“Times of crisis act as a revealer, like in photography, highlighting the true consequences of everyday violations and the gap in reproductive rights. Things that go on normally in ‘ordinary times' become more acute and more visible in times of crisis.”
UCLA International Institute, April 20, 2016 — “We need to assure reproductive rights in so-called normal times because we cannot predict when a crisis will come. We shouldn't wait until ‘Sex in the Time of Zika’ is upon us,” said Françoise Girard at UCLA.
A longtime advocate and expert on women’s health, human rights, sexuality, and HIV and AIDS, Girard is president of the New York–based International Women’s Health Coalition (IWHC). The IWHC partners with women’s groups in Africa, Asia, Latin America and the Middle East to support women’s health. The nonprofit organization funds and supports the priorities of local women’s groups in these regions, with a focus on women’s reproductive rights, health and services, as well as comprehensive sexual education. The IWHC also lobbies for women’s rights at the United Nations, where — as part of a coalition of 600 women’s groups worldwide — it recently helped make gender equality one of the newly adopted Sustainable Development Goals.
Girard spoke on April 7th at an event organized in recognition of International Women’s Day by the UCLA International Institute and cosponsored by the UCLA Luskin School of Public Affairs, UCLA Center for World Health, International & Comparative Law Program of the UCLA School of Law, and the Iris Cantor - UCLA Women’s Health Center. Among the attendees were a number of faculty from these schools, as well as from the Geffen School of Medicine and Fielding School of Public Health at UCLA, who together with students and other audience members, participated in an informed discussion after the speaker’s remarks.
Zika makes constraints to women’s reproductive rights more visible
Girard noted that the rapid spread of the Zika virus — known to cause a wide range of fetal abnormalities, including microcephaly — was already exacting a heavy toll on the health and economic survival of poor women in the Global South. In many developing countries, limitations on women’s reproductive rights and reproductive health services mean that poor women cannot reliably access affordable contraception or receive safe abortions except in cases where the mother’s life is threatened.
“Times of crisis act as a revealer, like in photography, highlighting the true consequences of everyday violations and the gap in reproductive rights,” observed Girard. “Things that go on normally in ‘ordinary times’ become more acute and more visible in times of crisis.”
Deteriorating and/or underfunded public health systems in certain countries have also been neglecting mosquito control efforts.* “Mosquitos,” noted the speaker, “breed particularly well in slums, where few homes have air conditioning and where people spend a lot of time outside.” As a result, an explosion in Zika infections is now occurring in Brazil, particularly in the Northeast.
Poor women exposed to the Zika virus while pregnant can find themselves further impoverished when they become mothers, as the care of a neurologically disabled child means they can’t work. She cited a case of a young pregnant woman who had consulted an IWHC partner organization in the hard-hit Brazilian state of Pernambuco. The 19-year-old student, who was finishing hairdressing school, suspected that she had contracted Zika a month before. “She doesn't want to risk having a baby with special needs, as this would place a huge burden on her poor family,” explained Girard.
“What is the response of the Brazilian Ministry of Health? Well, they've told Brazilian women not to get pregnant, that’s it,” said the speaker. “No other information has been provided and women have basically had no support and no services.” Girard said that Brazilian women’s groups were launching court cases to win mothers with microcephalic babies the right to disability welfare payments at the state level. They have also brought a case before the Supreme Court of Brazil with the hope of securing the right to abortion in the first trimester of pregnancy for pregnant women who have contracted Zika. Yet microcephaly cannot be diagnosed at three months, observed Girard, and women are being infected during all stages of pregnancy. “We are going to have to face the question of late abortions,” she contended.
“Neglect of reproductive rights is not new in Brazil and it has hurt Brazilian women for many years. But with Zika, it has become catastrophic,” she continued. “You may ask, will this move Brazilian lawmakers to do something about it? So far, no. In fact… ultraconservatives in the Brazilian Congress are moving in the other direction… They are looking to prohibit abortion altogether in cases of rape and now they seek to set a penalty of 20 years in prison for women who seek abortions in cases of Zika. It’s just cruel and grotesque,” she remarked.
While such challenges may appear specific to Brazil (or to the Global South more generally), Girard emphasized that poor American women could face many of the same problems should Aedes mosquitoes reach the American South. “Reproductive rights in this country, as you no doubt know, have faced an onslaught in the last 20 years. Nearly 900 bills restricting abortion access have passed at the state level in the last 20 years,” she said.
“When Zika hits a large portion of the South,” asked Girard, “what will we do? Imagine Zika in Texas, where half of the state's abortion clinics have already been shuttered… Imagine Zika in Mississippi, where there is only one clinic providing abortions in the entire state and access to contraception for poor women remains limited. Imagine being told not to get pregnant in those conditions.”
From left: Bonnie Taub, associate director, Latin American Institute; Cindy Fan, UCLA vice provost
for international studies and global engagement; Françoise Girard, IWHC president;
and Gail Kligman, associate vice provost, UCLA International Institute.
Women’s reproductive health: A global view
Improving women’s health and human development in the developing world, argued Girard, means ensuring their reproductive rights, providing affordable reproductive health services (including contraception and safe abortions) and making comprehensive sexual education available to both girls and boys.
“We [the IWHC] want to address the underlying factors in gender inequality,” she said. “In the last several years, we've persuaded UNESCO and several important agencies to adopt this approach of doing gender equality education from the earliest grades. So we talk about the differences in the socially constructed roles of boys and girls, and men and women, from a young age… We need to change the gender norms so that we can ensure true equality.”
Doing so, she insisted, means having frank discussions about sex, sexuality and what goes on behind closed doors. Prior to the advent of antiretroviral drugs, Girard said this was the approach used to limit the transmission of HIV/AIDS, but “once the antiretrovirals came on the scene, suddenly the topic of sexuality could be avoided.” Today, she said, “the leading cause of death among women of reproductive age in the developing world [today] is HIV and AIDS… By age 20 in South Africa, for example, 5 percent of 20-year-old men are infected with HIV, but 20 percent of 20-year-old young women are infected.”
“If you don't talk about sexuality and about sexual relations, unequal power, it doesn't work. That's why I think we have failed miserably to prevent HIV in adolescent girls around the world and in South Africa: because we haven't wanted to talk about these questions… and until we do,” she added, “we're not going to crack the prevention question.”
Interventions by the Global North rolling back progress
Hard-won gains in women’s reproductive rights won by feminists around the world are also being rolled back, argued Girard. Not only do the Catholic Church and “conservative clerics in all religions and denominations continue to fight reproductive rights at the global and country levels,” she said, “[they] continue to mount a rearguard attack on modern methods of contraception.”
“The opposition to reproductive rights also fights access to safe abortion, access to comprehensive sexuality education and access to sexual and reproductive health resources for unmarried adolescents all over the world — and also here,” she said.
“We are seeing an exporting of the methods, and the arguments and the money of the United States’ right wing abroad,” she continued. “The same arguments, phrased in the same way, the same talking points, and some of the same individuals pop up in places like Uganda, Nigeria, Kenya, and so on… We [the IWHC] have a message that talks about all of women's lives and is more nuanced. They have a very simple message, plus they have churches on the ground. They have the ability to organize at the ground level and take action against women's rights.
“It's very concerning and it has blocked progress where we were expecting progress, the case of Kenya, for example,” she continued. The constitution adopted by that country in 2010, explained Girard, “recognized the reproductive and abortion rights of women in an effort to address the very high rate of maternal mortality in Kenya.” Two years later, she recounted, “Kenya's Catholic bishops successfully pressured the Ministry of Health to withdraw a directive it had already issued to all hospitals in the country that would have allowed doctors to be trained in safe abortion procedures in public hospitals.”
“This, of course, affected primarily poor and young women, who rely on public hospitals everywhere -- where services are free of charge or at least nominally free of charge,” she said. “Too many governments around the world, encouraged by and closely allied with this opposition, continue to either actively repress women's rights to control their bodies and fertility, or they turn to [repressing] reproductive rights, leaving women and girls to fend for themselves,” she said, noting that an estimated 21 million unsafe abortions take place around the world every year, resulting in some 22,000 to 40,000 maternal deaths.
* Zika is spread by Aedes mosquitoes.