Ha sido un día realmente excitante, empiezo contándote que hubo una conferencia de prensa por la mañana de hoy, antes de eso, que crees? Me dieron una Hermosa cámara digital con las que he empezado a tomar algunas fotografías, jejeje, dicho sea de paso, todas las fotos que veas en mi blogsito las tome yo.... A ver, se presentaron cuatro personas, Scott Evertz, antiguo director de la Oficina Nacional de SIDA de USA, John Santelli, medico y profesor de la Universidad de Columbia y Beatrice Were, fundadora de la comunidad de Mujeres que viven con SIDA de Uganda, todos presentados por James Wagoner, presidente de Advocates for Youth. Todos hablaron del problema que los programas de prevención del VIH basados solo en la abstinencia plantean para el mundo de hoy, así pues, la abstinencia como única forma de prevención juega en contra de los pilares mismos de la Prevención: Los derechos, el respeto y la responsabilidad.
Ha sido un día realmente excitante, empiezo contándote que hubo una conferencia de prensa por la mañana de hoy, antes de eso, que crees? Me dieron una Hermosa cámara digital con las que he empezado a tomar algunas fotografías, jejeje, dicho sea de paso, todas las fotos que veas en mi blogsito las tome yo…. A ver, se presentaron cuatro personas, Scott Evertz, antiguo director de la Oficina Nacional de SIDA de USA, John Santelli, medico y profesor de la Universidad de Columbia y Beatrice Were, fundadora de la comunidad de Mujeres que viven con SIDA de Uganda, todos presentados por James Wagoner, presidente de Advocates for Youth. Todos hablaron del problema que los programas de prevención del VIH basados solo en la abstinencia plantean para el mundo de hoy, así pues, la abstinencia como única forma de prevención juega en contra de los pilares mismos de la Prevención: Los derechos, el respeto y la responsabilidad. Juega en contra de los derechos porque es tu derecho el tener o no tener relaciones sexuales, porque critica el uso de condones que se sabe científicamente que evitan la transmisión del VIH, así como ataca nuestro derecho a disfrutar de nuestras sexualidades en forma libre y sin culpas. Va contra el respeto, porque no respeta las orientaciones sexuales, las practicas sexuales seguras, usando condom por ejemplo, ni tampoco respeta la equidad de genero al promover discursos moralistas que como ya sabes en este rubro siempre cae con fuerza sobre los hombros de las mujeres. Va en contra de la responsabilidad porque de forma clara pone en duda nuestra capacidad para ser responsables por nuestros cuerpos, nuestra salud física, mental y emocional, ósea, duda de nuestra capacidad de ser autónomo en nuestras decisiones de vida, tratando por tanto de negar nuestros derechos sexuales y nuestros derechos reproductivos y en suma tratando de negar nuestros derechos humanos.
Para mi fue muy interesante que el Dr. Santelli reconozca que nosotros los chicos gays, así como mis amigas y amigos que no son heterosexuales, tu sabes, bisexuales, lesbianas y trans no tenemos mensajes incluyentes, directos y amigables acerca de la prevención del VIH y sexualidad , aun cuando los gobiernos están obligados a dar esa información, teniendo en cuenta que la educación en sexualidad debe brindarte todas las herramientas necesarias para crecer, desarrollarte y cuidar tu cuerpo en forma apropiada no solo del VIH sino de cualquier otra ITS.
El Sr. Scott Evertz resalto algo que aunque ya se habla de los jóvenes frente a la epidemia del VIH es necesario hablar de jóvenes homosexuales, jóvenes lesbianas, jóvenes bisexuales y por supuesto jóvenes trans porque cada población tiene sus propias características y necesidades. El ignorarnos solo nos hace mas vulnerables al VIH.
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In El Salvador, Maria Teresa Rivera was convicted of aggravated homicide after experiencing an obstetrical emergency. She is scheduled to have a new day in court on May 11, when she will argue that there were judicial errors in her original trial.
In November 2011, Maria Teresa Rivera unexpectedly went into labor, giving birth in the latrine of her home. The birth was dangerous and unattended by any medical professionals; the fetus died. Like many women in El Salvador, where abortion is completely illegal, Rivera’s medical crisis led to her being charged with and convicted of aggravated homicide; she was sentenced in 2012 to 40 years in prison.
Rivera’s sentence is the most extreme of “Las 17,” a group of women who have been imprisoned after obstetrical emergencies. Now, she is scheduled to have a new day in court on May 11, when she will argue that there were judicial errors in her original trial. If the judge rules in her favor, she will be freed from prison. Advocates say that her case could influence public sentiment about other similar cases around the country.
With the support of the Agrupación Ciudadana por la Despenalización del Aborto, a Salvadoran feminist organization, Rivera has been fighting her case for several years, as reported earlier in Rewire. Along with the rest of Las 17, she requested a pardon from the Salvadoran government in 2014, but her request was denied.
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“Rivera represents the maximum will of the state to criminalize women in this country,” Morena Herrera, president of the Agrupación, explained in an on-the-ground interview with Rewire. “Her sentence is the longest of any of the women with similar convictions; at 40 years, it is practically a life sentence.”
Fortunate To Be Alive
Maria Teresa Rivera, who shared her story on camera from prison in 2013, was a 28-year-old factory worker in 2011. She was living with her young son and his grandparents, her ex in-laws, in a very modest home in the outskirts of San Salvador. Rivera, the sole provider for the family, supplemented her factory work with house-cleaning in order to pay $13 a month to keep her son in a neighborhood Catholic school and purchase his asthma medication.
One night, according to court documents, Rivera said she awoke with intense thirst. But when she arose from her bed, she felt dizzy and then fainted. When she regained consciousness, she felt a strong urge to defecate and went to the latrine outside the house. As she sat in the latrine, she had intense cramping and “felt as if a little ball fell from her body.” Then she fainted and fell to the ground, where her mother-in-law found her in a pool of blood and called an ambulance to take her to the hospital. No one at the scene—family or paramedics—reported hearing any sounds of a baby, and no one realized she had given birth.
Rivera told doctors, attorneys, and others that did not know she was pregnant. She had been experiencing bleeding during the time of the pregnancy, which she interpreted as her menstrual cycle. Neither she nor any friends, relatives, or co-workers noted any physical changes that would indicate a pregnancy. She had also had two doctor visits for other complaints during those months, and no doctor had diagnosed her pregnancy. According to her own estimations, the last sexual contact she’d had that could have resulted in pregnancy had been six months earlier.
She arrived at the hospital in a severe state of shock from extreme blood loss, fortunate to still be alive. Doctors told her she had given birth and wanted to know where the baby was. Medical personnel contacted police, who went to her home to locate the deceased fetus. Rivera was detained by police at the hospital and has been imprisoned since that time.
Interrogation While Hospitalized
Multiple national and international organizations, including Amnesty International and the Center for Reproductive Rights, along with numerous medical, legal, human rights, and academic experts, have analyzed Rivera’s case in the years since her conviction. Harvard University sociologist Jocelyn Viterna and Salvadoran lawyer Jose Santos Guardado Bautista, for example, used parts of Rivera’s story and court documents in their 2014 analysis of systematic gender discrimination toward Las 17 within the judicial system.
Viterna and Bautista noted, for example, that the only witness testimony the judge considered credible was a supervisor from human resources at the factory where Rivera worked. Contrary to Rivera’s testimony, the supervisor testified that Rivera asked for time off for doctor appointments in January 2011 because she was pregnant. The judge refused to allow testimony from neighbors and friends who stated that they had never seen Rivera show any signs of pregnancy.
“Had Maria Teresa truly reported a pregnancy to her employer in January of 2011, she would have been 11 months pregnant when the birth occurred in November,” Viterna and Bautista observed. “This testimony is nothing short of preposterous. Nevertheless, this is the only witness testimony that the judge deems ‘credible’ in the final sentencing.”
According to Viterna and Bautista’s report, “The judge admitted that there was no evidence that Maria Teresa had done anything to hurt her baby. The judge also admitted that there was no evidence of any motive for why she would want to kill her baby.” However, he still convicted her of aggravated homicide.
A 2015 resolution from the Salvadoran Attorney General for Human Rights (Procuradoría Para la Defensa de los Derechos Humanos or PDDH in Spanish), which provided a formal opinion on violations of Rivera’s human rights, supports Viterna and Bautista’s findings.
The PDDH resolution observed that Rivera faced a slanted system even before she got to court:
At the First of May Hospital where Rivera was taken, the criminal investigation was prioritized over her right to health. She was subjected to interrogation when she was still in Intensive Care and without legal representation. In addition, the medical personnel did not seek information about her health history; they limited themselves to examining the birth canal, carrying out the extraction of the remaining placenta, and discharging her the following day, without attending to her overall health.
Both the PDDH and Viterna-Bautista reports noted that the judge relied on shoddy, unscientific evidence to convict Rivera. According to court records, the autopsy report for the fetus said its cause of death was “perinatal asphyxia.”
“It is perhaps worth reiterating that there were no signs of trauma on the [fetus], either externally or internally. It is perhaps worth reiterating that, despite the judge’s conclusion that the [fetus] died from suffocating within the latrine, the fetal lungs were clean with no sign of fecal matter or other materials inside them. Rather, the autopsy concluded that the [fetus] died of a medical condition—perinatal asphyxiation—that could have occurred before, during, or after the birth. Clearly, there is no evidence in these documents proving homicide,” Viterna and Bautista wrote. “Perinatal asphyxiation,” they said, “is a medical condition.”
Still, the judge interpreted the autopsy report to mean that Rivera had carried out an intentional criminal act. He also ignored the portion of the autopsy report stating that the umbilical cord could have been separated by its fall into the latrine. As quoted by the PDDH resolution, he wrote:
There is no doubt that the baby was born alive and was full-term and that the detached umbilical cord was cut by the mother …. This judge does not give credibility to what the accused says when she states she did not know she was pregnant …. She knew she was pregnant and that brought with it the obligation to care for and protect this young person she carried in her womb. In this sense, the fact that she went to the latrine, she did it with the intention of violently expelling [it] so that inside the latrine there would be no opportunity to breathe and in that way cause its death and then be able to say it was a [spontaneous] abortion.”
The judge also based his conviction, the PDDH resolution said, on the results of a DNA test showing the fetus was genetically related to Rivera.
“No evidence was introduced to show that Rivera had taken any intentional action to cause the death,” the PDDH resolution concluded.
Convicted by Patriarchy
Rivera’s legal representatives will likely use many of these inconsistencies as evidence for procedural judicial error in court this week. A favorable outcome in her trial can represent a significant step forward for women’s human rights, particularly sexual and reproductive rights in El Salvador. The country’s 1997 absolute ban on abortion, along with a 1998 constitutional modification to declare that life begins at conception, created the social, cultural, and legal environment that has justified courts sending women such as Rivera to prison for documented obstetrical emergencies, not even attempted abortion. According to the global organization Ipas, more than 600 women were incarcerated between 1998 and 2013 under the abortion law.
As the PDDH resolution noted, “in El Salvador, there exists a culture of the promotion of motherhood as the only form of self-realization for women, and the creation of the binomial ‘woman-mother,’ which locates women as instinctive and not rational. This imposes upon women [duties of] sacrifice, abnegation, and the prioritization of children over their own human conditions, behaviors that are not demanded in equal proportions from men.
“Women find themselves with a social expectation to comply with the role ‘woman-mother,’ even in the health system where women should be assured of conditions free of discrimination and obstetric violence,” it continued.
Advocates and researchers have argued that this sexist framework contributed to Rivera’s conviction. As Viterna and Bautista wrote, the trial judge claimed that Rivera “‘decided to carry out her criminal plan within the area of her household, looking for a moment during which there weren’t any other persons around to carry out this homicide,’ as if a woman has complete control over when, where and how her body will give birth.”
The PDDH concluded that “the judge convicted Rivera under subjective criteria with a heavily sexist ideology,” saying that Rivera’s rights to the presumption of innocence were overruled by such an ideology, unsupported by any medical or scientific evidence.
Rivera’s case, along with that of Carmen Guadalupe Vazquez (who was one of Las 17 granted a pardon in 2015 when the Salvadoran Supreme Court recognized judicial errors in her case), is representative of a consistent pattern toward this group of women that the Agrupación has been documenting.
“Correcting these judicial errors is very important, first of all for Rivera and her young son, so that she can go free, but also for all the other women in similar circumstances. It’s also necessary for those who work for justice in this country, particularly women’s reproductive justice, to see that the work has concrete results,” Herrera said.
Herrera hopes that a positive outcome will continue to make visible this pattern of judicial error and “move other cases [of Las 17] forward more rapidly and bring greater justice to the judicial system.”
According to IThe Agrupación is currently representing more than 25 women imprisoned with similar convictions: the original 17, two of whom received pardons, and others who have entered the system more recently.
“Maria Teresa’s story illustrates the systematic ways that women’s rights are violated: the right to health, the right to privacy in one’s life, the right to doctor-patient confidentiality, along with all the judicial procedural rights such as the presumption of innocence,” Herrera said in an interview with Rewire.
“The judicial system in El Salvador is the part of the state that has changed least since the signing of the 1992 peace accords” that ended the Salvadoran civil war, Herrera said. “Not just in how it deals with women, but how little sensitivity it demonstrates overall with regard to human rights.”
The Zika virus, its potential link to microcephaly and other complications, and the inadequate government responses to it so far all bring into sharper focus the threats girls and women already face in the country.
The arrival of the Zika virus is not the only threat to young women’s health and human rights in El Salvador. The virus, its potential link to microcephaly and other complications, and the inadequate government responses to it so far all bring into sharper focus the grave situation girls and women already face in the country. Such danger, highlighted in both government reports and the work of activists on the ground, includes sexual violence, a lack of access to medical care, and gang activity.
El Salvador’s health ministry recently recommended that because of the virus, women contemplating pregnancies should take measures to postpone their pregnancies for at least two years. However, as Rewire reported, feminists responded that the recommendation is inadequate. It does not address the realities in El Salvador, they said, a country where 31 percent of all pregnancies registered with the El Salvador Ministry of Health in 2014 occurred among girls and women ages 10 to 19. Because of a number of societal restrictions, many of these girls may not have a choice in whether to put off pregnancy.
A November 2015 report from the United Nations Population Fund (UNFPA) and the Salvadoran Ministry of Health (MINSAL) gives the most up-to-date details so far about this large segment of the population, especially where issues of relationships, pregnancies, and reproductive rights are concerned. Although the report was released before news of Zika became widely recognized, it describes interconnected systems of coercion and abuse any strategies to address the virus must take into account.
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The UNFPA and MINSAL report stemmed from two stark figures in a National Health Survey in 2014: One out of every three women ages 20 to 49 in the survey had a pregnancy before the age of 18. One out of four lived in a relationship with a man, married or unmarried, before the age of 18.
These numbers, notes Minister of Health Violeta Menjívar in the 2015 report’s introduction, reflect the environment young women must often navigate in El Salvador:
The relationships as well as the early pregnancies are the result of circumstances beyond the control of the girl and the adolescent, and they impede her from making key decisions about her life adequately. The situation of violence in the family and in the society places girls and adolescents in situations in which their rights are violated. The relationships and pregnancies before age 17 are a product of the social violence that they suffer daily, and which is not taken on as such by the society or the State.
Using interviews with girls between the ages of 10 and 17 who had a live birth in 2012 at a Ministry of Health facility, the authors of the 2015 report attempted to flesh out the stories behind those statistics. The majority of the relationships, it found, were “not among peers,” meaning an age difference of three years or less. Rather, two-thirds of the girls had a male partner at least four years older at the time they gave birth, and 18 percent had a partner at least 10 years older.
This, the report states, creates “very unequal power” in the relationships, which leaves the girls and young women with “very little margin with which to make decisions about their lives.”
The study recognizes the problematic and conflicting laws in the country that criminalize some of these relationships but legalize others. For unmarried individuals, for example, any sexual relation with a minor younger than 15 years old is a crime. But there are still laws in effect in the penal code, it says, that “permit marriage under the condition that the girl or adolescent is pregnant or [they] have children in common, and there exists the express permission of the parents or guardians.”
The study also shows that “one of every ten relationships was formalized through marriage, including some with girls ages 10 to 12.”
The report also highlighted the inadequate medical services many of the girls received. In the case of the 10-to-12-year-old group, 20 percent had no postpartum care, even though, as the report says, they are the most vulnerable to obstetric complications. Half the girls and young women who gave birth in 2012 were not using contraceptives at the time of the study in 2015. By that time, 29 percent had already had a second pregnancy or were pregnant.
Girls and adolescents with histories of sexual violence, as self-reported in the interviews, comprised 37 percent of the interviewees overall, but two-thirds of girls ages 10 to 12 in 2012. One out of five of the girls who were 10 to 12 years old in 2012 had their first sexual relation with a family member, which constitutes the crime of aggravated sexual aggression. Though the report did not discuss individuals’ experience with the justice system, feminist groups that collect data on violence against women say that few police reports are ever filed of crimes like these—and if they are, there is rarely any follow-up.
“Sexual aggressions committed against girls and adolescents take place in an environment of social permissiveness around assaults, abuse and deception, fed by neglect, violence and poverty,” wrote Menjívar in her introduction.
“The fact that a girl of 10, 11 or 12 years of age is pregnant or finds herself in a relationship, that she leaves school, that she does not have access to services to protect her, et cetera, should be considered a national priority especially, when the persons who should protect them, and the institutions that should guarantee their rights, permit that these rights be violated,” she continued.
Right now, local health educators say that combating this problem is not a national government priority—and their own community-based work reinforces the report’s conclusions. Zuleyma Lovo, psychology student and leader from the activist group Jóvenes Voceras y Voceros en Derechos Sexuales y Reproductivos, gave workshops in rural communities and in middle schools on sexual and reproductive health—until increasing gang violence caused the program to be suspended in late 2015.
In an interview with Rewire, she affirmed the frequent incidents of violence and sexual abuse among the students she knew, and the many young girls who lived with older men:
At the school we asked for anonymous written comments, and in addition to questions about our talks, the girls would tell us about the physical, sexual, and emotional violence they experienced at home. Many think they can escape it by leaving home and living with a man, almost always a man who is older. But, the same dynamics repeat themselves, the violence, the abuse, the control.
This coercion extends to the control of pregnancy planning. “The men decide whether or not the women can use contraceptives. The men almost never agree to use condoms,” she said.
“Then the Ministry of Health arrives and tells women to abstain or to keep from getting pregnant,” she added.
This is not the only situation, advocates say, in which adolescents have difficulty accessing contraceptives. Lovo, and Noel Gonzalez, health educator and national director of Voceros y Voceras, described the difficulties the young people they serve face when attempting to obtain birth control available at no cost from local health centers operated by the government. Such clinics are the providers for the majority of poor people, both urban and rural; those who can pay for private pharmacies tend to have more options.
Gonzalez explained that the centers are directed to offer “youth-friendly” services, but that is rarely the case. Frequently, Gonzalez said, the young people he’s interacted with are met with “judgmental, prejudice-laden treatment and a lack of confidentiality” from the time they walk in the door. When young people do request contraceptives, he said, they are often told, “You’re too young. It won’t matter. You’re just going to get pregnant, anyway.” As a result, Gonzalez said, “many never go back.”
Clinics, Gonzalez said, often have limited supplies of certain kinds of birth control. “They only have the three-month injections, which have more side effects for young women,” noted Gonzalez. In its 2014 reportOn the Brink of Death: Violence Against Women and the Abortion Ban in El Salvador, Amnesty International found that “these clinics have … been associated with provision of fewer options and poorer levels of service for young women including denial of services and discriminatory treatment.”
And if that contraception fails, Lovo noted, women have few options: Abortion is 100 percent illegal in all cases in El Salvador. “Pregnant women who are abused or whose partners deserted them might be considering interrupting their pregnancies, but they are afraid to talk about it because of the strong religious biases against abortion,” she said.
All this is worsened, Lovo explained, by the threat of gang violence, which shut down her project in 2015. “They murdered a woman leader in one community, and we can’t go back there,” she said.
Gangs claim territories, which makes access to some health clinics a dangerous matter. Gonzalez elaborated, “The gangs stop you and ask you for your [identification], and if you live in the area of a rival gang, they won’t let you into their area. That can be where the clinic is.” A young person with the resources can take a bus to a distant clinic, but most don’t have that option.
Working as a health promoter is also dangerous: Some, Gonzalez said, have been murdered by gangs as they move from one community to another. He also explained that gangs kidnap or threaten to kidnap young women from their families and rape them, which has caused families to relocate within the country or to leave the country in order to protect their daughters. Some health clinics are reluctant to report rapes when women come to them for fear of reprisals from gangs.
Violence and poverty work together to curtail school attendance, including access to sexual education. Rates of students who leave their school out of fear have doubled in the past five years. In some cases, schools have closed as families flee to other regions of the country or leave the country altogether. Lovo noted that independently run sexual education programs such as hers have been effective but small, and limited by safety concerns.
Various projects and programs to improve matters have been written at the ministerial level and partially implemented, but have not met their goals. A proposed law on sex education in the schools has stalled in various committees.
The potential risks and impacts of the Zika virus interact with and exacerbate the chronic dangers of being young and female in El Salvador. Any efforts to deal with Zika need to recognize those contexts, and to work on making the country safer for girls and women beyond the threat of the virus alone.