Women’s Health

“Grace”, Survivor:

He (my husband) used to take advantage during the lockdown, because he knew I couldn’t go anywhere.

He beat me up so badly, something he was used to doing. That day I thought he was going to severely hurt me, because he kept saying he’ll kill me one day.

Nereah Akoth, Counselor, Center for Rights Education and Awareness (CREAW):

Gender-based violence has become a national disaster in this nation and therefore, it needs to be dealt with as a national disaster.

Nairobi, Kenya

Nereah Akoth, Counselor, Center for Rights Education and Awareness (CREAW):

When COVID came, it came with that component of social distance.

If you are in a situation where the husband is the one who is working, now, he uses the power

which is having the money to now manipulate or abuse this other person.

So home became a danger in the sense that you are forced in one way or the other to be with the perpetrator, with limited options.

The Kenyan government should ensure women and girls at risk of gender-based violence have access to adequate medical and mental health services, safe spaces, financial support and justice.  

This is particularly critical during pandemic-related lockdowns. 

Nereah Akoth, Counselor, Center for Rights Education and Awareness (CREAW):

We were supporting so many clients who were going through GBV [gender-based violence].

We are now having around 1,500 cases. That's already triple the number compared to 2019.

Shelters were overwhelmed because of lack of resources. They are understaffed.

Trans Mara East, Kenya

In 2020, Gladys Koskey received a call from the police about a child who had been abused.

Gladys Koskey, Community Activist:

The child is small, the mother is sick in the hospital and they are poor. The police asked Gladys to care for the child.

Nereah Akoth, Counselor, Center for Rights Education and Awareness (CREAW):

The community activists, they become the first responder. And then now that also raises issues of child protection, how safe is this child with this, with this activist? Because probably they are not trained in issues of protection.

But even if they are trained, they need extra support because you find out that they rescue using their own finances.

Gladys Koskey, Community Activist:

When she was brought to me, her condition was not good, she could not walk. She was afraid to go out and play because she did not have the strength to walk. What really helped the girl was talking to her and counseling. It took her about two months to recover. She then started going out to play with the neighbors.

The government has never given me anything. They just ask me to live with the child as my own, as they sort out the case. I volunteer to take care of these children because if I don’t, they will be oppressed.

Nereah Akoth, Counselor, Center for Rights Education and Awareness (CREAW):

It's the government's responsibility to take care of its people.

Violence has a way of affecting somebody's mental well-being to a point of sometimes even making smaller decisions becomes very difficult.

So, by the time a woman is deciding to come out of an abusive relationship, there needs to be a lot of support.

“Grace”, Survivor:

I made a decision to leave. I went to the hospital and then went directly to the police station. I used to live a life of fear. At least here, I’m able to relax. The counselor comes to talk with me.

Trans Mara East, Kenya

Gladys Koskey, Community Activist:

We went to the Chief, because we refused to see our fellow women being battered. We said we want to go around teaching and sensitizing our women (to the problem).

Those in government, all they do is talk. We want the government to intervene because personally, it’s overwhelming.

The Department of Children Services should set up a child  protection referral system, with adequate monitoring and  support for community organizations, extended family or foster families when children are placed in their care. 

Community activists like Gladys who foster survivors, should be equipped with the skills and tools, including financial support, to provide these services. 

Voiceover:

“Maria” was 20 years old when she spent four months in a prison cell with her three-year-old son. While at work one day, she slipped and fell down the stairs. She started bleeding and was in pain.

She went to the hospital and learned she was having a miscarriage. Prior to this moment, she didn’t know she was pregnant.

The doctors told her everything was okay, but she was later arrested for allegedly having an abortion.

Ana Vera, Lawyer:

In Ecuador, women cannot be arrested for having an abortion in certain cases.

The first is when the life or health of a woman is in danger that cannot be avoided by other means. And the second is when the pregnancy is the result of rape. 

However, what usually happens is that mental and social health, for example, are not taken into account.

Voiceover:

“Soledad” was 38 years old when she found out she was pregnant with her first child. This was a wanted, planned and welcomed pregnancy for “Soledad” and her husband.

One day, she felt a sharp pain which made her go to the bathroom. She gave birth prematurely there and lost her daughter.

When she got to the hospital, the doctors assumed she had induced an abortion and they called the police. She was taken to prison.

From the 148 cases reviewed by Human Rights Watch, 73 percent of the prosecutions for alleged abortion were initiated after a health care provider reported a patient to the police in violation of medical confidentiality.

Dr. Susana Guijarro:

The professionals working in the health system are very afraid of being prosecuted of being imprisoned because they are also unclear about the law.

Voiceover:

In the cases where health care workers reported their patients, they were violating legal requirements protecting medical confidentiality.

Women and girls accused of abortion are often deprived of proper post-abortion care and encounter violations of their due process rights as well as barriers to accessing good quality legal representation.

Even though “Soledad” continued to bleed for days in prison, no doctor came to care for her or make sure she was safe.

The prosecutor charged her with aggravated homicide. She faced being sentenced up to 26 years in prison.  She was found not guilty at her trial. By then, she had already spent five months in jail.

Ana Vera, Lawyer:

The criminalization of abortion is a matter of social injustice, where the most impoverished women suffer the most consequences.

Dr. Susana Guijarro:

The poorest women don't have any access (to abortion) and they have to seek methods, the most inadequate methods, which lead to infections which can even lead to death.

Voiceover:

“Elena” was 21 years old, married, living in poverty, and with a child  when she was raped and became pregnant. She knew her reputation would be ruined if word got out that she was pregnant with someone else's child.

“Elena” took medication to end her unintended pregnancy. In Ecuador one in four women experience sexual violence.

Until April 2021, abortion after rape was criminalized unless the pregnant person had an intellectual disability.

Ana Vera, Lawyer:

Women are very afraid to report situations of sexual violence when they become pregnant because they think that they are the ones who may be prosecuted.

All the fear and the stigma that exists for victims of sexual violence is compounded by the fear and the stigma that exists about abortion.

Voiceover:

When “Elena” started having severe stomach pain and cramps, she went to a public hospital. The doctors who were treating her reported her to the police. She was arrested and placed on trial.

She told the judge: “Yes I used the pills. I didn’t want to have [the baby] because it was the product of rape. I didn’t want my family to find out.”

She was sentenced to 12 months in prison and was released after seven months due to good behavior. Her allegations of sexual violence were never investigated.

Ana Vera, Lawyer:

I believe that the criminalization of abortion is not an effective measure for anything; neither to reduce the number of abortions, nor to prevent women from getting pregnant, nor to prevent sexual violence.

I think it is a violation of human rights, but the denial of legal abortions could even constitute a form of torture, cruel, inhuman and degrading treatment, according to international standards.

Voiceover:

The criminalization of abortion has a devastating impact on the lives and health of women and girls.

The Ecuadorian Constitutional Court’s ruling to decriminalize abortion in all cases of rape is an important step.

Newly elected legislators and resident Guillermo Lasso should remove all criminal penalties for abortion and guarantee effective access to abortion on all legal grounds. 

Voiceover

Afghanistan's future looks uncertain as US troops prepare to leave the country before September 11, 2021.

In the years after the US-led military invasion and the defeat of the Taliban government in late 2001, the Afghan government and international donors gave priority to developing an effective health system, including extending access to basic health care to all parts of the country.

This led to significant improvements for women’s health. But even with two decades of effort and hundreds of millions of dollars spent, delivery of health services for women and girls remains far below international standards.

Dr. Najmusama Shefajo, Head of Afghanistan Ob/Gyn Society

Our maternal mortality rate nowadays is 638 per 100,000 live births. It is a shocking number.

 Voiceover

In the last several years, donor support to Afghanistan has been falling. Services that were already inadequate are further deteriorating. 

Women and girls often struggle to access even the most basic care. Access to contraception. Access to prenatal care. Access to safe birthing services. The cost for transportation, as well as medications and the supplies patients are obliged to pay for because government hospitals no longer have enough funding, keeps women from receiving care, with sometimes deadly consequences.

Insecurity and fighting due to the war in Afghanistan also create major barriers to women and girls accessing health care. Health facilities and workers are often caught in the middle of the conflict or even targeted themselves, making it almost impossible at times to provide services.  

In May 2020, attackers killed 24 people including mothers, children, and a midwife in a hospital maternity ward operated by MSF.

Shaharzad Akbar, Afghanistan Independent Human Rights Commission

With the conflict and the uncertainty about the outcome of the peace process, donors are more hesitant about committing funding to NGOs or Afghan governments. In the midst of uncertainty, it’s the most vulnerable, it’s the women, the children, the displaced communities, who are losing out. 

Voiceover

Over 75% of the Afghan government’s budget comes from international donors. Afghanistan cannot afford decent health services without help.

Donor countries should fully appreciate how deep and urgent are Afghanistan’s humanitarian needs, including for women’s health care. They should not use the withdrawal of foreign troops as a justification for disengaging when the need for international assistance is greater than ever.