Human Rights Policy and Nonprofit Organizational Development

Posts Tagged ‘Human Rights’

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Maternal Mortality

In Policy Blog on October 12, 2009 at 11:51 am

This is a cross-posting of a column I write for Gender Across Borders.

This month instead of focusing on a specific country, I’m going to broaden the scope to address a global epidemic– maternal mortality.  Each year more than a half a million women die during pregnancy, giving birth, or in the critical few weeks following birth.  That’s one woman every minute; most from preventable causes, and most (99%) occur in poor countries.  In fact, the difference between maternal death rates in developing countries as compared to developed countries is absolutely staggering.  Women in the developing world are 300 times more likely to die in childbirth than their counterparts in industrialized countries.  According to a UNICEF report, “A woman in Niger has a one in seven chance of dying during the course of her lifetime from complications during pregnancy or delivery. That’s in stark contrast to the risk for mothers in America, where it’s one in 4,800 or in Ireland, where it’s just one in 48,000.”  In addition to those women those women who perish, for each death 20 women suffer from illness or permanent injury like fistula.

The reduction of maternal mortality is part of the fifth Millennium Development Goal (MDG), but has only recently really begun to garner international attention.  Anna Browne, wife of the British Prime Minister, just had a piece on maternal mortality on the Huffington Post- a ticket to issue stardom.   More voices than ever before are trying to put and keep maternal mortality on the agenda.

Says one UNFPA communications specialist, more women die in childbirth than in wars.  Ban Ki Moon recently called current rates of maternal mortality “inexcusable,” espcially in a world where we can “map the human genome and send vehicles to far reaches of space.”  In addition, simple clinical interventions could drastically reduce the numbers of deaths, according to public health journal The Lancet.

A few countries where high rates of maternal mortality have recently made news:

A hospital in Ethiopia. Image care of The Huffington Post A hospital in Ethiopia. Image care of The Huffington Post

Ethiopia: Twenty-two thousand women die every year in childbirth or of related causes.  According to this Huffpo series, the major issue is health systems and access.  The country of 77 million has about 200 gynecologists, and most women live far from clinics.  The Ethiopian government’s response is an army of “health extension workers,” but even they can’t provide all the necessary services to the 15% of women who experience complications due to pregnancy or birth.

Nigeria: As the Center for Reproductive Rights has reported, nearly 60,000 Nigerian women die every year from pregnancy-related causes, but only 5% of the country’s annual budget goes to the health sector.    And although “Nigeria accounts for only 1 percent of the global population, it contributes 10 percent to the number of global maternal and child deaths.”  Half of the maternal deaths are the result of postpartum hemorrhaging, which could be stopped with proper equipment and trained personnel.

Bangladesh: The BBC calls Bangladesh “one of the most dangerous places in the world to have a baby.”  As part of the “Survival” documentary series, the BBC has focused on maternal mortality there.  The documentary shows home births attended by traditional midwives, and points out that they lack access to lifesaving medical care if complications arise.  It also mentions that programs like microlending have led to the empowerment of women.

Sierra Leone: Amnesty International has just launched a campaign on maternal mortality in Sierra Leone, pointing out the fact that health is a human right.

Amnesty president Irene Khan has toured Sierra Leone and blogged the whole way, posting stats and pictures.  One in 8 women die during childbirth in the country, many because they could not afford the fees associated with reproductive health care.  In this report, Amnesty calls on the government to fix its corrupt and inadequate healthcare system, and to remove cost as a barrier to care.  The government of Sierra Leone denies the validity of Amnesty’s report.  You can write a letter to the president of Sierra Leone here.

Mother and newborn in India A woman and her newborn in India. Image care of the Swedish International Development Agency.

India: This Human Rights Watch report points out that maternal death rates in the Indian state of Uttar Pradesh are the highest in the country, but that its not an isolated problem– about one in five maternal deaths last year took place in India.  All over India, women die from infection and shock after childbirth.  One nonprofit has anti-shock garments that have fallen out of favor in more developed areas because they are a time-consuming, yet simple, alternative to ongoing basic care.  The tight, girdle-like fabric must be worn on the trip home after giving birth to reduce the risk of hemorrhage, and then removed very slowly.  A friend and colleague from India once explained to me that her work with maternal mortality centered around the concept of the “five cleans,” basics like soap for washing the midwife’s hands, a clean razor, and a plastic sheet to deliver the baby on to.  Such simple interventions underscore the ease with which the international community could address maternal mortality, if the political will were there.

Swaziland: Rising maternal mortality has been attributed to “home delivery and lack of skilled attendants,” and poor health infrastructure.  The country is focusing on maternal mortality as part of its National Programme on Sexual and Reproductive Health.

It seems that most of these stories point to common causes for staggering rates of maternal morality.  Poor health systems come up over and over in accounts of African countries’ maternal mortality statistics.  This often includes lack of trained staff, lack of phsycial infrastructure making acess difficult, and inadequate healthcare delivery systems.  But given the health systems explanation for high levels of maternal mortality, what is the US’ excuse?

The United States: Black women in the US die from pregnancy or birth-related causes at almost double the rate of white women.   Check out this wonderful series on African American maternal health at Women’s Enews.

And overall, the US has been ranked among the worst industrialized countries for maternal health by Save the Children.  What’s going on here?

I think an overarching theme is the disempowerment of women by an international culture that seems to see women’s bodies as a commodity and females as expendible.  Although maternal mortality has become a bigger blip on the world’s radar, a woman dying a minute of a preventable cause is nothing short of outrageous– as Amnesty says, a human rights emergency.  The “position of women” emerges again and again as the root of maternal mortality.  “Study after study shows that investing in women brings broad economic and social benefits,” says Ban Ki Moon.  UNIFEM has said that although the medical and health systems causes are often emphasized, the solution truly lies in the empowerment of women.

Although health systems reform is critical, we must also keep working to force the heteropatriarchy to recognize women as agents in our own lives, as full citizens, and as equal human beings deserving of the full spectrum of human rights.

Brook Elliott-Buettner is a freelance human rights policy researcher and writer living in New York. More information and work is available at www.brookelliottbuettner.com.

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Article published

In Policy Blog on August 21, 2009 at 12:36 pm

An article I wrote on the human rights legal framework and abortion, using Mexico City as a case study, has just been published.  Available online here.  The abstract is available on my Publications page.

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Policy Blog: Human rights orgs criticize the Merida Initiative

In Policy Blog on June 8, 2009 at 7:55 pm

I have written before about the Merida Initiative to fund the “war on drugs” in Mexico.  A few weeks ago, a group of several dozen civil society organizations and well-known individuals wrote a letter to the U.S. Congress voicing concerns about the initiative.

The memo raises several issues and points to human rights abuses by forces trained and deployed under the Initiative. 

The deployment of the Mexican army to carry out public security tasks that legally correspond to the civilian police has brought with it a significant increase in human rights violations in the last two years, including extrajudicial executions, torture, arbitrary detentions and rape.

Signatories include several organizations that I’ve worked with in the past and deeply respect, including Catholics for the Right to Decide (Católicas por el Derecho a Decidir, which also figured in this post) and the Fray Fransisco de Vitoria Human Rights Center (Centro de Derechos Humanos Fr. Fransisco de Vitoria).  Centro Fray Vitoria definitely knows what it’s talking about- one of their major issues is the militarization of civil policing for indigenous areas in southern states and the resulting rights violations, including political imprisonment and mass rape of indigenous women by military personnel. 

It has always been so clear to me that the “war on drugs” in the South of Mexico is a thinly veiled mechanism for repressing the poor, (justifiably) angry, and largely indigenous residents of southern states.  I’ll post some time in the near future on poverty indicators for the southern states and specifically on the situation for indigenous women.

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Critiques of the Merida Initiative

In Policy Blog on April 30, 2009 at 7:11 pm

The Merida Initiative is a well-funded initiative, subtitled “Guns, Drugs and Friends,” ostensibly designed to address growing drug-related violence in Mexico and the U.S.’ responsibility for the problem.  Here’s a fairly favorable overview of the policy from the Woodrow Wilson Center.  

The policy has been heavily criticized by human rights activists and many others on both sides of the border.  One columnist points out that the bill will bring a wave of U.S. contractors to Mexico, calling the initiative a “Bureaucratic Invasion” (English translation of his article).

“Real security cannot be achieved without human rights. Both the US and Mexican authorities have the duty and power to ensure that international human rights standards such as the right not to be subject to torture, to a fair trial and to justice are protected and promoted. The safeguards under discussion in the US Congress advance these goals,” said Amnesty International.

The Washington Office on Latin America (WOLA)’s take on the Merida Initiative brings up several problems with the policy:

It is not clear whether there are well-defined objectives and indicators for success… [The policy] lacks built-in accountability measures.

and:

WOLA feels that the initative’s success should be judged by whether it helps to address the structural weaknesses in the civilian security system that have allowed violence in Mexico to get so out of hand and which have served to justify the increased invovlement of the Mexican military in combatting drug trafficking and organized crime.

This gets to my primary concerns with the policy.  It is problematic to put the miliatry in a civilian law enforcement role, and runs contrary to the spirit of international humanitarian law.  It certainly doesn’t help assuage my fears that Mexico is vulnerable to being made into a police state with total executive control maintained through repression of dissent, torture, and extrajudicial execution and imprisonment.  These things already go on– but are often hidden from international (or even national) attention or censure, and such impunity is a dangerous trend.  And the virtually unchecked U.S. financial backing of the military in a civilian police role means that we are helping pay for human rights abuses and implicitly helping undermine the rule of law.

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Center for Constitutional Rights to challenge US before IACHR

In Policy Blog on March 19, 2009 at 4:10 pm

The Center for Constitutional Rights and the World Organization for Human Rights USA will go before the Inter-American Commission on Human Rights on Friday (March 20, 2009) to demand that U.S. officials be held accountable for violations of international law, including torture and war crimes.

According to the CCR release,  they will argue that the Commission should:

  •  Issue official recommendations to the United States to engage in criminal investigations and prosecutions for torture, cruel, inhuman and degrading treatment;
  • Reform laws that prevent the victims of U.S. policies from learning the truth about these abuses; and
  • Make reparations to victims of human rights abuses committed by the U.S. government.

I think it is extremely important that the US be held accountable at the international level.  There is the obvious reason of the inherent value of upholding and promoting human rights, but beyond that I think that the US must be held to the same standards to which we hold other, less powerful countries.  The US, as a major international power, should be a shining example of respect for human dignity, not the sneaky, hypocritical player we are today on the international stage.

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UN Special Rapporteur on HR and Counter-Terrorism Watching US

In Policy Blog on March 12, 2009 at 3:45 pm

The United Nations’ Special Rapporteur on the promotion and protection of human rights while countering terrorism was appointed in April 2005 for a preliminary term of three years.  Rapporteur Martin Scheinin has been especially strong in statements on the use of intelligence.  I think it’s worth noting that gender was a specific part of the Special Procedure’s mandate, given the ongoing Gender Equity Architecture Reform (GEAR) process in which civil society is currently engaged.

The news is that on Tuesday the Rapporteur announced a global investigation into secret detention to the UN Human Rights Council, and promised not to ease scrutiny on the US.  We can only hope that the in this new phase of internationalism under the Obama administration, the US will take UN recommendations seriously.

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Mexican Supreme Court official decision on abortion law released

In Policy Blog on March 11, 2009 at 9:18 pm

The Suprema Corte de Justicia de la Nación (Mexico’s Supreme Court) has released its final decision in the form of a case file (click here for pdf), compiled by Justice Aguirre Anguiano and reviewed by the other justices.  The decriminalization of abortion in Mexico City was challenged by the Ombudsman of the National Human Rights Commission and by the National Attorney General.  One of the Attorney General’s claims had to do with the Legislature’s standing to change health code.  The Ombudsman claimed that the law violated the constitutional right to life, and the right to life under international human rights agreements.  

The constitutional right to life under the Mexican constitution was one of the most important lynchpins in the arguments of most of the justices who found in favor of the law’s constitutionality.  Several justices explicitly recognized the right to life in the Mexican constitution, but clarified that there was nothing in the constitution to prioritize it above any other constitutional goods or rights.

International commitments were also mentioned in several of the justices’ findings.  This in itself is significant, as it adds legitimacy to international law within the national constitutional framework (as the Supreme Court is considered a constitutional court).

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Policy Blog: Global Gag Rule and maternal health

In Policy Blog on February 12, 2009 at 9:29 pm

In a statement accompanying the act that repealed the Mexico City Policy, also known as the Global Gag Rule, Obama said that offices and officials in his administration will have “the goal of reducing unintended pregnancies. They will also work to promote safe motherhood, reduce maternal and infant mortality rates and increase educational and economic opportunities for women and girls.”

Family Care international, an NGO working on maternal health issues, has joined forces with colleagues to offer policy recommendations to the new administration.

Key actions range from the immediate — like repealing the Global Gag Rule and restoring funding to the UN Population Fund — to a number of bigger-picture goals. Specifically, FCI and its partners are calling for the U.S. government to allocate $1.3 billion for maternal and newborn health in 2010, and for an additional $1 billion allocation to support family planning programs. The community is also urging the Administration to develop a comprehensive, evidence-based Maternal and Newborn Health Emergency Action Plan, and to take the lead in global efforts to provide universal access to life-saving health care for mothers and newborns in the developing world.

Obama has embraced international treaties and agreements and international human rights law more than any previous American president, and has said that the U.S. will adopt the Millennium Development Goals under his administration.  

Maternal health is Goal 5.  According to an MDG Fact Sheet,

Estimates for 2005 show that, every minute, a woman died of complications related to pregnancy and childbirth.  This adds up to more than 500,000 women annually and 10 million over a generation. Almost all of these women – 99 per cent – live and die in developing countries.

Maternal mortality shows the greatest disparity among countries: in sub-Saharan Africa, a woman’s risk of dying from treatable or preventable complications of pregnancy and childbirth over the course of her lifetime is 1 in 22, compared to 1 in 7,300 in developed regions. Every year, more than 1 million children are left motherless and vulnerable because of maternal death. 

In many countries, unsafe clandestine abortion is a leading cause of maternal mortality, a fact which has been decried by the international human rights community and numerous treaty interpreting bodies.  The risk of abortion procedures performed in a safe, clinical environment is extremely low, making those deaths wholly unnecessary.

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Forcible sterilization case against Chile

In Policy Blog on February 4, 2009 at 12:33 am

The Center for Reproductive Rights announced today that a Chilean woman has filed a case against the Chilean government before the Inter-American Commission on Human Rights.  Her complaint alleges that she was forcibly sterilized because she is HIV positive, a violation of her human rights.

The Center for Reproductive Rights’ Luisa Cabal says, ”Forced sterilization is a violation of a woman’s most basic human rights and is all too often committed against members of vulnerable groups, which deserve special protection, such as women living with HIV.  It’s time that the Chilean government respect the human rights of all its citizens and take concrete action to guarantee that a woman living with HIV receives quality reproductive health services and has the ability to make decisions about her own life.”

The New York-based Center for Reproductive Rights and the Chilean NGO VIVO POSITIVO have presented the claim on the behalf of F.S., who wished to remain anonymous.  VIVO POSITIVO had found numerous cases of forcible sterilization of HIV positive women, and hopes that the case will promote systemic change.  The Inter-American Commission monitors OAS state compliance with human rights agreements.

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Policy Blog: Inter-American Human Rights Commission heralds closure of Guantanamo

In Policy Blog on January 27, 2009 at 10:13 pm

The Inter-American Human Rights Commission has released a statement expressing its approval of President Obama’s  decision to close the detention center at Guantanamo Bay.  A brief portion of the statement is below.  The rest of the statement references past calls by the Commission to close the detention center and to investigate rights violations allegedly taking place there.  It is so good to see the U.S. finally taking some of its international obligations seriously.

 

IACHR WELCOMES ORDER TO CLOSE GUANTANAMO DETENTION CENTER

Washington, D.C., January 27, 2009 — The Inter-American Commission on Human Rights (IACHR) expresses its deep satisfaction over the decision by the President of the United States, Barack Obama, to close the detention center at the Guantánamo Bay Naval Base within a period of no later than one year and to prohibit cruel, inhuman, or degrading treatment in interrogations of detained individuals.

President Obama made these decisions on January 22, 2009, with the signing of the executive orders entitled “Review and Disposition of Individuals Detained at the Guantánamo Bay Naval Base and Closure of Detention Facilities” and “Ensuring Lawful Interrogations.” These decisions order government officials to immediately review the status of all individuals detained at Guantánamo and to ensure that the conditions of detention comply with all applicable national and international laws, including the Geneva Conventions. The constitutional privilege of habeas corpus of all detained individuals is also recognized, and the detention center at Guantánamo is ordered to be closed within a period of no later than one year. 

[The rest of the statement is available here.]

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