March 09, 2004

Save Women's Lives

(This article by Sabrina Rubin Erdely is reproduced here from the April 2004 issue of Glamour magazine. I don't claim ownership or copyrights to this. I'm just trying to spread the word on how to help the lives of women around the world.)

On a recent tour of 10 African countries, human rights activist Kati Marton met a woman dying of AIDS in a shantytown outside Cape Town, South Africa. The woman was frail and thin, and it was painful for her to get out of bed. A mother of three, she was piecing together an album of her life, filling it with mementos from her childhood, newspaper clippings and blossoms from her favorite flowers to leave as a legacy for her children.

"When she showed the book to me, I sat there and cried with her," says Marton, chair of the International Women's Health Coalition, a nonprofit group that works to protect the rights and health of women and girls worldwide. After spending two decades as a journalist reporting from Europe, the Middle East and Asia, as well as traveling with her husband, former UN Ambassador Richard Holbrooke, Marton knows this woman is one of many: "You can multiply this woman's story by thousands -- women are dying because they aren't getting even basic health care." Often the cause of death is cervical cancer, an unassisted pregnancy or an unsafe abortion -- problems that are rarely deadly for women in this country. "Once you're exposed to cases like this, you have to do something," Marton says. "And after meeting everyone from presidents to tribal leaders, I know it is women who will turn this around." Here's a quick glimpse of the biggest crises now, and how you can help.

Surviving Childbirth

Every expectant mother worries about childbirth: How much will it hurt? Am I ready to become a parent? But rarely in this country do we wonder: Will I die having this baby?

Unfortunately, that's the reality in many poorer nations. In sub-Saharan Africa, one in 16 women will die as a result of pregnancy or childbirth (compare that with one in 2,500 in the U.S.); in Sierra Leone, it's one in six. "It's infuriating -- so many of these deaths are preventable," says Lucy Atkin, Ph.D., director of the Margaret Sanger Center International at Planned Parenthood of New York City, which works with local agencies overseas to help them provide reproductive health care.

Why is childbirth so dangerous? Often because women are forced to go it alone: In Bangladesh, only 22 percent of deliveries are attended by a professional such as a midwife or doctor. Sometimes, such services are simply too expensive -- at least to those doling out the cash. "In rural areas in Chiapas, Mexico, the men often make the decisions, so they have to value health care enough to say it's worth it. A woman's health often isn't a priority," notes Atkin. In other areas, cultural barriers may prevent pregnant women from getting help. Under the Taliban, which ruled from 1996 to 2001, women in Afghanistan couldn't be examined by a male obstetrician unless they were chaperoned by a male family member. Yet female ob-gyns are rare because women were prohibited from practicing medicine.

WHAT YOU CAN DO: Donate a dollar. The 34 Million Friends of United Nations Population Fund (or UNFPA) was set up to provide reproductive health services to women worldwide and has been asking to end coercive abortion practices. Send your dollar to U.S. Committee for UNFPA, 3800 Arapahoe Avenue, Suite 210, Boulder, CO, 80303, or go to

Battling HIV/AIDS

Nearly half of those living with HIV/AIDS worldwide are female. The steep rise in infection rates in women is partly due to the fact that women are biologically more vulnerable to HIV infection during intercourse than men, since sex can cause tiny tears in the vagina that may lead the virus directly to the bloodstream. But in many countries women may be beaten or abandoned if they refuse sex, which is why insisting that a man use a condom is often unthinkable. In Zambia, for example, one study found that only 11 percent of women think it's acceptable for a wife to ask an unfaithful, HIV-infected husband to use condoms. The stigma of AIDS is so fierce that if women do get tested and learn they've contracted the disease, they often can't admit it. When Marton traveled to Namibia, she says she could only safely meet with a group of HIV-positive women in a remote location in the dead of night. "These women hadn't told their husbands about their diagnosis -- they would have been abandoned," says Marton. "And if they couldn't tell their husbands, they couldn't go to a doctor because of the possible consequences."

WHAT YOU CAN DO: Give to the International Women's Health Coalition. Marton's group has established community programs in Africa and Latin America to teach teens about safe sex. In Nigeria, the organization's efforts have led to a national curriculum that builds girls' self-esteem and teaches boys that women have equal human rights.

Ending Rape And Violence Against Women

"If you call 911 here in the U.S. to report abuse or an assault, the police have an obligation to do something," says Roxanna Carrillo, human rights adviser for the United Nations Development Fund for Women (or UNIFEM). But in many third-world countries, she says, violence against women is often dismissed. In Pakistan, for example, 70 to 95 percent of women suffer abuse. Worried about their children's welfare, many mothers are never able to escape the violence. "The women are not free to leave," Carrillo explains, especially because they have so few ways to earn money. And the violence continues despite an increased awareness of the problem (it was widely reported in 2002 when a Pakistani tribal council ordered a woman gang-raped to punish her brother for allegedly having an affair). In November, Afsheen Musarrat, a 22-year-old woman in Pakistan, was strangled after she left the man her family had forced her to marry and tried to flee with another man. Under media pressure, President Pervez Musharraf finally ordered an investigation of the suspected "honor killing."

Rape is also pervasive -- in South Africa, an estimated one in every three women will be raped in her lifetime. And in some cultures sexual assault and genital mutilation are often hallmarks of the transition from childhood to adolescence. "In some cases it's like a bar mitzvah, although it's not about celebration, but physical injury," says Carrillo. "That becomes their initiation. But I haven't heard of an initiation for boys that included sexual abuse."

WHAT YOU CAN DO: Help UNIFEM's Trust Fund in Support of Actions to Eliminate Violence Against Women (click on "Women's Human Rights"). Its campaigns have built a domestic violence support network in Trinidad and Tobago, and have trained journalists in Kyrgyzstan about negative stereotypes of women that contribute to domestic violence.

Preventing Cervical Cancer

Researchers now know that cervical cancer is almost always caused by human papillomavirus (HPV). Simple tests can detect the sexually transmitted disease and the earliest stages of cervical cancer; in fact, in the U.S., the Pap smear slashed cervical cancer death rates by 70 percent. But "people in poor countries see the doctor for emergencies only," says health activist Atkin. "At best, women will go to health centers for their children, not for themselves." As a result, only about 5 percent of women in poorer countries get Pap smears, and each year cervical cancer kills nearly 185,000 women in those countries, more than any other cancer.

Even where screening is available, women often don't understand why it's so critical. "In some countries, women aren't taught that heavy vaginal discharge may be a sign of infection or an STD, so they don't think to see a doctor," says Atkin. And they may avoid treatment for fear of being accused of infidelity by their husbands. "In Latin America, for example, if you have any kind of infection -- even a yeast infection -- you may be accused of sleeping around," says Atkin. "The reaction is: 'I didn't give it to you!' and then a woman may be beaten."

WHAT YOU CAN DO: Support the Pan American Health Organization's Education Foundation. As a member of the Alliance for Cervical Cancer Prevention, the organization has helped screen about 40,000 women for cervical cancer and is working to develop low-cost screening and treatment that can be provided in just one visit.

Guaranteeing Safe Abortion

"Abortion is a very serious decision that a woman never faces lightly. And when it's necessary, she will put her life in jeopardy to terminate a pregnancy," says Atkin. In developing countries, some women take toxic substances to induce contractions and prod the uterus with sharp objects to induce miscarriage. "These acts are a reflection of their desperation," says Atkin, and they lead to the deaths of about 80,000 women worldwide each year.

Seeking treatment at a hospital -- often for urgent medical care for hemorrhaging or infection -- can land a woman in jail. In Brazil, where abortion is illegal except to save a woman's life, 25-year-old Viviane Borges Coutinho went to a hospital in 2002 in unbearable pain after a self-induced abortion; she was accused of infanticide and jailed. "The U.S. government is pushing abstinence, which is important, but in places where women don't have the right to just say no to sex, abstinence cannot be the sole form of birth control," says Marton. "We've had Roe vs. Wade for 31 years -- why are we not helping the most vulnerable women have a right that we take for granted?"

WHAT YOU CAN DO: Sign the Center for Reproductive Rights' petition to free Nepali women imprisoned for abortion-related charges. In September 2002, the government in Nepal decriminalized abortion, but more than 30 women continue to serve sentences there.

We can't ignore these health care injustices -- when women are treated badly, it's likely there will be other human rights violations that will set the stage for war and violence, says Marton. "But when women are healthy and involved in their communities, families are healthier, better fed and more likely to prosper." Marton was reminded of the impact women can have when she visited a refugee camp outside the capital of Angola. "There's no more hopeless place. But inside each tiny tent, the makeshift pots are piled neatly, the bed is made, what clothes they have are folded. They are doing everything they can with what they have, but they need help," she says. "We're talking about life and death. If we turn our backs, nothing will change."

Posted by cybette at March 9, 2004 01:49 AM
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