International Day for Sexual and Reproductive Rights, September 28th

FAMME | Recent events such as the Taliban’s elimination of Afghan women’s rights, the rollback of Polish women’s reproductive rights and the new restriction on abortion in Texas alert us to a possible adverse domino effect on SRHR around the world.

We believe that the rights we are slowly winning through struggle and suffering are sacred, human, inalienable and untouchable. On the International Day for Sexual and Reproductive Rights, when we should be commending advances in sexual diversity and sexual and reproductive health in a celebratory manner, without discrimination or risk, we are confronted with a reality for little fanfare.

Recent developments in Afghanistan, with the return of the Taliban to power, are a real catastrophe for Afghan women and girls. In the last 20 years, they had been gradually regaining rights and freedoms such as the return to education, work outside the home, access to public institutions, and the possibility to travel alone (including visits to the doctor) among others. In terms of Sexual and Reproductive Rights, in 2016 the government of Afghanistan committed to the FP2020 partnership to “accelerate access to rights-based voluntary family planning.” Since 2012, the country has increased the number of voluntary family planning users by 645,000; increased the number of health centers by 25 per cent; and signed new agreements with private hospitals to provide free family planning services. It was even on track to reach a modern contraceptive prevalence rate of 30 per cent. Now, with the change of government towards a repressive system and the overriding of the female figure as a “reproductive container” and slave, all that had been achieved in the restitution of rights over the last 20 years has disappeared at a stroke.

Meanwhile, at the other end of the world, another unthinkable event in Texas (United States), has just taken place against women’s constitutional rights: the entry into force of a law that prohibits abortion after the sixth week of gestation (when pregnancies are still practically undetectable and without considering rape or incest) despite the 1973 Supreme Court ruling that established the “constitutional right” to have an abortion. This law prohibits access to safe abortion for thousands of women and, most seriously, opens a legal avenue for other states to attempt something similar to the so-called “Heartbeat Law”. This new law will force many women to have abortions outside the State of Texas and many others without resources to resort to illegal methods without medical supervision, putting their lives at risk. Reactions have been swift. Dr Alan Braid has just performed an abortion and will be the first to be sued under the newly passed law: “I wanted to make sure that Texas did not get away with trying to prevent this blatantly unconstitutional law from being put to the test… And I believe abortion is an essential part of health care”.

On this side of the Atlantic, the case of Poland in early 2021 is similar to that of Texas, as it also marked a dramatic step backwards for Polish women’s reproductive rights. The Constitutional Court outlawed abortion in the case of foetal malformations, leaving only rape, risk of maternal death or incest as legal grounds. It thus joins the group of countries – Andorra, Malta, San Marino, Monaco and Slovakia – that are the most restrictive in Europe in terms of abortion law. The greatest harm once again falls on the women who have the least resources: if they cannot go to another country that allows them to have an abortion, they have no other option but to buy anti-abortion drugs on the black market without medical supervision, thus putting their own lives at risk.

The counterpoint to these three manifest setbacks is provided by two countries, where progress in freedoms has borne fruit in terms of greater sexual rights. They are Argentina and Mexico. We celebrate the fact that after many years of demanding the right to abortion, it has finally been decriminalised. This is a huge achievement of the feminist and women’s struggle in Latin America.

But in most parts of the world there are millions of people who do not have access to SRHR, or are persecuted when they exercise them. Governments, religious leaders, conservative political groups still try to tell women who they should be with, how many children they should have and who they should love. The control over sexuality and over their bodies is taking its toll on the lives of girls and women, but also on lesbian, gay, trans, bisexual, bisexual and intersex, LGBTQI+ people. The numbers are still staggering: 830 women around the world still die every day from preventable causes related to childbirth or pregnancy; some 222 million women want to postpone or stop childbearing, but do not use any method of contraception because of the lack of family planning; the teenage pregnancy rate for 15-19 year olds is 49/1000, 95% of them in low- and middle-income countries. There are no figures for LGBTQI+ or sexual orientation refugees, but more than 70 countries criminalise same-sex relationships.

We know that reducing these numbers depends on measures such as access to contraceptives, reducing the gender inequality gap, ending forced relationships, eliminating child and/or forced marriages, and educating the entire population about the problems of teenage pregnancy.

medicusmundi considers sexual and reproductive health as one of the fundamental pillars of our work. In 2011 medicusmundi approved the Declaration on Sexual and Reproductive Health and Rights, in which it sets out its position and expresses its commitment to defending women’s right to decide.

We are currently involved in the fight for sexual and reproductive rights with different projects including medical care, health education, family planning for both women and men so that they become involved in joint responsibility, and awareness-raising work in society to support women’s rights.

An example of our commitment is the recently completed Comprehensive Approach to Sexual and Reproductive Health and Violence against Women Programme, with special emphasis on adolescent girls, guaranteeing their access to quality services in Mexico. A strategy has been developed to support and accompany women and adolescents, especially victims of gender-based violence. At the same time, mechanisms for citizen participation have been articulated through awareness-raising and prevention programmes.

Also in El Salvador, the Project to Improve the Capacities of Health Centres for a comprehensive approach to Sexual Violence, Pregnancy and Maternal Mortality in adolescents has been developed. The project is aimed at improving the capacities of primary health care centres to improve the exercise of their sexual and reproductive rights, especially for adolescent women in the municipalities of Santa Ana, Coatepeque and El Congo.

In Peru, we continue to make progress with the project Strategies for coordination between society and public institutions against gender-based violence against women and LGBTQI+ people in El Agustino, Lima. It seeks to contribute to the fight against macho violence and hate speech that violate the rights of women and LGBTQI+ people in this area of Lima, strengthening women’s organisations, groups of egalitarian men and LGBTQI+ collectives in political advocacy and citizen vigilance and improving care for victims of violence in public services.

In Morocco, in the region of Tangier-Tetouan-Al Hoceima, the project Improving assistance to victims of gender-based violence in public health services promotes women’s rights, with special attention to the inclusion of migrant women, through assistance to women victims of gender-based violence in public health services, promoting the right to health and the reduction of gender inequality with an intercultural approach.

In Mali (in the area of Koulikoro), we care for 200 women for the third consecutive year. In this project we offer medical care and training on different subjects: maternal and child nutrition, excision, sexually transmitted infections (STIs), family planning and personal hygiene. Among the objectives, one is to involve fathers in pregnancy and active parenthood, as well as in co-responsibility in health, and therefore a process of training husbands in the care of pregnant women and babies, STIs, family planning and prenatal care is initiated.

Time is running out if we are to achieve by 2030 the commitment made to ensure universal access to sexual and reproductive health services, including family planning, information and education, and the integration of reproductive health into national strategies and programmes. This is recommended by SDG target 3.7.


English translation of an article first published by Medicus Mundi Spain in Spanish
Original post with links to references: here