Health is a Basic Human Right, not a Commodity


ON THE NINTH INTERNATIONAL CONFERENCE WOMEN AND HEALTH

"A wrong message is going around the world. Health, education, justice, and free political participation have not been given to people as charity, those are basic human rights."
Mary Robinson, Ireland

The conference was held from August 12th to 17th in Toronto, at York Univer¬sity , and with the participation of more than 400 activists from five continents. From the area of the former Yugoslavia, the author of this report and an activist of CESI (Center for Sexual Education of the Young) from Zagreb were present. The conference was organized in the form of plenary sessions, with around twenty workshops, panel discussions, and video projections being held daily.
These conferences are part of the activi¬ties of the international autonomous women's movement, and they have been held since 1975 by autonomous networks for women's health.
At this conference, the basic topics were the following: reproductive and sexual rights, violence (state and domestic), global health, and ecology.


WHAT POSES THE BIGGEST THREAT TO WOMEN’S HEALTH AT PRESENT?
"We cannot and must not divide the world into the North and the South, because there is the North of the South and the South of the North. but still, we are facing more problems in the south..." (Maria Hose Olivera, Brazil)

Here are a few facts and data that were presented at the Conference:
- T feminization of poverty: 70% of women in the world are poor—i.e. out of 1.3 billion poor people, 70% are women. The gap between the North and the South is deepening and poverty is spreading at an accelerated pace.
- The privatization of medical services: the so-called reforms of health services, assisted by the World Bank and similar institutions (according to the reports of the Women's Health Movement from many countries, primarily from South-East Asia and Latin America) generates even more inequality, especially concerning women. Social services and health insurance are scrapped, state hospitals are being closed down widely in poor countries; the quality of services is deteriorating: health has become a commodity, a piece of capital ("those who do not have money have no health either"). Health has permanently lost the status of a human right. Women's bodies, especially the bodies of women in poor countries, have become a testing ground for medical experiments; the medicalization of the body for the sake of generating profit for the pharmaceutical industry has become a threat for women due to the overuse of medicines during menopause, pregnancy and child¬birth. On the other hand, illegal abortion is still a reality for the majori¬ty of women in the world, and is one of the major causes of death among women in poor countries.
- War and militarism: these induce and justify all kinds of violence against women. Military expenses are ever increasing (globally, 800 billion dollars are spent each year on military budgets, with the USA spending 500 billion dollars per year on defense), whereas expenses for health services, education and culture are constantly being reduced.
- The globalization of conservatism and fundamentalism: the theocratization of the state and disappearance of its secular fea¬tures; the strengthening of the clerical-fascist, pro-life movement in the world; and the interaction between the churches and those movements. As a conse¬quence, there are fewer women in positions of power than there used to be (UN Human Development data).
- The rise in state and political violence: there is a direct link between domestic violence and state violence. The war against terrorism, that has been launched by Bush's government after 11th September, has introduced new forms of interventionism in the world. It excuses and justifies the suppression and even crushing of democratic forces, and is used as a pretext for the massive violation of human rights.
- AIDS: over recent years, the AIDS pan¬demic has become feminized, especially in Africa. 44,7 million people in the world have contracted AIDS, out of whom 16,4 million are women, predom¬inantly of heterosexual orientation. Africa accounts for 70% of the AIDS cases, and the area south of the Sahara is the most affected in the world.
- Pollution: 40% of deaths in the world are a consequence of pollution (according to research conducted at Cornell University), and five million children die every year from respiratory diseases. We can even talk of a breast cancer pandemic (one in nine women is affected by breast cancer, whereas this ratio used to be 1:30): pesticides destroy women's bodies, the poison contained in the food is omni-destructive. Women living in the North are even more exposed to pollution than those living in the South. Armies are the major polluters, provoking environmental and other disasters everywhere.
- Traditional practices and customs: in the name of preserving "cultural specificity," women are subjected to some of the most brutal forms of violence: for example, genital mutilation is a reality for dozens of millions of African women. The patriarchal control over women's reproductive capacities is a universal fact in women's lives; all fundamentalists aim to control sexuality and to prescribe desirable forms of reality, one of its manifestations being murdering women in order to protect the honor of the family or clan.
- The health of women activists is threatened by activism: most feminist activists do not have social or health insurance, which is not financed by donors or by the international NGO-s: "The feminsts constantly talk about other women's health, while half of us here are ill...." A Venezuelan activist).

REPRODUCTIVE AND SEXUAL RIGHTS: CHALLENGES, NEW PROCTICES…
At UN conferences held in the course of the past decade (Vienna, Cairo, Copenhagen, Beijing), the governments of 180 countries reached a general consensus that women's rights are human rights, that sexual rights and reproductive rights are women's human rights, and that abortion is a public health issue. Therefore, member states accepted the recommendation to liberalize abortion.
The platforms and the so-called action programs from the above mentioned conferences are one thing, but reality is quite different, because "women's reality is even worse than it used to be." The only changes in the governments are on the rhetorical level, a far cry from implementing the adopted documents.
The feminist movement participated at all the UN conferences (at its alternative forums), yet with utterly modest effects. That is why the feminist strategies are being changed, more as a result of practical, pragmatic attitudes than because of ideological concepts. One of the most important examples of this is the activity of the IRRRAG (International Reproductive Rights Research Action Group) network.
This group is made up of feminist researchers, medical workers, and activists. They embarked on their research project in 1992 in seven countries (The Philippines, Malaysia, Mexico, USA, Nigeria, Egypt and Brazil). The third phase, which started in 1999, is currently under way. One significant point is that men have been included both in research teams and as interviewers.

WHY HAVE MEN BEEN INCLUDED?
From the analyses and findings of two researchers, Rashida Abdullah (Malaysia) and Radika Ramasuba (India), the arguments for the inclusion of men are the following:
- In most cultures and societies, men play a key role and have the power. Therefore, without getting acquainted with men’s views, and without empowering women for negotiations, it is not possible to expect changes in the position of women;
- Though the research aims to improve the position of women and to include male participation, it must by no means decrease women's freedoms, but rather, empower them;
- The efforts of the women's movement (since the 1970's) to alter the behavior of men in this sphere, so that they would assume more responsibility, have been fruitless—the entire responsibility in the reproductive sphere is borne by women;
- In spite of the fact that family planning programs encourage the use of condoms, the rate of their use has remained the same. In all contraceptive methods, women are the main protagonists, and also objects, while men are relived of responsibility;
- Objectives such as achieving gender equality, decreasing or increasing demographic growth, or decreasing risk of contagious diseases cannot be achieved without male participation.
The research methodology is very innovative, the research team being made up of men and women, with the implementation of a "gender active dialogue." However, difficulties have occurred in working with men: it is more time-consuming than doing interviews with women, confidence-building time is much longer; the researchers have to be well trained for applying qualitative methods and analyses in order to be able to discriminate between what men are saying and what they are doing.
In view of the fact that this type of research is time consuming, this approach poses a problem with the founders because the research requires far more time and money. The financial crisis has reduced project expenses to 40% and IRRRAG is facing a serious problems in fund-raising.
The aim of this research is to answer the following questions:
- Can reproductive rights apply to women only? do men have reproductive duties ,and what are they?
- Do men negotiate from power positions, and in which cases can the responsibility be shared between dominant men and subjected women? Do men have reproductive rights?
This phase of the research revealed the following:
- Where strong social movements are present (Mexico, Brazil), men's response is much higher;
- Men who work on issues connected with violence against women are more sensitive to women's issues;
So far, the research has found the following about women’s expections:
- Women have a very ambivalent attitude regarding men's expectations;
- Very often, women condone men;
- Women want men to become more involved into their lives, but exclusively on the condition that they become more sensitive to women's needs;
- Men's participation is not desirable if it entails even more pressure on women's freedoms:
- Much more than economic support (particularly in Mexico, Nigeria and Malaysia) what women expect from men is emotional support, respect and acknowledgement, which men are, unfortunately, unable to provide;
- Women want men to put an end to domestic violence;
- Women want men (their fathers, husbands, brothers and sons) to stop drinking.


POPULATION POLICY—REPRODUCTIVE RIGHTS
"The population control has remained the same, it is only the discourse that has changed." (Farida Akhter. Bangladesh)

At UN conferences in Cairo. Beijing, and Copenhagen, new criteria for population policy were introduced: demographic goals (the decrease or increase of the population) must be replaced and integrate women's reproductive health, needs, and wishes.
Over the past decade, pressure on autonomous women's health networks and progressive medical workers has led to certain reforms. Unfortunately, every form of population control, even when it is euphemistically called family planning, is essentially patriarchal in character: women are still responsible for demographic growth. The woman's body is the object of medical research and experiments, and "nearly all contraceptive methods take the responsibility for contraception and power relations between the sexes off the men’s shoulders." The most harmful and the most dangerous for women are the hormone capsules of long duration (the most widespread being Depo Provera and Norplant, which are in use predominantly in poor countries, but are also widespread among poor women and women immigrants in developed western countries) as well as the "new methods," i.e. immune-contraceptive and anti-fertility vaccination (the most widespread being Kinakrina, which is also imported by Croatia). At first sight, it could be inferred that women have a reproductive choice, but this is not true. Reproductive choice excludes compulsion and childbearing according to state or national goals and comprises the application of reliable and harmless contraceptive methods.
The patriarchal character of all forms of demographic control is also revealed by the fact that men are still being exempted from responsibility. Not only do men fail to use condoms (with usage rates of only 6% on the world level, and only 4% in FRY), but also so far, science has only invented condoms and vasectomy for them.
Demographic control (the decrease or increase of the population as the function of a certain state, nation, religion, or race) remains a priority in many countries. On the one hand, the fundamentalists and pro-life movements are launching cam¬paigns against all contraceptive methods, and on the other, they profit from importing utterly dangerous and harmful contraceptive methods.

ABORTION
"Abortion is inseparable from the concept and practice of democracy, is it a question of social justice." (Catholic Women for the Right of Choice, Mexico)

UN members have recognized abortion as a public health issue, and have therefore adopted the recommendation that legislation regarding abortion should be liberalized.
The feminist health networks regard abortion as a democratic issue, because:
- It means legal recognition of the ethical competence of women concerning reproduction, sexuality and intimacy;
- Abortion is an issue pertaining to public health services and social justice.
However, abortion is still one of the major causes of women's death throughout the world. Every day, 55,000 women throughout the world have abortions performed in illegal conditions, and every year more than 20 million women abort illegally, risking their lives.
The reality of women in the whole world has not been changed by resolutions and platforms because national legislations, even more than before, punish women, relieving men of responsibility. On the global plan, the state and legislators are increasingly succumbing to the influence of the church and ultra-rightist circles.
In Latin America, governments have devised new strategies against abortion, i.e. they have launched new forms of fundamentalist offensives against reproductive rights and sexuality:
- THE DAY OF THE UNBORN CHILD / DAY OF THE FETUS, in accordance with the Vatican recommendation regarding the protection of fetuses. This mentality has not remained only on the ceremonial level, but has been incorporated in the penal code: medical workers can be persecuted for the "violation" of the fetus’ rights.
- -THE BAN OF THE EMERGENCY CONTRACEPTION: This pill that does not provoke abortion, but rather is an effective means of contraception which can prevent thou¬sands of abortions. Owing to the pres¬sure exerted by the feminist movement, many countries in Latin America have undertaken the commitment to include free distribution of "the morning-after pill” in their health programs.
- THE CONDOM: The Catholic Church prohibits the use of the condom or any other form of contraception.
- COMPROMISING / BANNING of sexual education. For example, the program of sexual education has been discontinued in Chile under pressure from the Catholic Church.

FUNDAMENTALISM
"The universal model practiced by fundamentalism is violence against women." (WLUML - Network of Women Living Under Islamic Laws")

It is worth mentioning that:
- Fundamentalism uses of religion, culture, and ethnicity for political ends, in order to seize political power;
- Fundamentalism takes advantage of religion, cultural heritage, and ethnicity in order to assume and spread control over women, especially over their reproductive capacity and sexuality;
- The basic aim of fundamentalism is to win political power so as to control women's lives; it is a political tool for controlling people and remaining in power;
- Religious fundamentalism is not a religious movement, but an extremist right-wing political movement.
Fundamentalism is also a reaction and a response to the efforts of the autonomous women's movement to organize and to make decisions.
What are the characteristics of the present-day fundamentalist movement?
- The combination and synergy of conservative and retrograde rightist forces—the Shadow Fundamentalists—and the fundamentalist religious leaders—the Open Fundamentalists;
- Fundamentalism occupies the private sphere much more than the public sphere and rests in the authority and power of the family: the aim of the fun¬damentalists is to deal with education issues, to enter educational institutions and influence the curricula;
- Religious fundamentalism is no longer under the control of fundamentalist leaders, because "fundamentalist conservatives are far more dangerous and therefore the activities of such groups have to be closely watched" (Frances Kissling);
- Fundamentalism is a "world movement, assembling religious fundamentalist sectors, the ultra-rightists everywhere in the world (particularly in the USA, with Bush as their paragon), the Italian and French neo-fascists (Berlusconi, Le Pen) that oppose multi-culturalism, promote racism and the cultural superiority of the white race, opposing the equality of the sexes, reproductive and sexual rights" (Esperansa Seron, Columbia).
The fundamentalist conservatives throughout the world win the votes of discontented masses, of depoliticized and frus¬trated people...and such is the experi¬ence that we have had in this area for over ten years now.
The fundamentalist conservatives every¬where in the world create strategic alliances: for example, the Vatican is not fond of Islam and the Islamic leaders do not like the Catholic leaders, but they create alliances in order to promulgate their fundamentalist ideology. This has been another familiar situation for us over the past ten years.


BUSH LEADING THE AXIS POWERS OF GOOD
"Since September 11th, Bush has divided the world into two poles: into the good and the bad. the righteous and the subversive, while the feminists are. in Bush's opinion, on the evil and subversive side." (Eteldrita Ajbar. Peru)

Not only since September 11th. but also since the moment he took office, Bush has been pursuing an extremist, interventionist policy. Beforehand, Bush's government had introduced a series of measures and restrictions applying to NGOs that receive funds for family planning. Let us mention a few of them:
- THE LAW ON GLOBAL OBSTRUCTION: Bush's administration has reactivated the Helms Amendment (1973), forbidding funds based in the USA to support abortion-related activities. In January 2001, Bush's administration revamped this requirement: foreign organizations, which are often the only ones providing health services for women in the Third World, have been forbidden to perform illegal abortions, even in case of mental and physical violence (the only exception being rape and incest); to provide information and counseling about abortion; to exert pressure on governments for the legalization or depenalization of abortion; or to implement educational campaigns related to abortion. As a consequence of this law, NGOs receiving funds for family planning (mostly through USAID) in at least 59 countries have been affected; in 17 of those countries abortion is legal, while in 19 there exist restrictions. In 23 of those countries, where abortion is totally illegal, the freedom of thought and expression are suppressed. A number of moves were taken against this law, both at the Senate and Congress level and at the NGO level. However in May 2002, the US Congress refused to revise this law.
- SEXUAL ABSTINENCE: Bush’s government supports programs for the promotion of sexual abstinence, so that in 2001, 20 million dollars were allocated for such purposes from the American budget, and an increase has been envisaged for the year 2002. Some other countries have joined this trend: for example, Belarus has been trying to amend the liberal abortion law (1978). However, it is worth noting that France has further liberalized its abortion law (adopted in 1975) by extending the time limit for the termination of pregnancy from 10 to 12 weeks.

WHAT CAN BE DONE?
- Continue to put pressure on the governments to abide by the conventions they have signed on the international and regional levels;
- Support international networking, so that the governments would know that their activities are being monitored on the global level;
- Demand that the UN and individual countries increase financial means for the realization of the goals set at international conferences;
- Insist on the secular character of states (the separation of the church from the state) and prevent churches from interfering with political processes; demand from the governments and legislators to keep the church out of public politics.

WHAT ARE THE ALTERNATIVES?
"A different world is possible.” (The Social Forum)

- Instead of an unjust globalization, a CREATIVE, JUST, and FAIR GLOBALIZATION (comprising social justice, peace and non-violence) should be conducted;
- The influence of corporate policies of multinational companies on everyday lives should be examined;
- People should be empowered on the local level—the decentralization of power.

THE FEMINISTS CONFRONT CHALLENGES AND OFFER ALTERNATIVES
"Feminists should not be part of the elites, but activists.” Farida Akhter)

Many different experiences as well a many recommendations were heard at the conference:
- It is indispensable to create real alliances of solidarity within the feminist movement (for example, how Latin American feminists operate on continental dimensions regarding many issues);
- The feminist movement should link its struggle with other social movements, i.e. it is necessary to create strategic alliances. "We have to look for alliances and allies, with whom we might not always share all ideas and issues, but we must make an effort in that direction. That is why the role of networks is so important in rallying and negotiating common actions" (Esperansa Seron, Columbia); or "repressive forces are all the stronger and united, and therefore groups for human rights have to combine their activities and work together, i.e. women's groups should not conduct their activities separately" (Betsy Hartman, USA);
- The experiences of poor women have to become the object of our interest and "the more we base our activities on the experience of those women, the more will they be connected to the reality that surrounds us and not with ideologies, the more efficient they will be" (Joanna Kerr, Canada);
- Take activist organizations as a starting point and rely on some of their practices: "I am a university professor, but above all, I am an activist. I have gone through three phases: learning, acting and encouraging others to act" (Anne Firt).


SOME INITIATIVES ON THE GLOBAL AND REGIONAL PLAN:
- THE WORLD SOCIAL FORUM, whose slogan is "A different world is possible."
- Many women think that our interests can be represented better at such forums rather than wasting our energy and knowledge at UN alternative forums;
- The third WOMEN'S WORLD STRIKE: an activist movement against unjust globalization and exploitation, a direct protest against war and violence and military expenses. Organizations and individuals from more than 60 countries participated in this strike;
- SEWA: the Self-Employed Women’s Association in India supports some forms of liberalization of trade that create job opportunities for poor women;
- THE PRACTICE OF BARTER AND EXCHANGE outside the official economic trends in any Latin American countries, especially after the Argentinean collapse, involves millions of people and is still an unexploited field, seen by many as extremely promising;
- THE INTERNATIONAL COUNCIL FOR POPULAR HEALTH: a world coalition of progressive individuals, movements and groups, dedicated to striving for the basic right to health and for essential health services, which have been scrapped by the global and national economic policies

Report prepared by: Stasa Zajovic


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