OpenForum – a blog by the Health and Human Rights community

Media coverage of Dr. George Tiller’s murder may have lessened since his fatal shooting on May 31^st, but the severe restrictions placed on women’s access to abortion services continue. A new report from the Center for Reproductive Rights describes the “unacceptable obstacles” that abortion providers face in providing reproductive rights, using testimony from both providers and women seeking abortions throughout the country. The reasons cited for limited access to abortion services include a shortage of providers due to the social and financial costs of performing abortions, intimidation and harassment of providers and women seeking abortions, and legal restrictions such as mandatory waiting periods and prohibitions on federal funds.

Constant harassment and intimidation at abortion clinics continue to limit the ability of abortion providers to do their jobs and of women to obtain abortions in a safe and respectful space. Laws such as the Freedom of Access to Clinic Entrances Act (FACE) are meant to stop the often violent harassment that anti-abortion protesters use outside of abortion clinics. However, local and federal law enforcement can be lax in investigating threats: the report notes that the police often do not understand the provisions of FACE, or are unwilling to interfere with what they perceive as “the expected cost of providing abortion.”

Increasingly, anti-abortion groups are using litigation as a strategy to further harass abortion providers and burden law enforcement and the judicial system. For example, an anti-abortion group in Allentown, Pennsylvania sued the city after their protesters were arrested for “trespass, impeding access, racist and sexual taunting, and residential picketing” outside of a women’s clinic. The city eventually settled after a lengthy case, paying $10,000 to each of the 13 protestors. Experiences such as these have made law enforcement officials reluctant to interfere with protests outside clinics for fear of the legal repercussions. In this case, the Allentown City Solicitor told the clinic director that the city could no longer respond to any complaints at the clinic “unless there is a threat to life or person,” effectively admitting to the city’s almost complete inability to enforce the law with regards to abortion protestors. Read more

The absolute abortion ban enacted in Nicaragua in 2008 is endangering the lives of women and girls in that country and marks a “grave departure” from the Nicaraguan government’s efforts in improving health and equality, according to a new report from Amnesty International. The report details the results of the ban, which it says has denied women and girls life-saving treatment and prevented health care professionals from providing necessary medicine. Of the 115 maternal deaths that occurred in Nicaragua in the past year, it has been estimated that over 10% (at least 12 deaths) could have been prevented if therapeutic abortions had been available.

The ban, included in Nicaragua’s revised Penal Code, allows no exceptions, even in the case of maternal health, incest, or rape. Previously, therapeutic abortion (performed if the life or health of the woman is at risk because of the pregnancy) was legal but highly restricted – it was only permissible if three medical practitioners deemed it necessary and a family member agreed. Now, however, medical practitioners can even be arrested for treating a pregnant woman with a condition such as HIV/AIDS or cancer, because the treatment may cause injury or death to the fetus. Health care workers can also be prosecuted if a fetus is accidentally injured or harmed during birth. The threat of these harsh legal consequences may simply keep medical professionals from seeing pregnant women at all, to avoid prosecution in the event of unintentional fetal injury or death. Even women who have miscarriages fear being arrested, as it can be nearly impossible to determine whether an abortion was spontaneous (a miscarriage) or intentional.

Women and girls who are raped or victims of incest are also included under the abortion ban. Most reported rape cases in Nicaragua involve victims under the age of 18, and 87% of rape or incest victims who get pregnant are between 10 and 14 years old. In the report, a local NGO described supporting a nine-year-old victim of incest and rape through pregnancy, because no other legal options were available. Young women and girls who have not reached physical maturity have higher rates of pregnancy complications and are particularly endangered by this abortion ban. Read more

“Airborne” Highlights MDR-, XDR- TB Cases

Airborne: A Journey into the Challenges and Solutions to Stopping MDR-TB and XDR-TB is a powerful new book written by John Donnelly that features interviews and images to put a human face on the TB epidemic across the world. In her foreword, WHO Director-General Margaret Chan wrote, “I urge you to read the personal stories collected in AIRBORNE. These are human tragedies that should never have happened. But these are also stories about the uplifting success possible when the right elements are in place.”

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Australian Abortion-Aid Ban Lifted

A thirteen-year ban in Australia on providing foreign aid for abortions has been lifted and Australia will provide  funding of up to $15 million for reproductive health activities to help reduce maternal deaths across the world.

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$50 Million US Contribution to UNFPA

President Obama has recently signed legislation to provide $50 million to the United Nations Population Fund (UNFPA) to improve the health of women and children and reduce poverty throughout the world.

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US Capital Blighted by HIV/AIDS

The U.S. Capital has an HIV/AIDS rate on par with or worse than some African nations the city’s health department reports.

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US Urged to Fix Iraqi Refugee ‘Mess’ It Created

As the Iraq war enters its 7th year, the United States is urged to provide aid to Iraqi refugees displaced by the fighting.

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Immigration detainees held under the custody of the U.S. Immigration and Customs Enforcement (ICE) are being denied the proper medical treatment they are entitled to by law and regulation. As immigration policies have grown stricter and federal agencies’ resources have grown increasingly strained since 9/11, the agency has lowered its healthcare standards to keeping immigrants healthy enough for deportation. The consequences for the health and rights of female detainees are especially appalling.

Recently, Human Rights Watch released a report that documents the unique struggles women face in accessing health care in detention. It documents reports of women who suffered from affronts to their health and dignity during detention, including inadequate care during pregnancy, having to beg and plead to get enough sanitary pads not to bleed through their clothes, or not being offered counseling after testing positive for pregnancy. In “Access Denied,” The Texas Observer highlights the denial of reproductive rights for the large number of detainees who are sexually assaulted; they are not identified when they come into ICE’s custody, nor are they informed of their options if they become pregnant. Read more

Protesters seek legalization of abortion in Brazil

It may be hard to imagine a 9-year-old, all of 79 pounds and four feet tall, 15 weeks pregnant with twins. Now compound that image with the girl’s story– sexually abused repeatedly, allegedly by her stepfather, since the age of 6. While the alleged rape should be enough to raise media attention, it is the tense controversy over reproductive rights in the predominantly Catholic country that is making headlines after the medical team who performed the legal abortion, as well as the girl’s mother, were summarily excommunicated by the Church.

Brazilian Minister of Health Jose Gomes Temporao declared, “It is legitimate for the church to have its dogmas, but theses dogmas must not be imposed on society as a whole.” Archbishop Jose Cardoso Sobrinho of the coastal city of Recife countered in a TIME interview, “They took the life of an innocent… Taking that life cannot be ignored.” Read more

Imagine waking up after giving birth to your first child, to discover that, despite plans for a large family, you have been sterilized without consent by the doctors whom you trusted with your life. According to an international suit filed by an HIV-positive woman against the Chilean government, this exact scenario occurred when the 27 year-old woman was forcibly sterilized in a state hospital.

The suit highlights the fact that the hospital operated on the woman because of her HIV status, even though the possibility of transmitting the virus to a fetus or newborn can be reduced to less than 2% with proper intervention. Moreover, the case illustrates the violations of reproductive rights frequently suffered by women living with HIV, who may be forced to have abortions against their will or are even excluded from healthcare services. A countrywide study done by Vivo Positivo, a Chilean HIV/AIDS advocacy group, found that 41.9% of HIV-positive women who had been sterilized had done so under pressure from doctors or even without consent. How such a patent violation of human rights in one country could be occurring without international outrage is startling; yet, the Human Rights Watch has documented similar cases throughout the world. Read more