Reproductive justice remains an unfulfilled promise for Latin American (LA) women. This is particularly the case with regard to abortion. With the exception of Mexico City and Puerto Rico, the region’s laws still embrace either a model of total criminalization (i.e., Chile, Nicaragua or El Salvador) or variations of a hardly accessible model of indications (i.e., Argentina, Brazil, Colombia or Peru). Moreover, irrespectively of the regulatory approach adopted, LA abortion laws share at least two traits: (a) they are largely non-complied with by women forced to resort to backstreet abortions in significant numbers; and (b) they are extensively unenforced both from the point of view of criminal prosecution and from the perspective of the duty to provide legal abortion services when indications are the rule. Another common characteristic of the region’s abortion rules is the stability of the practices of noncompliance and under-enforcement. A stability that has endured the transitions to democracy underwent by a majority of LA countries since the 1980s. As it has proved to be the case with other women rights issues during such transitions, in Latin America, democratization did not equal liberalization.

Faced with the reluctance to embark or even address abortion law reform by politicians and players from all sides in the ideological spectrum, LA feminists turned to international human rights law in search of another tool to promote a liberalizing reinterpretation of domestic laws. Indeed, in the years following the UN Conferences in Vienna, El Cairo and Beijing, feminists increasingly began to explore alternative uses of what was then slowly becoming a more woman friendly international human rights law with respect to many issues, reproductive rights among them. As part of this shift, feminist organizations timidly began to bring cases to international forums. Such feminist move towards international law in the quest for reproductive justice reforms took place in a context in which the internalization of international human rights had achieved some potential and where transnational networks of activists were successfully building a common legal language.

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As I thought harder about the question, I realized that while the civil rights delineated on our Constitution may not demand comprehensive sexuality education, various international human rights documents and directives do. Like the American Constitution, human rights law applies to state action. Unlike the Constitution, however, human rights law demands that nation states take affirmative steps to ensure that all persons have the means and conditions necessary to enjoy their rights.

Several treaties specifically support adolescents’ right to comprehensive information about sex and sexuality, including the Convention on the Rights of the Child (CRC) and the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW). The rights enshrined in these documents do not carry binding legal force in U.S. courts because Congress has not ratified them. However, many courts—including the Supreme Court in Lawrence v. Texas—have cited human rights documents and doctrine as persuasive authority.

Even though international human rights law has various applications to the domestic struggle for reproductive justice, most law students—past and present—have to go outside the classroom to learn about them.  Law Students for Reproductive Justice (LSRJ), a national nonprofit organization that supports law students around the country in their efforts to promote reproductive justice, is filling the gaps left by our coursework.   With resources like the new Human Rights Law Primer and Human Rights on the Home Front Easy Event in an Envelope, LSRJ provides the next generation of legal experts with the information and skills we will need to make reproductive rights a reality for all people.  With these tools, aspiring legal scholars and advocates like me can enter practice ready to articulate well-reasoned arguments that demand access to a full range of reproductive health services and induce government action to effectuate those rights. (more…)

The American health care system has been largely criticized over the last couple of years as administratively burdening, financially inefficient and inaccessible leaving millions of people uninsured without any medical care at all.  But let us look now at the other side of the spectrum: the universal health care systems adopted in most of the European countries. 

The founding idea of universal health care systems is based upon providing health care coverage to all or as widely as possible through some form of government action.  The idea took different forms in different countries throughout Europe according to various socio-economic and cultural circumstances.  In Scandinavian countries and the United Kingdom, for example, the government has a high degree of control in developing and providing health care, basing the eligibility criteria upon residency and not on one’s ability to pay.  In these countries every facet of health care is covered primarily from tax revenues, so that beneficiaries need not pay anything.  Other countries such as France and Serbia developed systems based on mandatory medical insurance with contributory insurance rates deducted from salaries or income, which are usually jointly funded by employers and beneficiaries.  The insurance rates, however, are kept low through subsidies, thus they are considerably lower than US rates.  Sometimes the health care funds are derived from a mixture of insurance premiums and government taxes, and many countries use mixed public-private systems to deliver universal health care.

Although the idea was first achieved on a national level in Germany, in the 1880s, through reforms conducted by Otto von Bismarck, one of the most socialized systems of universal health care today is the English health care system provided by the National Health Service (NHS).  The NHS services are available to all irrespective of an individual’s ability to pay.  The services include among other things; primary care, long-term health care, dentistry, psychiatric care, in-patient care.  Hospitals provide treatment either free or at minimal charges with certain exceptions for optical and dental care (which are still free for elderly, unemployed, children and people on low incomes).  Private health care paid by private insurance coexists with the NHS, but it only covers approximately 10% of the population, providing merely acute care from specialists.  

As idealistic as it sounds, the idea of a universal health care system is not without problems in its practical application.  (more…)

I can’t help but recall Jonathan Swift’s “A Modest Proposal” when I read the internet buzz around the recent U.N. data analyzed in a “FEWER EMITTERS, LOWER EMISSIONS, LESS COST,” a report from the London School of Economics. 

The New York Times Science Blog reports that the data suggests:

[T]hat meeting unmet need for family planning would reduce unintended births by 72 per cent, reducing projected world population in 2050 by half a billion to 8.64 billion. Between 2010 and 2050 12 billion fewer “people-years” would be lived – 326 billion against 338 billion under current projections. The 34 gigatons of CO2 saved in this way would cost $220 billion – roughly $7 a ton [metric tons]. However, the same CO2 saving would cost over $1trillion if low-carbon technologies were used.

The blog is entitled “Are Condoms the Ultimate Green Technology” and the author, Andrew Revkin, writes, “I recently raised the question of whether this means we’ll soon see a market in baby-avoidance carbon credits similar to efforts to sell CO2 credits for avoiding deforestation. This is purely a thought experiment, not a proposal.”

Really? Not a proposal? Pardon my skepticism, but why entertain such a “thought experiment” when the forced sterilizations and “contraceptive incentives” (read coercive family planning) that took place in the Global South at the hands of Western trained academics and physicians are well within the institutional and personal memory of many in the international family planning community? Population experts from that time still lament that the Programme of Action that came out of the 1994 Conference on Population and Development in Cairo, Egypt was “hijacked by feminists.” Yes it was, and as a consequence we have an international document adopted by 179 countries stating that, “The empowerment of women and improvement of their status are important ends in themselves and are essential for the achievement of sustainable development,” and that,  “Reproductive rights…rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so…free of discrimination, coercion and violence.”

These statements and the birth of the Reproductive Justice movement may be the most positive consequences ever to come out of a hijacking.  (more…)

Here’s our latest installment from Lisi Owen, an LSRJ international intern working at Engender Rights in the Philippines. The text of this post is an excerpt from a letter Lisi recently published in the Manila Times.

I arrived in Manila to intern with EnGendeRights, a women’s legal NGO, almost ten weeks ago. As I’m preparing to return to the U.S. next week, I’d like to offer my thoughts on reproductive health policy in the Philippines. My departure conveniently coincides with the CBCP’s recent vow to vehemently oppose the reproductive health bill pending in the House of Representatives as part of its “pro-life” stance on family planning, so this letter is all the more appropriate.

I have a staunchly Catholic friend in the U.S. with whom I shared all the recent news articles articulating the CBCP’s position and vow to oppose the RH bill, and his response was that Filipino Catholics need to “wake up.” Spain, Belgium and other Catholic countries have woken up and changed their laws on contraception, and even abortion, so why is the Philippines still sleeping?
In response to the Church’s so-called “pro-life” position, I have this to say: Life is more than the possibility of a fertilized egg. Life is children living in pushcarts on the sidewalk, wearing no pants. Life is women who risk death every time they get pregnant, but continue to do so because their husbands beat them when they refuse sex in the name of “natural family planning.” Life is sitting on your front step waiting to die, because you’re that miserable, and have nothing else to do.

If the Church is pro-life, then I ask this of the bishops: How do you justify the suffering you cause? This is not a matter of the Church or the government sitting idly by and allowing people to suffer, but an active promotion of misery, and it is wrong.
I recognize the American imperialism that has preceded me in the Philippines, and how that might influence your opinion of my views. But before you dismiss me as another American trying to impose my heathenous, western views on a country that’s seen enough outsiders meddling in its business, let me clarify my position: It is one of choice. If you want to practice natural family planning with your partner, that is your prerogative. If you want to capitalize on the benefits of scientific progress to control your own reproductive health, that is your prerogative as well.

It is not, however, the prerogative of the government to impose its own archaic, paternalistic religious views on the suffering people of a nation, (in violation of both the Philippine Constitution and international law, I might add) such that they are stripped of their power of autonomous decision-making.

Our next intern dispatch comes from Lisi Owen, who is an LSRJ intern in Manila, Philippines. Here’s more about Lisi, and then her first fabulous post.

Lisi Owen is a rising 2L at the University of Denver (DU). She wants to pursue a career in public international law and hopes to some day be able to work for the U.N. At DU she is involved with Amnesty International, LSRJ, the Denver Journal for International Law and Policy, and the DU Law Civil Rights Clinic. Outside DU she volunteers with the Colorado Lawyers Committee, the African Community Center, and Dress for Success Denver.

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Hello from the Philippines! As Emily told everyone last week, this summer LSRJ has placed interns in Thailand, the Philippines and Nepal. I am the intern in Manila, Philippines, and am working with EnGendeRights, Inc., a women’s rights legal NGO.

Our biggest project for the summer is working to repeal an executive order of former Manila Mayor Jose “Lito” Atienza that effectively bans modern family planning services (pills, IUDs, ligation, injectables, vasectomies, etc.) in Manila City. Executive Order No. 003 was instituted in 2000 shortly after Atienza took office, and although a new administration has now taken over, the EO has yet to be repealed.

The effect of the contraception ban has been felt most heavily by poor women who are unable to afford contraceptives and other family planning services from private hospitals or who are unable to spend the time and money to travel to other cities where such services are available. For detailed accounts of the burden the ban has placed on these women, you can check out a report compiled by local Philippine NGOs and the Center for Reproductive Rights, in New York, entitled Imposing Misery: The Impact of Manila’s Contraception Ban on Women and Families, available on CRR’s website under publications.

While we are working hard to pressure the current Mayor, Alfredo Lim, to repeal the executive order, and to pressure the national government to maintain a more pro-family planning stance, we have already made some progress in terms of actually addressing the family planning needs of women in Manila. Through a partnership with Marie Stopes we were able to provide free ligation services for women in Tondo, Manila, which is one of the poorest areas in the entire Metro Manila area. Additionally, last Friday in honor of World Population Day the Reproductive Health Advocacy Network held a reproductive health fair, also in Tondo, at which hundreds of women availed of family planning services. Such an event is unprecedented in Manila, and was a huge achievement given the difficulty NGOs and other healthcare providers have faced in the past in providing family planning services in Manila.

I must reiterate Emily’s point about how amazing it is to actually see the accumulation of my academic knowledge “filled in by the color of experience.” Reading about international law and its implementation and actually seeing it on the ground, so to speak, are two entirely different things. It certainly is inspirational and exhilarating to be a part of the latter!

As some of you may know, this summer LSRJ has set up a series of fantastic international opportunities to send law students into the field, and fight for reproductive justice abroad. LSRJ has put dedicated activists in Thailand, the Philippines, and Nepal. Our crew will be blogging about these experiences throughout the month of July. This first post is by Emily Kane. Emily is a rising 3L at the University of Arizona James E. Rogers College of Law in Tucson, AZ. A native of California, Emily spent her two years in between undergraduate and law school in Washington, DC at the Religious Action Center of Reform Judaism (RAC) doing advocacy work predominantly in the areas of reproductive justice and judicial nominations. She is currently spending her summer as an LSRJ International Intern in and around Mae Sot, Thailand working on international reproductive justice advocacy.

In Thailand, where I am one of two LSRJers placed, we are working on a project through the New York based Global Justice Center. Specifically, we are asking two major questions of international human rights law: 1) are women (and their partners) protected from government pressure and interference in making their family planning choices?; and 2) if maternal birth rates are abnormally high, at what point can a government be blamed? These questions, perhaps seemingly uncomplicated, have not been asked in quite this way and represent uncharted territory in the reproductive justice world. In seeking these answer, we are scouring the net (thank you Westlaw and Lexis Nexis!) and the countryside (interviewing Burmese refugees in western Thailand).

As with all summer law jobs, it is amazing to see the outlines of classroom conversations and mountains of text filled in by the color of experience. Last fall, I took a course about the UN and human rights, related treaties, and the processes by which these treaties are actualized. Reading CEDAW for class last November, while fantastic, cannot compare to reading it now as we try to apply it to the project before us.

Struggling with language barriers, gauging foreign cultural norms, and mining through the vast universe that is international human rights law has been humbling. At the same time, studying the law and (perhaps) finding new avenues to help women attain the international human rights to which they are entitled is emboldening.

The subject line of the email sending me this article read “omg omg omg omg omg.” How else would one react to the following:  an Australian obstetrician/gynecologist, who performed countless surgeries on countless women over the course of his career, has been found to have botched many many surgeries — and to perhaps maliciously alter many more. In one case, a woman went into the hospital to have a small lesion on her labia removed. As she slipped into unconsciousness (from the anesthesia), he leaned over and whispered to her, “I’m going to take your clitoris too.” Sure enough, she woke up to the searing pain of genital mutilation. Because of her trauma and embarrassment, the woman didn’t speak up for two whole years. Because no one was checking credentials, neither this woman nor the countless others who visited Dr. Graeme Reeves, knew that he had been barred from practicing obstetrics in 1997 because he had refused to treat a woman’s puerperal fever. The woman later died. The medical board found that the doctor had “impaired mental capacity”. But he didn’t stop practicing, and he even lied his way into a job in 2002–the position in which he later mutilated Carolyn, the woman whose story is related above. There’s more:  

 Another woman went in for surgery on an ovarian lesion, and ended up with both ovaries, both Fallopian tubes removed; and a kidney gone, also, after complications ensued.

Another woman reports that Reeves failed to use gloves when performing a gynaecological examination, and used an “intimate, sexual” touch, as well as touching her breasts unexpectedly.

Another woman says that Reeves spent over an hour painfully attempting to insert an IUD after she had an abnormal Pap smear, saying “I haven’t got this right”. He performed no cervical biopsy, and she was later found to be riddled with cancer throughout her pelvis. 

So how did Dr. Reeves get this far? Why did more women not speak up?  And why, for the love of all that is holy, is Dr. Reeves’ medical malpractice insurance not covering care for Carolyn’s injuries? Like Hoyden (linked above), I’m going to say that this is a product of patriarchy at work. Hoyden writes:

This isn’t a borderline case, a known but unfortunate side effect, a medical slip: this is a seriously impaired doctor practising for many months in completely inappropriate ways, mutilating, and raping patients - and nobody around him, not his colleagues, not nurses or other staff, were able to stop him. Did they convince themselves that it “wasn’t that serious, really”? Did they convince themselves it was none of their business? Did they fear personal repercussions should they blow the whistle? Why did nobody so much as check his registration when he was employed? 

No one spoke up because women are told to feel shame about their bodies, and are made to feel like deviants for talking or thinking about their sexual and reproductive health. Carolyn waited two years (two years!) before speaking up about what Dr. Reeves did to her. And while I can’t for the life of me begin to explain why Reeves did this, I can’t help but think that it’s in some way connected to some sort of patriarchy-fueled desire to mark/own/control women’s bodies.What’s more, our society (this took place in Australia but is reflective of trends worldwide) continues to tsk-tsk men like this but not really to punish them. Dr. Reeves is not practicing any more, true, but he’s not in jail. Seems to me he’s much more dangerous than the average non-violent drug offender who finds him or her-self serving a long prison term, a victim of the US’s overly harsh drug laws. So now, 11 years after the first complaint was lodged about Reeves, he’s finally being held back from raping and injuring any more women (even if not by jail cell bars). But 11 years!? Makes me wonder if we’ve made much headway tackling subconscious misogyny and antipathy toward women’s sexual lives.