Roundups Media

Global Roundup: Madagascar’s Sex Work Industry On the Rise; Al Qaeda Threatens Maternal Health in Yemen

Jessica Mack

Weekly global roundup: The latest with the delayed RH Bill in the Philippines; HIV/AIDS stigma impedes maternal care in Kenya; Maternal deaths rise due to fighting in Yemen's south; and the sex work industry booms in Madagascar.

Latest in the Philippines: Reproductive Health Bill Held Hostage in Congress

Although Congress voted to end all debate on the RH Bill (House Bill 4244) in August, it has remained filibustered in Congress since then, with no clear signs of when and if it will move toward passing. The bill, which has been present in Congress in various versions for nearly 15 years, would secure access to comprehensive sexuality education and contraception for Filipinos. More than 90 million live in the Philippines, a collection of more than 7,000 islands in the Asia Pacific where highly restricted access to reproductive health information and services has contributed to vast poverty and other social and health issues. Although the bill has broad bi-partisan and global support, the Catholic Bishops’ Conference of the Philippines has continued to fight tooth and nail to undermine its passage, and launching an all out war against those who support it, including an investigation of 159 faculty members of Ateneo de Manila University for their support of the bill. This is a clash of the titans—ideology versus science, human rights, and public health—to the greatest degree. And as the bill sits frozen in Congress, policymakers are pointing fingers at who is to blame, and one excuse after another seems to bubble up – including that although a quorum could be secured to pass the bill, some argue that such an important piece of legislation shouldn’t be passed by a minority. Meanwhile, Representative Kimi Cojuangco, who supports the bill, claims that each day its passage is delayed, the government wastes 50 million Pesos (approximately one million USD): That’s what it cost [when we delay the voting on the RH bill]. This is really a disservice to the nation, we could be saving so many lives.” Via Philippines Daily Inquirer.

Sub-Saharan Africa: HIV Stigma Deters Women From Pre-Natal Care

A recent study released in Kenya, which tracked the pre-natal activities of nearly 2,000 women, found that only 44 percent delivered in clinics, and that a fear of submitting to HIV tests was a major factor in this decision. These findings support others from across the continent, suggesting that while stigma around HIV and AIDS has been considerably reduced in recent years (numerous African leaders have gone public with their status and taken HIV tests publicly as well), stigma remains strong enough to prevent women from seeking care they know could save their lives as well as the lives of their babies. Prevention of mother to child transmission (PMTCT) programs are relatively well developed and accessible across the continent, but still the knowledge that one may be HIV positive has social ramifications that some are unwilling to risk. In the study, women reported fear of being kicked out by their husbands or being seen as promiscuous by their community if they received positive test results. Via The New York Times.

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Yemen: Ongoing Violence Threatens Women’s Lives

The Yemeni Army continues to clash with Al Qaeda-linked Islamist militants in the south of the country, and women’s rights and health are suffering. Ongoing fighting in Abyan, a central-southern region, has displaced thousands and impeded women’s access to critical maternal and reproductive health services. The UN reports that, currently, a woman in Yemen as a 1 in 91 chance of dying during pregnancy and childbirth. Increased violence, instability, and the resulting restrictions on health resources put women and girls in an even more precarious situation. Women living in temporary camps often cannot access the care they need, and those who have returned to their homes in the south fear violence if they venture to clinics and hospitals. Earlier this year, militants in the south targeted girls and women who were not veiled, harassing them and even throwing acid. Yemenis will see the first independent election in 2014, and women’s rights advocates in the country are hoping to pass a law that would guarantee them 30 percent representation in parliament – a political gender quota that has been implemented in a number of countries already. Via IRIN.

Madagascar: Sex Work a Legal and Growing Profession

IRIN reports that over the last two decades, the number of registered sex workers in the main port city of Toamasina (on the country’s Indian coast), has grown by more than 50 percent, from 17,000 in 1993 to 29,000 in 2012. The city’s total population is about 200,000, meaning approximately one in seven residents are a sex worker. Sex work is legal in the country, and has been relatively successfully regulated through the use of ID cards that individuals apply for, or “unofficial red books,” which give sex workers access to judicial clinics and government protection of their financial and bodily well being. While national laws dictate that registered sex workers must be at least 18, a 2007 UNICEF survey of sex workers in Toamasina and the island Nosy Be found that between 30 and 50 percent were under age 18. This has raised significant concerns among the community, who fear the growing prominence of sex tourism, and police harassment of registered sex workers remains an issue. While there is a tendency to frame the growth of sex work as indicative of “no other economic options,” it certainly is not always the case. While women should be afforded a range of economic opportunities of their choosing, the legalization of the industry is a positive thing, enabling regulation and a platform for the continued protection of women’s reproductive health and rights. Via IRIN.

Commentary Human Rights

Are Sex Workers’ Rights Becoming Thinkable?

Anna Forbes

Recent political developments suggest some growing political awareness of sex workers as human beings.

In most countries, the concept of sex workers’ human rights has been unthinkable for the last few millennia. As Bubbles, the co-founder of the blog Tits and Sass, has observed, “Sex workers are generally portrayed as victims or punchlines.”

Recent political developments, however, suggest some growing political awareness of sex workers as human beings. On December 20, Canada’s Supreme Court ruled in favor of the plaintiffs in Attorney General of Canada v. Terri Jean Bedford, Amy Lebovitch, and Valerie Scott. These three women, self-identified sex workers, filed suit in 2007 because they felt three provisions in the Canadian Criminal Code violated their constitutional rights.

After six years of weaving its way through the courts, their case resulted in a unanimous decision striking down laws against keeping or being found in a brothel (or “bawdy house,” to use the law’s term), living on the avails (profits) of selling sex, and “communicating in public for the purpose of prostitution” (street soliciting). These provisions, the Court ruled, violated the right to “security of the person” guaranteed by Canada’s Charter of Rights and Freedoms enacted in 1982. The Globe and Mail, Canada’s nationally distributed newspaper, described Chief Justice Beverley McLachlin’s decision (on behalf of the Court) as not being “about whether prostitution should be legal or not, but about whether Parliament’s means of controlling it infringe the constitutional rights of prostitutes.”

The decision states:

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Parliament has the power to regulate against nuisances, but not at the cost of the health, safety and lives of prostitutes. … The prohibitions all heighten the risks. … They do not merely impose conditions on how prostitutes operate. They go a critical step further, by imposing dangerous conditions on prostitution; they prevent people engaged in a risky—but legal—activity from taking steps to protect themselves from the risks.

The Court agreed on a one-year suspension of the ruling to give Parliament time to respond. If lawmakers choose to pursue passage of new prohibitions, they will be obliged, under the ruling, to ensure that they do not violate sex workers’ right to safety.

Prostitution, per se, is not illegal in Canada, but the decision and other laws circumscribe its practice. Laws against brothel keeping specifically put indoor sex workers at risk of arrest, and the ban on living on the avails criminalizes a sex worker’s children and other people who are supported by her earnings. The public communications laws severely affect the estimated 5 to 20 percent of Canadian sex workers who are street-based. By compelling them to complete negotiations quickly (in order to avoid arrest), it deprives them of the time needed to assess the potential risk of going with a prospective client.

The Pivot Legal Society, Downtown Eastside Sex Workers United Against Violence, and the PACE (Providing Alternatives Counseling and Education) Society all worked in coalition with the Bedford petitioners and other sex worker groups to advance the case. When Pivot was allotted time to address the Supreme Court directly, a collective decision was made that Pivot’s legal director, Katrina Pacey, would use the time to “paint a picture” for the justices of the violence sex workers routinely experience under existing laws. They agreed that Pacey would emphasize the “Bad Date Sheet,” a tool used by sex workers to record and share descriptions of clients known to be dangerous and predatory. Pacey told the justices that “having time to adequately screen a client means having time to refer to the information on this sheet … and it can be a life-saving measure … time to communicate, time to screen, can mean the difference between life and death for a sex worker.”

This struck a deep chord because of the epidemic of missing and murdered women—most of them sex workers—that Canada has experienced in the last three decades. At the center of this was Robert Pickton, a serial killer in British Columbia who told an undercover police officer that he had killed 49 women and wished he could have made it an even 50 before his arrest. Pickton was charged in 2002 with the murders of 26 women, most of them sex workers and/or drug users from Vancouver’s Downtown Eastside neighborhood. He was convicted in 2007 of killing six of them, with the 20 other charges stayed, and sentenced to life imprisonment.

Pickton is far from an anomaly. Seattle’s Gary Ridgway (the “Green River Killer”) was convicted in 2003 of murdering 48 women, and later confessed to killing 71 in all. He said he picked sex workers specifically because “I knew they would not be reported missing right away and might never be reported missing. I picked prostitutes because I thought I could kill as many of them as I wanted without getting caught.” Meanwhile, the search for the alleged Gilgo Beach serial killer in Long Island, New York, is ongoing. The first woman went missing in 2007, and to date ten to 14 of the bodies identified on that isolated section of beach are thought to have been his victims. As in the cases above, the New York police have been repeatedly accused of insufficient action because many of the murdered women were sex workers.

After hearing Pacey’s statement to the Court, Chief Justice McLaughlin wrote in her opinion, “If screening could have prevented one woman from jumping into Robert Pickton’s car, the severity of the harmful effects [of the law] is established.”

A breakthrough of a different type, but similar in proportion, occurred in South Africa on December 10, when the South African National AIDS Council (SANAC) launched its National Strategic Plan for HIV Prevention, Care and Treatment for Sex Workers. The Sex Worker Education and Advocacy Taskforce (SWEAT) and Sisonke (a South African movement advocating for the rights of adult, consenting sex workers) were pivotal in the plan’s development and describe it as a “comprehensive rights- and evidence-based approach to HIV interventions within the sex worker key population.” Maria Stacey, SWEAT’s deputy director, added, “Following World Health Organisation guidelines on HIV prevention amongst sex workers, the Plan does advocate for the decriminalisation of sex work.”

SANAC, an entity made up of government ministries, civil society organizations, and private sector corporations, is charged with building and coordinating the HIV and AIDS response for a country with the world’s largest population of people living with HIV. This new program launch is a historic development in what has been a prolonged political battle. When the SANAC board approved a final draft of its 2012-16 National Strategic Plan on HIV, Sexually Transmitted Infections, and Tuberculosis (commonly referred to as the 2012 NSP) in November 2011, the draft contained language directing the Department of Justice and Constitutional Development and the South African Law Reform Commission to “take urgent steps to finalise the legislative reform process. … This must result in the tabling of a bill to decriminalize adult sex work by no later than 30 June 2013. Thereafter, SANAC must closely monitor the law reform process in Parliament.’’

When formally issued on World AIDS Day a few weeks later, however, SANAC’s plan omitted that language, replacing it with the following: “Decriminalisation of sex work is a matter that has been a subject of debate and society should continue to deliberate on the matter until final resolution.” As one SANAC member commented, “Government ministers, officials, other sectors and NGOs at the meeting endorsed this [decriminalization] as a key, evidence-based. Now, in one week, all that has dissolved.”

The sex workers’ rights and HIV prevention advocates who had been working for over a decade to get the board-approved language into the 2012 NSP saw this deletion as, once again, fatally dismissive of sex workers’ lives. Data from 2005 (the most recent year for which data is available) showed an HIV prevalence of 43 percent among female sex workers surveyed in Johannesburg, evidence of the government’s disregard for their need for effective HIV prevention interventions.

The two-year turnaround from this political betrayal to the launching of a national program dedicated to their needs is attributed to (among other factors) the 2012 hiring of SANAC’s new CEO, Dr. Fareed Abdullah, and the government’s decision to make SANAC an independent entity, answerable to all its constituencies. Abdullah came to the job with a decade of experience “pioneering” innovative HIV programming in South Africa, as well as service at the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) and the International AIDS Vaccine Initiative (IAVI). The first grant he authorized from SANAC’s newly independent budget was to SWEAT.

The new National Plan for HIV Prevention, Care and Treatment for Sex Workers not only includes the provision of a full package of sexual and reproductive health services to an estimated 153,000 sex workers in the country (including sexually transmitted infection screening and treatment, post-exposure prophylaxis for rape and sexual assault, contraception, and peer support, as well as education, condoms, and lubricant) but also funds measures to reduce violence and human rights abuses against them. In an interview shortly before the ICASA launch, Abdullah said that “[t]his approach allows the social capital of the sex work community to be strengthened—which we know to be protective for HIV.” He added, “The time has come for us to suspend our moral judgments in respect of sex work in the interest of the public health of the nation and human rights.”

Interestingly, former U.S. ambassador Mark Dybul was among the panelists at the ICASA session where the new plan was launched. Currently the CEO of the Global Fund, Dybul was one of the founding architects of PEPFAR, serving as U.S. Global AIDS coordinator from 2006 to 2009. In his remarks at the ICASA launch, Dybul described the fact that HIV-positive sex workers are 12 times less likely to receive antiretroviral treatment than other people living with HIV as “appalling,” and said that SANAC’s plan demonstrated “what needs to be done, not only in South Africa but everywhere.” One wonders if this evolving awareness—manifested in two countries and by the head of the Global Fund so recently—will become evident in U.S. policy anytime soon.

Roundups Media

Global Roundup: Iran Says No to Women Engineers; South Korea Considers Regulating Birth Control

Jessica Mack

Weekly global roundup: The RH Bill remains in the balance in the Philippines as Catholic Bishops put up new road blocks; Iran bars female students from 77 science- and technology-related fields of study at 36 universities; and South Korea re-considers emergency contraception access as their fertility rate dwindles. 

Philippines: Church Boldly Delays RH Bill Passage, Begins Inquisition of Supporters

As the RH Bill moves slowly but steadily forward in the Philippines, irate Catholic Bishops have a new tactic to affect its delay. They are pushing for a period of amendments to be allowed following the vote to end all debate on the bill August 6, which they have referred to as a blitzkrieg. “It’s not delaying. It’s about using existing parliamentary procedures because this has plenty of loopholes. We foresee that this period of amendment, hopefully, will take a while,” said Friar Melvin Castro, executive director of the Catholic Bishops’ Conference of the Philippines. Perhaps the CBCP is hoping to simply tire out their opponents, but the RH Bill has overwhelming support throughout the country and the world, and that won’t soon change. The bill, which would grant historic access to contraception and sex education to the country’s vast and impoverished population, is backed by the majority of Filipinos, the United Nations, countless global child-welfare, human rights, and women’s health groups, and the President himself. The bill has been erroneously represented as promotional of abortion, a procedure entirely restricted in the country. In addition, however, the Church has launched what can only be considered an inquisition, investigating 159 faculty members of Ateneo de Manila University, a Catholic university, for signing a letter of support for the bill. If they are found guilty of espousing teachings contrary to those of the Church, they will lose their jobs. Via Philippines Daily Inquirer.  

Iran: Women Barred From Studying Science and Engineering

Iran’s Ministry of Science, Research and Technology has barred women in 36 universities from 77 fields of study, according to recent national news reports. While more than half of university graduates in 2009 were women, the unemployment rate for women graduating in science, engineering, and technology-related fields has remained extremely high. This is a justification for the ban, according to some (men) in higher education: “We do not need female students at all,” said Gholamrez Rashed, head of the University of Petroleum Technology. Difficult working conditions in Iran’s oil industry are a main reason for not admitting women, he said. Though gender segregation pervades Iranian society in many ways, literacy and access to education has been relatively equal since the Iranian Revolution in 1979. Prominent Iranian feminists see this latest ban as an effort on the government’s part to counteract important gains for women in recent decades. Iranian feminist Shirin Ebadi, a human rights lawyer who endured imprisonment and persecution then earned a Nobel Peace Prize, wrote an open letter to the United Nations this month: “The Iranian government is using various initiatives, laws and policies to restrict women’s education and their active presence in society, to return them to the house so that they may stop fighting for their rightful demands and let the government go ahead with its erroneous policies.” Via Bloomberg.

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South Korea: Planned Reclassification of Birth Control Pills Draws Controversy

The Korean Food and Drug Administration is proposing a reclassification of contraceptive and emergency contraceptive (EC) pills as part of the agency’s efforts to reconsider the classification of all medications sold in the country. Currently, oral contraceptive pills are available over the counter, while EC requires a prescription. Under the new proposal, the regulations would be switched, with EC available over the counter and birth control pills prescription-only. There has been considerable response from doctors, pharmacists, and women’s health advocates, and as a result the government has postponed the reclassification. There also has been the usual outcry against unfettered EC availability, that it would promote use of EC in lieu of more consistent contraception and promote promiscuity. There has also been suspicion over financial motivations for the regulation switch, and whether it would be pharmacies or hospitals that would get paid. Regardless of access, South Korea’s fertility has been quite low in recent years, at just 1.21 per woman. Last year, Bloomberg reported that a persistently low birthrate was South Korea’s main obstacle to economic growth. Abortion is restricted in the country, though readily available, and recent efforts on the part of advocates have sparked historic national discussions on the issue of access. Via The Korea Times.

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