Free Condoms for Internal Migrants in China, But Continued Neglect of Reproductive Rights

Ramona Vijeyarasa

The Chinese Government has decided to distribute free contraceptives to the migrant population, a group previously denied access to the free condoms distribution system.

Internal migrants in China,
a group of over 150 million people, frequently face multiple vulnerabilities,
particularly regarding their reproductive health. However, the Chinese
government’s decision
last month marks a potential improvement in guaranteeing the reproductive
rights of migrants. The Government decided to distribute free contraceptives to
the migrant population, which was previously denied access to the free condoms
distribution system. 

In some respects, the Government’s motives are suspect. With the National
Population and Family Planning Commission estimating that 70 percent of the
migrant population is of childbearing age, fear of breaches of the one child
norm is at play. To the extent that male migrants are the primary targets of
this initiative, a further and valid driving force is the spread of HIV
transmissions among migrants, given the vulnerability of mobile groups. This stems
from the Ministry of Health’s fears that sex has overtaken intravenous drug use
(IDU) as the main cause of HIV/AIDS transmission in China. 

"Relations involving multiple sexual partners have increased as male
farmers flocked to cities, thus increasing the possibility of HIV
transmission," said Wu Zunyou,
director of the National Center for AIDS/STD Prevention and Control
. He believes
that migrant groups are sexually active, but unaware of how to protect
themselves. 

The inclusion of migrants in the free contraceptives program is one of several
government initiatives
since late 2008 designed to reduce HIV vulnerability
among migrant populations. However, insufficient numbers of people undertaking
HIV tests, underreporting of rates of HIV infection and general lack of
transparency about the issue, which I have discussed previously,
mean it is difficult to assess whether such programs have or will be
successful. 

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

In December 2008, the Government was involved
in the launch of a joint campaign
to reduce discrimination against HIV/AIDS and to encourage safe sex among male
migrant workers. In some areas, including bars in Beijing and construction sites with more than
500 workers, the Government has also set up automatic condom-vending machines.
In Dalian City,
in the northeast province
of Liaoning, the
Government also provided 3,000 migrants with free HIV tests in 2008. 

One of the gravest shortcomings, in terms
of reproductive rights, is the common case of public health initiatives and
reproductive health programming aimed migrant populations. In an effort to target HIV-prevention, insufficient
attention is given to other reproductive health vulnerabilities associated with
mobility. Migrant women, in particular, frequently lack access to sexual and
reproductive health services, whether because of unaffordable user fees or lack
of access to national health schemes. 

Several years ago, one Chinese writer
revealed the vulnerability of migrant women in China,
reporting that although China’s
Labor Law guarantees women workers maternity leave and protection for their
reproductive health. The large supply of workers places employers in a position
to refuse to pay maternity leave, or fire women who are pregnant. Zhang Ye also
reported the general and specific reproductive health harms resulting from
factory working conditions, specifically in the footwear and garment factories,
where workers face chemical fumes, unbearable heat and long hours of standing. 

This is not to suggest that migrant women
are completely being ignored. In April, Li
Bin, China’s
minister in charge of the National Population and Family Planning Commission,
reported to the United Nation’s Commission of Population and Development the intention
of the Government to issue regulations on reproductive and family planning
of migrants to protect their reproductive rights. Recently, there has
also been an increased focus on corporate
social responsibility
, targeting companies like Nike, Disney and Levi
Strauss. One project is focused on the role of companies to recognize the
harmful effect of neglecting women’s reproductive health. 

In reality, HIV vulnerability is one of many vulnerabilities internal
migrants in China
face, particularly with respect to lack of
redress for violations of labor rights
, including workplace hazards and
absence of pay. However, in the specific case of the reproductive rights of
migrant women, it seems that Government-funded programming, at present, is
insufficient at addressing the very particular set of vulnerabilities facing
this population, including mandatory health testing, denied pregnancy, forced
abortion and lack of access to healthcare. Though the Government of China’s efforts in terms of
free HIV testing are indeed commendable, in reality they are only one part of a
wider approach that is essential to guarantee the reproductive rights of the
very significant internal migrant population in terms of the reproductive
rights violations Chinese women migrants suffered in the past.

Analysis Human Rights

ICE Releases Reports for 18 Migrants Who Died in Detention, Medical Neglect Is Suspected

Tina Vasquez

Though the death reviews released by ICE provide further insight into the conditions inside detention centers, the bigger concern among researchers and advocates is what they don't know.

A new report from Human Rights Watch (HRW) documents the deaths of 18 migrants in Immigration and Customs Enforcement custody from mid-2012 to mid-2015. In some cases, the deaths were likely preventable and the result of “substandard medical care and violations of applicable detention standards.”

These are not the only deaths that occurred, however. ICE acknowledges on its website that 31 deaths have occurred between May 2012 and mid-June of this year. It is unclear whether ICE intends to release information about the additional 13 deaths that have occurred.

Even so, these new findings add to a growing body of evidence showing what HRW calls “egregious violations” of medical care standards in detention centers. A February report found such violations contributed to at least eight in-custody deaths over a two-year period.

The public is just beginning to learn more about the deeply rooted problem, Clara Long, a researcher with Human Rights Watch and the lead researcher on the report, explained to Rewire. Long referenced an ongoing investigation by reporter Seth Freed Wessler at the Nation, which explores the numerous deaths that have occurred inside immigrant-only prisons.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Though the death reviews released by ICE provide further insight into the conditions inside detention centers, the bigger concern among researchers and advocates is what they don’t know. For example, HRW worked with two independent medical experts to review the 18 death reviews released by ICE. The experts concluded that substandard medical care “probably contributed to the deaths of seven of the 18 detainees, while potentially putting many other detainees in danger as well.” Long told Rewire that the information provided by ICE simply wasn’t enough for their independent medical experts to determine that all 18 deaths were related to inadequate medical care, but that it was “likely.”

So there is the larger, systemic issue of inadequate medical care. Researchers at HRW also don’t know exactly how ICE collects information or why the agency releases information when it does. There’s also the core of the issue, as Long noted to Rewire: that the United States “unnecessarily” detains undocumented immigrants in “disturbing conditions” for prolonged periods of time.

Major Failures Lead to Death

The new HRW report identified two of the most dangerous ways ICE is failing migrants in detention: not following up on symptoms that require assistance and not responding quickly to emergencies. Both failures are illustrated by the case of 34-year-old Manuel Cota-Domingo, who died of heart disease, untreated diabetes, and pneumonia after being detained at the Eloy Detention Center in Eloy, Arizona.

ICE’s death review for Cota-Domingo suggests there was a language barrier and that Cota-Domingo was worried about having to pay for health care, which isn’t surprising given that detention centers make migrants pay for things like phone calls to their attorneys and family members. HRW asked Corrections Corporation of America, the company that runs the Eloy Detention Center, about potential fees for medical care, and it said there are no fees for such services at Eloy. For whatever reason, Cota-Domingo was not aware he had a legal right to access the medical care he needed.

When it became clear to his cellmate that Cota-Domingo was in serious need of medical attention and was having trouble breathing, the cellmate “banged on a wall to get a guard’s attention. His cellmate said he did that for three hours before anyone came to help,” Long said. The researcher told Rewire the death report outlines how investigators checked to see if the banging would have been audible to correctional officers.  It was. “Once [the cellmate] got their attention, our medical experts said this was something that should have been followed up on immediately, but the nurse decided to wait several hours before doing anything. All of these sluggish responses went on for eight hours. This is not how you treat an emergency,” Long said.

As Human Rights Watch noted in the report, “When officers finally notified medical providers of his condition, they delayed evaluating him and finally sent him to the hospital in a van instead of an ambulance. Both medical experts concluded that the combination of these delays likely contributed to a potentially treatable condition becoming fatal.”

In other death reviews by ICE, the agency’s own records show “evidence of the misuse of isolation for people with mental disabilities, inadequate mental health evaluation and treatment, and broader medical care failures.” Tiombe Kimana Carlos, Clemente Mponda, and Jose de Jesus Deniz-Sahagun all committed suicide in ICE detention after showing signs of “serious mental health conditions.” HRW’s independent experts determined that “inadequate mental health care or the misuse of isolation may have significantly exacerbated their mental health problems.”

It’s important to note that none of the death reviews released by ICE admit any wrongdoing, and that’s primarily because they don’t seek to examine whether medical negligence was at play. The reports simply present information about the deaths.

“There is no conclusion drawn, really,” Long told Rewire. “There’s one [report] in particular that even goes beyond that; it doesn’t even take into account the quality of care that led to the death, even though it’s clearly an issue of quality of care. That raises the question: What is the report for? ICE doesn’t conclude the cause. If you read [the death reviews], you can see there’s a lot of detailed information included in them that allows someone with expertise in correctional health care and who is familiar with how these systems should work, to make an assessment about whether care contributed to death, but that’s not something ICE doesat least not in the information we are able to access.”

ICE’s Murky Death-Review Process 

In a statement to Rewire, ICE explained that when a person dies while in the agency’s custody, their “death triggers an immediate internal inquiry into the circumstances.” The summary document ICE releases to the public is “the result of exhaustive case reviews conducted by ICE’s own Office of Detention Oversight (ODO), which was established in 2009 as part of the agency’s comprehensive detention reforms,” Lori K. Haley, a spokesperson with ICE, told Rewire in a prepared statement.

In fact, the ODO was created as a direct result of a series of reforms from the Obama administration after reports of human rights abuses and deaths in detention centers. The death review it produces includes a mix of findings from ICE’s own investigators and from a Beaumont, Texas-based company called Creative Corrections.

According to its website, Creative Corrections serves “local, state and federal government agencies,” offering “training, advising, professional management and consulting services” in “correctional, law enforcement, rule of law, and judicial systems.” The company contracts include the Department of Homeland Security (DHS).

“From what we can see from the documents, both ICE and Creative Corrections interview various people involved, check records, do what seems to be a pretty robust investigation for the death review,” Long said. “Unfortunately, in the set of death reviews that we used for this investigation, [the public doesn’t] have access to the Creative Corrections reports or any of the exhibits that go along with them.”

As the ICE spokesperson noted, the summary documents are typically written by ICE staff. The documents released to the public do not include medical records, full reports from Creative Corrections, or any exhibits that would provide more insight into the apparent medical neglect resulting in an estimated 161 people dying in ICE custody since October 2003. Six migrants have died in ICE custody since March 2016, two of whom died at two different detention centers in the same week. The causes of these most recent deathsand whether they can be attributed to medical neglect—is still unknown.

“If we had access to all of the information gathered during these investigations, including the reports from Creative Corrections, they would be very rich sources of information,” Long said.

Long and other researchers are also hoping for more information regarding the deaths that happen just after migrants are released from ICE custody. Teka Gulema, an Ethiopian asylum seeker detained at Etowah County Detention Center in Gadsden, Alabama, was released from ICE custody in November 2015 while in the hospital after becoming paralyzed from a bacterial infection acquired in detention. He died in January.

“One concern we have, and it’s a very big fear, is that there are multiple reports of folks who are released from ICE custody while in critical condition,” Long said. “When they die, they are no longer counted as in-custody deaths [by ICE]. We’re worried that’s a loophole being exploitedand for obvious reasons, we don’t have a number in terms of how often this is happening.”

The researcher said she has “no idea” when or why ICE decides to release information, including death reviews.

ICE did not respond to Rewire‘s request for information about its schedule or process for releasing such information.

“Maybe they released the 18 reports because they were cleared for release. Maybe a congressional office asked for them. Maybe they decided to be transparent. It could have been a [Freedom of Information Act] request from the ACLU. I wish I knew, but we really have no idea who decides—or why they decide—to release information, especially without making anyone aware that it’s been released,” the researcher told Rewire.

In April, ICE posted a series of spreadsheets about the inner workings of the detention system on their website that Long said provided a lot of information about how detention operates. The spreadsheets were removed from the site in a matter of days, too soon for many researchers—including HRW—to download them all.

“It’s a big system. We still don’t totally know how it works, which in itself is a major problem,” Long said. “One of the biggest lessons we’ve learned is to always check the ICE website. You never know what you’ll find.”

Rethinking Detention

DHS secretary Jeh Johnson is engaging in what some advocates are calling an “enforcement overdrive,” by funneling more undocumented immigrants into an already overcrowded detention system thanks to the detention bed quota established in 2009. This quota requires 34,000 undocumented migrants be locked up each day. It is in place to ensure more people get deported, though it’s costing taxpayers $2 billion a year while also creating “a profitable market for both private prison corporations and local governments,” the National Immigration Forum has said.

Reporting for the Nation, Michelle Chen recently noted that “migrants are warehoused under convoluted partnerships involving private vendors and state, local, and federal agencies. Homeland Security may contract out security duties to, or use facilities owned by, private vendors—dominated by Corrections Corporation of America (CCA) and GEO Group—with preordained headcount distributions ranging from 285 in Newark to more than 2,000 in San Antonio.”

Long told Rewire that 80 percent of migrants currently in detention are in what is considered “mandatory detention,” which, according to the Immigrant Legal Resource Center, means that “non-citizens with certain criminal convictions must be detained by ICE. People who are subject to mandatory detention are not entitled to a bond hearing and must remain in detention while removal proceedings are pending against them.” This also means that those in mandatory detention aren’t allowed to have an individual assessment by ICE of their case, “so they just sit in immigration detention indefinitely,” Long said.

“This system doesn’t work. We’re detaining far too many people for far too long and not determining on an individual level if they should be detained in the first place, taking into account all of the options available,” Long said. Options include being monitored by ICE using telephonic and in-person reporting, curfews, and home visits.

Long joins a long list of undocumented community members, researchers, organizers, activists, and other advocates pushing for the Obama administration—and whoever comes after it—to see detention as a last resort, rather than the only resort.

“We spend a lot of time talking about the disturbing conditions in detention centersthat’s what our report is about. But step one requires taking a step back and rethinking this system and how it’s unnecessary and also abuses vulnerable peoples’ rights,” Long said. “In terms of the legality of treating people this way, under U.S. and international law, people who are detained are entitled to medical treatment. The state has an obligation to provide care to this population. They are failing, and people are dying.”

Analysis Politics

In Michigan Governor’s Race, Candidates Battle Over Economy, Reproductive Rights

Nina Liss-Schultz

This November, Michigan residents will decide whether to cast their vote for Republican incumbent Rick Snyder or long-time Democratic politician Mark Schauer in the gubernatorial election. The candidates have already begun to spar over the economy, education, and public health in the state, which will all be central issues leading up to the November election.

That Michigan is in the middle of a deep financial crisis is no secret. For the last decade, a combination of the flight of wealthier residents to the suburbs and the decay of the auto industry has left many Michigan cities on the brink of financial ruin. Detroit, the state’s largest city, declared bankruptcy a year ago, making it the most populous city in the country to ever do so. Since then, Detroit has made news for shutting off water to residents, for the overwhelming number of vacant and abandoned homes and buildings, and a maternal mortality rate three times higher than the national average and higher than rates of maternal mortality in Libya, Uruguay, and Vietnam.

Though Detroit has been the face of Michigan’s economic crisis, the state’s money woes go well beyond the Motor City: 12 municipalities, including Detroit, and five school districts are in serious financial stress, and many of those institutions have been taken over by emergency financial managers appointed by the state government, ostensibly in the hopes of keeping the municipalities afloat. Many others are on the brink.

This November, Michigan residents will decide whether to cast their vote for Republican incumbent Rick Snyder or long-time Democratic politician Mark Schauer in the gubernatorial election. The candidates have already begun to spar over the economy, education, and public health in the state, which will all be central issues leading up to the November election.

Economy and the Emergency Manager System

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

The emergency manager system under Gov. Snyder has been perhaps the most controversial policy of the governor’s term so far. The system—in which officials appointed by the governor intervene in the finances of economically stressed municipalities—has existed in Michigan in some form since the late 1980s. Gov. Snyder, however, has drastically expanded the scope and jurisdiction of these managers. According to an MSNBC reporter, the system under Snyder has “economically transformed” the State of Michigan. It has been dubbed “Financial Martial Law” by advocates and “disaster capitalism” by opponents.

Schauer, a Democrat who represented Michigan in the U.S. House from 2009-2011 after more than a decade in state-level politics, has made the emergency manager system a central criticism of his opponent.

After taking office in 2011, Gov. Snyder made a move to revamp the system by signing into law Public Act 4, shortly after taking office in 2011. The act allowed emergency managers to essentially control city government at the behest of the state. Once the governor’s administration declares a financial emergency, managers are given power over elected officials and to change local statutes. The emergency manager can hire and fire local officials as they see fit, sell local assets, and change local law, among other things. PA 4 was repealed by a voter referendum the following year. Then, shortly after the repeal in 2012, Snyder signed into law another emergency manager bill, Public Act 436, which took effect in 2013.

As with PA 4, under Public Act 436, emergency managers take the place of the local government or governing body. The manager has the power to enact law by decree, disregard local law, cancel collective bargaining and union contracts, privatize existing services, and even dissolve the local municipality in some cases.

Unlike PA 4, PA 436 gives municipalities slightly more power. For example, after 18 months a local government or school district can vote to get rid of the emergency manager. It also has more options out the outset: when a financial crisis is declared, the municipality can choose between four types of emergency management systems. 

But the newer law also places some additional restrictions on Michigan residents’ ability to voice opposition to emergency managers, by including a provision that prohibits voters from repealing PA 436 through the referendum process, which was used to ax Public Act 4.

Many opponents to the legislation say that PA 436 is nearly identical to PA 4, and doesn’t address the public’s concerns with the system.

“The trouble with the emergency manager law is that the government shoved it down people’s throats,” says Shelli Weisberg, the legislative director of the American Civil Liberties Union (ACLU) of Michigan. Groups have attempted to recall Gov. Snyder twice during his term.

Though the title “emergency manager” implies that the city’s financial stress is due to mismanagement or incompetent bureaucrats, economic experts in the state say that in most cases, financial crises are the result of systemic economic issues, not municipal mismanagement. Eric W. Lupher, research director of the Citizens Research Council of Michigan, a fact-based, non-partisan research institution, says that Michigan has been in economic decay for over a decade. “The root of the problem is the rust-belt status of so many cities in Michigan,” Lupher told Rewire in an interview. While most of the nation rebounded after the post-9/11 recession, Michigan stayed in a rut. “Year after year, the economic growth of the state declined.” A combination of the move away from auto-manufacturing—a major source of revenue for the state—in the United States, and what Lupher calls “community disinvestment”—wherein the wealthy leave cities for the suburbs, leaving “behind communities that don’t have the tax base to support services”—Michigan cities and their residents have struggled to stay afloat.

Notably, as The Atlantic points out, African Americans are by far the majority population in cities and school districts controlled by emergency managers. While cities with emergency managers contain about 9 percent of Michigan’s population, they also contain an estimated half of the state’s Black population.

Schauer, along with his running mate Lisa Brown, has staunchly opposed Snyder’s economic policies and the emergency manager system, and has offered an alternative approach. This month, at a Netroots Nation conference in Detroit, Schauer criticized the emergency manager system saying it “sets aside elected officials … with accountability to only one person, and that’s the governor.”

At the conference, Schauer said that if elected governor he would scrap the emergency manager law and replace it with “financial transition teams” that would collaborate with local governments toward financial solvency.

Education

Schauer has also come out strong against Gov. Snyder’s education policies and the so-called education crisis in Michigan. “The single most important investment we can make in Michigan’s economy is the education of our children,” reads his website. “Mark will work to put students first by reversing Gov. Snyder’s devastating cuts to our schools and colleges.”

Though Snyder has recently taken steps to reinvest in the Michigan school system, according to the Michigan Education Association, “during his first year in office, Snyder cut school funding to give billions of dollars in tax breaks to big corporations—resources that children are not likely to recoup unless their classrooms are fully funded.” Despite the recent increase in funding, per-pupil investment in the state in 2015 will still be below the 2009 level. As of February, 46 school districts were operating with a budget deficit.

The education system is unique in Michigan: unlike in most places, school districts in the state are independent of, not run by, local governments. According to Lupher, the districts’ independence also leaves them uniquely vulnerable to economic issues. “In the Michigan cities that have experienced economic decline, the same is true of the school districts because they have that tax base.”

So in addition to the lack of government investment in schools, the systemic economic issues that caused the downturn in cities such as Detroit have also hit school districts hard.

That 46 schools are running a deficit is seemingly an improvement on 2013, when 50 schools were under water. The reason for the decrease, though, is not so encouraging: several schools were dissolved and several other struggling schools merged.

The state government has declared five school districts to be in a state of financial emergency, including the entire public school system of Detroit. The managers of at least two of those school districts have turned their public schools into charters, and hired private companies to manage them.

On his website, candidate Schauer says he plans to remove the profit motive from charter schools if elected governor. In July, Schauer released a ten-point plan, titled “Blueprint: A Michigan That Works for Everyone,” which calls for, in part, an increased investment in education.

Snyder has disputed Schauer’s criticism, saying that he has increased both state funding of the K-12 system and early childhood education. According to Michigan Live, Snyder says he has increased funding to classrooms by “$660 more per student.” That claim is misleading, however, because it’s not all going directly to the classroom and is instead going to other parts of the education system, including fulfillment of teachers’ retirement plans.

Reproductive Health Care 

Though fiduciary concerns may take center stage in the run up to the November election, access to health care, and particularly reproductive care, has been a lightning rod in the state during Snyder’s term.

Snyder and Schauer have made clear and distinct names for themselves in relation to their position on abortion and reproductive rights. According to the ACLU’s Shelli Weisberg, Snyder has tried to remain as neutral as possible on the issue. “From the beginning he’s said it’s not one of his top priorities.” But, while Snyder has taken a stand against at least one piece of extreme anti-choice legislation, during his term some of the most controversial anti-choice legislation in the country has made its way through Michigan’s legislature, whether by his signature or through alternative legislative processes.

In December 2013, Michigan lawmakers passed the Abortion Insurance Opt-Out Act, which has become known as the “Rape Insurance Act,” banning private insurance plans from covering abortion in most cases, including rape or incest, and unless the woman buys coverage through a separate rider. The bill became law without the governor’s signature, because it had been introduced through the citizen’s initiative process, which does not require one.

According to the Huffington Post, the year before the legislation passed there were 23,230 abortions in Michigan, and fewer than 4 percent of abortions were paid by insurers. Abortions can cost anywhere between $500 and $10,000, depending on the circumstances.

Notably, Gov. Snyder had vetoed a similar measure the year before. According to the Detroit Free Press, Snyder said he wanted to remain moderate on the issue of abortion. “I’m a pro-life person … but still, I wanted to strike a balance.”

Though the governor’s veto in 2012 was a win for women, he also signed into law several pieces of anti-choice legislation during his term. During his first year in office, Gov. Snyder signed into law a “partial-birth” abortion ban, Public Act 168, which makes it a felony to perform so-called partial-birth abortions, itself a misnomer and myth.

Candidate Schauer voted against earlier iterations of the legislation while serving in Michigan’s state government.

The next year, Snyder signed into law an omnibus anti-choice bill, which included a targeted regulation of abortion providers (TRAP) provision imposing the same regulations on abortion clinics that are required of hospital operating rooms, and a ban on tele-medicine prescriptions for first-trimester medication abortions.

Aside from the legislation it has introduced, the Michigan legislature has made a name for itself as traditionalist and anti-woman. Most recently, a local reporter tweeted a picture of three state representatives reading fashion magazines and quoted them saying, “Don’t say we don’t understand women.” And in 2012, Lisa Brown, who is now running alongside Schauer for lieutenant governor, was notoriously barred from speaking on the house floor after saying the word “vagina.”

Weisberg says that the GOP’s reputation will hurt Snyder in the race, and will only add to Schauer economic case against the governor. “Keeping the government out of the exam room, and ‘This isn’t my boss’s business’” are salient issues for women in the state right now. “I think that women’s rights will play an important role, mostly around birth control and women being treated as second-class citizens in terms of their health-care needs,” she says.

Though Weisberg says that Republicans in the state, including Snyder, will try to come off as neutral on gender equality and reproductive justice in order to get the women’s vote, in the lead up to November Schauer will do his best to position himself in opposition to Snyder’s politics, both economic and social.