RIGHTS

For many girls and women, severe violations of their human rights are deeply rooted within their families and reinforced by norms of male privilege, religious doctrines, and appeals to custom or tradition. Such hidden injuries of gender are rarely addressed in public policies and international assemblies because they appear to threaten the "sanctity, harmony, and stability" of the family unit. At the same time, some countries are not fully adhering to human rights standards in the implementation of their population policies.


WOMEN'S REALITY

Violence Against Women Is a Global Human Rights and Public Health Issue


Reproductive and Sexual Rights: Their True Meaning

Reproductive and sexual rights consist of the following four ethical principles, which are routinely violated, as the examples show.

1. Bodily Integrity-- The right to security in, and control over, one's body; the right not to be alienated from her sexual and reproductive capacity; integrity of her physical person (e.g., freedom from sexual violence, from false imprisonment in the home, from unsafe contraceptive methods, from unwanted pregnancies or coerced child-bearing, from unwanted medical intervention). "Integrity" connotes wholeness, treating the body as a unit, not as piecemeal mechanical functions or fragments.

In Maharashtra State, 92 percent of women using local family planning clinics suffered from untreated gynecological infections or diseases, reflecting the fact they were viewed as contraceptive acceptors, not as whole women.

Family planning programs often emphasize medically efficient methods of contraception to the exclusion of barrier methods, and fail to offer women protection against STD and HIV infection, exposing them to morbidity, infertility, or death.

2. Personhood-- Requires that providers trust and take seriously women's desires and experiences; for example, concerning contraceptives' side effects.

Women's concerns about irregular bleeding while using Norplant were often dismissed and their requests for removal of the implant not honored in clinics in the Dominican Republic, Egypt, Indonesia, and Thailand.

3. Equality-- This principle applies to relations between men and women, and relations among women (conditions such as class, age, nationality, or ethnicity that divide women as a group).

Population policies traditionally demand that women bear the medical risks and social responsibility for avoiding unwanted pregnancies, never putting equal emphasis on male responsibility for controlling their fertility and using contraceptives.

4. Diversity-- Requires respect for differences among women in values, culture, religion, sexual orientation, and family or medical condition. Rights have different meanings, or different points of priority, in different social and cultural contexts.

Clinic staff disseminating Norplant do not always understand the meanings menstrual blood has in local cultures, and how frequent bleeding--a common side-effect of Norplant--may result in the exclusion of women from sex, rituals, or community life.


Two Women in Peru

Maria lives in Peru. She has five children: the first one delivered at a doctor's office, the next three at home, and the last one in a hospital. She had no prenatal care and little contraceptive choice. "The midwife told me that I could use an IUD, pills, or an injectable. I didn't check into it any further because I was afraid and embarrassed to ask about this. I thought that if I asked the midwife for further information she would take it badly, and that she would judge me. . . .Some people told me that one has to take care of oneself through natural methods because contraceptives are harmful. I now live alone."

Susana also lives in Peru. She has four children and has had one abortion. "They have never explained family planning to me. In the Maternity [ward] they told me that I could not have any more children and that I should go to the hospital and have my tubes tied. They didn't tell me how to take care of myself. My husband took care of himself. . . [by having sex with another woman]."


WOMEN'S POWER

What Women Want

From the Women's Declaration on Population Policies:

1. Women can and do make responsible decisions for themselves, their families, their communities, and, increasingly, for the state of the world.

2. Women have the right to determine when, whether, why, with whom, and how to express their sexuality. Population policies must be based on the principle of respect for the sexual and bodily integrity of girls and women.

3. Women have the individual right and the social responsibility to decide whether, how, and when to have children and how many to have; no woman can be compelled to bear a child or be prevented from doing so against her will.

4. Violence against girls and women, their subjugation or exploitation, and other harmful practices such as genital mutilation or unnecessary medical procedures, violate basic human rights.

5. The fundamental sexual and reproductive rights of women cannot be subordinated, against a woman's will, to the interests of partners, family members, ethnic groups, religious institutions, health providers, researchers, policy makers, the state, or other actors.


What Works and Why

Colombia: Health for Women, Women for Health

In Colombia, the combination of government willingness, support from the Pan American Health Organization, and the action of feminists led to a national women's health policy called "Health for Women, Women for Health." This policy explicitly aims to reduce inequality between women and men and sees women as "subjects of the decisions over their lives, their bodies, their sexuality and their health."

Adhering to the four principles outlined above, it goes on to say: "The woman has the right to treatment and care from the health services as a whole being, with specific needs--according to her age, activity, social class, race and place of origin, and not to be treated exclusively as a biological producer. She has the right to respectful and dignified treatment by health workers of her body, her fears, and her needs for intimacy and privacy."

The policy also recognizes the problem of violence against women, which it notes is the main cause of death among women fourteen to forty-four years of age. It also recognizes the need for special attention to adolescents. Regarding sexual and reproductive health, the policy states that the decision about the number of children they will bear is the right of individuals.





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