise protests, speak out against human rights abuses and end oppression, he added.

Increasing numbers of Malian women are being raped by Tuareg rebels and armed groups that have swept across the north of Mali since the beginning of year, expelling all government troops from the region.

Increasing numbers of Malian women are being raped by Tuareg rebels and armed groups that have swept across the north of Mali since January. Credit: William Lloyd-George/IPS

According to Corinne Dufka, senior West Africa researcher at Human Rights Watch, who is currently on a mission in Mali, there have been reports of rape and sexual violence taking place in towns and villages across the region.

“We’re very concerned about what appears to be a drastic increase in the targeting and sexual abuse of women and girls by armed groups in the north,” Dufka told IPS.

“Since rebel groups consolidated their control of the northern territory they call the Azawad, Human Rights Watch has documented several cases of rape and many others cases in which girls and women have been abducted from their homes, towns and villages, and very likely sexually abused.”

Dufka reports that most of the abuses have been, “perpetrated by rebels from the MNLA and to a lesser extent Arab militias allied to them.”

The National Movement for the Liberation of Azawad (MNLA) is an umbrella term given to groups of armed Tuaregs who have come together with the declared goal of administrating an independent state, Azawad.

Since the colonial French left the region in 1960, there have been several Tuareg rebellions against the Malian government. Previous uprisings ended in negotiations and the appointment of rebel leaders to state positions.

However, the rebels say the Malian government has failed to stick to promises made in negotiations, and continue to demand an independent state.

This time, armed with a heavy arsenal of weapons left over from previous rebellions, and additional arms coming from Libya over the last few years, the MNLA have made unprecedented advances. This was made easier by the coup in Bamako and the subsequent withdrawal of state military in the north.

Commenting on the allegations made by Human Rights Watch, MNLA spokesman Moussa ag Assarid, currently in the Malian city of Gao, denied MNLA men were involved in the sexual violence. “These men are not MNLA, but are other men around,” says Ag Assarid speaking over the phone from Gao. He admitted, however, that “We cannot control all the people in Azawad.”

Although the MNLA declared an independent state on Apr 6, residents in the region say the rebel movement does not really seem to be in control. “One day, one armed group will come into town, then the next day it will be another; we feel very unsafe,” one resident in Gao who preferred to remain anonymous told IPS over the phone.

Since the conflict began, several armed Islamist groups have emerged in the region, adding to concerns for the future of women’s rights.

One group, Ansar Dine, led by Iyad Ag Ghali, a prominent leader in previous Tuareg uprisings, has begun attempting to enforce Sharia law in the north. Soon after entering Timbuktu, Ag Ghali announced the group’s beliefs on the radio.

“Misfortune is due to people’s lack of faith in God, and because they have abandoned the practice of Sharia, because we have changed our way of life under the influence of whites,” he said.

While Ag Ghali is estimated to only have around 300 men in his ranks, his influence goes far and wide. Many MNLA commanders are still loyal to him from previous rebellions, as are drug smugglers, and other Islamist groups in the region.

Since Ansar Dine announced Sharia law, there have been unconfirmed reports of Ag Gali travelling with leaders from AQIM, the regional Al Qaeda group. It is also believed that Nigeria’s extremist group, Boko Haram, and the Movement for Unity and Jihad in West Africa have been operating in the region.

As residents report foreigners increasingly being spotted in the Islamists ranks, fears grow that Ag Ghali’s goal of creating an Islamic state could be closer to being achieved. Many Malian women, who have enjoyed freedom and relative equality compared to women in other countries in the region, are concerned this freedom could soon be a thing of the past.

“Since these groups have arrived, we hardly go outside, we are terrified what will happen if we forget to do something they have told us to do,” a 40-year-old market vendor in Timbuktu, who also wished to remain anonymous, told IPS.

“I have been working in the market all my life, it is how I feed my children, how can I just stop now? Even if they allow me to work, I am not used to sitting in the baking heat all day covered head to toe.”

It is reported that Ansar Dine and other Islamist groups have been going door-to-door ordering women to wear veils and respect Islamic law. They have been going to hairdressers and ripping down photos of unveiled women, shutting down brothels and prohibiting the sale of alcoholic drinks.

While there have not been any reports of women being punished by Ansar Dine for failing to adhere to Sharia law, women in the region are growing increasingly fearful of the possibility that they will start being punished if the Islamist group gains more control.

Food, electricity and infrastructure have also been severely affected by the conflict. In many cities food and water are running low, and it has been difficult for civilians to receive humanitarian aid.

“The vulnerability of women in the north is increased by the lack of medical care, non-existent rule of law institutions, and limited humanitarian assistance which could mitigate their suffering and deter further abuse,” says Dufka.

It was personal experience that turned Gul Bano and her cleric husband, Ahmed Khan, into ambassadors against early marriage and its worst corollary – obstetric fistula which allows excretory matter to flow out through the birth canal.

Bano and her cleric husband campaigning against child marriage. Credit: Zofeen Ebrahim/IPS

As is the custom in the remote mountain village of Kohadast in the Khuzdar district of Balochistan province, Bano was married off as soon as she reached adolescence, at 15, and was pregnant the following year.

There being no healthcare facility near Kohadast, Bano did not receive antenatal care and no one thought there would be complications. But, events were to prove different.

After an extended labour lasting three days, Bano delivered a dead baby. “I never saw the colour of my son’s eyes or his hair. I never held him once to my bosom,” recalls Bano, now 20.

Her troubles had only begun. A week later, Bano realised she was always wet with urine and reeking of faecal matter. “I was passing urine and stools together.”

Unable to handle the prolonged labour, Bano’s young body had developed a fistula caused by the baby’s head pressing hard against the lining of the birth canal and tearing into the walls of her rectum and the bladder.

Bano’s family attributed her condition to fate, her father refusing to visit “due to the bad odour coming from me.” However, through those trying times, Khan stood by his young wife and sought medical help.

After Bano spent a year in a perpetually “wet and stinky” condition, her husband finally discovered a hospital in Karachi specialising in treating fistula and other conditions related to reproductive health.

Koohi Goth Women’s Hospital, where fistula victims are treated free, was started by Dr. Shershah Syed, one of Pakistan’s first gynaecologists to train in repairing a painful and socially embarrassing condition.

In addition to incontinence, the medical consequences of fistula include frequent bladder infections, painful genital ulcerations, infertility and kidney failure.

In 2006, the United Nations Population Fund (UNFPA) launched a four-year fistula repair project as part of a programme to improve maternal health.

According to UNFPA, at least two million women in the world live as Bano did – in shame and misery. Most are not even aware that fistula can be repaired.

A major challenge for healthcare professionals is that the number of women suffering from fistula in the world is increasing by about 75,000 cases annually.

In Pakistan the true prevalence of fistula is unknown, but Syed estimates that there are about 5,000 new cases every year.

With only 500 – 600 women undergoing corrective surgery annually, Pakistan needs to put more resources into addressing fistula – which falls under the Millennium Development Goal (MDG) of reducing maternal mortality by three-quarters by 2015.

The MDGs are eight United Nations targets to be met by 2015 and, according to studies published by the International Youth Council, a major civil society organisation, Pakistan is unlikely to meet the fifth that deals with maternal health.

Pakistan, according to IYC figures released in 2010, has a maternal mortality rate (MMR) of around 500 per 100,000 births that is sought to be reduced to three-quarters from 1990-2015.

Pakistan’s maternal mortality ratio is wide-ranging, from 286 per 100,000 births in Karachi’s urban areas to 756 in rural Balochistan, where child marriages are compounded by non-existent health services.

“For both physiological and social reasons, mothers aged 15-19 are twice as likely to die of childbirth than those in their 20s,” says a UNFPA document. “Obstructed labour is especially common among young, physically immature women giving birth for the first time.”

Obstetric fistula is now generally acknowledged to be another burden on the girl child, deprived of basic education and forced into marriage – for which she is neither physically nor mentally prepared.

Pakistan’s Child Marriages Restraint Act passed in 1929 permits girls to be married at 16, but poverty, illiteracy and socio-cultural practices result in girls being married off as soon as they reach puberty.

Syed’s team continues to hold fistula repair camps in the remote areas of Pakistan that include training programmes for doctors and paramedics in fistula management. “The complicated cases come to Koohi Goth and simple repair is done in the field hospitals.”

The camps provided an opportunity to reach out to affected women and their families and encourage them to avail themselves of the free treatment in Karachi, where necessary.

Getting Bano to Karachi was not easy. Khan gathered a group of able-bodied men who took turns carrying her on a rope bed for three days just to reach a motorable road.

“It’s been almost three years and she has gone through six operations,” says Dr. Sajjad Ahmed, who worked at Koohi Goth as manager of UNFPA’s fistula project from June 2006 to February 2010. “She would not speak at all and she did not understand Urdu.”

Today Bano and Khan are regular visitors at Koohi Goth and vocal advocates of the campaign against fistula. They travel across Pakistan, spreading the word about how to prevent the injury and what to do about it.

“Khan is a cleric and yet he does not conform to the stereotype of a religious person,” said Syed. “He tells parents that fistula can be avoided if they stop marrying off their daughters at a very early age.”

Bano shares her story and tells married women about the importance of birth spacing, antenatal checkups and timely access to emergency obstetric care.

Syed says Pakistan badly needs a mass awareness campaign on fistula prevention and stresses the importance of social support for victims. “That’s the only way we can eradicate fistula from this region.”

“I smell nice now and it’s all because my husband wanted me to get well,” said Bano, who may have spent many more years in a miserable state if not for the treatment at Koohi Goth.

Agnes Torres, a transsexual psychologist and gay rights activist, left her home in the central Mexican state of Puebla on her way to a party. The next day, her body was found in a gully, naked from the waist down. Her throat had been slit.

Demonstrator holds up photo of Agnes Torres. Credit: Felixe/CC BY-SA 2.0

Three weeks after her body was found, the authorities closed the case, determining that the murder was not a hate crime but part of a violent robbery.

The police presented 160 pieces of evidence, along with the confessions of four suspects arrested for the murder.

The Puebla government says the only loose end in the case is the whereabouts of Torres’s partner, who is wanted by the police.

Torres was 28 years old and in the process of changing her identity in Mexico City, the only part of Mexico that has passed progressive laws such as the decriminalisation of abortion, same-sex marriage and a gender identity law allowing transgender people to change their gender and sex, under the left-leaning Democratic Revolution Party (PRD), which governs the capital.

She was also in the process of getting a degree at the University of Veracruz, which refused to recognise her new identity.

“Robbery might have been a motive, but it was clearly aggravated by transphobia, which besides homophobia has an added element: misogyny,” said Gloria Hazel Davenport, who worked alongside Torres in the project “Humana, Nación Trans”, aimed at achieving respect and dignity for people who undergo a sex change.

“The fact that we are transsexuals makes us more likely to be targeted as victims, because we don’t exist, since not having documents (with the new chosen name) makes us invisible in the eyes of the law,” said Davenport, who is also director of the Género, Ética y Salud Sexual (GESS – Gender, Ethics and Sexual Health) civil association based in the northern city of Monterrey.

“Agnes’s case had major repercussions because she was an activist involved deeply in the struggle for our rights. But there are many other cases that no one has ever heard about,” Davenport told IPS.

She and 17 others presented the Agnes Torres for Trans Dignity Self-Help Group on Wednesday Apr. 4.

Despite the investigation’s conclusion that it was not a hate crime, Torres’s murder in early March sparked growing concern about an escalation of homophobia in this country.

Between Mar. 10 and 12 alone, two homosexuals were killed in the same state where Torres was murdered. The bodies of Jorge Roberto Merchant, a 47-year-old public employee, and 37-year-old César González were found in their respective homes, with signs of torture.

The murders of Torres, Merchant and González bring the number of gay-bashing murders in Puebla to seven so far this year and 21 since 2005, according to the organisation No Dejarse Es Incluirse.

Suspects have been arrested in just one of those cases, Torres’s murder.

The situation is no better in the rest of the country. A report on homophobia-related hate crimes, “Informe de crímenes de odio por homofobia (1995-2008)”, presented in 2011 by the gay rights group Letra S said that 628 gay-bashing murders committed between 1995 and 2008 made Mexico the second-highest ranking country in Latin America for this kind of killing, after Brazil.

But experts say the real number of such murders is actually higher. They estimate that for every killing of a homosexual that is reported as a hate crime, two others go unreported.

“There is an institutional problem, because politicians, who send messages to society, should be the first to speak out against these crimes and promote tolerance for sexual diversity, especially during election campaigns, like now,” Gerardo Sauri, with the Federal District human rights commission, told IPS.

“But they are not doing that. In fact, patterns of mistreatment, misogyny and homophobia prevail in the government apparatus itself,” he said.

The legal reforms in favour of the LGBT (lesbian, gay, bisexual and transgender) community passed in Mexico City have not only faced opposition from society but from state institutions as well.

Two years ago, the Attorney General’s Office filed a complaint with the Supreme Court, seeking to have the Mexico City same-sex marriage law overturned, on the argument that it violated the constitutional clause on protection of the family.

In March 2011, the Senate approved the inclusion of the term “sexual preference” in article 1 of the constitution, in a list of grounds on which discrimination is banned. But when the reform was sent to the states for ratification, several state legislatures rejected it.

In Puebla, the legislature deemed that raising respect for sexual freedom to the level of the constitution was going too far, and the lawmakers only approved the inclusion of the term “differences.”

Two months later, Mexico’s conservative President Felipe Calderón modified a decree that he had approved in December 2009 to declare May 17 the Day of the Fight against Homophobia, renaming it the Day of Tolerance and Respect for Differences.

“There is government responsibility for these crimes at two or three different levels,” said Sauri. “The first is the judicial system, because the legal invisibility generates a structural problem: government bodies do not feel that they have to respect the right to sexual diversity.

“Another layer has to do with the perceptions of high-level officials. If they don’t send out signals of equality and respect, and of support for the fight against homophobia, it will obviously be more difficult to implement a legal framework,” he said.

A few days before Torres’s murder, a Youth Parliament met in Mexico City – a simulated legislative session aimed at promoting political participation among the young. A scandal was triggered by comments made during the session by Juan Pablo Castro, a law student from a private university who belongs to the governing right-wing National Action Party (PAN).

“What have the governments of the PRD in the DF (Federal District) dedicated themselves to? To destroying institutions, allowing ‘jotos’ (a denigrating local term for gays) to marry, and permitting abortions. We cannot let these people govern us,” said the young man, who later was forced to publicly apologise for his homophobic remarks.

According to Sauri, there is even a culture of homophobia within the Federal District government apparatus, and among leftist politicians. “The prevailing perception is that (homosexuals) are sick, perverted social deviants who pose a risk to the community and, above all, to the children,” he said.

After Torres’s murder, the Inter-American Commission on Human Rights urged authorities in Mexico “to conduct an investigation that takes into account whether Agnes Torres’s murder was committed because of her gender identity and/or her work defending the rights of LGTBI persons.”

The Puebla state Congress, meanwhile, was forced to accept the constitutional reform that it voted against in 2011.

There is much to be done in a country where four out of 10 people would not be willing to live with a homosexual, according to the last National Survey on Discrimination – which did not even include references to the transsexual community.

“The problem is that we are in a country choking on hypocrisy, where, as the violence increases, a big bubble is growing that is going to burst around those of us who are most vulnerable to becoming victims of crimes,” said Davenport.

Teenage pregnancies are on the rise in Guatemala, along with the drop-out rate in schools, family breakdown and many other related social ills.

More and more girls in Guatemala are having babies. Credit: Fiat Luxe/CC BY-ND 2.0

A graph of statistics from the Ministry of Health and Social Assistance shows a rising trend, with 41,529 pregnancies in girls aged 10 to 19 in 2009, 45,048 in 2010 and 49,231 in 2011, giving an average of 135 a day last year.

A long list of factors contribute to early motherhood, ranging from lack of sex education to the influence of the Catholic Church’s ban on contraceptive use, and impunity for statutory rape, according to Mirna Montenegro of the Sexual and Reproductive Health Observatory, a local NGO.

“Imagine! In 2011 there were 21 babies born to 10-year-old girls! What’s more, we have no social protection system for them,” she told IPS.

“We are one of the few countries where there are so many pregnancies among 10 to 14-year-old girls. In 2011 alone there were 3,046 births to such young mothers in Guatemala,” she said. “Pregnancy in an underage girl is the product of statutory rape, so logically there should be an equal number of court prosecutions under way, but this is not so,” she complained.

Montenegro said the Guatemalan justice system finds it problematic to punish offenders in these cases. “The younger the victim, the closer the family ties between herself and the rapist,” she said.

The Catholic Church’s opposition to using birth control methods and to a comprehensive approach to sexuality that includes avoiding unplanned pregnancy and sexually transmitted diseases is also a hurdle, Montenegro said. “It affects the development of attitudes within the family,” she said.

The Health and Education Ministries signed a cooperation agreement in 2010 to implement programmes to prevent unwanted pregnancies in the six provinces with the highest HIV/AIDS incidence, maternal mortality rates and other indicators of concern.

“Progress has been made in raising the awareness of teachers, developing teaching materials and learning modules, and analysing the context of the situation in the provinces. But these things have not yet reached classrooms, as they are bogged down in provincial and ministerial head offices,” Montenegro said.

The Family Planning Law, regulations for which were adopted in 2009, brought sex education into primary schools and facilitated access to contraceptive methods. The following year the Healthy Maternity Act was approved, which obliges health authorities to provide basic services and care before, during and after pregnancy.

But the new laws have not been successful in curbing teen pregnancies.

One out of five Guatemalan mothers are aged between 10 and 19, the highest adolescent fertility rate in Latin America, according to a 2011 study on the state of the world’s girls, titled “Because I Am a Girl: So, What About Boys?” by Plan International, a child protection agency.

Deep-rooted cultural factors also encourage pregnancies and prevent women from taking advantage of opportunities for a better life.

Cecilia Fajardo, a psychologist with the Family Welfare Association of Guatemala (APROFAM), told IPS, “We are still taught that women’s role is to be wives and mothers, which is our right, but we are not told about other avenues of self-improvement.”

Fajardo said there could be more child and teen pregnancies than those reported by the Health Ministry, since “many of the births take place at home, or pregnancies are terminated without the authorities’ knowledge.”

To help teenagers, APROFAM has created innovative programmes in schools for young people of both sexes to come to grips with practical aspects of pregnancy, fatherhood and motherhood, using aids like the electronic baby and the pregnancy simulator.

“The pregnancy simulator is a strap-on garment with an enlarged bust and belly weighing 25 pounds (11 kilograms), the average weight gain a woman experiences in pregnancy. It enables teenagers to experience 26 different signs and symptoms of pregnancy,” Fajardo described.

The electronic baby is a computerised infant-sized doll that mimics the behaviour of a newborn, including crying to signal that it is hungry or tired.

“We give young girls these experiences to give them knowledge about sexuality and reproductive health. We do not impose on them the idea that they should not be mothers,” Fajardo said.

This impoverished Central American country of 14 million people has an adolescent (under-20) birth rate of 114 per 1,000 women in rural areas, according to the National Mother and Child Health Survey for 2008-2009.

Silvia Maldonado of the National Alliance of Indigenous Women’s Organisations for Reproductive Health (ALIANMISAR) told IPS that dropping out of school, malnutrition and discrimination are among the consequences of teen pregnancies.

She said education was one of the most important factors for the prevention of adolescent pregnancy, which severely curtails life opportunities for thousands of teenagers and creates the phenomenon of “kids having kids.”

“It is essential to talk about sexuality in schools, and for parents to talk to their children in depth about this issue in order to prevent more teen pregnancies,” Maldonado said.