Abstract
No. 101
Title:
War-Related
Sexual Violence In Sierra Leone: A Population-Based Assessment
Author:
Yamin, Alicia Ely , Email: ayamin@hsph.harvard.edu
Key
words: Sexual
Violence, Quantitative Survey, Human Rights, Gender, Sierra Leone
Objectives:
In 2002, Physicians for Human Rights (PHR) and the United Nations Assistance
Mission in Sierra Leone (UNAMSIL) conducted one of the first studies that set
out to scientifically document the extent of sexual violence as a result of war.
In turn, PHR sought to create a
model for standardized methodology for assessment of sexual violence.
Background: Sierra
Leone's decade-long conflict has been one of the deadliest in recent history and
has been marked by an extraordinary level of brutal human rights abuses. The
devaluation of women in society made women particularly vulnerable to egregious
human rights abuses during the conflict in Sierra Leone.
Methods: PHR
combined a quantitative survey with testimonies, which permitted triangulation
of converging and diverging lines of evidence. Through
the survey PHR documented the objective prevalence of human rights abuses among
internally displaced persons (IDPs), including
war-related and non-war-related sexual violence (as well as other human
rights abuses). The
survey was conducted in 991 households-- 9166 household members in 4
sample locations representative of the total IDP population.
PHR
also explored women’s subjective perceptions about gender roles and their
human rights.
Results:
An alarming 94% of households surveyed reported one or more abuses.
One in eight households reported some form of war-related sexual violence
among its members. Nine percent of
respondents reported sexual violence (i.e,
approximately 50,000-64,000 IDP women). The forms of sexual violence reported
were very serious: 89% of women
reporting sexual violence were raped; 33% reported being gang raped. The
rebel force, Revolutionary United Front (RUF), was most often reported as
perpetrators (51-71%) for all abuses and, stunningly, the majority of women
detained by the RUF had suffered sexual violence and other terror tactics. Among
respondents reporting sexual violence, the study probed beliefs about punishment
for perpetrators, as well as willingness to provide their names to the Truth and
Reconciliation Commission or the Special Court. With respect to thoughts about
women’s rights and gender roles in society, the questionnaire obtained results
which warrant further analysis and discussion. For example, stated beliefs about
women’s rights (e.g. to space the
number of their children) coexist with a widespread acceptance of domestic
violence and subjugated gender roles within the private sphere.
Conclusions: PHR’s
study demonstrates the critical role that public health methods can play in
population-based assessments of the prevalence and distribution of human rights
abuses, including sensitive issues such as sexual violence.
Such data may prove critical for establishing accountability in Sierra
Leone and elsewhere; it is also useful for policy-making, program planning,
guiding humanitarian relief efforts, and planning treatment and prevention
programs for survivors. While the objective evaluation of prevalence of abuses
is critically urgent in terms of the Truth and Reconciliation Commission and the
Special Court, as well as in devising humanitarian policies and programs to
respond to health needs of IDPs, women’s
subjective perceptions of ri ghts and gender roles provide an important opening
for critical debate about the structural constraints on women’s rights and
well-being in Sierra Leone an society.
Abstract No. 102
Understanding
Women’s Human Rights Violation In Armed Conflict Situations
Author:
Goswami Sathyasree , Email: sathyasree1974@yahoo.com
Keywords:
Violence, Conflict, Womens Rights, North East, India
A
beautiful part of the world being unknown to most North Eastern India is home to
more than 200 of India's 300 odd listed tribes and most of these are of the
Mongoloid stock belonging to the Tibet-Burmese and Mon-Khmer races. At war for
over five decades now it is sandwiched between most international borders of
India. A violent turmoil existing in five of its seven states is on account of a
perceived threat to identity, pathetic infrastructure, traditional societies
unable to cope with the sudden transformation to modern life and a huge gap
between the level of aspiration of a highly literate society and an abysmal lack
of opportunities presenting a continuing state of a complex
political emergency in the region.
This
paper aims to highlight the multifold human rights violation that a woman faces
in the given context of poverty and armed conflict. It explain how there is
little acknowledgment of the situation of armed conflict, and women's rights are
sacrificed as there is a resurgence of patriarchal values. Violence caused by
development paradigm coupled with the conflict situation has created or
intensified poverty and its impact on women.
The public health system does not address women's health problems such as
mental health, stress disorder and trauma women face in times of war, conflict
and natural disasters. The paper highlights the ground realities of women’s
condition and position in an area of conflict.
There
is large-scale displacement of people on account of conflict and natural
disaster; women face greater economic pressures with growing food insecurity and
face serious health consequences. The breakdown in infrastructure and basic
civic amenities such as water, roads, bridges and hospitals has further
compounded the problem. On the other hand it is very difficult for young people
to find employment and there is a powerful incentive to join rebel groups as
they can at least make some money.
State
propelled victimization is evident in the area and the onslaught on the woman is
three sided; extremist, police, army, para-military forces. There is an urgent
need for improved protection for women by the law of armed conflict in the light
of the fact that women experience war fundamentally differently from men,
irrespective of whether the man is a civilian, combatant or part of militia.
People
born in the region are used to understanding fighting by extremist groups, gun
fires, police torture, bomb blasts and arbitrary arrests as an accepted part of
life; however the entire mire is a part of larger arms, drugs and political
nexus. In this situation no woman lives a dignified life and that the woman is a
totally forgotten person. Information gathered for this paper is through
experiential understanding, secondary sources like books, documentation by
various groups within in North East India and India, news clippings, and
personal interactions.
It
is understood that in the situation of war there is gross violation and
marginalization of women’s rights, sometimes extreme violence, exclusion of
women from decision making and peace processes.
Author:
Khanday Zamrooda, Email: zamrooda@hotmail.com
Key
Words: Honour,
Conflict, Women health, Need, Reproductive health, Islam
The
paper is trying to look at the way the last 16years of conflict situation in the
valley of Kashmir (India) has made health and especially women’s health a need
based requirement to be dealt with when there is absolutely no other option left
for the family. The paper will also look at the way women’s health especially
reproductive health in the face of fundamentalism has become a taboo and hence
been neglected to such an extent that family honour overshadows the health of
young girls in the state.
My
area of work is the state of Jammu and Kashmir in India that has been under
insurgency for the last sixteen years. I have been working in the state for the
past two years conducting a research on the effects of Conflict on Women’s
Reproductive Health and the negotiating skills used by the women to live life
with the more or less non-existing health structure in the state. The state is
divided into six districts with 12 million populations but there is only one
functional reproductive health hospital in the state in the district of Srinagar
averaging a minimum of forty-five kilometers from any of the other five
districts. In scenario of conflict the people of the state are left to mercies
of the local healers and the non-professional doctors. The study has used the
qualitative method of research. In-depth interviews of twenty-five women were
conducted over a period of eight months. The interviews were conducted in three
districts of the state across the socio-economic strata with age group ranging
from 12 to 65 years old. The analysis has thrown a light on the way in which the
militants (insurgent forces) in the state under the guise of Islamic religion
not only controlled but also dictated the Reproductive Health of the women in
the State. It has brought to light the methods by which these terrorizing forces
controlled the government
health structure with the private medical practitioners to follow their
dictates. The study hopes to be able to produce a base line data of health
scenario in conflict situation, to be able to bring forth the repercussions on
health which at all times get un-noticed in the larger scenario of the war
crimes.
The
research “Negotiating reproductive health needs in a conflict situation in the
Kashmir Valley” published in 2005.
Abstract No. 104
Author:
Wilks Michael, E-mail: Michael@mwilks.demon.co.uk
Key
words:
Health Professional, Prisoners, Abu Ghraib
The
paper gives a history of recent events at Guantanamo Bay and at Abu Ghraib.
Following press reports in June 2004reports of the involvement of
physicians in the abuse of prisoners at these facilities, there has been
confirmation in official reports, following investigation, of medical personnel
failing to report evidence of torture, failing to intervene to stop it being
repeated, and making available to interrogators information from confidential
medical files, thereby allowing interrogators to exploit weaknesses. Although
these are likely to be isolated events, rather than evidence of
institutionalised abuse, there is a pattern here that has been repeated many
times and in many countries. Doctors
appear to have been able to accept a state ideology, in this case a declaration
from the President of the USA that Al Qaeda terrorists were no longer covered by
the terms of the Geneva Convention, followed by a Justice Department document
that redefined torture, stating that “for an act to constitute torture….it
must inflict pain that is difficult to endure”.
This acceptance leads doctors to justify grossly unethical practice.The
paper will examine this events in the context of previous abuse involving health
professionals, including Germany, South Africa and Chile, and look at the way in
which medical bodies can become complicit.
As an example, recent declarations from the US military and intelligence
community that “physicians assigned to military intelligence have no
doctor-patient relationship with detainees and, in the absence of
life-threatening emergency, have no obligation to offer medical aid,” have
received little opposition in the USA. In new guidance issued to the military
the Pentagon has subtly changed the wording of a 1982 UN resolution on the
ethical duties of health professionals with respect to prisoners.
At first glance, this seems to provide more protection to prisoners, but
when one realises that the guidance sets out ethical guidance only in the
context of a “provider/patient treatment
relationship” (my italics) and outlaws “interrogations not in accordance
with applicable law” there must be considerable concern, given the
President’s own view that these “terrorists” are detained outside
conventional laws or conventions.
The
paper goes on to show that USA professional bodies have themselves blurred the
boundaries of their own ethical statements.
The American Psychiatric Associations’ Statement on Psychiatric
Practices at Guantanamo Bay is weak. Far
worse is the recent Report of the American Psychological Association’s
Presidential Task Force. This
rehearses conventional ethical principles in relation to individual patient
care, but then performs a total “about turn” when it comes to sanctioning
psychologist input and advice on techniques to be employed in interrogation.
In effect, it becomes acceptable for a health professional to dispense
with any ethical responsibilities once his/her training and expertise is used
outside a strictly therapeutic context. The
use of such knowledge in creating techniques intended to damage the minds of
people under interrogation, and to advise how these techniques can be refined,
is grossly unethical.
The
paper suggests that only international and national medical institutions,
working together, can successfully oppose this change in ethical emphasis.
Through bodies such as the World Medical Association, national medical
associations should:
Abstract No. 105
Title:
Women’s
Health
Author:
Surinder Jaswal, Email:
surijas@tiss.edu
Key
Words:
Conflict, War, Abuse, India
Violent
conflicts have a profound effect on women. Even though women are more likely
than men to be effected they have no say in the conflict. They suffer from war
and conflict in many ways including dying, experiencing sexual abuse, and
torture, losing loved ones, homes and communities. Besides direct impact of
violent conflict such as rape, prostitution etc. research shows that there is
also a sharp increase in other forms of violence against women such as war time
domestic violence. Loss of family members such as spouses, brothers and sons
mean not only emotional loss but also the loss of economic support and social
legitimacy. Further loss of work, community and social structure affects women
in unique ways because of their care taking roles in families and communities.
Thus apart from the direct stressors of conflict, the many long term
consequences of violent conflict for the economy, essential services,
social systems and life patterns produce considerable stress. The impact of
these chronic stressors on the health of women can be very great in terms of
mortality, morbidity and disability.
This
paper seeks to understand women’s health concerns in conflict situations
particularly in ongoing violent situations such as the civil strife in Kashmir,
with reference to both physical and mental health problems, their access to
health care, discrimination and other concerns (where conflict has a direct
impact on women’s health) through women’s experiences of conflict and its
varied impact on their health and related matters.
Sub Theme-2
Domestic
violence as an issue of violation of health and human rights
Abstract
No. 201
Author:
Sazonova, Liliya, Email: cwsp@cwsp.bg
Key
words:
domestic violence, health, human rights,Bulgaria
The
paper focuses on domestic violence - the so called ”invisible” violence
often not even seen as “criminal” but dramatically shaping human lives and
leading to demolishing consequences. Therefore, the main argument of the essay
is that domestic violence is not only a matter of family privacy but also an
issue of public concern that violates fundamental human rights. To prove this
argument, the way different kinds of domestic violence – physical, sexual,
psychological, economic, etc. violate fundamental human rights is shown.
Additionally to the human rights approach, domestic violence is elaborated as a
health problem.
In
this line of reasoning, the ambition of the paper is to demonstrate how the
issue of domestic violence as a health and a human rights problem is tackled in
Bulgaria. This objective is accomplished by presenting concrete cases of local
or regional projects and good practices of preventing or countering gender-based
violence undertaken by various Bulgarian non-governmental and governmental
structures.
The
above-mentioned aspects of domestic violence as a health and a human rights
problem are thematically developed in three separate chapters. In the first
chapter definitions of key concepts used in essay like “domestic violence”
and “public health approach” are offered.
In
the second one the analysis of the newly adopted Law on Protection against
Domestic Violence in Bulgaria illustrates some aspects of the role of the state
in preventing and countering violence within the family. The importance of such
an overview of the Law is based on the presumption that states are obligated
under international law to take effective steps to protect women from violence
and hold batterers accountable and to guarantee to women equal protection of the
law. In this regard, the first implications of the Law requiring from the law
enforcement officials to recognize and take action against domestic violence are
pointed out. Together with the above-mentioned governmental efforts some
examples how the non-governmental sector approaches domestic violence as a
violation of women's human rights are included in this chapter. For instance,
the Bulgarian Violence Against Women Monitoring Program who works to further
women's human right to be free from domestic violence is presented. The program
is part of the International Stop Violence Against Women Website providing
advocacy and information about domestic violence and other types of gender-based
violence in 30 countries from the Central and Eastern Europe, the Commonwealth
of Independent States (CEE/CIS), Kosovo and Mongolia.
The
last part of the paper elaborates the health aspects of violence. Together with
the therapeutic health approach, the public health emphasis on preventing
violence is stressed. Here a number of good practices and concrete cases of
awareness raising campaigns undertaken by Bulgarian NGOs are mentioned. For
instance, the Center of Women’s Studies and Policy’s Break
the silence on violence in Rhodopa Region Project. Additionally, the Cultivation of Non Violence Awareness Program aimed at individual
and group consultations for boys and men with violent behavior so that to
prevent future aggression is presented.
In
order to achieve bigger objectivity both legal instruments and health
practitioner’s and health researcher’s publications are referred to.
Additionally, the paper addresses some examples from the author’s own practice
as a consultant on a help-line for victims of violence and as a coordinator of
programs sensitizing public opinion about the issue of domestic violence.
Abstract No. 202
Title:
Health Disorders
Of Abused Women: A Study In Kolkata
Author:
Basu,
Sohini, Email: gharebaire@yahoo.co.in
Key
words:
domestic violence, women, qualitative research, health, welfare programmes ,Kolkata
In
this study the researcher aimed to understand the violence from a woman
victim’s perspective. Hence fifty victims who had been out of abusive
relationships for at least 6 months post abuse and outside the relationship
context referred to the researcher by women’s organizations and
non-governmental organizations (NGOs) were interviewed. Appropriate
semi-structured interviews and objective psychometric measures like General
Health Questionnaire-28 (GHQ-28)
were used to assess health conditions.
It
was found that women exposed to domestic violence suffered from a form of
psychological traumatization. This, in turn, had serious repercussions on
functioning both within and outside the family. A serious anxiety disorder,
sense of fear and helplessness developed within them owing to exposure to or
witnessing of events that at times threatened life. This is marked by a pattern
of potentially capability eroding responses to such traumatic experiences which
included (a) psycho-physiological problems like unnecessary anger, tension,
irritation, and sleep disorders; (b) avoidance of trauma relevant stimuli; (c)
recurrence of traumatic events in the form of memories or flashbacks; and (d)
reduced performance level at workplace and home. Moreover, the findings resulted
in the emphasis on multifarious complex needs of abused women.
To
conclude, services in many areas are essential to provide rehabilitation of
these survivors so that they strive to acquire self-confidence, self-sufficiency
and self-empowerment. Once we recognize the burdens these women face, we have to
look after the quality of their lives by providing necessary resources and
services like sensitization trainings for care-givers, access to health services
and welfare programmes for victims and the like that promote healing and
well-being of them.
Author:
Basu,
Tapas Kumar, Email: basutk@hotmail.com
Key
words: Intimate
Partner Violence (IPV), women, health professionals, community, development
The
aim of this paper is to emphasize the hitherto inadequately utilized role of the
health professionals as an essential part of any synoptic scheme to solve the
hateful practice of intimate partner violence (IPV) eroding the social fabrics.
For our purpose, ‘health professionals’ mean providers and facilitators of
health care service like doctors, nurses, paramedical workers, State government
and local government officials attached to health services including health
assistants, NGOs dealing with health issues and other social activists in the
field of health. A host of historical evidence shows that women have always
suffered from domestic violence, particularly, from abuses perpetrated by their
husbands. Yet, the task of identifying and articulating the issues involved in
intimate partner violence (IPV) remains inadequate. Still lesser adequate is a
systematic, multi-pronged and practical approach to the solution of this
problem. But without such an approach we can hardly to make any headway in
tackling the social evil.
This
paper attempts to design a scheme for activating health professionals to take up
a positive part in building up a community-wise bottom-to-up demand upon the
relevant authorities to frame and implement proper policies in the
legal-cum-socio-economic sphere for eradicating IPV. For this, highly motivated
and professionalised non-government organizations (NGOs) should take upon
themselves the onerous responsibility of getting other health professionals
properly sensitized and involved in the concerned process at the beginning. This
is no education on the basis of need assessment, but a participatory interactive
process of qualitative nature based on equal partnership. The concerned
professionals will imbibe from this process by themselves the ability to adopt
an equality-based and woman-supporting attitude in their work, to realize how
health is related to gender violence, to make women realize their own rights to
personal health needs as full-fledged human beings, and to interchange their
experiences among themselves thereby facilitating the formation of associations
to ventilate these. Such associations, initially formed at the lower level, may
be organized gradually at the district, State and National levels, each higher
level consisting of representatives of immediately lower ones. They will, in the
fashion of pressure groups, urge the authorities in power to take suitable
legal, political, social and economic measures for minimizing IPV. In this way,
demands and supports of the civil society will, as proper inputs, produce
desirable outputs in the form of government decisions. If we can get such a
scheme going, health professionals will go beyond their traditional function of
providing temporary medical relief to provide support and protection to
survivors of violence. They will be able to relate women’s health to gender
discrimination in society and will play their role accordingly. IPV seeks to
continue male domination in society. Apart from the inherent injustice embedded
in it, this entails a heavy social cost. By disempowering women it disallows
them to contribute their best to production, decision-making and participation
in the development process of the country. Unless violence against women is
stopped, sustainable development will suffer to the detriment of the entire
society.
Abstract
No. 204
Title:
The
Most Horrific Domestic Violence,Acid Violence -In Context Of Bangladesh
Author:
Hafiz
Khairul, Email: hafiz@acidsurvivors.org
Key
Words: Acid
attack, Prodigy Consequences, Underlying Responses, Role Model,
Bangladesh
Acid
attacks represent an exceptionally cruel addition to the long list of violence
especially against women and children. In Bangladesh, there is one acid attack
per day.
Isolated incidents of acid violence take place in other countries like in India,
Pakistan, China, Malaysia, Srilanka, Vietnam, Cambodia, Nigeria; But nowhere
else except Bangladesh, this violence is addressed in an organised way since the
grounding and effective role playing of Acid Survivors Foundation(ASF) by providing
assistance in the treatment, rehabilitation and reintegration into society of
survivors of acid violence and to counter further acid attacks.
So this study on acid violence in Bangladesh context and the ASF would be a role
model for the others.
Of
course, numbers are momentous only to convince the authorities about the
seriousness and pervasiveness of the crime, and the need for special measures to
deal with it. The audacity in acid attacks is that they are clearly and cruelly
planned to permanently disfigure, debilitate and, eventually, destroy the person
at the receiving end, both physically and psychologically.
Acid
burn injuries necessitate immediate chemical burn first-aid and prolonged,
continued and complicated medical treatments as larger portion of the body or
vital organs i.e, head, eyes, ears, nose, mouth or joints are affected
simultaneously. In most developing countries, the specialized acid burn
management, reconstructive and plastic surgery are only available at capital
cities that are not always reachable for the poor. Also not all the medical
practitioners are aware of chemical burn treatments, specially the psychological
distress of the victim immensely affect the total healing process, unless they
are sensitized, or trained. Sometimes, the nurses and even doctors suspend
themselves in providing support to the victim due to the horrific disfigurement
which becomes horrendous for them too. Poverty, lack of education, lack of
health service, relevant infrastructure unavailability, public health
insecurity, social attitude, and knowledge gap makes the rights, to have
treatment for such complicated burn victims, very poor. All these revealed the
urgent need for more informed and sensitive responses from healthcare
professionals, not to mention families, friends, employers, colleagues and
society as a whole.
The
root causes of acid violence and other forms of violence against women and
children are similar e.g. gender based violence, patriarchal structures and
poverty. Prevention campaign will only be successful if there are successful
prosecution. The Bangladesh National Women’s Lawyers Association (BNWLA) and
the ASF estimate that only 10% of attackers are ever brought to trial. New law
regarding special tribunal for acid cases is an excellent opportunity to improve
the prosecution rate.
To
bring about long term changes in the values and attitudes to prevent acid
violence in the principle of zero tolerance for such violence, it is important
that the respective Government (to the constitutional obligation and commitment
to the international accords), NGOs, professionals and civil society are
actively, effectively and efficiently working toward developing immediate
support services and the elimination of acid violence from the total surface.
Sub
Theme- 3
Dealing
with sexual assault and harassment for protection of rights of victims and
survivors
Abstract
No. 301
Title:
Sexual
Assault, Harassment, Rights & Social Justice
Author:
Behera, Shanti Ranjan, E-mail : livelydemocracy@yahoo.com
Objectives:
of the paper is to discuss sexual assault, harassments, are human rights
violations not only in India but also in advanced countries like United States
of America, Canada, with reference to law and social and political practices.
According
to a study of World Bank, in established market economies, gender-based violence
is responsible for one out of every five healthy days of life lost to women of reproductive age.
The
United Nations Development Fund for Women (UNIFEM) stated that “Women can not
lend their labour or creative ideas fully if they are burdened with the physical
and psychological scars of abuse”.
The
paper also showed the occurrence, consequences (Physical, psychological,
immediate and long-term impacts, social, health behaviours, vulnerability
factors for victimizations etc.
Sexual
Assault Report also rise sharply in Armed Forces. In 2004, military criminal
investigators, received 1,700 allegations of sexual assault involving members of
the armed forces worldwide. The allegations included 1,275 incidents in which a
service member was the victim, and 1,305 incidents in which a service member was
allegedly the perpetrator. There were 1.5 million active-duty troops that year.
The
paper also calls for the development of the sexual Assault Care Centre in
Canada, the Canadian Law etc. So far as sexual harassment is concerned the paper
presented the abridged version of the judgment of Supreme Court of India in (Vishaka
and others Vs State of Rajasthan & others – AIR1997 Supreme Court 3011)
and Code of Conduct for work place.
We
looked into –
Ø
Sexual Violence and Adolescent Sexuality.
Ø
Sexual Rights in International Documents
Ø
Sexual Assault in Comparative Penal Law etc.
The
paper calls for a focus that the victim is never at fault. The offender is
responsible for the offence and strongly recommends for amendment of Rape Law
& higher sentences for the offender.
Author:
Chanda Sanchoy Kumar, Molla
Musaraf Husain, Rahman Fazlur, Islam Tuhinul
Email:
sanchoychanda@yahoo.com
Key
words:
CSW, Violence, Brothel, Human Rights, Bangladesh
Background:
Several hundred thousand of Commercial Sex Workers (CSW) carries on their
existence in many different ways including providing brothel-based sexual
services in different parts of Bangladesh. This group has been unrecognized yet
as high-risk group for violence and violation of health and human rights. Even
there is no valid or organized information on violence among this group. Only
print media reports very often about the violence against the Commercial Sex
Workers in Bangladesh.
Objectives:
Objective of the study is to estimate the incidence and severity of violence
experienced by CSWs in a brothel in Bangladesh, and to gain an understanding
about the types and causes of violence experienced by CSWs, health seeking
behaviors and to sensitize the policy makers and stakeholders about the safety
concerns of the brothel-based CSWs.
Methods:
During August and September 2004, about 176 out of 952 CSWs in Tangail Brothel
(situated in northern part of Bangladesh) were interviewed with a structured
questionnaire. Those who lived for last 12 months or more in the Tangail Brothel
were included in the study. Trained female interviewers conducted a face-to-face
interview with each CSW. Incidence of violence in preceding one year was
collected along with their socio-demographic characteristics.
Results:
All CSWs experienced number of episodes of violence during their staying period
at brothel. The estimated incidence of physical violence is severe enough to
restrict themselves from their normal activities for couple of days or took
medical treatment for the ailments were 62/100 person-years. The most common
type of physical assaults were beating (81.8%), punch (50%), kick (34.5),
cutting (30%), cigarette burn (12%) and others like pulling of hair, crushing of
fingers, burn with hot iron or hot water bottle in body or private parts
(33.4%). The reasons were failure to negotiation (44.54%), monitory (35.45%),
customer was drunken (25.45%), perverted customers (16.36%), forced sex (10.9%),
failure to satisfy customer (10.9%), others like wanted to be freed from
brothel, refused to have sex during menstrual period etc. (20.9%). Violence is
usually done by customers (57.4%), pimps (39%), local musclemen (32.7%),
law-enforcing personnel (19%), Co-CSWs (18%), and others like boyfriends (2%).
98% cases required medical treatment, and hospital stay in many cases. Violence
prevented them to resume normal duties in 77% cases
Conclusion:
Sex workers in Bangladesh are deprived of their rights socially, and
politically. Violence is very common in brothel and incidence rate is much
higher than our national data making the CSWs as most vulnerable group for
violence. To promote the safety of this high vulnerable group, immediate program
should be taken by the policy makers.
Abstract
No. 303
Title: Atrocities
Against Workers Of The Unorganized Sector–Daylight Is A Long
Way Off
Author:
Dr. Vaswani Vina, Email:
nirvigna2001@yahoo.com
Keywords:
Atrocities,
Gender –Based, Unorganized Sector, India
In
assault cases like in most other situations, the public outcry and media
sympathy lies with those young in age and of the “weaker sex”.
This gender bias however takes backseat when the same crime is committed
against “commercial sex workers”. When
rape and assault happens to be on a CSW, there is a guarded response &
opinions are loaded against the aggrieved.
Sometime
ago, a CSW was taken to a police station in a large city of India, illegally
detained & sexually assaulted by a constable while on duty.
Only on pressure by women’s rights activists, was a case registered and
the lady was sent for examination on the 7th day after the crime was
committed. By which time no
evidence was forthcoming on medical examination.
Moreover, the Medical Officer, did not collect the evidence objectively
and documentation was woefully inadequate.
Irrespective of the publicity pressure put on the administration by NGOs
& medicolegal fraternity, no concrete steps were taken to ensure the safety
of the citizens.
This
case brings to the forefront many issues related to the rights of people working
in unorganized sectors, levels of abuse that take place, lack of empathy from
health care workers and the delay in collection of physical evidence that
results in miscarriage of justice. This
paper will discuss these issues, probing for avenues of possible improvement in
the medical & legal service provided.
Abstract No. 304
Title:
Severity Of Injuries
Among Sexual Assault Victims
Author:
Alempijevic Djordje*, Slobodan Savic,
E-mail: djolea@fon.bg.ac.yu
Key
words:
Sexual Assault, Injury, Victim, Medical Examination.
Objectives:
It
is generally accepted that, among the other consequences, victims of sexual
assault may sustain body injuries. This study aims to provide an overview of
type, frequency, patterns, and severity of body injuries in sexual assault
victims.
Background:
Sexual
violence may be regarded as a global problem, not only geographically, but also
in terms of age and gander of victims. It is a harsh reality for millions of
victims worldwide, predominantly women. The estimation is that one out of five
women experience sexual aggression during lifetime. Although sexual violence in
many countries remains primarily legal concern, it is becoming more often
perceived as a public health problem. There are numerous negative effects of
sexual violence on victims’ health including body injuries, pregnancy,
transmission of sexually transmissible diseases, exposure to HIV/AIDS, increased
risk for adoption of unacceptable sexual behavior (e.g. early beginning of
sexual activity, multiple sexual partners, etc.) and negative effects on mental
health.
Method:
We
perform retrospective study of files in District Court of Belgrade to select
cases where plead guilty or verdict guilty has been passed for sexual offences
as defined by Criminal Code of Republic of Serbia. Analysis of medical record
and other available medical evidence has been performed following the selection
of the cases. Clinical Injury Extent Score (CIES) was used for estimation of
injury severity.
Results:
A
total of 113 court cases have been analyzed for five years period (1995-1999).
All victims (113) were female, at average 24.08 years old (range 5-80 years).
Medical
examination in majority of the cases (84%) took place within 72 hours
post-assault, while approximately in half of the cases (52%) examination was
completed on the day of assault. Due to delayed referral, body examination was
not conducted in 12 victims (10.6%). Other victims underwent complete body
examination that reveals at least one extra genital injury in 64 cases (63.4%),
no extra genital injuries in 36 victims (35.6%), whereas for one victim medical
records were inconclusive. Injuries were most frequently located on limbs (32%),
face (23%), and torso (7%), whereas other regions were rarely affected.
Bruisses
were the most frequently observed injuries (50%) regardles of body region,
excluding neck. Abrasions and contusions were somewhat less frequently present,
while only two victims sustaind lacerations.
Although
insufficient quality of medical records made certain constrain, the severity of
injuries was estimated. Majority of victims (44%) sustained light injuries
(CEIS-1), 18% has moderate injuries (CEIS-2), whereas severe injuries (CEIS-3)
has been documented only in one victim of sexual assault.
Conclusions:Body
injuries may result from sexual assault. In our study at least one extra genital
injury was present in 64 cases (63.4%). Body injuries were predominantly located
on extremities and face, in form of bruisses
(50%), while other types of blunt trauma were less frequently oserved. Light
injuries (CEIS-1)
were
prevealing over moderate
(CEIS-2), and severe injuries (CEIS-3) among the victim of sexual assault in our
study.
Sub
Theme 4
Misuse
of Reproductive technology, gender discrimination and rights violations
Key
Words:
cultural perception of the body, universal human rights, cultural relativity,
culturally competency, medical praxis,Israel.
This
paper reveals an Arab-Bedouin perception of ownership of the body and of future
children at the stage of pregnancy, discussing the possible influences on
decision-making in the arena of use or refuse to use of prenatal medical care.
The paper then concentrates on how medical professionals should take into
account these different ways of viewing ownership of the body and of approaching
the implementation of decision-making rights. The question emergent is what kind
of cultural awareness and competence should Medical professionals develop when
treating Arab-Bedouin women who are the larger non-western community in South
Israel?
Data
was collected from a preliminary short term survey conducted at the Soroka
University
Medical Center (hospital) in Israel, as part of the activity for reducing infant
mortality among Arab-Bedouin population. About 30 Arab-Bedouin women who were in
birth-hospitalization were interviewed about their knowledge and understanding
of Amniocentesis tests. The women were then asked whether they would agree to
utilize such tests if they were medically recommended to them. Many of the women
responded that in that case the decision would not be theirs but of their
husbands and extended families. These results were triangulated with data
collected through participant observation and conversations with Bedouin mothers
of children born with congenital malformations at the neonatal unit at the
hospital. Conversations with medical personnel in the hospital indicate that the
dominant medical discourse presupposes that all women are the ultimate
controllers of their bodies, and therefore able to make independent decisions
about using or avoiding the use of various medical services with strong
implications over the future of both mothers and (future) children. This
assumption leads to a praxis in which pregnant women are usually the first to be
approached and informed by medical staff about possible problems in pregnancy,
while husbands are often considered of secondary importance concerning
decision-making on the future of their wives pregnancies.
This
brief example illustrates how Western-biased perceptions of the human body as
the sole ownership of (female) individuals may lead to inter-cultural
miscommunication due to misunderstanding of the source of women's possible
resistance, and ultimately may lead to misjudgment of women’s responses to
medical recommendations.
In
terms of moral values this case example raises a dilemma between a relativistic
approach supporting the legacy of respecting ’otherness’ versus a universal
approach to human rights emphasizing gender equality and women’s rights.
This
paper suggests that obtaining optimal intercultural communication and
establishment of mutual trust between medical professionals and Bedouin users of
prenatal services requires maintenance of a delicate balance between a respect
to Others' perceptions of body and children ownership and between supporting the
rights of women in making independent decisions over their bodies.
Abstract
No. 402
Title:
Addressing
Infertility- A Reproductive Health Right
Author:
Joshi Meghana, Email: joshi.meghana@gmail.com
Key
Words:
Infertility, Contextual Vulnerability, Treatment Seeking, Male Involvement,
Mental Health Concerns ,Mumbai
Focus
of Paper: This paper is the
output of an M.Phil study on “Understanding the Experiences of Childlessness
among Low-Income Group Women in Mumbai Slums”. The framework considers gender
as a central element of stratification and attempts to understand the position
of women and their vulnerabilities to
reproductive health vis-à-vis their social class, cultural, educational and
occupational background.
Lessons
Learnt: This study points to
the severe lack of focus in reproductive health policy on women without
children. Reproductive health has largely been defined within the biomedical
model; allowing women's bodies to be brought under medical scrutiny and
treatment to be provided accordingly. This conceptualization has filtered into
and pervaded the understanding of a wide range of medical and health
professionals and policy makers. In policy this gets translated into a focus on
family planning, which essentially concerns itself with provision of
contraceptives and meeting sterilization targets. The concept of ‘Reproductive
Health’ however, is multidimensional, hence concerned with a wide range of
conditions related to the freedom from disruption of reproductive functioning
and potential. It thus follows that reproductive health; related choices and
rights would include not only the ability to choose when to have children or
avoid unwanted child-bearing, but also the possibility of bearing wanted
children. The prevention, diagnosis and treatment of infertility are thus an
integral part of right to attaining reproductive health.
Conclusions:
A
growing body of research has verified the importance of infection as a cause of
female infertility worldwide and traced the link between Sexually Transmitted
Infections (including a symptomatic infections), postpartum and post abortion
infections, Pelvic Inflammatory Disease, and tubal damage. Government of India
recognizes the issue of infertility as a Reproductive Health right and it is
imperative that large scale preventive interventions be adopted. Data reveals
that in the hospital settings by sheer virtue of entering the medical set up
women are at a greater risk to mental distress and discontinuation of or
inconsistency in treatment seeking. Creating an enabling environment in
hospitals through setting up of infertility counseling clinics within the Out
Patient Department, training of medical staff in helping couples deal with the
psychological trauma of infertility, helping them with educational information
and considering alternatives like adoption, would be key areas of intervention.
Directly linked to reducing the psychological burden of childlessness is the
involvement of family and community members in providing support systems, which
can be made possible through educational community level interventions and
promoting the culture of support groups.
Abstract
No. 403
Title:
Impact
Of Gender Discrimination And Violation Of Human Rights On Sex Ratio In India
Author:
V. Nirmala , E-mail:
nirmala_velan@yahoo.com
Key
Words:
Sex ratio, sex discrimination, gender disparity, infant/child mortality,
human rights, India.
Although the Constitution of India confers right to equality to all citizens before law, social, cultural, economic and political factors make them unequal in practice. Gender disparity manifests itself in various forms, the most obvious being the continuously declining female ratio in India. The National Policy for the Empowerment of Women 2001, includes equal human rights and fundamental freedom for both males and females in all spheres of life, besides elimination of discrimination and all kinds of violence against the girl child and women. The rights of girl child also ensures protection against pre-natal sex selection, feticide, health, education, food and nutrition, and child labour. The issue of declining sex ratio has caught the attention of policy makers, administrators, social thinkers, NGOs and researchers in different disciplines for long, due to the discrimination and violation of female children's and women's rights to a dignified life in the Indian society. Factors like poverty, scientific development contributing to female feticide, dowry system, and the religious role of males in society have all worsened the conditions of females in general. Sex selective abortions lead to enhanced morbidity and mortality among women, besides leading female fetus from the 'womb to the tomb' and the infants from the 'cradle to the graveyard'. The problem of inequality and discrimination is thus multifarious, which is further structured and perpetuated by the social system, which calls for a holistic treatment. Against this background, the present paper proposes: i) to examine the impact of sex discriminatory practices on sex ratio in India in general and among children in particular; ii) to survey infant and child mortality by sex; iii) to observe the kind and extent of abortions taking place in India; and iv) to make a primary survey of the nature of discrimination and attitude towards it in the society. The study would be based on data drawn for National Family Health Survey - 1 & 2, Family Welfare Programme in India Year Books, Census of India, and Sample Registration System Bulletins, besides primary data collected locally. The methodology would include simple averages, ratios, percentages, correlations and statistical tests for analyses. The results confirm the existence of gender discrimination as a major cause of adverse sex ratio in India. This situation is aggravated by the socio-cultural and economic conditions prevailing in the country. The consequence is severe violation of female human rights in the country. It calls for corrective measures through education, mass media, women’s empowerment, strict legal action against the violators of the various protective laws and acts, besides political commitment and involvement of NGOs.
Sub
Theme 5-
Violation
of Rights of people living with HIV/AIDS
Abstract
No. 501
Title:
Defeating
Hiv Stigma With Accurate Information About Hiv Risks In Health
Care
Settings
Author:
Correa Mariette, PhD and Gisselquist David, PhD* , E-mail: mariettec@gmail.com
E-mail:
david_gisselquist@yahoo.com
Key
words:
HIV, human rights, misinformation, iatrogenic, stigma.
Objective:
To
describe incomplete and misleading information communicated to the public and to
health care professionals on risks for HIV transmission through blood exposures,
and to consider the impact of this information on people’s risk of HIV
infection and stigma.
Background: Within
the overall human rights framework, the right to health as part of the right to
life has been well established in various international declarations,
conventions and national constitutions. The right to accurate information about
threats to health is a logical component of the right to health.
Method: We
identified incomplete and misleading information through literature review and
discussions with doctors, counselors and people living with HIV/AIDS.
Results:
People,
including the medical community, have been misinformed regarding the
contribution of blood exposures to the epidemic, the survival of the virus
outside the human body and the transmission efficiency of the virus through
various invasive procedures. Due in large part to a low suspicion of efficient
HIV transmission through the iatrogenic route, evidence for HIV transmission in
health facilities in various parts of the country have been downplayed or
ignored. Similarly, evidence from research studies pointing to associations
between medical procedures—especially injections, as well as other blood
exposures—and HIV has been discounted or ignored.
Voluntary
Confidential Counseling and Testing Centres (VCCTC) have for years been the
prime interface between the HIV-positive individual and the State. With these
centers functioning primarily to address and change individual personal risk
behaviors, particularly sexual behaviors, sexual blame gets further reinforced.
Similarly, prevention messages stress sexual exposures, while mention of unsafe
injections focuses on injection drug use, not medical injections. Other common
blood exposures, e.g., in dental care and tattoos, are ignored.
Implications: Misinformation
about risks of acquiring HIV from unsafe health care has several linked human
rights implications. First, people are not aware of the need to protect
themselves from acquiring HIV in health care settings. Second, this has led to
HIV/AIDS being almost exclusively equated with sexual ‘promiscuity’, and to
subsequent blame, guilt, and shame. This second issue is a particular concern
for women, who are increasingly on the front lines for HIV testing through the
Prevention of Parent to Child Transmission (PPTCT) programme. With expanding
PPTCT programmes, counseling and testing is not only extended to ALL pregnant
women (irrespective of any risks of acquiring the virus), but women have very
little choice to refuse. Women are usually tested first and, if they test
positive, their husbands are called in for testing. Significantly, an important
proportion of husbands of HIV-positive women test HIV-negative. Given the way
HIV-positive women are treated in India, the discrimination to which they have
been subjected, this programme would inadvertently further victimize them.
Conclusion: Removing
the unnecessarily strong and unwarranted emphasis on the sexualization of the
epidemic would go a long way in ensuring that women are not further victimized.
Accurate information about unsafe health care and about other possible exposures
that could have led to the infection is a necessary first step in this regard.
Author:
Ahmad Rana Gulzar,
E-mail:argulzar@yahoo.com,
Ahmad Rafi-ush-shan, E-mail: dr_shan2@yahoo.com
Keywords:
HIV, Sexual Relationship, Gender, Pakistan
Introduction:As
a young Muslim nation with a complex anthropology, Pakistan continues to
struggle with a common sense of identity. This struggle also touches our
personal lives particularly amongst young people with severe identity and gender
stereotyping issues, poverty and low levels of literacy. This confusion is
propounded and manifests clearly in sexual behaviors and practices. Community
based sexual health /HIV/AIDS prevention programs in Pakistan must incorporate
self-reflection, self-concepts and identity issues to ensure ownership and
sustainability of their programs. Working on self-encourages/ facilitates strong
self-concepts, which translates to assertive behavior, negotiation skills and a
sense of rights.
Gender
identity refers to how one thinks of one’s own, gender: whether one thinks of
oneself as a man (masculine) or as a woman (feminine). Society prescribes
arbitrary rules or gender roles based on one’s sex. These gender roles are
called feminine and masculine.
Methods/procedures:
Promote
Peer education, Life Skills Training’s and educate public on gender sexuality-
for behavior change. Exercise responsibility in sexual relationships, by
abstinence addressing power imbalances, negotiation skills resisting pressure
during sexual intercourse, encouraging contraception use. Gender Sexuality
education must be a central component of development/reproductive health
programs designed to prevent STIs/pregnancies and HIV infection.
Results:
In
Pakistani socio cultural framework is supremely gender and often-sexual
relationships are framed by gender roles, power relationships, poverty, class,
caste, tradition and custom, hierarchies of one sort of another. Here for many
the term “man” is a male gender identity not a sexual identity. The phrase
males who have sex with males, or men who have sex with men is not about
identities and desires it is about recognizing that there are many frameworks
within which men/males have sex with males, many different self-identities, many
different context of behavior. The public arena is male dominated and
male-to-male friendship is expressed in the public domain.
Conclusions: To
bring ownership among individual/communities to work on HIV/AIDS prevention
could only be achieved by incorporating self-concepts and identity issues. Must
need to explore and understand male-to-male desires, as to involve men, if we
are truly to develop effective and sustainable HIV/AIDS prevention strategies
amongst males who have sex with male.
Author:
Dr. K.I. Jacob, E-mail: kodiyattu_jacob@yahoo.co.in
Key
words:
AIDS, Stigma, Community Programme, Discrimination, Andhra Pradesh
A
word about us …
AIDS control Foundation of India – (ACFI) HIV/AIDS control and care and
support initiative of St. Paul’s Trust, spear heading the war against HIV/AIDS
from 1991 has so far produced more than 1120 varieties of I.E.C. and B.C.C
Materials on HIV/AIDS, which is a world record. Through our Care and support model
i.e. home/community owned care and support, we are taking care of more
than 5000 PLHA including 226 HIV infected children in 7 Mandals (Blocks)
out of 57 Mandals in East Godavari District – one of the Hyper-endemic
districts in Andhra Pradesh.
Since
our home and community based care and support is community based,
we have changed the word community based by community
owned i.e. Home/Community owned care and support program.
And we were the first to introduce the ultimate answer to HIV/AIDS
i.e. the unique initiative - prevention
linked care and support. Also we were one among
the few to develop a care and support model which goes a long way in
addressing stigma and discrimination and to make any project area PLHA friendly.
That is why our home and community owned
care and support program is being accepted and recognized as one of the best
models in the whole world.
The
First HIV case reported to St. Paul’s Trust happened to be Mr. M. Raju in the
year 1992 and we are happy to announce that he survived with out A.R.V. for 12
years and now he is on A.R.V.
Already
a 1000 plus Government and Non-Governmental institutions both from with in the
country and out side the country has visited St. Paul’s Trust to study our
Home/Community owned care and support program. Majority of the visitors have
already implemented our model in their project area.
St.Paul’s
Trust through its humble work has shown a way for others as to how we can
address stigma and discrimination and make any project area PLHA friendly.
Through the following activities in 7 Mandals (Blocks)
we could address stigma and discrimination and PLHAs are able to live a
life in dignity with out any stigma and discrimination. PLHA are able to run mini hotels,
sell all kinds of eatables(Fruits and Vegetables), sell Milk and Milk
products and could work as servers in hotels, sweet stalls and female PLHA
working as servant maids etc. with out any stigma and discrimination.
Out
of 226 HIV infected children, more than 100 are studying from L.K.G. to 10+
level in private and government schools
and colleges with out any stigma and discrimination(NDTV has made a documentary
nearly 3 years back showing how HIV/AIDS
infected children are studying in
private and government schools with
out any stigma and discrimination).
Important
activities to address stigma and discrimination.
Counseling
,Medical Support- Treatment of opportunistic infections (OIS).
Training
:Staff Training, Self Care/Care Givers Training, Peer Educators/Volunteers
Training
Goodwill
Meetings, Linkages – Referral Services: District Tuberculosis Center(DTC) for
DOTs, Temporary Hospitalization Wards for serious patients. , VCTC (Voluntary
Counseling Testing Centre), PPTCT (Prevention of Parent to Child Transmission)
Emergency
Services, Burial expenses etc., National Family Benefit Scheme/Widow Pensions
and
other schemes , Gram Sabha (Janmabhoomi) for awareness , Medical Care of
Infected
Children,
Nutritional Support, Special Nutrition to HIV
infected Children, Children’s
Care(Affected
children), Linkages and Referral Services to Children, Picnics, Tours for
Children,
House to House campaign—Intense I.E.C. and B.C.C activities., Community based
rehabilitation
(C.B.R), Income Generation Activities, Community Mobilization, Self Help
Groups(Credit
and Thrift groups), GIPA/MIPA, CNP+ (Networks of Positives), Positive
Speaker’s
forum, Advocacy, Involving the District Administration Mainly the District
Collector—DRDA,SC Society
etc.(Multi-Sectoral approach)
Author:
Shuanguang Wang PhD,
Email:
shuguangwang2004@yahoo.com.cn
Key
words:
HIV human right policy
environment minority
China
Objective:
This
study carried out in Sichuan of China by West
China Ethnic Minority
Health
Promotion Volunteer Organization (WCMhealth) and Centre
for International Program Development in HIV Social Study (CIPD), Sichuan
Academy of Social Sciences， P
R China is the first to explore how
to use cultural resources to build evidence-based
culturally appropriate strategy to
promote community commitment and mobilization at multi-sector levels, to
advocate health and human right through change policy environment, and to
support decision-making on the best use of healthcare and cultural resources to
reduce collective vulnerability to HIV/AIDS in
local Yi ethnic community, where resources are scarce and public health
infrastructures least developed in China.
Background:
The
HIV/AIDS
epidemic
in China has had a significant impact among
ethnic minorities who reside
in the poorest and most socially disadvantaged rural areas.
The provinces of Sichuan, Yunnan, Xinjiang, and Guangxi, with over 25
minority groups, have the highest reported HIV-rate, which has been as a highly
challenge of health, human rights and development in these ethnic areas of
China. However,
the empirical evidence in previous studies showed the
official traditional approach, which has used “official-led” social
anti-epidemic campaigns with a simply
threatening moralistic strategy from major Han cultural power and value based
perspective, were having little effect in promoting development of health
behavior and human right environment in the various ethnic minority cultural
groups.
Methods/Strategies:
Project
is designed with a coherent and expanded
comprehensive approach
to link three focuses: 1) capacity building and empowerment through
developing the
ethnic peer-led communication strategy to make action in communities;
2) community mobilization and
advocacy through cultural leaders involvement by a participatory approach to
adopt their own initiatives (faith and descent-based cultural response to
impact of various difficult issues at community level);
and 3) policy formulation and sustainability through integrating project into
local governmental programs of cultural, socioeconomic development and
healthcare policy by development approach.
Results:
Evidence
from empirical and qualitative data in both process and effective evaluation in
three years study clearly
indicated that WCMealth
& CIPD have proved to be successful model of practical cost effective in
ethnic minority
community to significantly promote:
1) community based health behaviour change; 2) key stakeholders
(ethnic Yi cultural leaders, community leaders and local government officers)
involvement in community advocacy and mobilization; 3) maximize
use of cultural and community resources at multi sectoral levels to advocate
human rights and reduce poverty; and
4) cultivation of policy environment in commitment
to the development and delivery of sustainable and replicable HIV
programs for all Yi ethnic groups and a broader range of ethnic minority
communities.
Conclusions/lessons
learned:
Effective
change in
community full evolvement and promoting health behaviour and human rights was
achieved through
using cultural resources to develop an expanded
comprehensive strategy which was integrated into the pivotal ethnic
cultural system and existing structures of community organizations.
Abstract
No. 505
Title:
Judicial
Response To Reproductive Rights Through Public Interest Litigation: A Nepalese
Experience
Author:
Chapagai,
Raju Prasad, Email:gender@propublic.wlink.com.np, rpchapagai@enet.com.np
Keywords:
Public Interest Litigation, Court, Reproductive Health, Nepal
Throughout
much of the history of Nepal, defective cultural beliefs allowed women only
limited roles in society. Many
people believed that women’s natural roles were as mothers and wives. Women
were considered to be better suited for childbearing and household work rather
than for involvement in the public life. Till
1990, Nepalese society denied women some significant rights and freedoms
accorded to men. Since the promulgation of democratic constitution in 1990,
women’s efforts to control their own reproductive systems have been an
important part of the women’s rights movement.
In 1991, Nepal also ratified
"Convention on the Elimination of all Forms of Discrimination against Women
1979" that has further vitalized the reproductive issues.
Though
the constitution doesn't explicitly incorporate reproductive rights but it
provides wide scope for the materialization of these rights in living reality.
The Article 11 not only guarantees formal equality but also aims at
securing substantive equality that requires state to devise various measures to
promote reproductive health of the women. Directive principles provided under
Article 25 and 26 further impose positive obligation upon state to give priority
to women's health. Moreover, Article 9 of the Treaty Act 1990 gives the
status of domestic laws to the ratified human rights conventions; therefore,
reproductive rights guaranteed under the conventions are also equally
enforceable. Scope of remedy in the
case of violation is also effectively provided especially through the Article 88
as it empowers the Supreme Court with jurisdiction for "Judicial
Review" and "Public Interest Litigation".
In
this backdrop, the paper is mostly aimed at assessing applicability of Public
Interest Litigation (PIL) in enhancing enforceability reproductive rights. It
highlights major achievements of judicial intervention in this regard through
critical analysis of selected Supreme Court decisions in light of state
obligation under the constitution and ratified conventions. For examples, the
Supreme Court for the first time in Mira Dhungana V. His Majesty's Government
et al (1995) asked government to eliminate discriminatory laws against women
that ultimately resulted in reform of abortion laws also through which women are
now provided freedom of choice where or not to have abortion within first twelve
weeks of pregnancy. In Annapurna
Rana V. Kathmandu District Court (1998) the Supreme Court recognized women'
right to control over their own body through nullifying "Virginity Test
Order" of Kathmandu District Court. Most significantly in Mira Dhungana
V. His Majesty's Government et al (2001) the Supreme Court labeled marital
rape as heinous sexual crime and endorsed the sexual autonomy of women even
within marital bond. Judgments concerning maternity leave, breastfeeding
promotion, forced abortion, sexual harassment, state protection of polygamy are
also counted important in this regard.
The
paper finally observes that Public Interest Litigation has become instrumental
in promoting government accountability towards reproductive rights, eliminating
discriminatory legal provisions and accelerating law reformation process.
However, It's effective exercise is still more expected for furtherance of
meaningful realization of reproductive rights in future.
Abstract No. 506
Title:
Family Planning
In India : Rights, Laws And Standards
Author:
Das Abhijit, Email – abhijit@sahayogindia.org
Key
Words:
Reproductive Rights, Family Planning, Human rights, Advocacy, India.
The
concept of Reproductive Rights has gained currency since the International
Conference on Population and Development (ICPD). In the ICPD Program of Action (PoA)
Reproductive Rights have been mentioned as
embracing “certain human rights that are already recognized in national
laws, international human right documents and other relevant United Nations
consensus documents”. This paper uses the benchmarks of international human
rights standards and national law to review of the concept and practice of the
national Family Planning programme in India. It starts with a comparison of the
terms Family Planning, Contraception and Birth Control and the importance of the
distinctions in a rights approach. The paper traces the history of the
Malthusian idea in Europe and its relationship to eugenics and the
implementation of sterilization programmes based on eugenic laws. The paper
relates modern reproductive rights and human rights to the design and delivery
of family planning programmes. On the basis of this understanding of rights and
law the paper reviews the current practice of Family Planning in India
especially in the eleven years since ICPD. The paper describes recent
experiences of using human rights standards and national laws to improve Family
Planning programme service delivery as well as accountability, and the different
results that have been obtained using both legal as well as social advocacy
strategies. The paper concludes with a series of recommendations on how rights
based approaches may be used for setting standards for services, improving their
delivery as well for monitoring them and ensuring accountability.
Sub
Theme-6
Discrimination in access to
healthcare, especially reproductive health
Abstract
No. 601
Author:
Dr. Thomas, Joe , Dr. Bandyopadhyay Mridula, E-mail: jthomas@afxb.org,
E-mail:
mridula.bandyopadhyay@nt.gov.au
Key
words:
Public health, HIV, Human Rights, Stigma, Developed countries
Increasingly,
the inter-linkages between health and human rights in the context of HIV/AIDS
are being acknowledged. Although, health is understood as a human right, less
attention is given to the trajectories of health impact of HIV/AIDS related
social exclusion. This paper develops a discourse on public health consequences
of HIV/AIDS related stigma and discrimination and discusses causes, forms, and
patterns of discrimination. Discussion on agents of discrimination, emerging
responses to AIDS Related Discrimination (ARD) are also presented.
Some of the major conceptual concerns in explaining and tracing the
interrelationship between HIV/AIDS, public health, and Human Rights are also
introduced. The intellectual rigor and clarity of such conceptualizations has
its consequences on our ability to combat discrimination experienced by people
living with and affected by HIV/AIDS. Stigma is a process of justifying the
group action of excluding someone based on perceived or real, undesirable
characteristic - behaviors related to HIV infection - This process could take
place through a variety of channels of communications; from interpersonal
communications to mass media. In a private realm of communication,
stigmatization could remain as a personal opinion. However, in the public realm
stigmatization is always a precursor for discrimination. In the context of
HIV/AIDS, objectives of stigma reduction, combating discrimination, and
promoting human rights of individuals and communities are expected to contribute
towards creating an enabling and supportive environment, which is essential for
HIV prevention and care.
In
popular as well as intellectual discourse on HIV/AIDS, the terms stigma,
discrimination, and human rights violations, are often used synonymously or
interchangeably without describing the differences between these concepts. Such
conceptual ambiguity comes from bias in approaches, lack of data and evidence
based discourse, as well as the political context. In exploring the deeper
meaning and implications of the concept of stigma, discrimination, and human
rights, we pose the following questions.
a)
The social phenomena described as stigma, discrimination and human rights
violations, are they similar, or are there shades of differences in their
meaning in the context of HIV/AIDS?
b)
What are the policy and program implications of these differences?
c)
Strategically, is it necessary to prioritize these concepts in developing
policies and programs?
d)
What is the most beneficial approach? Stigma reduction efforts,
discrimination reduction efforts, or promotion of human rights?
e)
Should
the contextual variation have any implications in selecting priorities?
HIV/AIDS
related stigma, discrimination and human rights discrimination is alive in
developed as well as developing countries. Developing countries often present
active discrimination whereas developed countries present proactive
discrimination, often camouflaged as policy and procedures. This paper
identifies the public health consequences of HIV/AIDS related Discrimination as
it impacts on social cohesion, impacts on quality of life, burden of disease, on
the course of disease progression, on prevention efforts, on service delivery,
surveillance, quality of care and in the implementation of best practices. Some
of the emerging responses to HIV/AIDS related stigma and discrimination are
advocacy and community mobilization, community education, policy responses,
administrative and professional guidelines and legal responses
Abstract
No. 602
Title:
Level Of Awareness Of Rti, Sti And Hiv/Aids And Gender Discrimination In
Treatment In India
Author:
Buragohain
Tarujyoti, E-mail- tburagoahin@ncaer.org
Key
words: RTI/STI,HIV/AIDs,
Gender, India.
The
Reproductive and Child Health (RCH) approach emphasizes a healthy sexual life
for couples. However, diseases like Reproductive Tract Infections (RTI)/Sexually
Transmitted Infections (STI) and Human Immune-deficiency Virus (HIV)/Acquired
Immune Deficiency Syndrome(AIDS) affect not just a couple’s sexual life, but
also the health of their newborn children.
Reproductive
Tract Infections (RTI) defined as an infection of the reproductive system of a
man or a woman, refer to three different types of infection: (i) sexually
transmitted infections (STIs) – also known as sexually transmitted diseases
(STDs), caused by viruses, bacteria, or parasitic organisms that are passed
through sexual activity with an infected partner. (ii) Endogenous infections,
which appear an overgrowth in the vagina. (iii) Iatrogenic infections, which are
introduce into the reproductive tract by a medical procedure, such as menstrual
regulation, induced abortion, IUD insertion, or childbirth. All these three
types of RTIs overlap and are considered together. The RTIs and STIs, are also
known as Urinary Tract Infection (UTI), and are both the gateway to HIV&
AIDs.
In
India, the awareness about Reproductive Tract Infection (RTI) among women is
higher than among men by eight percentage points, but the level of awareness
about Sexually Transmitted Infections (STI) among men is higher than among women
by seven percentage points. The awareness about HIV/AIDs among men is higher
than among women by 18 percentage points. In general, in most states and union
territories men are more aware about STI than about RTI, whereas women are more
aware of RTI than STI. Among both males and females, awareness about HIV/AIDS is
substantially higher than of RTI and STI. In India, about 30 per cent of women
in the 15-44 year age-group had at least one symptom of RTI/STI, as against only
12.3 percent of men in the 20-54 year age-group. However, only about 38 per cent
women sought treatment, as against 55 per cent men. The inter-state variation,
represented by co-efficient of variance in case of treatment sought among women
and men, is 51.3 and 39.7 per cent respectively.
Abstract
No. 603
Author:
Yamin, Alicia Ely , E-mail: ayamin@hsph.harvard.edu
Key
words: Maternal
Mortality; Essential Obstetric Care; Survey, Human Rights; Gender-Based
Discrimination, Afghanistan.
In
2002, Physicians for Human Rights (PHR) conducted a rapid assessment of
maternal
mortality in the Herat province of Afghanistan in order to (1) provide an
accurate estimate of maternal mortality in Herat; (2) assess violations of
women’s rights that might contribute to maternal deaths; and (3) evaluate
maternal health services in the region.
Maternal
mortality is widely recognized as an indicator of the level of marginalization
of women in a society, as well as of the functioning of the health system.
Ninety-nine
percent of maternal mortality occurs in the developing world; discrimination
against women in both the private and public spheres exacerbates contexts of
poverty and inadequate health care. Afghanistan
is one of the poorest countries in the world, ranking 170 of 174 on UNDP’s
Development Index in the year the study was undertaken. In 1997, the maternal
mortality ratio in Afghanistan was reported to be one of the worst in the world:
820 per 100, 000 live births.
Methods:PHR’s
study included a randomized, population-based survey of 4486 women from 34 urban
and rural villages/towns in seven of the thirteen districts of Herat province.
The women provided maternal mortality information on 14,085 sisters in
structured interviews with Afghan researchers. In order to gain insight into
individual experiences of health care providers and family members, PHR also
conducted detailed qualitative interviews. Finally, PHR conducted a
comprehensive survey of all health facilities in the districts of Herat province
that were sampled.
Results:The
household survey found the maternal mortality ratio for Herat province to be 593
per 100,000 live births; 92% of maternal deaths were reported from rural areas.
The health facility survey found serious deficiencies in the availability and
accessibility of Essential Obstetric Care (EOC). Individual interviews with
health practitioners and family members reported on the many barriers to care,
including inadequate supply of medications and equipment; traditional beliefs
and male decision-making; ignorance of the warning signals for serious obstetric
complications; unaffordability of care; and lack of
transportation.
ConclusionsAfter
twenty years of war and almost a decade of brutal and systematic discrimination
under the Taliban, meaningful reconstruction of the country must include
attention to reducing the alarming levels of maternal mortality as an urgent
human rights as well as public health priority.
These
findings can be understood in light of the findings of two earlier studies
conducted by PHR on women’s health and human rights in Afghanistan. The first
study, conducted in 1998, documented how the Taliban’s systemic gender
discrimination seriously undermined the health and well-being of Afghan women.
The second study, conducted in 2000, assessed the degree to which Afghan women
perceived that violations of their human rights by the Taliban regime were
responsible for affecting their health and well-being.
Together these three studies demonstrate the critical importance of
protecting women’s human rights, including their health rights, to creating a
fully democratic Afghanistan.
Title:
“Triple
Jeopardy” Of Women – Discrimination In Access To Healthcare
Based
On Gender, Caste-Status And Disability.
Author:
Samal Viswo Varenya , Email:
samalviswo@hotmail.com
Key
Words:
Gender Inequity, Access , Healthcare, Disability
Objective
– To address the key issue that violate gender equity – discrimination in
access to healthcare, especially reproductive health services based on gender,
caste-status, and disability. The focus is also on contraception and safe
motherhood including abortion related issues.
Background
– Access
means that services are available within reach of women who need them. Denying
access to health services to women both physically and psychologically is a form
of social injustice. Men make the major health decisions while women are often
reluctant as they feel threatened and humiliated by health workers, or pressured
to accept treatments that conflict with their own values and customs. Therefore
policy-makers – government and non-government – need to address and educate
within communities and at the national level to support and improve access to
health, family planning and abortion-related services.
Methods
– A
Three-pronged strategy is adopted:
Results/Conclusions
–
·
Social taboos and unequal power relations between men and women
often
prevent women from accessing healthcare.
·
Women face high risk for unwanted pregnancy, unsafe abortions and
other
sexual and reproductive health problems.
·
Health services are often not available in the rural interiors. Lack
of
training, equipment and protocols, drugs and basic supplies, including blood for
transfusion; misdiagnosis; negative attitudes of health workers; and/or
overcrowded emergency wards lead to costly delays for women seeking treatment.
·
Women and community members often do not know how to
recognize,
prevent or treat health complications, or when and where to seek medical help.
·
Interference by traditional healers, local quacks and political
opportunists sometimes paralyses the situation and aggravates health
complications.
Abstract
No. 605
Title:
Socio-Economic
And Medical Provider Correlates Of Post Abortion Complications Among Married
Women In India: Findings From Reproductive And Child Health Survey
Author:
Chellan, Ramesh, E-mail: rameshchellan@hotmail.com, rameshchellan@gmail.com
Keywords:
Induced abortion, Spontaneous Abortion,
Post abortion morbidity, Treatment seeking behavior, India.
Objectives:
This study seeks to understand levels of post abortion complication and
treatment seeking behavior in India and across the states, and to determine the
socio-economic and medical provider factors which influence post abortion
complication and abortion related care in the country.
Background:
India, with
the passing of Medical Termination of Pregnancy (MTP) Act 1972, permits legal
abortion for various socio-medical reasons. However, only a small fraction of
induced abortions take place in medical establishments registered and recognized
for that purpose whereas many abortions are conducted by untrained persons and
in unsafe conditions. Hence, post abortion complications pose a risk to women
and are an important issue in reproductive health.
Materials
and Methods:
The study uses data from the Reproductive and Child Health (RHS) and Rapid
Household Survey (RHS)-1&2, conducted in 1998-99. The sample covered
4,74,980 currently married women in the reproductive age group of 15-44 years.
The present study considered those who have had induced and spontaneous
abortions. To examine the net effect of various socio-economic and medical
provider factors on post abortion complications and treatment seeking behavior
in different health sectors, logistic regression and multinomial logistic
regression models have been employed out respectively.
Results:
It
was found that 39.5 percent of women reported any one or more post abortion
morbidity within six weeks preceding survey. The commonly reported problems were
excessive bleeding (21.0 percent), followed by weakness (21. 6 percent), pain in
lower abdomen (18.9 percent), backache and body pain (15.0 percent), high fever
(11.3 percent), and foul smelling discharge (4.8 percent). Among those who
reported problems, nearly eighty percent of women have taken care from some
source. Rural women, women with low level of education, and women with poor
economic condition are more likely to report post abortion complication.
Complications are more likely for abortions by untrained persons, followed by
public, and private sector institutions in that order.
Conclusion:
The results indicate high level of post abortion complications in the country.
There is urgent need to provide quality health care services for post abortion
care. Health care service providers, public as well as private sectors, must be
better informed about the details of the MTP Act so that they can implement the
Act more effectively. It is also
likely to be of significant interest to policy makers and programme managers.
Focus
Theme 2: Adressing the Missing Links of Gender Equity in Health and Human
Rights
Subtheme
7
Good practices and strategies for engendering health and human right
Title:
Engendering
Health And Human Rights In Developing Countries: What Does
Have
Bioethics Have To Offer?
Key
words: Bioethics,
human rights, developing countries, women’s health, gender discrimination.
The
bioethics movement arguably started gaining ground at the same time as the human
rights movement and the women’s health movement (late 1950s and 1960s). While
the human rights movement and the women’s health movement have been supporting
each other, bioethics has tried to remain aloof. This has been a flaw as
bioethics shares the fundamental value of ‘protecting the vulnerable’ with
the other two movements. The feminist philosophers have contributed to the field
of bioethics by adding a discourse on the power relationships in the social
systems, which impact the professions such as medicine, as well as biomedical
and social science research. Feminist
approaches to bioethics acknowledge the patterns of dominance and subordination
existing in the social system, and power hierarchies within professions, and
offer critiques to the same. Its
emphasis on the principle of social justice distinguishes itself, and the
emerging discipline of global health ethics from the mainstream/modern
bioethics. Feminist analysis can offer strategies to better address issues and
concerns in bioethics.
There
have been many controversies in biomedical research and clinical medicine,
including the exclusion of women from trials for a long time (leading to drugs
being released in the market without being tested for safety among women), lack
of informed consent and deception in research on women’s health etc.
This
is perhaps a reason that feminist bioethics developed as a strong (&
independent) stream of thought within bioethics to address the larger inequity
issues and specifically gender discrimination in the practice of medicine. Some
shared goals of feminist bioethics are: (1) to provide moral critiques of
actions, practices, systems, structures, and ideologies that perpetuate
women’s subordination; (2) to devise morally justifiable ways to resist the
economic, social and cultural causes of women’s subordination; and (3) to
envision morally desirable alternatives to the world as we know it: sexist,
racist, ableist, heterosexist, ethnocentric, and colonialist (social justice is
of over riding concern). Feminist bioethicists recognize that women are
oppressed in our society; oppression takes many different forms. It is often
compounded by other forms of oppression based on features such as race,
ethnicity, sexual orientation, and economic class. Feminist bioethicists believe
that oppression is objectionable on both moral and political grounds, and most
are committed to transforming society in ways that will ensure the elimination
of all forms of oppression.
Bioethics
is a growing field in developing countries, and there is an increasing interest
in it. Our paper will examine this trend and also strategize how feminist
bioethics, which best captures the essence of and supports the concept of
engendering health and human rights, can be made the focus of this growth. We
will look at emerging models of south-to-south co-operation in bioethics. We
will also make strategic suggestions for partnerships with those working in the
field of bioethics to further the aim of engendering health and human rights
globally, and especially in developing countries.
Abstract
No. 702
Title:
A
Community Based Clinic’s Approach To Addressing Sexual Violence
Author:
Sodhi Geeta, E-mail: swaasthya@satyam.net.in,
gsodhi@vsnl.com
Key
words: Community
based clinic, community based programme, sexual violence, strategies for,
addressing sexual violence
Issue:
Violence against women is the denial of fundamental human rights to women.
International human rights instruments such as CEDAW affirm the principles of
fundamental rights and freedoms of every human being. CEDAW is guided by a broad
concept of human rights that stretches beyond civil and political rights to the
core issues of economic survival, health, and education that affect the quality
of daily life for most women.
Sexual
violence, as a form of domestic violence, is quite commonplace although it is
often not talked about. It leads to far-reaching physical and psychological
consequences, some with fatal outcomes.
Programme:
Swaasthya is an NGO in Delhi working on reproductive & sexual health issues.
Amongst other things, Swaasthya is also involved in community based work. As
part of its comprehensive reproductive and sexual health work, Swaasthya
operates a community based clinic that is primarily run by field staff who
belong to the community itself. Other elements of its programme comprise of a Mahila
Panchayat and micro credit groups. These groups are run by women from the
community, with Swaasthya only providing technical back-stopping.
As
part of its services, counseling is provided to women who visit the community
based clinic. The counselor is a trained field staff from within the community.
This makes her more acceptable to the community as they view her as one of them
who understands their context. This is important if women are to bring up their
issues of sexual violence. Women who generally come to the clinic are married
women who belong to the community and from neighboring slum colonies. In our
experience, women who have talked to the counselor regarding sexual violence had
actually visited the clinic for STI treatment or with a complaint of PID. On
finding vaginal lesions during internal check up, the doctor suggested that they
speak to the counselor. It is during these sessions that some women have poured
their hearts out about the sexual violence that they have been subjected to by
their husbands. Besides counseling the women, the counselor has also linked them
to the Mahila Panchayat where they
could take some social and legal recourse.
Results:
Some women who have sought the intervention of the Mahila
Panchayat, have managed to resolve their issues by leaving their husbands or
coming to a point of self-belief where they are thinking of ending the violent
relationship.
The
paper will discuss design and strategies of Swaasthya programme for addressing
sexual violence.
Conclusion:
Domestic violence is a complex problem and there is no one strategy that will
work in all situations. If strategies and interventions are designed within a
comprehensive and integrated framework keeping in mind the interconnections
between gender dynamics of power, they are likely to be more effective. A
multi-layered strategy that addresses the structural causes of violence against
women while providing immediate services to survivors ensures sustainability and
is perhaps the only strategy that has the potential to eliminate domestic
violence.
Abstract
No. 703
Title:
Therapeutic
Groups: Listening to Women who have Experience Domestic and Sexual Violence
Author:
Paredes, A. Giannina, E-mail: demus@demus.org.pe
Key
Words:
Violence, mental health, gender, identity, therapeutic groups, Peru
Domestic
violence is a complex situation that makes us aware of the discrimination and
subordination of women in our society. This
violence is still been tolerated and overlooked in
some societies. The magnitude of this situation is revealed in statistics
that shows us that at least
one of three women in the world has been physically assaulted. Moreover,
the Institute of Legal Medicine from Peru, reveals that each hour 9 women are
suffering domestic violence. DEMUS,
is a peruvian NGO that has been working for the last eighteen years protecting
women’s rights.
DEMUS,
incorporates in the struggle for women’s rights various forms of intervention
like psychology, laws, communication, social assistance, sociology and arts. All together this disciplines allow us to have a better
understanding of the dynamic of violence and discrimination that affect
women’s life and mainly their mental health.
The
main objective of this presentation is to share DEMUS’ five years experience
working with therapeutic groups. This
groups are formed by women who have suffer from domestic violence and sexual
abuse. Our aim by this supports groups is to offer women the opportunity to
share their suffering, to express their feelings of anger, pain, loneliness,
without being judged, and recovering their capacity to make decisions and
overcome this situation.
Therapeutic
groups show us the
impact of violence on women’s mental health and lives, that in extreme
cases can also end up in death. The therapeutic groups shows to women that they
are not alone and makes them feel relief to share their feelings with other
women that are living similar situation, in despite socio-economic, education,
cultural or ethnic differences. Maybe
the most important for women is the opportunity to listen themselves. These
therapeutic groups help women change their views on the way society expects them
to behave. Women will think now more about their own
needs rather than making others their priority, as the way our gender
socialization expect from us.
Our
proposal is to evidence the impact that violence against women have for their
mental health, their identity and subjectivity. Recovering their history and their voice.Therapeuticgroups is
offer as a model of psychological attention, responding to a demand that is not
being attend by our society. But
the most important is the opportunity to offer women a possibility to think of
themselves, to question their situation and to evidence the position of
subordination that women still have on our society,that limits our development
and empowerment.
Key
words:
HIV, Councelling, Reproductive, Health, Ecuador
CEMOPLAF:
Its role in sexual and reproductive field in Ecuador
This
experience has its origins in the work performed in the Medical Center of
Orientation and Family Planning (CEMOPLAF,
for its initials in Spanish), which is a non-profit organization (NGO).
CEMOPLAF,
mainly attends poor women living in urban-marginal areas. Sexual and
Reproductive health services are offered, including women who live with the HIV
and AIDS. The services are gender-focused. As a preventive measure, it has been
incorporated a previous and basic level of counseling to the medical
appointment, and the case is linked to a system of reference and
counter-reference of organizations that mainly work in the legal area and in the
defense of human rights.
Life
conditions of the Users: The
60% of the homes have a feminine management, the social and economical pressure
that many of our users receive, becomes a heavy psychological burden. The lack
of access and of power of decision is one of the major problems that these women
face regarding their sexual and reproductive health care. Access to family
planning methods, for example, is fairly good A large group of women live family
relationships in which their partners maintain and defend sexual practices with
multiple partners, based on a patriarchal structure perpetuated by the macho
educational system. Under it, the use of a preservative, in or out the home is a
practice that question their masculinity. A recent phenomenon, caused by this
very same situation of poverty, is that a lot of women
have increased their sexual and reproductive risk in order to face their
economical needs, as well as their children’s.
Learned
Lessons: To
provide a confidential space of quality and warmth, where no one is to be
judged, criticized or questioned; in which thoughts and feelings are respected
and, the professional and the user, together, could look for the best
alternatives.
To
make an approach to the daily experiences of the patient and, if possible, work
with the couple in their sexual and reproductive health and lives. To elaborate
a critical route regarding the health risks that the user face in her familiar
and personal relationships. A reference and counter reference net for
psychological and social attention of the users. A broader participation in
capacitating networks and gender work with the users.
Conclusions:
Increasing,
through the personal, social and communitarian work, the women’s capacity to
empower themselves in their sexual and reproductive health and care, surpassing
the barriers built by centuries of superstition, rejection and abuse. CEMOPLAF
keep building networks for the promotion and defense of sexual and reproductive
rights
Sub
Theme- 8
Monitoring
gender concerns in rights violations
Abstract No. 801
Title:
Righting
Health Sexually: Examining The ‘Health & Human Rights’ Approach To
Sexuality
Author:
Sircar, Oishik, Email: oishiksircar@gmail.com, oishiksircar@hotmail.com
Key
words:
Sexuality, Health, Human Rights, HIV/AIDS, Non-discrimination
Although
public health and human rights are widely regarded as powerful, modern
approaches to defining and advancing human well-being and generating change,
they have also been powerful tools for maintaining status quo of hierarchies
of power. Thus, the labeling of a concern, policy or programme with “health”
or “human rights” does not give it unqualified value. Highlighting some
elements of a ‘health and human rights’ approach to sexuality – that might
prove useful to health policy and practice in the context of diverse sexualities
– this paper will suggest that neither ‘health’ nor ‘human rights’
should be employed without an interrogation of the ways in which each concept
functions.
The
growing diversity of rights-based advocacy in public health and health policy
has inevitably engaged questions of sexuality. United Nations human rights
bodies are increasingly taking on new norms and laws relating to sexual
diversity, health and harm; struggles for law reform engage with sexuality and
rights claims in the context of sexual violence, HIV/AIDS and emerging demands
for sexual non-discrimination. The World Health Organization has formulated a
working definition of sexual rights, and for health policy-makers, programmers
and planners, recognition that effective health interventions require an
understanding of complex sexualities has become evident.
With
these links between health and human rights growing globally and locally, the
full potential of a progressive human rights approach to health has not yet been
explored. So how will sexuality be included in work on health and human rights?
In search of the exact nature and/or terms of its inclusion this paper will
highlight several problems that arise at the intersection of sexuality, rights
and health.
Of
the ‘health and human rights’ approaches developed through global work, this
paper would focus on the one claiming that promoting and protecting health
requires explicit and concrete efforts to promote and protect human rights. The
paper will establish how this approach could take on the many complicated ways
that discrimination on the basis of gender, race/caste, sexual orientation, HIV
status, age or disability affects health status. It would also include how
intersecting discriminations, like sexual forms of racial/caste discrimination
affect health, or the right to health. Recognizing sexuality as a critical
element of humanity and establishing a fundamental right to health can play a
broader role in social justice claims. However, the paper will caution, call for
scrutiny and challenge the dangerous tendency to ‘normalize’ and
‘discipline’ human behavior when public health and human rights advocacy are
coupled together.
Drawing
on the seminal works of Alice Miller, Carole Vance and Lynn Freedman, the paper
will argue that a critical use of the ‘health and human rights’ approach to
sexuality can be part of a politically perceptive and accountable coalition
strategy. Because of its focus on persons of non-hetero normative sexualities
this approach can contribute both to revitalizing calls for social justice in
health for the most diverse range of people and to transforming the nature and
practice of state accountability in ensuring conditions for the ‘healthy’
life of all persons.
Author:
Dr Sheather, Julian, E-mail: jsheather@bma.org.uk
Keywords:
Health,
BMA, Gender, Ethics, UK
This
paper explores two basic issues. Firstly it looks at the broad question of the
ways in which national medical associations (NMAs), such as the British Medical
Association (BMA), can promote gender equality in the provision and uptake of
health services. Here it will look at the development of the BMA’s
understanding of gender rights, and of the right to health, and the policy work
it has undertaken to promote gender equality. It will look in particular at the
work of the BMA’s Science and Ethics Committees and explore the ways the BMA
has promoted this agenda, through its teaching, publishing and lobbying
activity. It will also explore the BMA’s work in promoting human rights and
related issues in medical teaching and training.
Secondly
this paper takes a critical look at issues of gender equality in the United
Kingdom medical workforce. It details both the historical development of women
working in medicine in the UK, and looks at current and future trends in
employment. It then goes on to look at the role played by the BMA in relation to
gender equality in the medical work place. It explores the actions and policy
decisions that the British Medical Association has taken – or at times failed
to take – in promoting gender equality. Using a rights-based framework, it
seeks to explore the extent to which the medical profession has promoted or
stifled gender equality in the workplace.
A
crucial aspect of the paper is the recognition of the need to disaggregate the
variety of complex and interdependent factors that lead to gender
discrimination. It will therefore consider the ways that interlinked issues such
as race, class, education and religion impact upon the role of women in
medicine, and looks at their effect on employment.
This
paper seeks to identify good practice in promoting gender equality. It looks at
gender-sensitive policies that the BMA has worked to promote, including flexible
working and the provision of child care services to facilitate equality of
employment opportunity.
Data and evidence on gender inequities in the human rights context
Abstract
No. 901
Author:
Karim Dr. Md. Rezaul,
Hossain Rakib, E-mail: rk@bttb.net.bd,
E-mail: mrakib_hossain@yahoo.com
Key
Words:
Women, Shrimp Farming, Insecurity, Health Risk, Gender Discrimination,
Bangladesh
The
aim of the study is to highlight the activities performed by women who are
involved with shrimp cultivation in the southwest coastal belt of Bangladesh.
The main focuses of the study was to find out the consequences of shrimp farming
activities on the socio-economic state of affairs of women and its impact on
their health and securities. Shrimp farming has become an integral part of the
economy of Bangladesh. The shrimp sector is the second largest export industry
of the country. Presently, it contributes more than 10 percent of the
country’s total export earnings with an annual income of more than US$ 300
million and employing more than 600,000 people. The area under shrimp
cultivation has registered a three-fold increase over the last decade.
The
paper has been prepared on the basis of information received from primary and
secondary sources. Women's working in the shrimp industry and shrimp fry
collection from the coastal shores are considered target group of the study. A
number of case studies and focus group discussion including interview of experts
regarding the health risks for women involved in the shrimp cultivation were
also included in the study.
The
issues of social and human rights violation in the shrimp industry is really a
matter of great disquiet that concerns the women involved in shrimp cultivation.
The health and insecurity of women has increased through the occurrences of
kidnapping, rape, wage discrimination and other forms of female harassments.
Various types of health risks including cold and fever, skin diseases, diarrhea,
respiratory and reproductive tract infection and even HIV/AIDS are getting
prevalent for women. Among others, reproductive health conditions of women are
worsening more. Women are forced to be involved in the shrimp cultivation
process as they do not have any other viable employment alternatives. The women
associated with the shrimp culture process are generally poor and illiterate.
They are socially, economically and physically disadvantaged group.
The
lives of people in the coastal areas have been adversely affected both
economically and socially by the shrimp culture. It may also be said that the
shrimp culture has been succeeded to some extent to provide some rays of hopes
to some women at least for some days. But their hopes and expectations,
discontent and sufferings are now increasing that needs to be critically
addressed. Though lately, the time has come to think by the all concerns - what
are the best ways and means, how the benefits of the shrimp culture can be
reached to the women those are involved with the process of shrimp cultivation
at the grass root level, in the coastal areas of Bangladesh. It is urgently
necessary to develop a holistic and integrated approach addressing the
socio-economic affairs, health and security issues of women for sustainable
management of shrimp farming in the country.
Abstract
No. 902
Title:
Young
People Rights Violation, An Engine To Hiv/Aids Prevalence Rates Among Young
People.
Author:
Ocen Sam Fortunate, E-mail: ocensam@yahoo.com
Keywords:
Child Health, HIV, Rights, Reproductive Health Rights, Uganda.
Issue;
The
rights of young people in Uganda have continually been violated yet young people
account for the biggest population of the country. According to UBOS (Uganda
Beaural of statistics) 2002 report, young people account for 78% of the
country’s population yet they are the most vulnerable to HIV infections. Young
people are denied their rights to sexual reproductive health, rights to non
discrimination and rights to marriage when they are HIV positive, right to
privacy, right to information and knowledge.
Description:
To
examine and evaluate the impact of human rights violation among young people in
Uganda, a study was conducted by Makerere Child Health Development Center in
Busia, Eastern Uganda and according to the research findings, the highest
adolescent pregnancy rate was 37% while the National rate is 31%. In Busia,
children 12 to 18 years are considered to be mature enough to engage in sexual
activities. Almost 68% of the adolescents were reported to have been pregnant at
one time or another, while 40% experienced problems during pregnancy. Busia is
one of the districts in Uganda with the highest prevalence rates of HIV/AIDS.
Lessons
learnt: Violation
of sexual and reproductive health rights, rights to education and lack of enough
parental care engines pregnancy rates, numbers of school drop outs and increases
the HIV/AIDS prevalence rates among young people.
Recommendation: Actions of prevention of HIV/AIDS among young people should strongly focus on the strengthening their rights to good child mentorship, parental care, love and good upbringing, sexual reproductive health and rights, education and other basic rights of young people.
Abstract No. 903
Title:
Gender Dimensions Of Health Sector Reform: Challenges And Limitations To
Women’s Health And Rights
Author:
Roy
Bijoya, Email: bijoyaroy@hotmail.com
Key
Words:
Health Sector Reform Policies, Gender Inequality, Women’s health needs,
Accessibility, Availability of health services to women
Acquiring
highest possible level of health is a fundamental human right and can be
attained with co-operation from various sectors along with health sector. The
paper aims to explore how changing provisioning system of state health care
system impacts upon gender equity and women’s basic right to general and
reproductive health.
The
practice and provisioning of medical care situate women and men differentially
in terms of needs, access, utilization of services and overall as users.
Interestingly over the years despite realizing increasing gender gap and
discrimination through misutilisation of technology, high maternal morbidity and
mortality and violence there seems to be widening gap between those advocating
women’s health and health reforms. In the early nineties health sector reform
gradually gained centre stage in India across public health practitioners
acknowledging the need to reform public health system coupled with fiscal crisis
of the state. Reforms meant pruning of state intervention, responsibility and
promotion of privatization. Interventions are premised on cost efficiency and
recovery, quality control. Health care reform programmes were and are being
implemented across primary, secondary and tertiary level health care promoting
model of care that perpetuates health as freedom from disease and health care as
treatment of disease with increased usage of technology. Reforms of this nature
will prevent the public health care institutions at different levels to act as
interconnected referral units and behave more as individual separate units that
can fall easy prey to commercial interests of private investors.
In
public and private sphere right of women to health is at precarious situation.
Whatever rights to health care women have gained is by virtue of being
child bearers and as adolescent girls who will be future mothers. Her health
care needs as human being are recognized less. Different South Asian countries
show how reform policies lack gender analysis and inspite of acknowledging
discrimination and inequitable access to health care services limited role has
been played. In Indian context changes through reforms over a decade within the
public sector health care institutions will influence the availability and
accessibility of services to women as very few have the right to make decision.
Even when they make decisions they are not only guided by the decisions made by
the male family members but also by priority accorded to her health in
comparison to the others, cost of care (medical and non-medical) and
availability. Juxtaposed market driven approaches to health care are likely to
marginalize and violate right of women to general and reproductive health.
Using
this framework the paper will build linkages between health sector reform
programmes, gender and women’s health needs. It will analyze country (India)
specific reform strategies that bear its impact on access, availability (indoor
and outdoor services, clinical and non-clinical services), utilization of
general and reproductive health services and its implication on women’s health
across differential age group and class. Examples from state level experiences
will be referred to and concern areas posing challenges to women’s right to
health through reforms can be identified.
India
has witnesses a growing climate of violence in which the victims are mostly
women. The different mode of crime against women, takes place in community as
well as within the four walls of her house, which is considered to be the safest
place for her.
Using
data from Crime in India published by National Crime Records Bureau, Ministry of
Home Affairs and Census of India 2001, this study attempts to show the degree of
domestic violence that reign in Indian houses over a period of 2000 to 2003.
The
grip of domestic violence in the form of cruelty by husband or relatives against
women accounted for one third of the total crime against women in 2000 and which
increases to 36 percent in 2003. The increase in the negativity in the
relationship of married couples is one of the very serious concerns, which need
to be solved mainly at the family level.
On
the other hand though the rate of dowry deaths to total crime against women is
not very high (4.9% in 2000 to 4.4% in 2003), but death of a single woman due to
dowry related issue is a disgrace for a nation in the present century.
Among
the major states of India, both the form of domestic violence is higher for the
state of Uttar Pradesh. Uttar Pradesh alone accounts for nearly one fourth or
more dowry related deaths in India from 2000 to 2003.
Thus, finding the higher magnitude of prevalence of domestic violence in
Uttar Pradesh further investigation has been done at the district level.
There
is a great regional variation in the incidence of domestic violence in Uttar
Pradesh where a number of clusters were found with a high occurrence of violence
zone. The level of literacy does not seem to have any positive influence on the
primacy of domestic violence. The level of urbanization shows a negative
influence on the incidence of domestic violence in most of the cases.Thus,
seeing the pervasiveness of controlling women’s life mainly by their partners
along with his fellow admirers raises a very big question for researchers,
policy makers, law makers, and community leaders as well as each and every
individual who is a part of the society. “How can we bring up our daughter
who can
stand strong against the vicious nature of human aggressiveness in the form of
domestic violence?” Or “Do we need to bring up our sons to recognize that
getting married to a woman does not mean that she loses her rights as a human
being?” We need to solve it, the
quickest we do, we can save a large number of women’s life.
Poster
No. P02
Title:
Violence
Against Women, Health And Rights – Policy And Programme Implications In India
Author:
Das Abhijit, Email – abhijit@sahayogindia.org
Key
words:
Health, Violence, Policy, Women, India.
Violence
Against Women (VAW) is acknowledged as one of the most pernicious forms of human
rights violations. There is also an increasing awareness that VAW is a very
important public health issue. However there is little provision of addressing
VAW within the health system in India and the relationship is restricted to the
provision of medical certificates or to emergency trauma care. Even though some
collaborations between hospitals
and Non Government Organisations (NGOs) have been started in the country to
provide support to victims of VAW, there has been no systematic review and
planning done to understand and outline the role of the health sector. This
paper relates VAW to the health sector, not only through its medical role but
also provides an analysis of how some of the major health programmes can
contribute VAW and human rights violations. The two programmes that are reveiwed
are the Revised National Tuberculosis Control Programme and the Family Planning
Programme. The paper explores the possibility to address VAW within the health
sector by analysing the National Population Policy 2000, National Policy on the
Empowerment of Women 2001 and the National
Health Policy 2002 and the National Rural Health Mission. The paper concludes
with a set of recommendations for improving the response of the health sector to
VAW at the policy and programmatic level.
Poster
No. P03
Title:
Barriers To Health Rights
Author:
M.Gunasekaran ,
E-mail: consortguna@yahoo.com
Key
words:
Health Rights, HIV, Reprodutive Health
The
majority of problems that all people living with HIV/AIDS are confronting today
originate from a lack of respect for human and health rights. Although AIDS is
now treatable, less than 5% of the 40 million people living with AIDS have
access to antiretroviral. The 34 countries targeted by the initiative are home
to 94% of people needing treatment in the developing word (1). However, all 65
million people living with the diabetes or hypertension are getting treatment
with out economical problems and are not stigmatized (2).Health
should be one of the goods of life to which man has a right (3). However,
it looks like an honest assessment of the global situation today shows that it
is the market where peoples’ attitude and stigma decides who lives and who
dies. To address the greatest health crisis in the past 500 years, a
human-rights based – rather than market based- approach and effort towards
strategies of changing stigma and peoples attitudes is the only realistic
strategy for an epidemic that is concentrated in poor and marginalised
communities who have neither access to health care nor the ability to pay for
treatment.
In
the context of the above, this paper concentrates on health right of people
living with HIV/AIDS, who need more than an average ‘reproductive health
package’.
Poster
No. P04
Title: Issues Emerging Working With Hiv + Persons In The State Of Punjab
Author:
Manmohan
Sharma E-mail: vhapunjab@rediffmail.com
Key
words:
Human Rights, HIV, Women, Punjab
The Status of any society can also be best adjudged by observing towards
status of Human Rights in a given society meaning by how far the Human Rights of
Individual are guaranteed, respected & being implemented. The Human Rights
is reflected more differentially in an unequal society. The Human Rights of
women &Children get reflected in the prism more unequally where the concept
of gender equity is not being implemented. The paper will try to attempt to
understand the Human Rights of Women & Children and its grass violation in
the area of HIV Positive people. Our presentation will try to draw lesson,
issue, solution and also the prevailing status of Women and Children who have
got the HIV Positive status being silent recipient. Our people will also try to
understand their status and position with in the frame work of their social and
economic rights.It has been generally observed that in the absence of generally
defined HIV Positive people rights, all the above-mentioned category (Male,
Female and Children enuch) sufferer badly. But in the case of women &
children they are the worst sufferer by being of having HIV Positive status.
Women are the worst sufferer because generally gender equity is violated not by
individual but even by the State and also by the Societal Gesture.
They suffer because of the prevailing gender based violence like sexual assault,
domestic violence against women. All these three categories operates in
converting normal women into HIV Positive. Women & Children also suffer
because of their low economic status and more of their domestication. They also
suffer for not having associability to available health services and also the
increasing trend of costly remedies available in their case.
We will like to present this paper on the basis of our experience working in the
three district of Punjab with HIV Positive male, female and Children. We
will like to present five cases one of male, three women and one child.
Poster
No. P05
Title:
Gender & Hiv/Aids:
Double Geopardy Of Women
Author:
Ms. Johny Silppa, E-mail: silpajohny@yahoo.co.in,
shilpajohny@indiatimes.com
Key
words-
Gender, HIV/AIDS, Women, Vulnerability, Rights, Kerala
Background:
Present statistics indicates that 5.1 million people in India are infected with
Human Immune Virus (HIV),
making India second only to South Africa in the number of HIV infected
individuals in a single country. HIV is an extra ordinary kind of crisis it
requires an exceptional response that remains flexible, creative and vigilant on
the one hand and on the other hand those who are affected needs a multi
dimensional approach to their lives. Now HIV infection in India has a woman face
because of its fastest growth in the subpopulation in the ratio of 3:1. How
Gender & HIV/AIDS (Acquired Immuno Deficiency Syndrome) make women
jeopardized?
Gender
is a crucial element in health inequalities in developing countries. Gender can
be conceptualized as a powerful social determinant of health, which interacts,
with other determinants such as age, family structure, income, education and
social support and a variety of behavioural determinants. Ina patriarchal
system, men dominate women and exercise control over their lives including their
sexuality and reproductive choices. Indian women’s vulnerability for HIV is
further fragmented by a combination of factors such as biological, social-
class, caste, urban/rural location, sexual orientation, culture-, economic and
legal etc. These factors have an
impact on women’s access to services, resources and information.
Objectives:
A study was conducted with women who are HIV positive in Kerala
To
examine the complexity of HIV/AIDS and to learn more about the specific problems
faced by women living with HIV
How
the concept of gender & HIV/AIDS make their life vulnerable
Methods:
Case Studies and Informal Interviews with HIV infected women
Results
& Conclusions: Case studies and interviews with women from the study
illustrates that low status in family, sexual violence, economic and social
problems such as poverty, lack of education are some of the primary reasons to
get infection.
Cultural
orientation inhibits them to talk about sex to their partners, which results in
infectious status.
In
the middle-aged women, after sterilization they do not practice serious use of
condoms, because they think it is primarily for family planning.
Among
the newly married women they know their status only at time of pregnancy, which
results in psychological trauma and other related aspects. Most of them are
widows and they know their sero status at a later stage of partner’s HIV
infected life. After the death of their partner, some of them are being expelled
from their home and undergoes various violations of human rights.
Poster
No. P06
Title:
Women’s
Midlife Transition ……….. Is The End Of Life?
Author:
Joshi Pratibha
Dr, Email: pratibhajoshilko@yahoo.co.in,
pratibha.lko@gmail.com
Bhardwaj
Devyani, E-mail: devyanilko28@rediffmail.com
Key
Words:
Women Midlife Transition Awareness Policy
Introduction
Today,
women’s health and longevity have improved significantly. Even as recently as
a century ago, a large percentage of women did not live up to menopause. The
women who did did not live long after menopause. Improved nutrition and medical
care have contributed to the longer life of women. Nowadays, women are
encouraged to live in good health and happiness after their fertile years are
over. Menopause might mean the end of fertility but not an end of active life
itself. There is no valid reason why a woman should not be well and comfortable
in the years – or decades – ahead. Unfortunately in our cultural and
traditional milieu the women as well as the society itself is not aware of this
transition period. Our Government health policies have never targeted and made a
life cycle approach for women. The woman’s maternal health and population
control become the focal point of the government programmes. Menopause related
physical and mental problems have no place in any of their policies/ programmes.
Methodology
A
study was conducted by the Department of Social Work, University of Lucknow to
assess the knowledge, attitude and practice of women during menopause.
Sample
Size
100
Women (age group 45-55)
50
Urban (50 % working and 50 % Non-working)
50
Rural (50 % literate and 50 % Non-Literate)
Control
Group – their immediate family (spouse) peer group and Gynaecologist..
Tools
Questionnaire
(inclusive of depression rating etc.)
Focus
Group Discussion (to capture their knowledge, attitude and practice.)
Observation.
Result
The
problems related to women normally cut across all barriers, similarly in our
study, the results cut across all above mentioned parameters, focusing that the
basic knowledge of the target group seemed quite low and its outcome was that
they considered it to be an end of active and productive life and this
manifested in the form of acute depression, psychological turbulences etc. in
the rural background however the situation seemed more alarming with women being
subjected to witch hunting and other forms of violent practices.
Discussion/ Conclusion
Menopause
is not a disease but a natural phenomenon.
Massive
awareness to be created amongst the women and their family/ peer group.
The
medical fraternity should remove the myth that the symptoms are not due to
mental disorder but hormonal. Support from midlife peers.
Government
policy should incorporate needs of women’s menopausal phase.
Counseling
centers should strongly emphasize that
midlife period is a time for continued growth and creative expression.
Poster
No. P07
Title:
Endangering
Health And Human Rights Of Tribal Women In The Koraput District Of Orissa
Author:
Padhi Soubhagya Ranjan , Email
Address: jitasrp@sancharnet.com,
butu_11@yahoo.co.in
Key
Words:
Health disparities, Gender inequality, Illiteracy, Orissa
The
western concept of development has contributed to an increase in economic and
gender inequalities, notwithstanding its promise of providing improved living
conditions. An improved health facility and apt human rights for women
especially tribal women is a device in ensuring sustainable development. Their
empowerment and access to decision making will certainly lead to sustainable
future for the country.
Despite
the rosy picture of greater human rights in recent days, women are facing gender
inequalities in every sphere of life. Tribal women are identified to be the most
exploited class for obvious reasons of their socio-economic inequalities.
Eradication of atrocities against them still remains a distant reality. The
negative effects of gender inequalities and environmental degradation yet again
has seriously challenged the very existence of them. It has lead to nutritional
deficiencies, more pollution of rivers and ponds with fertilizers and
pesticides, affecting health of expectant mothers and babies.
As
per scheduled Area Order, 1977, Orissa is one of the scheduled areas. About 45%
of state’s geographical area has specified as scheduled area. The order again
specifies that Koraput district is one of the major scheduled area of the state.
The tribal communities are living throughout the length and breadth of the
district. According to 2001 census they constitute almost 50 % of the total
population of the district. Among tribal population women constitutes 50.44%
Though
tribal women constitute half of the total tribal population they live in a male
dominated society. The women folk work more than the men do. Invariably polygamy
is the practice which leads to large number of single women in the society.
Frequently they are tortured by their intoxicated and dipsomaniac husbands. Some
tribal girls like gonda girls are also sexually harassed by their male folk. All
these practices are definitely a mockery at the innocence of tribal women.
Time
is ripe now to evaluate seriously the gender issues in tribal communities of
Orissa. In this context the present paper focuses on the emerging gender issues
of tribal society in the Koraput district of Orissa.
Data
are collected from both primary and secondary sources. Information’s are
collected through various informal discussions with both female and male from
different parts of the district, health professionals and other related persons
for enriching the study. In addition to these primary sources, a good deal of
information is collected from secondary sources, viz. the census reports,
District census hand book, Statistical abstracts etc.
It
is observed that apart from various gender inequalities tribal women of Koraput
district are deprived of health facilities. Their accessibility to professional
standards of health is severely limited. Till now most deliveries take place at
home by using primitive tools in unhygienic conditions. Vasectomy is not
accepted in the present time. Women’s choice in dealing with unwanted
pregnancies is limited. Nutritional levels are low among tribal women. Anemia
rate is high among them.
To
sum up, tribal women face many consequences of gender inequality, contrary to
the myth that they enjoy a high status in their society. All-out efforts by both
government and non-government agencies should be made to check any kind of
exploitation of the tribal women, particularly in regard to their health and
education. Various awareness programmes can bring about better results to combat
gender inequalities in tribal society.
Poster
No. P08
Title:
Access
To Information On Health : Rights Denied To Women With Disabilities
Author:
Sengupta Shampa , E-mail: shampag@vsnl.com
Key
words:
Human Rights, Disability, Women, Health
Background / Introduction
Women
with disabilities are denied of access to most of the things we take for granted
in our lives. When it comes to health care, there is no exception. People with
disabilities are in general denied of rights to information. However women,
being women, are targeted by both families and outer societies.
Methods:
Women
with disabilities are not a homogenous group. Workshops for different groups
were organized. Individual interviews were also used.
Results:
A 28 year old Graduate woman with hearing /speech disabilities goes to
Government Hospital in Kolkata. Staffs refuse to talk to her. She tries to write
down her compliant. She was told not to waste hospital’s time. She was told to
bring with her “someone who can talk”. A 23 year old student with visual
disabilities wants to know about her chances of being a mother. No material in
Braille/larger prints available. Private Doctor says her mother must accompany
her. Her teachers in schools scold her for asking such questions. A 30 old woman
with mental disabilities suffer from severe pains in lower abdomen area. She
goes to doctor with her mother He asks the mother about her illness. She tries
to explain but doctor does not listen. She asks what her ailment is, doctor
ignores her.
Discussion:
Neither hospitals nor private doctors treat women with disabilities as
individuals. They cannot access information on health without having an escort
with them. They are treated as minors and always ask to bring family members
with them. Their right as Human Beings totally ignored.
Conclusion(s):
To sensitise medical professionals is an important area to be worked on. Not
much work from Government side towards this is found. Disability is not a
medical issue now but Human Rights issue. All out effort to ascertain it is
required.
Poster
No. P09
Title:
Medical Care
In Indian Prisons: Perspectives And Issues
Author:
Tiwari, Dr. Arvind E-mail: tiwari_a@tiss.edu, Guin, Sayantani ,
Email: sayantani@tiss.edu; sayantanihi@yahoo.com
Key
Words:
Prisons, Medical Care, Prison Managers, Jail Manual, Madhya Pradesh
Objectives
of the Study:
The study aims to:-
understand
the extent and quality of medical care in the
prisons;
analyse
role of prison managers to realise right to health in the prison setting; and
suggest
ways and means to strengthen health care in prisons.
Background:
The right to health is one of most sacred rights and is covered by Article 21 of the Indian Constitution.
The Supreme Court has expanded the scope of the Article by laying down that the right to life includes the right to
healthy living with dignity for every individual. The Committees and
Commissions set up to review prison conditions from time to time have
severely criticised medical care provided to the prisoners. The present study is based on the data collected from 16
prisons of the Madhya Pradesh State. The
primary assumption of this study is that prison doctors and prison managers
could act as the change agents in
providing qualitative health care in prison setting. They may also help in
preventing torture and ill treatment in the prisons if they are properly
sensitised regarding their obligations under national and international law for
protection and promotion of human rights of prisoners.
Methods:
The present study is exploratory in nature. Primary data have been collected
using interviews (individual and group) and focused group discussions with
cross-sections of people including prison doctors and the prisoners. Total 300
samples have been drawn from 16 prisons from the State of Madhya Pradesh, India.
Appalling
conditions of overcrowding, lack of sanitation, inadequate diet, unhygienic
living conditions and lack of health awareness among prisoners are the most
responsible factors for various diseases (viz. tuberculosis, diarrhoea, anaemia,
malarial fevers, skin diseases, sexually transmitted diseases and respiratory
related problems) and health related problems in prison setting.
In
none of the prison having woman prisoners is lady doctor appointed.
Mentally
ill persons (prisoners) detained in the Central Prisons are not attended by
psychiatric social workers.
The
Prison Visiting system is redundant and ineffective.
Proactive
approach of Human Rights Commissions regarding responsive prison medical system
has proved quite successful in curbing custodial violence and deaths in judicial
custody.
Prison
medical services are not effectively linked with State Health Services.
Conclusion: Broadly,
it is found that thorough medical examination of newly admitted prisoners is not
being carried out in the prisons. The vision, mission and perspective plan for
medical care in prison setting is missing. Doctors and para-medical staff posted
in the prisons lack training in Torture
Medicine and Human Rights Jurisprudence with special reference to health care in
prisons. Overcrowding, corruption and clandestine approach of the prison
managers (i.e. Superintendents and Jailors) and doctors are main factors for sub
standard quality of medical care in the prisons. The study came out with various
recommendations relating to provision of proper medical care for prisoners,
restructuring the prison medical services, and effective monitoring mechanism in
order to provide effective medical care to the prisoners.
Author:
Dr.
Joseph Mary Venus, E.Mail: msw@rajagiri.edu /maryvenus@rajagiri.edu
Key
Words:
Kerala Women, Health Status, Health Rights, Self Help Groups, Community
Participation
Introduction:
Health Status Of Women In Kerala
In
Kerala the rapidly declining growth rate, highest mean age at marriage, a very
high level of acceptance and awareness of family planning methods and fertility
control, a moderate decline in the mortality rate, low birth rate and death rate
along with higher female life expectancy, low infant mortality with negligible
gap between rural and urban and lower levels of disability are commendable
health indicators.
Whether
Women In Kerala Have Health Rights? – An Enquiry
The
attractive health parameters of Kerala State has left the presenter with a
curiosity to enquire into health rights of women in Kerala, with the following
objectives.
Objectives:
To
find out the level of awareness and utilization of health rights among women in
community.
To
study the role of Integrated Child Development Scheme in enhancing the capacity
of mothers at grass root level to look into the health and nutritional needs of
the family.
To
study the opinion of the following on Health Rights of women in Kerala
Professional
Social Workers
Health
Care Professionals like doctors, nurses and community health workers.
Human
Law Network
Methodology
- Focus group discussion
Women
in community among two Self Help Groups
-
Personal interview
The
Medical social workers in Government and private hospitals
Human
Rights law Network
Health
care providers (doctors, nurses and community health workers in Government
Hospital)
Results
– Responses
From The Cross Section Of The Society
The
women in community who are members of kudumbashree project are well aware
of their health issues and utilizing their health rights rather
unknowingly. They have adopted the small family norm with the consent of their
spouses.
The
Integrated Child
Development Scheme
is successfully implemented in Kerala with high degree of community
participation.
Medical
Social workers are of the view that, many educated women are not aware of their
rights and they have lot of misconceptions on health rights.
Human
rights law network - Legal awareness camps organised at community level is the
preventive step for the occurrence of sexual harassment, child sexual abuse and
abortion through sex determinations. They are of opinion that the women need to
be sensitized on reproductive rights.
Health
care providers – Women in general are availing the health services at
Government Hospital and they are aware on their rights. But they are not
utilizing their rights adequately because of lack of cooperation from the male
counterparts.
Good
Practices Leading To Better Awareness Of Health Rights Of Women In Kerala
High
literacy among Women.
Wide
network of health infrastructure and manpower, policies of successive state
governments.
Increase
in awareness level among women through mass media and Kudumbashree efforts.
Economic
empowerment of women at grass root levels through kudumbashree units to maintain
healthy life styles.
Existence
of Adolescent Clubs for girls.
High
level of participation of women in legal Awareness camps and counseling.
No
discrimination in basic and higher education, health and nutrition, employment
in girls.
Conclusion
- Challenges In
Human Rights Of Women In Kerala
Following
are the challenges facing the Kerala Society presently.
Domestic
violence
Child
Sexual Abuse
Reproductive
Rights
Suicidal
Attempts
Alcoholic
Spouses
Poster
No. P11
Author:
Upadhyaya, P.C*,
E-mail: pcupadhyaya@rediffmail.com
Key
Words:
vagrant,
nomadic, ex-criminal-tribe, tattooer, ethno-medical occupation, Uttar Pradesh
Objectives:
The
main objectives of the study depends upon keeping in view of these issues
involved in the study:
1.To
assess the various occupations based upon the socio-cultural practices of Nat
women in the area taken for the study.
2.To
analyse the present traditional healing roles performed by the Nat women in
Mirzapur District.
3.To
find out the impact of traditional beliefs and practices upon the health care of
Nat women.
4.To
analyse the present health care system and the role of state health facilities
among them.
Background:
Nats are vagrant tribes. Since long
times they are nomadic people moving
from one place to another. They have been placed in the category of ex-criminal tribes by the British Colonial administrators during
1871. They originally belong to Rajasthan. Their main profession on which they
are dependent are acrobating feats, snake charming, rope dancing, domestication
of reptiles and animals, performing of magical shows, selling beads and
amulets, tattooing practices,
collection
of herbs and medicinal plants etc.
In this article special emphasis has been given on Nat women healers who are
expert in diagnosing various diseases to apply their traditional practices
generally known as the community doctors among the poor and marginalised section
of the society. At present they are mainly found in the South-eastern part of
Uttar Pradesh in Mirzapur and Sonebhadra District. Still they are illiterate and
ignorant and largely depend upon the traditional modes of occupations.
Methods:
This study is based on fieldwork conducted among the various Nat settlements
situated in various villages of Mirzapur District using participant observation
method and interview and case study method. A total of ninety two households
were taken for the study. Among a total population of 617 persons, the sample
was consisted of 356 males and 315 females which gave the sex ratio of 88.48%.
Results: This
paper gives the result about the healing practices of Nomadic Nat women
who contribute to their cultural roles depending upon certain practices
as beliefs, customs, rituals generally found in rural areas of Mirzapur
District. This reflects how Nat women healers have acquired certain properties
of diagnosis of certain diseases as arthritis, batash, lakwa, backache and pain
in various parts of body as abdomen generally occurred in pregnant women. It
displays how specialized roles of Nat women healers who perform the midwifery
roles, tattooers, dentists and surgeons etc. are significant enough to
judge the health condition among the people. Keeping in view the engendering
health and human rights of Nat women healers of this area, it shows how certain
factors relate to Nat women who are living as semi-nomadic, illiterate and
underprivileged in the society as compared to others, make their life more
vulnerable and denies access to human rights unsatisfactorily.
Discussion: In
U.P. certain ethnic
communities are involved in such hazardous ethno-medical
occupations and they apply cures in
an unscientific and random way. The
point is that these should be analysed and discussed in a proper way as to be
placed in the mainstream National Health Policy of the country.
Poster
No. P12
Title:
Women And Disability
Management In Rural Haryana
Author:
Mehrotra, Nilika , E-mail: nilika@mail.jnu.ac.in,
Key
Words :
Disability, Cultural Perceptions, Social Management,State Policy, Haryana
The
term disability holds a multitude of meanings ranging across age, caste, gender
and class, exhibiting divergence in types of impairment, severity and prognosis.
One’s perception of disability is profoundly shaped by social values and
beliefs, which distinguishes between the ‘able’ and ‘disabled body. This
study elucidates cultural perceptions and social management of physical
disabilities in the life of women in the rural context of Haryana, India. It
also explores the role and strategies of community, family and state in
supporting disabled women. It is argued that women with disabilities face double
discrimination due to prevalence of traditional gender roles and expectations
and the stereotypes of disability.
This
research is based on qualitative field research project on disabled women in
rural Haryana funded by ministry of Social justice and Empowerment.
The
study reveals that a strictly patriarchal agricultural
set up of society puts emphasis on ability to do hard manual work. Only
those with severe locomotor disabilities are seen as ashrit (dependent)
or viklang and thus in need of support. For instance limb deformities are
considered to be more disabling than being deaf and dumb. Mental
illness is not recognized as illness or disability. Such a person may be
referred to as bholi (simple) or bawli (innocuous). As a group,
however, disabled are seen to be afflicting from several social stereotypes that
marginalize them. Disabled are stereotyped as hot
tempered, sexually impotent and unreliable. Thus, disability is culturally
constructed and socially negotiated. Men take care of the treatment.
Women are primary care givers. Family and kinship networks create and
allocate resources
Disabled
women experience disability and gender discrimination simultaneously. Though
stereotyped to be incomplete, they are expected to fulfil all the gendered
duties and primarily taken to be working members of the society.
Almost all women are married off either to other disabled or to other socially
appropriate persons. A social practice of marrying two or more sisters (cousins)
in the same household aids in finding the groom for the disabled girl.
Traditional gender roles are strictly enforced, with concessions granted
situationally. In the marital home woman has a harder life. Older women
receive help from the daughters and daughter in laws. Rural
society does not perceive disabled as people with any special requirements.
Disabled are culturally conceived to be incomplete but not necessarily
redundant.
The Disability Act 1995 ignores gendered realities of everyday lives of disabled, situated in families, wider kinship networks and communities. State definitions have been instrumental in creating a new awareness, which might lead to exclusion. There was no evidence of special schools or community based rehabilitation programmes in this area. NGOs’ initiatives are also almost negligent. Poor access to health care, lack of education and indifference of state towards the harsh realities of disabled rural women further marginalizes them. The study clearly shows the inaction and insensitivity of the state policy for Disabled towards rural disabled women as much of its content is heavily biased for urban middle class population.
