East Timor’s Dire Family Planning Needs

Ramona Vijeyarasa

The entrenchment of fundamentalist religious beliefs in East Timor's laws and the promotion of "natural family planning" has posed grave threats to women's health and lives.

East Timor, the world’s
newest nation, is currently threatened with a soaring population, expected to double by 2020. UNFPA reports that Timor-Leste has the
highest fertility rate in the world, averaging 7.8 children per woman. It is additionally alarming that countries
with high birth rates tends to have high
maternal and infant mortality.

Reliable child and maternal mortality rates are hard to obtain for East Timor,
but it is unquestionable that the poor quality and accessibility of family
planning has directly impacted the health of Timorese women and children.
According to WHO, East Timor has a maternal mortality rate of 380 deaths per 100,000
live births. UNICEF report correspondingly shocking rates of death
exist for infants and children under the age of five, with an under-five
mortality rate of 55 per 1,000 live births in 2006, and an infant mortality
rate of 47 in 2006.

It is promising that the former-President, turned Prime Minister, Xanana
Gusmao, recently noted that "fertility is a matter of education". Improved access to family planning education
and services together are vital not only as a matter of reproductive choice but
to ensure that East Timor achieves some level of sustainable development. Yet,
this "new approach" may have to face the notable influence of the Catholic
Church. If the state of family planning in the Philippines, the other
predominantly Catholic country in Asia, is a reflection of what is to come in
East Timor, we should be alarmed. Millions of
Filipino women of reproductive age have limited or no access to modern
contraceptives. National figures suggest almost half of all pregnancies in the
Philippines are unwanted, especially in rural areas and amongst low-income
families. The entrenchment of fundamentalist religious beliefs in laws and
policies and the promotion of "natural family planning" have undermined women’s
choice and posed grave threats to their health and lives.

Low rates of contraceptive prevalence in East Timor
are equally alarming, though, in this case, the Catholic Church has taken a more reasonable stance
and has been more receptive to the promotion of contraceptives. According to
WHO, only around 22% of the Timorese use modern
contraceptives. Lack of awareness about contraceptives amongst the population
is potent, with the former first lady and Prime Minister’s
wife, Kirsty Gusmao affirming that the combination of
poor education, poverty and the influence of the Catholic Church means that
contraception is rarely discussed. According to a survey conducted in 2003 by
the Ministry of Health, over 94% of currently married female adolescents and
87% of 20-24-year-old currently married young women were not using any
contraception. The survey also reported that more than 90% of
youth did not receive any information on family planning.

When it
comes to abortion, the Catholic Church in the Philippines and East Timor are
much more in sinc. The Philippines has one of the most restrictive abortion
laws in the world, with no express exception to save a woman’s life, and
penalizing both the woman and her provider. Criminalization of abortion has
resulted in a overwhelming number of illegal and unsafe abortions. In 2000,
approximately 473,000 women had abortions and an estimated 79,000 women were hospitalized for complications arising from the
abortion. Similarly, the Timorese Government and Catholic Church do not endorse
abortion and the Timorese law severely punishes abortion, even when the mother’s life is in
danger.

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Despite the
sensitivity of discussing sexual health and family planning, the health needs
of Timorese cannot be ignored. Achieving high standards of reproductive health
is not only a question of reproductive choice. It is in fact essential to the
achievement of sustainable development for East Timor, a country that is
evidently still very much undergoing transition.

Women in East Timor Unite in the Fight for Justice and Equality

Ramona Vijeyarasa

Nearly 350 women gathered together for the Second International "Women for Peace Conference" in East Timor to talk about the role women can play "as creative agents for peace."

Nearly 350 women gathered together
in the lead-up to the International Women’s Day for the Second International
"Women for Peace Conference" from March 4-6 in East Timor
to talk about the role women can play "as creative agents for peace."
The First International Conference, which was organized by the Government
of Norway and the University of Indonesia in April 2007, discussed women’s
global challenges. In the words of Eva Tuft, the Norwegian Chargé
d’Affairs: "We called it the first because we did not want it to
end there," and it certainly did not. Drawing together women from
Papua New Guinea, Angola, Australia, Ireland, Germany, the US, Canada,
Portugal, Norway, and Indonesia and a large crowd of passionate and
strong East Timorese women, the Second International Conference saw
the sharing of ideas and stories, some very personal, the shedding of
tears and lighting of candles and at times some divisive debate on issues
like abortion for victims of rape and incest.

The injustices suffered by
women across the globe led us to devote most of our time to the discussions
about justice for women survivors of war, justice for survivors of gender-based
violence and the need to stop domestic violence and rape against women.
However, the words of East Timor’s Prime Minister (and former President) Xanana Gusmao
reminded us to look beyond the wrongs: "When we talk about the rights
of women, these are human rights. We normally talk about human right
as being violated but we need to start talking about these rights as
obligations" (oral translation from Tetum).  

Among the very rich discussions,
one that peaked my interest was the session devoted to the impact of
culture and religion on women’s rights, with a particular focus on
reproductive rights.  Madalena Hanjam Leste, Deputy Minister for Health
of the Government of Timor, started her presentation by citing
the definition of health in the Constitution of the World Health Organization:
"Health is a state of complete
physical, mental and social well-being and not merely the absence of
disease or infirmity." She
highlighted the importance of women being guaranteed safety, autonomy
and choice. In her view, the institutional challenge for East Timor
is increasing the value given to women’s voice; ensuring women have
access to decision-making; and prioritizing women’s health throughout
the life cycle. She admitted that reproductive health in East Timor
is insecure, with only 37 per cent of births attended by skilled health
professionals and 20 to 42 per cent of pregnant women undernourished
and anemic.

Her co-speaker, Bishop Gunnar
Stålsett, the Special Envoy of Norway to Timor, also advocated for
the need to enhance the capacities of religious leaders to monitor laws
and fight against all forms of rape and violence against women. When
asked about the sometimes-oppressive role of the church when it comes
to women’s rights, Bishop Stålsett responded, "The discussion
needs to be open and free in every society. The church has sometimes
stood against the freedom and equality of women. It is important to
raise the issues and rise above taboos."

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In a predominantly Catholic
community, with a strong presence and involvement of the Catholic Church,
it was unsurprising that the issue of abortion was highly controversial
and created heated debates. It unfortunately broke some of the solidarity
that had been achieved over the three days amongst the women participants
of diverse national, religious and ethnic backgrounds. 

Both Indonesian activist Gadis
Arivia, and Maria Barreto, of the Timorese NGO Fokupers (The East Timorese
Women’s Communication Forum), also raised the issue of abortion in
their respective countries. In Indonesia, 2.3 million women each year
have an abortion because access to contraception is significantly limited.
In East Timor, despite increasing recognition of the importance of women’s
empowerment and gender equality for the development of the country,
women who fall pregnant as a result of incest and rape do not have access
to safe and legal abortions. Advocates continue to push for change and
a group of Timorese women attending the conference went before the East
Timor Council of Ministers on March 6 to argue that the exception for
abortion in cases of rape, currently in the draft penal code, should
be kept. Alarmingly, in light of the backlash and pressure from the
clergy, this exception may be removed from the final version.  

Yet, a consensus was almost
reached on a number of key recommendations, including completely implementing
CEDAW and the other human rights treaties that the Government of East
Timor has signed, putting an end to rape, torture and other forms of
violence against girls and eliminating all laws that discriminate against
women. 

Timorese women certainly have
the courage and passion to fight for their rights and voice their grievances.
What is clearly lacking, however, is the space, particularly political
space to do so. We will have to wait to see in particular how much this
momentous meeting has given Timorese women more space and the creative
tools to push for their right to choose and protect their own lives
and health. At the same time, though far away from most readers, the
conference recommendations included a valuable call for action to all
of us: "We need to strengthen networking among women internationally
in the fight for justice, to support victims to speak out, and to find
creative solutions for holding human rights violators accountable."

Australia’s Foreign Aid Funding For Abortion

Ramona Vijeyarasa

The Australian Government recently made a monumental decision to resume the use of its foreign aid funding for the provision of abortion services and information.

The Australian Government recently
made a monumental decision to resume the use of its foreign aid funding
for the provision of abortion services and information. Six months of parliamentary debate, which
many activists, including myself, followed closely, culminated in this
decision to reverse the 12-year long ban. Some have attributed the reform
to Prime Minister Kevin Rudd. Since his election to office in 2007,
Rudd has introduced a host of positive changes for the country and world,
including signing the Kyoto Protocol less than one month after being
sworn into office, making a formal apology to the "stolen generations"
in February 2008, and proposing greater recognition of LGBT rights in
Australia by announcing reforms to the legal recognition of same-sex
relations.  

However, the decision to overturn
the ban, imposed in 1996 by the previous conservative government, in
fact challenges the personal
beliefs
of Prime
Minister Rudd. Rudd said he had "long-standing conservative views"
on the issue and did not support the change. Rather, after extensive
consultation with parliamentary colleagues, Foreign
Minister Stephen Smith

made the decision to lift the ban: "I was left with the very distinct
impression that the substantial, if not the overwhelming majority of
the parliamentary members of the Labor Party believed that this was
also the correct outcome."  

Sarah
Hanson-Young, an Australian senator from the Australian Greens
, who was the youngest Australian woman
ever elected to parliament, noted how out of step Australia has been
with the international community. Although not an entirely accurate statement about the changes introduced by the Obama Administration, Hanson-Young stated: "Australia, until this morning,
was the last country who had these ridiculous, archaic, inhumane restrictions
placed on our aid funding and support. What we now see is Australia
has stepped up in line with Barack Obama, who in his very first week
as president moved to ensure that these restrictions would be lifted,"
she said. In the February Parliamentary sitting of the Australian Senate,
Senator Hanson-Young also moved for the Senate to recognize that an
estimated 34,000 mothers die in the region each year due to the lack
of maternal health care. 

Bob
McMullan, Australia’s Parliamentary Secretary for Development Assistance
, also recognized the potential significance
this decision will have for maternal health, "the greatest gap in
health services between the developed and developing world." Honing
in on the rights of women to decide the number and spacing of their
families, Jane
Singleton, chief executive officer of the Australian Reproductive Health Alliance
(ARHA),
also commented
on this reform. In Singleton’s opinion, "It will have huge impacts
on hundreds of thousands of women and their families who want to make
choices about the numbers of children they have and the spacing and
it will also free up funds for family planning generally." She also
highlighted that while these restrictions have been in place, Australia’s
funding for a whole range of family planning has diminished by 84 per
cent. Foreign Minister Smith has promised to reverse this decline in
aid for family planning organizations. As part of Australia’s commitment
to advancing the Millennium Development Goals (MDGs) and to improve
child and maternal health, the Government will also provide additional funding
of up to $15 million over four years

through UN agencies and NGOs for family planning and reproductive health
activities to help reduce maternal deaths.  

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The potential for this change
to save women’s lives and guarantee women their right to health is
enormous. AusAID, the Australian Government’s Overseas Aid Program,
funds a range of countries in Asia and the Pacific, with $AUS3.7 billion worth of official
development assistance planned for 2008-2009. I have previously drawn
the spotlight on East
Timor

and expressed my hope that a change in Australia’s foreign aid funding
requirements would help stop the 68,000 unsafe abortions that unnecessarily
take place every year, risking the lives of young Timorese women. However,
women all around the region, including those from some of Australia’s
biggest recipients like Bangladesh, Pakistan, Cambodia, and the Solomon
Islands, could now have the opportunity to access legal abortions, safely,
more affordably and be armed with the necessary information to do so.
This is particularly important in South Asia. Whilst more
than half of the world’s unsafe abortions take place in Asia (10.5 million),
more than one-third of these are in South Central Asia. According to Action Canada for
Population and Development (ACPD)
,
in the Asia region, excluding East Asia where safe abortion is widely
accessible, one unsafe abortion occurs for every 5 live births.

In Nepal, unfortunately one
of the smaller recipients of Australian Government aid (with an estimated $AUD8.2 million foreign aid to be
received from the Australian Government in the period 2008-09), unsafe
abortion causes 20 to 27 per cent of all maternal deaths. Given that nearly a quarter
of Nepalese women give birth before the age of 18 and over 50 percent
women give birth by the age of 20, the number of young women dying is
staggering. An increase in family planning funding will help to address
the low levels of education, including reproductive health education,
limited access to health services and the higher risks of complications
that exist for these some of the younger women, whose reproductive system
may not being fully developed in light of their age.  

Sexual and
reproductive health and rights groups have been waiting a long time
for this decision. One of the key outcomes of roundtable discussions held in 2006 on Australia’s
family planning aid was the realization that
unsafe abortion could not be left out of a comprehensive approach to
sexual and reproductive health programs in the region. Donor
money isn’t everything, but it certainly can have a huge impact on
countries that de-prioritize reproductive health. All recipients of
Australian funding can now freely use this money to arm women with the
information and services they need to make choices about their own lives,
hopefully shrinking the gap between the rights, health and choices of
women in the global north and south.

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