Category Archives: News

Southern Africa: Gender violence still hinders women’s freedom

GenderLinks

It seems incongruous that we celebrate Women's Month, yet stories of conflict and gender based violence (GBV) flood today's headlines. Whether it is the abduction of girls in Nigeria, the unending trial of Oscar Pistorius or the young woman raped and murdered last over the weekend because of her sexuality- the horrific immediacy of violence is all too apparent. Yet the majority of cases go unreported, unnoticed and justice is not served. It is also evident in conflict and post-conflict situations where rape is often used as a weapon of war. While everyone is vulnerable to violence, women and girls remain disproportionately affected.

 

While we honour the women who marched against the Apartheid pass laws in 1956 and the efforts of many individuals who have toiled towards improving the status of women, we also need to take a moment to reflect as we take stock of what we have achieved. This is particularly important at this time as we fast approach the 2015 deadline for the SADC Gender Protocol on Gender and Development target of halving GBV. We need to face up to the reality that twenty years into democracy, South Africa and the entire Southern African region remain a far cry from this ‘dream.'

 

GBV no doubt weakens the efforts toward all goals set out in the SADC Gender Protocol Studies by Gender Links in six countries of the SADC region reveal that GBV is pervasive, with the highest prevalence reported in Zambia, where 89% of women from the Kasama, Kitwe, Mansa and Mazubuka experienced violence in their lifetime. Meanwhile 86% of women in Lesotho, 68% of women in Zimbabwe, 67% of women in Botswana, 50% of women in South Africa (Gauteng, Limpopo, Western Cape and KwaZulu Natal) and 24% of women in Mauritius have experienced GBV.

 

Men on the other hand are affirming their hand in this violence: from 73% men in Zambia to 22% men in Mauritius reported perpetration of violence at least once in their life time. The studies further show that there is serious under-reporting of violence across the region, and the scourge thrives in this culture of silence and denial.

 

Studies also show that GBV is inextricably linked to gender inequalities. In the SADC region it is embedded in the patriarchal social system which perpetuates the subordination of women. According to a GL attitudes survey, while both men and women claim to believe in equal treatment between women and men, it is shocking and rather infuriating to learn that on average more than three quarters of men believe that a woman should obey her husband.

 

More saddening is the fact that equal proportions of women affirm this assertion.

 

Women and girls are expected to subservient at all stages of their life cycle and this comes with a hefty price tag- unequal access to all rights whether in the economy, in education and in the health sector- to name just a few. A study undertaken by Swedish International Development corporation Agency (SIDA) Zimbabwe revealed that responding to GBV costs about $2 billion in that country alone. That money could invested in more productive areas, such as infrastructure, business development, or education. The higher productivity that would result, from building a school rather than a jail, for instance, cannot be overemphasised. This underscores the urgent need for a paradigm shift to a more preventive approach. Although SADC generally enjoys peace, acts of conflict and related violence have been reported especially during elections and amid the widespread scramble for resources such as land water and jobs.

 

Thirteen SADC Heads of State signed a Protocol committing their countries to integrating gender firmly into their agendas, repealing and reforming all laws and changing social practices which subject women to discrimination. Linked to this is the obligation that all laws on violence against women (VAW) provide for the comprehensive testing, treatment and care of survivors of sexual offences which shall include emergency contraception, access to post exposure prophylaxis at all health facilities to reduce the risk of contracting HIV and preventing the onset of sexually transmitted infections. In line with international and continental instruments, the Protocol also commits member states during times of armed and other forms of conflict to take necessary steps to prevent and eliminate incidences of human rights abuses, especially of women and children, and ensure that the perpetrators of such abuses are brought to justice.

 

However, it is most unlikely that the target of enacting such legislative measures will be met by 2015, let alone that of halving GBV. One major shortfall in the current Protocol targets is the lack of specific indicators to measure governments' progress. Countries need to ensure that interventions designed to combat violence are based on accurate empirical data. This requires not just the compilation of accurate information, but also of indicators that make the data accessible for non-specialist decision makers and allow public scrutiny of interventions. There is a glaring policy gap in regards to the magnitude of sexual violence in conflict settings. Women in peace and security decision making are relatively few while crimes perpetrated during conflict are seldom viewed with a gender lens yet women often bear the brunt of political instability.

 

To date, 13 SADC countries have enacted laws on domestic violence and on sexual harassment. Eleven have laws on sexual assault and specific laws on human trafficking. While this is relatively commendable, a consistent pattern observed in many settings in Africa is that of robust policy formulation coupled by weak patterns of implementation, resulting in relatively weak knowledge of and use of services. It is one thing formulating and readjusting legislature and another for the legislature to effectively bring positive change in the lives of the beneficiaries. Studies undertaken in different settings globally have recorded that knowledge of VAW laws is generally low, more so among the women, the intended beneficiaries.

 

There has been a positive shift towards a victim empowerment approach with several governments and NGOs up-scaling support towards survivors of GBV. Fourteen countries now offer accessible, affordable and specialised services including legal aid to survivors of GBV. Thirteen countries offer places of safety to the survivors. However, the number of available structures in the region is outnumbered by the survivors. Places of safety and legal aid, where available, continue to be mainly offered through local NGOs. Generally governments have not committed sufficient resources towards these services.

 

Now is the time for all to take a step back and re-strategise regarding tackling GBV in the region. We need to put our heads together and work towards strengthening the post-2015 agenda as far as eliminating GBV is concerned. The existing targets need strengthening and we also need to review and add other relevant realistic targets accompanied by indicators that cover all forms of GBV including female genital mutilations and hate crimes towards the minority groups. Governments need to spearhead these efforts rather than leave it to NGOs.

 

Linda Musariri Chipatiso is Gender Link's Senior Researcher and Advocacy Officer. This Article is part of the Gender Links News Service Women's Month Special series, offering fresh views on everyday news.

 

By Linda Musariri Chipatiso

22 August 2014

Source: http://www.genderlinks.org.za/article/southern-africa-gender-violence-still-hinders-womens-freedom-2014-08-22

Uganda criminalises HIV transmission

Museveni_Uganda_president_3

Uganda’s President Yoweri Museveni signed legislation this week criminalising the transmission of HIV, a measure that allows doctors to violate confidentiality and disclose their patients’ HIV status without consent and calls for mandatory testing for pregnant women and their partners in violation of their human rights.

 

While the “HIV Prevention and AIDS Control Bill” was created in an effort to curb the HIV/AIDS epidemic in the country, the law as written poses serious human rights violations that infringe on Ugandans’ right to privacy and right to be free from discrimination.

 

The law calls for a sentencing of up to 5 years for individuals found guilty of transmitting HIV. Furthermore, the bill singles out women in the country, subjecting survivors of sexual assault and pregnant women to routine HIV blood testing—a provision that fosters discrimination in the health care system, deepens the stigma of HIV and AIDS among those groups, and discourages women from seeking essential health care.

 

“No one should ever fear discrimination or imprisonment when trying to access essential medical care in her or his country—regardless of HIV status or other health nee

 

Evelyne Opondo, regional director for Africa at the Centre for Reproductive Rights.

 

“Rather than passing a measure that effectively address the very real challenges that exist in curbing the spread and treatment of HIV and AIDS, this law inflicts punishment, shame, and fear on men and women in Uganda, including pregnant women who desperately need and deserve quality maternal health care.”

 

Under this new law, medical and health practitioners are allowed to disclose or release HIV test results without a patient’s consent.

 

Non-consensual disclosure of HIV status places women at risk of physical, sexual, and psychological abuse. In 2008 alone, five women in Uganda were murdered by their husbands after the men learned about their wives’ HIV-positive status.

 

Cases of discrimination against pregnant women living with HIV have occurred in many parts of the world, including Uganda and Namibia where 15 women who were sterilized without their consent brought a complaint against the government.

 

In 2009, the Centre for Reproductive Rights and Vivo Positivo brought a case against Chile before the Inter-American Commission on Human Rights on behalf of F.S, a Chilean woman living with HIV who at age 20 was sterilized during delivery without her knowledge or consent. Her case is still pending before the commission.

 

In November 2010, the Centre and the Uganda Association of Women Lawyers submitted a joint letter to the United Nations Committee on the Elimination of Discrimination against Women raising concerns over the negative impact the bill would have on women’s reproductive rights.

 

The Centre has worked extensively in Uganda on the human rights implications of lack of access to legal abortion and modern contraceptives. In November 2013, the Centre, the International Women’s Human Rights Clinic and the O’Neill Institute for National and Global Health Law at Georgetown Law released a joint report entitled The Stakes Are High: The Tragic Impact of Unsafe Abortion and Inadequate Access to Contraception in Uganda.

 

The report documents personal stories of women impacted by the widespread and false impression that abortion is illegal in all circumstances in Uganda— when in fact it is permitted for women with life-threatening conditions and victims of sexual assault.

 

In 2012, the Centre launched its first research report on Uganda's laws and policies on termination of pregnancy. The report found that the laws and policies are more expansive than most believe, and Uganda has ample opportunity to increase access to safe abortion services.

 

By Center for Reproductive Rights, Press Release

22 August  2014

Source: http://www.ntvuganda.co.ug/news/local/24/aug/2014/uganda-criminalises-hiv-transmission#sthash.dkCJgLXF.dpuf

African Union to immediately deploy joint military and civil mission against Ebola

Directorate of Information and Communication

 

Press Release NO. 184/ 2014

 

African Union to immediately deploy joint military and civil mission against Ebola

 

Addis Ababa, Ethiopia–21 August 2014: The Peace and Security Council of the African Union on Tuesday invoked Article 6(f) relating to its mandate with regard to humanitarian action and disaster management at its 450th meeting.  The Council authorised the immediate deployment of a joint AU-led military and civilian humanitarian mission to tackle the emergency situation caused by the Ebola outbreak.

 

“Using the infrastructure of the Peace Support Operations, the African Union Commission is finalising the planning of the joint military and civilian mission code named Operation ASEOWA that could start deployment by the end of August 2014,” Said Dr. Mustapha Sidiki Kaloko, Commissioner for Social Affairs of the African Union Commission.

 

The African Union Support to Ebola Outbreak (Operation ASEOWA) is expected to deploy civilian and military volunteers from across the continent to ensure that Ebola is put under control. The mission will comprise medical doctors, nurses and other medical and paramedical personnel. The operation is expected to run for six months with monthly rotation of volunteers. The operation will cost more than USD25 million and the US government and partners have pledged to support the African Union with a substantial part of this amount.

 

The operation aims at filling the existing gap in international efforts and will work with WHO, OCHA, US CDC, EU CDC and others agencies already on the ground.

 

For more information, visit http://www.africa-union.org

 

For further information contact

 

Wynne Musabayana | Deputy Head of Division | Information and Communication Directorate | African Union Commission | Tel: (251) 11 551 77 00 | Fax: (251) 11 551 78 44 | E-mail: MusabayanaW@africa-union.org | Web: www.au.int|Addis Ababa | Ethiopia

 

Tawanda Chisango | Social Affairs | African Union Commission |Tel: +251115182029 | E-mail: Chisangot@africa-union.org | Web:www.au.int |Addis Ababa | Ethiopia

 

About the African Union

 

The African Union spearheads Africa’s development and integration in close collaboration with African Union Member States, the Regional Economic Communities and African citizens.  AU Vision:to accelerate progress towards an integrated, prosperous and inclusive Africa, at peacewith itself, playing a dynamic role in the continental and global arena, effectively driven by an accountable,efficient and responsive Commission. Learn more at: http://www.au.int/en/

500 days and counting: Progress for girls and women means progress for all

August 18 marks 500 days remaining before the Millennium Development Goals expire at the end of 2015. Some countries are on track to meet those goals and some are not, and central to the difference is their relative levels of investment in women and girls.

The MDGs emerged from an historic summit of world leaders to mark the new millennium nearly 15 years ago. Since then, countries that worked to boost girls’ education, women’s rights and comprehensive maternal, sexual and reproductive health care saw benefits not just for gender equality and longer lives for women and children but in other areas as well — against poverty and hunger, against diseases including HIV and AIDS, and toward a more sustainable environment. Investment in girls and women turned out to be the most cost-effective way to advance on all the goals.

Women Deliver was organized to point out this connection. At three global conferences of activists and decision-makers from around the world — in London in 2007, in Washington, D.C. in 2010 and in Kuala Lumpur in 2013 — it provided statistics and case studies that proved the truth of its slogan, “Invest in women — it pays!” Every year brought more proof and better examples of investments in girls and women in which everybody won. So today, as the international community begins final MDG assessments and considers future plans, we are proud to announce that the next triennial Women Deliver conference will be held on May 17-19, 2016 in Copenhagen, Denmark.

Like the previous three gatherings, this one will bring together advocates, policymakers, journalists, young people, researchers and leaders of the private sector and civil society to showcase what it means and how it works when women and girls become the focus of development efforts. It will document the great results around the world where investment in women rose.

The Women Deliver 2016 Conference will also be the first major global conference after the post-2015 development framework, so far called the Sustainable Development Goals, is decided. It will be a first chance for strategizing on ways to turn the MDG spurs for growth into the plowshares of a livable planet, to make startup programs sustainable over the long term, to bring pilot programs to national scale — in short, to firm up long-term support, ensure that girls and women are kept at the center of the new development plans from the beginning, and include them in operations and evaluations at every stage into the future.

Copenhagen was chosen because Denmark is a leader and champion for progress in sexual and reproductive health and rights. The Danish International Development Agency has already launched a new Strategic Framework for Gender Equality, Rights and Diversity to assist women and girls in seizing opportunities and resources to take full control over their own lives. The Ministry of Foreign Affairs of Denmark is fully in support of Women Deliver’s call for additional global commitment on behalf of girls and women.

The post-2015 development framework is being developed as we write, and Women Deliver is working  to ensure that decision makers prioritize maternal, sexual and reproductive health and rights, especially in countries where inequality prevails and where it would help development most.

Closing the gender gap in agriculture alone, for example, could lift up to 150 million people out of hunger. Investing $8.1 billion a year in voluntary family planning would reduce pregnancy-related deaths by 79,000 and newborn deaths by 1.1 million every year. Increasing girls’ school attendance by only 10 percent raises a country’s GDP by 3 percent. And eliminating barriers to employment for girls and women could raise labor productivity in some countries by 25 percent.

These are the facts of life in the 21st century. Imagine a world where no woman dies giving life, where no baby is born with HIV, where every girl can attend school and get a quality education, and where everybody has a chance to fulfill their potential. The post-2015 process can move us closer to that day — if it prioritizes the health, rights, and well-being of girls and women.

In these last 500 days, Women Deliver will build on the momentum generated by our previous gatherings to see that it happens. We will insist that adolescents and young people, who predominate in most developing areas, should get special focus. We will make sure that women are present at the tables where decisions are made. And we will continue playing a critical role in fueling the global movement for maternal, sexual and reproductive health and rights.

We will see you all in Copenhagen!

Aug. 18, 2014, marks the 500-day milestone until the target date to achieve the Millennium Development Goals. Join Devex, in partnership with the United Nations Foundation, to raise awareness of the progress made through the MDGs and to rally to continue the momentum. Check out our Storify page and tweet us using #MDGmomentum.

By Jill Sheffield and Katja Iversen

18 August 2014

Source: https://www.devex.com/news/500-days-and-counting-progress-for-girls-and-women-means-progress-for-all-84064

Boko Haram kidnaps 100, Chad frees most captives

MAIDUGURI, Nigeria (AP) — Nigeria's Boko Haram militant group kidnapped 100 people earlier this month but most were freed by security forces from neighbouring Chad, a Nigerian security official and a local self-defence member said Friday.

 

The abductions took place on Aug. 10 in Doron Baga in the Kukawa area near the border with Chad, said the official, who spoke on condition of anonymity because he was not authorized to speak to the media.

 

He said the terrorists were stopped as they crossed the Chad border by Chadian soldiers who killed most of them and set free most of the captives.

 

Muhammed Gava, a member of the anti-Boko Haram vigilante movement, said 20 females and about 70 young men had been forced to board speed boats in Lake Chad, which lies on the border between Nigeria, Chad, Niger and Cameroon.

 

Nigeria's fight against the extremist group began in 2009 but hit the international spotlight in mid-April, when the militants kidnapped more than 200 schoolgirls. The girls have still not been freed.

 

Boko Haram wants to enforce an Islamic state in Nigeria, whose population of more than 170 million people is almost evenly divided between a mainly Muslim north and largely Christian south.

 

The group has intensified its violent campaign this year and is increasingly targeting civilians. More than 4,000 people — mostly civilians — have been killed this year alone by all sides in the conflict, which include Nigerian security forces, Amnesty International said on Aug. 5. This compares to an estimated 3,600 people killed in the first four years of the Islamic insurgency.

 

While the group's attacks are mostly in northeast Nigeria, Boko Haram has detonated bombs as far away as Lagos, the commercial capital in Nigeria's southwest.

 

16 August 2014

By Haruna Umar

Source: http://news.msn.com/world/boko-haram-kidnaps-100-chad-frees-most-captives

Uganda holds first pride rally after ‘abominable’ anti-gay law overturned

Ugandan men hold a rainbow flag reading

Uganda has hosted its first gay pride rally since a draconian anti-homosexuality law was overturned by the courts.

Sandra Ntebi, organiser of the rally held on Saturday in Entebbe, 35km from the capital Kampala, said police had granted permission for the invitation-only "Uganda Pride" event.

"This event is to bring us together. Everyone was in hiding before because of the anti-homosexuality law," she said. "It is a happy day for all of us, getting together."

The overturned law, condemned as "abominable" by rights groups but popular among many Ugandans, called for proven homosexuals to be jailed for life.

The constitutional court rejected the law on a technicality on 1 August, six months after it took effect. The government swiftly filed an appeal, while MPs have signed a petition for a new vote on the bill.

Homosexuality remains illegal in Uganda, punishable by a jail sentence. However, it is no longer illegal to promote homosexuality and Ugandans are no longer obliged to denounce gays to the authorities.

Amid music, dancing and laughter, activists gathered in a park on the shores of Lake Victoria, close to the country's presidential palace. "Some Ugandans are gay. Get over it," read one sticker a man had pasted onto his face.

Ugandan deputy attorney-general Fred Ruhinda said that government lawyers had lodged an appeal against the ruling at the supreme court, the country's highest court.

"We are unsatisfied with the court ruling," he said. "The law was not intended to victimise gay people, it was for the common good."

In their surprise ruling last week, judges said it had been passed without the necessary quorum of MPs in parliament.

Rights groups said the law triggered a sharp increase in arrests and assaults on members of the country's lesbian, gay, bisexual and transgender community.

Homophobia is rampant in Uganda, where American-style evangelical Christianity is increasingly popular.

Gay men and women face frequent harassment and threats of violence, but activists celebrated openly on Saturday.

"Since I discovered I was gay I feared coming out, but now I have the courage after the law was thrown out," said Alex Musoke, one of more than 100 people at the event.

One pair of activists waved a rainbow flag with a slogan appealing for people to "join hands" to end the "genocide" of homosexuals. There were few police in attendance and no protestors.

Critics said President Yoweri Museveni signed the law to win domestic support ahead of a presidential election set for 2016, which would be his 30th year in power.

However, it lost him friends abroad, with several international donors freezing or redirecting millions of dollars of government aid, saying the country had violated human rights and democratic principles.

US secretary of state John Kerry likened the law to antisemitic legislation in Nazi Germany.

Analysts suggest that Museveni secretly encouraged last week's court ruling as it provided a way to avoid the appearance of caving in to foreign pressure.

Gay rights activists say the battle is not over. MPs have signed a petition calling for a new vote on the bill and to bypass parliamentary rules that require it be formally reintroduced from scratch – a process that could take years.

By Chris Johnston

9 August 2014

Source: http://www.theguardian.com/world/2014/aug/09/uganda-first-gay-pride-rally-law-overturned

The Evidence Is In: Decriminalizing Sex Work Is Critical to Public Health

During the 2014 International AIDS conference, The Lancet medical journal released a series of articles focused exclusively on HIV and sex work. One study by Kate Shannon et al., demonstrates that decriminalization of sex work could reduce HIV infections by 33 to 46 percent over the next decade. Shannon’s team showed that “multi-pronged structural and community-led interventions” are essential to promoting the human rights of sex workers, as well as improving their access to HIV prevention and treatment. Dr. Chris Beyrer, the researcher who coordinated this Lancet series, told AIDS conference participants that“[e]fforts to improve HIV prevention and treatment by and for people who sell sex can no longer be seen as peripheral to the achievement of universal access to HIV services and to eventual control of the pandemic,” drawing an irrefutable line between the social, legal, and economic injustices sex workers face and their subsequent vulnerability to HIV.

 

The Lancet series authors join many other prominent public health voices in identifying the decriminalization of sex work as vital to preventing the spread of human immunodeficiency virus (HIV) and of acquired immune deficiency syndrome (AIDS). For two decades, sex workers rights’ activists throughout the world have pushed human rights, public health, and HIV and AIDS response leaders to recognize that they, along with people who inject drugs and men who have sex with men, are “key populations” without whom an effective HIV and AIDS response is impossible. In 2012, the World Health Organization (WHO) declared that “all countries should work toward decriminalization of sex work and elimination of the unjust application of non-criminal laws and regulations against sex workers.” In South Africa (with the largest population of people living with HIV in the world), the National AIDS Council is urging its government to decriminalize sex work—a demand that advocates and health policy professionals are making in dozens of other countries as well. Amnesty International, Human Rights Watch, and the UN’s Global Commission on HIV and the Law all endorse this position. The latter points out “the impossibility of governments stigmatizing people on one hand, while simultaneously actually helping to reduce their risk of HIV transmission or exposure on the other.”

 

Sex work has been decriminalized in New Zealand and one province (New South Wales) in Australia leaving sex work businesses subject to standard occupational health and safety regulations. Law enforcement treats the sale of sex as it does any other business, without any intrusion or interruption unless existing laws are being violated.

 

Decriminalization has resulted in higher rates of condom use and enables sex workers to organize community-based health practices that demonstrably improve health and reduce HIV risk. It also makes it possible for sex workers to report and for the police to address illegal acts as they occur, such as assault, theft of services, employment of minors, or client coercion. In this decriminalized setting, sex workers can be strong allies in the fight against trafficking, intimate partner violence, and child abuse since they can report incidents to the police and social service agencies without putting themselves at risk of arrest.

 

So, why is the HIV-AIDS field only just beginning to recognize the connection between the decriminalization of sex work and HIV? And why is the trend toward criminalizing populations involved in the sex trades increasing in the United States—moving in the opposite direction from other countries? The following are three contributing factors.

 

Conflating Sex Work With Trafficking

 

Public debate around sex work in the United States increasingly focuses on people who have been trafficked or otherwise coerced into the sex trade. Anti-trafficking advocates conflate sex work (people choosing to sell sexual services from among employment options available to them) with trafficking (people being forced into the sex industry against their will). Laws that criminalize all people selling sex (voluntarily or involuntarily) violate the rights of the former and undermine efforts to identify and assist the latter. The Global Commission on HIV and the Law states unequivocally that, “Sex work and sex trafficking are not the same. The difference is that the former is consensual, whereas the latter is coercive.”

 

A commentary by Steen et al. in the recent Lancet series notes that “repressive and counterproductive police action,” including the arrest and incarceration of trafficking victims for the purposes of “rescue,” has overtaken far more effective responses in several countries. The understandable, but destructively over-simplified, mandate to “rescue and restore” sex workers is also being imposed in public health settings where providers are now charged with identifying and intervening with potential victims of trafficking in the sex trade. Certainly, health-care providers have a duty to watch for and help patients in abusive situations of all kinds. They also have a duty to understand the complexities of human experience, respond to patient-identified needs, and maintain that patients are experts of their own lives, whatever that may look like.

 

Lack of Access to Health Care for Sex Workers

 

Providing access to health-care services targeted to consumers’ needs is a vital part of any country’s HIV response. Without it, those most in need of prevention, care, and treatment are least likely to get it.

 

In a 2010 survey, 53 percent of medical students said they were not adequately trained to address their patients’ sexual issues comfortably. Far fewer professional medical curricula explicitly prepare students to understand that they will encounter sex workers as patients who, like all other patients, are individuals with a wide range of experiences, backgrounds, and needs that can best be treated with patient-centered care.

 

When sex workers receive demeaning and unprofessional treatment in health-care settings, they see health-care providers as an extension of the larger system that criminalizes them. A survey by the New York City-based Persist Health Project found that few sex workers disclosed their occupation to their health-care provider; only one study participant reported a positive experience after doing so. As one respondent explained, “I think for security reasons, I don’t usually disclose. Mainly because I don’t trust doctors … I sort of treat them like law enforcement.” Another noted that most health-care providers “have no clue who you are, no clue about your background, you can’t read them or know that they’re not going to try to lecture you or give you a stink-eye.”

 

St. James Infirmary, a peer-based occupational safety and health clinic for sex workers in San Francisco, corroborates these findings. Of their incoming patients, 70 percent had never previously disclosed their occupation to a medical provider for feared of bad treatment. Providing sex-worker friendly health care requires training health-care workers appropriately and supporting services designed specifically with and for the communities they serve.

 

Violence Risk Exacerbated by Criminalization

 

People usually envision a sex worker as someone soliciting on the street, but only about 20 percent of U.S. sex workers are street-based. The vast majority see clients in other venues including massage parlors, brothels, apartments they share with other sex workers, or a client’s hotel room. Many connect with clients online.

 

HIV risk is high among street-based sex workers who experience high levels of violence at the hands of clients and abusive law enforcement personnel. One important way they reduce this risk is assessing a potential client before getting into his car—looking for signals that he might be violent and relaying his license number to a colleague in case the worker disappears. This assessment time is also used to negotiate price and condom use. Law enforcement crack-downs compel sex workers to complete their negotiations quickly (in order to avoid arrest), depriving them of the time needed for assessment and negotiation.

 

Street-based sex workers have little or no protection if a client becomes violent or refuses to use a condom. Of the street-based workers surveyed in The Lancet study by Shannon et al., 25 percent reported being pressured by clients to have sex without a condom. Those working in remote areas (such as industrial parks) to escape local policing were three times more likely to report being pressured into having sex without a condom than the study population overall. The recent Lancet series data also shows that, in some countries, up to one-third of sex workers do not carry an adequate supply of condoms due to “condoms as evidence” policies that allow police to seize a sex worker’s condom supply and use it as evidence of their intent to engaged in sex work—a widely-used policy in several U.S. cities. 

 

Getting From Here to There 

 

Punitive laws against sex work are in place in 116 countries, including the United States, creating, according to the Open Society Foundations, “a state-sanctioned culture of stigma, discrimination, exploitation, and police and client violence against sex workers.”

 

Decriminalizing sex work in the United States is a long and challenging process, but there is a path to follow. The 1988 ban on federal funding for syringe exchange remained in place for 20 years and, after briefly lifting it in 2009, the Obama administration agreed to its reinstatement in 2011 at Congress’ insistence. Advocacy pressure to overturn it continues.

 

Thanks to the efforts of dedicated researchers and activists during the two decades between 1988-2009, public health professionals, medical institutions and virtually everyone working in the HIV-AIDS field learned why harm reduction practices are essential. Services to people who use drugs began to improve, although they are still inadequate, primarily because they are grossly under-funded. Progress has been made.

 

The U.S. National Institutes of Health (NIH) issued a consensus statement that addressed the need for syringe exchange but also observed that “[p]rograms targeting sex workers have been highly efficacious in other countries, but [in the U.S., programs] will encounter cultural and political barriers.” The public silence maintained on this issue for the last 17 years is emblematic of those barriers.

 

But sex workers’ rights organizations in most U.S. cities, though heavily marginalized, have not been silent. They are struggling to end “condoms as evidence” practices, train health-care providers, find or establish sex worker-friendly health-care services, and demand their rightful place as invaluable allies in ending human trafficking and preventing the spread of HIV. Like the harm reductionists who set up the first syringe exchange sites in the United States, they need the support of mainstream sexual and reproductive health advocates willing to learn from them and join them. Like the early harm reductionists, they need the rest of us to bring our money, skills, and political support this human rights struggle.

 

We can’t stop HIV in the United States without sustainable and long-term solutions to end the arrest, detention, and incarceration of sex workers in the United States, as well as end the violations against sex workers within the correctional system. A meta-analysis of more than 800 other studies and reports, published in the recent Lancet series, listed abuse experienced by sex workers as including “homicide; physical and sexual violence, from law enforcement, clients, and intimate partners; unlawful arrest and detention; discrimination in accessing health services; and forced HIV testing.” It added “protection of sex workers is essential to respect, protect, and meet their human rights, and to improve their health and well-being.”

 

Expert voices in support of community-led, sex worker-centered health care in the fight against HIV are becoming more and more numerous. When will the mainstream HIV and AIDS organizations and women’s health advocacy communities join loudly in this demand?

 

by Anna Forbes and Sarah Elspeth Patterson

13 August 2014

Source: http://rhrealitycheck.org/article/2014/08/13/evidence-decriminalizing-sex-work-critical-public-health/

The silent crisis: Mental health in Africa

Steadily approaching the title of the second highest cause of disability in the world, mental health disorders are an international health concern that is gaining considerable attention.(2) Of the global burden of disease, 14% is attributed to neuropsychiatric disorders, indicating a 2% growth since the year 2000.(3) It is believed that the figure will have increased by another percent by 2020.(4) According to the Mental Health and Poverty Project, one in five individuals will suffer from a diagnosable mental disorder in their lifetime.(5) Among the adults who suffer from these disorders, 75% are found to have developed them in their youth.(6) In fact, sufferers of persistent mental disorders in adulthood tend to be those whose condition first arose between the ages of 12 and 24.(7)

 

The 2011 World Health Organisation (WHO) Mental Health Atlas reveals that 110 of its 184 member states have an identifiable mental health policy.(8) Of the 45 African member states surveyed, 19 reported to have mental health policies in place.(9) This paper discusses current deficits in mental health services in Africa, as well as the challenges faced by mental health patients and practising mental health professionals on the continent. The paper also illuminates strides made by groups in various parts of the continent in improving service provision to affected populations.

 

Services available

 

To describe the current accessibility of mental health services in the majority of African countries as deficient would be an understatement. The psychiatrist-to-patient ratio in Africa is less than 1 to 100,000,(10) and it is reported that 70% of African countries allocate less than 1% of the total health budget to mental health.(11) Liberia is a case in point. A 2008 report compiled by the WHO states that there are only 0.06 mental health professionals per 100,000 people in Liberia,(12) where, the S. Grant Mental Health Hospital is the sole inpatient facility for those suffering from mental disorders. A study conducted by the American Medical Association found that 44% of Liberian adults exhibit symptoms indicative of post-traumatic stress disorder (PTSD).(13) The likelihood that these individuals are receiving treatment is very low, when taking into account the scarcity of mental health facilities in that country. The Liberia National Mental Health Policy found that of those living in low income areas that need mental health services, only 15% actually receive treatment.(14)

 

Similarly, in Ghana only 1.17% of those who are suffering from mental health problems have received the required treatment.(15) There are only three major psychiatric hospitals in that country, all of them located in the southern region. Furthermore, there is only one psychiatrist allocated to 1.5 million people. With such limited accessibility, many mental health sufferers seek treatment from traditional and faith healers.(16)

 

Compared with the West African countries mentioned, the situation in East Africa is similarly dire. There is an evident shortage of mental health professionals in public practice. In 2001, Tanzania recorded 10 active psychiatrists catering to a population of 30 million. Of the 10, four work at Muhimbili, a teaching hospital, where patients with serious mental health disorders are referred.(17) Kenya is regarded as comparatively better prepared to cater for those suffering from mental health disorders, with 47 practising psychiatrists in the private and public sectors. Twenty-two physicians exclusively provide services in Nairobi, while the remaining 22 practise in other parts of the country.(18) Mathari Hospital, located in Nairobi, is the national referral and teaching hospital for mental health patients. Its 750-bed facility is divided into two wings, a civil wing for stable patients and a maximum security unit for those suffering from severe mental problems.(19) Middle and upper class citizens have the option of seeking services from psychiatrists in private practice.

 

Risk factors in the African context

 

Mental health issues among African populations are instigated by an assortment of factors. The financial standing of populations in many African countries may be predisposing them to mental health problems. Various studies state that individuals of a lower socio-economic status are twice as likely to suffer from common mental health disorders, as compared to the wealthy.(20). Furthermore, populations in East African countries such as Somalia, Ethiopia, Sudan, Rwanda and the Democratic Republic of Congo (DRC) have encountered armed conflicts and natural disasters in varying degrees. This has resulted into the displacement of more than 1.5 million individuals from the East African region.(21) A consequence of these hardships may be the emergence of mental disorders. The WHO estimates that 50% of refugees have mental health problems ranging from post-traumatic stress disorder to chronic mental illness.(22) The rise in the numbers of individuals who present with mental health problems places an even greater burden on an already under-resourced healthcare service in Africa.(23)

 

Mental health stigma

 

In many African countries, communities are often not empathetic towards mental health patients. The mentally ill face discrimination, social ostracism and the violation of basic human rights, all due to an on-going stigma associated with mental health problems. Ironically, some of these violations occur in institutions where people with ill mental health seek treatment. Mental health facilities have been found with unhygienic and inhumane living conditions, such as the use of caged beds with netting or metal bars to restrain patients.(24) There are documented cases of individuals having been tied to trees and logs far from their communities for elongated periods of time without adequate food or shelter.(25) A study performed in Uganda revealed that the term ‘depression’ is not culturally acceptable amongst the population, suggesting that mental health issues are not acknowledged or considered a legitimate affliction.(26) In another study conducted in Nigeria, participants generally responded with fear, avoidance and anger to those who were observed to have a mental illness. The stigma linked to mental illness in that country can be attributed to a variety of factors, including lack of education, fear, religious reasoning and general prejudice.(27) When surveyed on their thoughts on the causes of mental illness, over a third of Nigerian respondents (34.3%) cited drug misuse, including alcohol, marijuana and street drugs as the main cause. Divine wrath and the will of God were seen as the second most prevalent reason (18.8%), followed by witchcraft/spiritual possession (11.7%). Very few cited genetics, family relationships or socioeconomic status as possible triggers.(28)

 

Challenges faced in improving services

 

There are many barriers faced by African mental health workers in their efforts to improve and increase the availability of services in their regions. As mentioned earlier, the lack of funds allocated by most African governments to the mental health field poses a problem in expanding services so as to adequately meet demand. Furthermore, difficulties such as finding adequate transportation and medication are general obstacles for health workers attempting to reach rural dwellers.(29)

 

Limited research in mental healthcare has also been cited as a major concern. A study spear-headed by the United States National Institute of Mental Health and the Global Alliance for Chronic Disease found that one of the biggest barriers in mental healthcare is the lack of global collaboration in the conduction of research.(30) Research is essential for determining general needs when treating mental health disorders, as well as for creating and monitoring cost-effective interventions.(31) A WHO mapping project on research capacity for mental health in low and middle income countries indicates that epidemiological studies focusing on burden and risk factors, health systems research, as well as social science, were regarded as most desirable by researchers and other mental health stakeholders.(32)

 

Emerging efforts

 

Despite the many shortcomings in their field, mental health professionals are resilient in their efforts to serve and challenge the status quo. For example, the Ministry of Health and Social Welfare in Liberia is working towards increasing access to mental health services throughout the country. The Ministry has partnered with organisations such as the Carter Center and Doctors of the World, with the intention being to establish wellness centres in each of Liberia’s 15 counties.(33) The Carter Center is also currently training 150 mental health clinicians in Liberia. Staffed with trained mental health workers, these organisations will offer treatment to mentally ill individuals in the affected communities. In the event of a case requiring knowledge beyond the expertise of clinicians at the centre, referrals will be made to specialists located in Monrovia.(34) Dr Meiko Dolo, the Director of the Mental Health Department in Liberia, is confident that these plans will come to fruition. A recently released draft of Liberia’s national budget for 2013 depicts, for the first time ever, provisions made for mental health.(35)

 

Following its 11-year civil war, Sierra Leone, established a child-solider rehabilitation project, providing counselling and other support to children living with war trauma.(36) In the DRC, women facing gender-based violence can now go to ‘listening houses’ where they can talk through their trauma in a secure setting.(37) In addition, the University of Cape Town in South Africa completed a project on mental health and policy, whose goal was to expand mental health research in Africa, evaluate existing mental health policies in Uganda, South Africa, Zambia and Ghana, as well as develop new ones.(38)

 

Conclusion

 

Though not as notorious as HIV/AIDS, tuberculosis and malaria, mental health is a global issue that is in need of more attention than it is currently being given. In 2003, 450 million people worldwide were estimated by the WHO to have some type of mental health issue.(39) Eleven years later, it is likely that this number has increased. The WHO also reports that expenditure on mental health is less than US$ 0.25 annually per person in low income countries.(40) Currently, Africa has the lowest rate of mental health outpatient facilities, at 0.06 per 100,000 people.(41) Given the steady rise in the number of mental health sufferers, African countries need to optimise the delivery of mental health care services and take steps towards making this crisis silent no longer.

By Modupeola Dovi

Source: http://www.consultancyafrica.com/index.php?option=com_content&view=article&id=1213:the-silent-crisis-mental-health-in-africa&catid=61:hiv-aids-discussion-papers&Itemid=268

Pressure on SA to host talks to end gay persecution

download (1)

Rights groups are putting pressure on SA to hold an Africa-wide seminar on discrimination and violence that has been postponed several times.

 

The department of international relations and co-operation says it still plans to host an Africa-wide seminar on violence against people because of their sexual orientation and gender identity, even though the meeting has been postponed several times since it was first mooted more than a year ago.

 

Altogether 38 African countries have laws that criminalise homosexuality and in Mauritania, Sudan and Nigeria it is punishable by death. The issue has lately become a political tool for some African heads of state, such as Uganda’s President Yoweri Museveni. Last week, the Ugandan Constitutional Court rejected a new anti-gay law that would have imposed even more stringent regulations against homosexuality than those already in place.

 

Rights groups across the continent now accuse South Africa of stalling on the crucial meeting to follow up on a United Nations report titled Discriminatory Laws and Practices and Acts of Violence Against Individuals Based on Their Sexual Orientation and Gender Identity.

 

“It is essential for policymakers and gatekeepers to have a dialogue with civil society on this issue,” says Tendai Thondhlana, spokesperson for African Men for Sexual Health and Rights (Amsher), based in Johannesburg. “In some countries, governments say violence against sexual minorities doesn’t exist. It is up to us to show them the evidence.”

 

South Africa, together with Brazil and Norway, was instrumental in passing a resolution at the UN Human Rights Council in June 2011 that led to the report on the issue.

 

Regional seminars were then held all over the world that fed into the International Conference on Human Rights and Sexual Orientation and Gender Identity in Oslo in April 2013. But none were held in Africa.

 

No meeting

In March this year, South Africa’s minister of international relations and co-operation, Maite Nkoana-Mashabane, told the UN Human Rights Council that the meeting would be held before the end of June this year, but this has not happened.

 

The international relations and co-operation department’s spokesperson, Nelson Kgwete, responding to written questions from the Mail & Guardian, says: “South Africa is planning to hold the African regional seminar focusing on finding practical solutions for violence and discrimination against persons based on sexual orientation and gender identity.

 

“The objective thereof will be to facilitate an open and constructive dialogue on the issue of discrimination and acts of violence against individuals … and generate greater understanding on the root causes of these challenges. It is key to note that the objective of the seminar is not to create new or special rights.”

 

Kgwete denies that South Africa is succumbing to pressure from other African countries where anti-homosexual laws are in place.

 

“South Africa remains a sovereign and democratic state, founded on values of, among others, human dignity, the achievement of equality and the advancement of human rights and freedoms, nonracialism and nonsexism.

 

“South Africa conceived and initiated the idea of the regional seminar without pressure from any country, both inside and outside of the African continent,” says Kgwete.

 

Pepe Julien Onziema, programme director at Sexual Minorities Uganda, told the M&G telephonically that organisations on the continent understand that, in the current climate, there is a lot of pressure on South Africa in the UN Human Rights Council and in the African Union. South Africa also wants to play an important role in issues of trade and security on the continent, he said, but it needs to stick to its prior commitments.

 

“South Africa at this point needs to take a stand because it has for many years now had laws protecting sexual minorities and has led the process in the past,” he said.

 

Rights organisation Amsher, together with the Coalition for African Lesbians, said in a statement that, even if not all African states attend the planned seminar, it should go ahead: “The worsening hostility and increasing violence against persons on the basis of their sexual orientation and gender identity and expression demands accountability,” they said.

 

In April this year, the African Commission on Human and Peoples’ Rights – an organ of the African Union – passed a resolution on ending violence against Africans based on their sexual orientation and gender identity, which was seen as a step in the right direction by human rights groups.

 

By Liesl Louw-Vaudran

8 august 2014

http://mg.co.za/article/2014-08-07-pressure-on-sa-to-host-talks-to-end-gay-persecution/

Young people demand sexual and reproductive health rights

Young-people_feature-634x252

The first time Alfred went to a HIV voluntary testing centre, the healthcare provider did not treat him well. As a gay man, his story is not so rare.

“He [healthcare worker] asked me are you a man or a woman? I answered I am a man. Then he asked me about my parents,” said Alfred, who lives on the Caribbean island of Saint Lucia.

“He just looked at me and treated me as if I was a disgrace to my parents. I decided not to go to the health centre after that. Because I do not want to go to a place where I am judged based on my sexual orientation. I am gay and I have sex. So what? ”

Challenges for youth to accessing sexual and reproductive health

Key populations in the HIV epidemic, such as men who have sex with men, sex workers and transgender people, have the same sexual and reproductive health rights as anyone else— the right to have sexual relations free from coercion, to have children and to protect themselves from infection.

Last week’s International AIDS Conference in Melbourne, Australia was an opportunity for young people, especially youth from key populations, including young people living with HIV, to discuss the barriers and challenges they face in accessing sexual and reproductive health services.

During a session moderated by the Athena Network and the International HIV/AIDS Alliance, one young panelist Violet Lindiwe, 23, from Malawi, said: “In my community, when you attend HIV testing and family planning, healthcare professionals are likely to judge you because they think you misbehaved and that’s why you are there.”

Myo Minn Htet, a young man from Indonesia, added: “Culture and religious beliefs make it very difficult to talk about sex and to go to sexual and reproductive health services. Moreover discrimination against young key populations make their access to these services more difficult.”

The legal age to attend health centres is also one of the barriers identified by young people. Annie Zamina from Malawi said: “In my country though the legal age to have sex is 16, you cannot go a clinic and ask for contraceptive pills without your parents’ approval. It seems that while the law says you’re old enough to have sex, you are still too young to use contraception or to protect yourself from HIV.”

young-people_inpost

Young people vulnerable to HIV infection and unwanted pregnancies

According to the UN, globally young people account for 40% of all new HIV infections. Each day, more than 2,400 young people become infected with HIV, and some 5 million young people aged 15–24 live with HIV.

Apart from HIV infection, poor access to sexual and reproductive health and sex education opens the door to many other consequences, such as unintended pregnancies and dropping out of school.

Violet said: “When you listen to me, you may think I have a PhD but in fact, I stopped school when I became pregnant. I have to care for me and my son now. And this is what happens to young women in my community when they get pregnant when still students.”

Integrated services

According to the World Health Organization, linking sexual and reproductive health with HIV services is an approach that has the potential to increase universal access to prevention, treatment, and care services.

This is what Link Up— a programme to improve the sexual and reproductive health and rights of young people—is trying to achieve. The project works with young people living with and affected by HIV in Bangladesh, Burundi, Ethiopia, Myanmar, and Uganda and is implemented by a consortium of organisations, including the International HIV/Aids Alliance, Global Youth Coalition against Aids, and the Athena Network.

Sexual and reproductive health rights

Reproductive rights only become tangible when reproductive health services that offer a high quality of care are made widely available. Availability includes both affordability and easy access, which also implies a range of services under one roof.

Like Alfred, Rebeccah, a young woman living with HIV from Zimbabwe, was also treated badly the first time she went to a clinic to receive counselling about contraception. She said: “The nurse said she was surprised I was still having sex considering my ‘condition’. And she told me I should abstain from sex since I am HIV positive. I cried a lot in her office and decided not to go to that clinic anymore.”

But Rebeccah, like many other young people, is now getting to grips with her rights. “As a young woman living with HIV, I am sexually active and I have the right to go a clinic for family planning services,” she said. “My status should not be an argument to be denied this service. And I really hope people should not use our status, our sexual orientation or sex work as argument to deny access to healthcare because we need, no, we demand access to comprehensive sexual and reproductive health services.”

Nina Benedicte Kouassi is a member of the Key Correspondents network, which focuses on marginalised groups affected by HIV to report the health and human rights stories that matter to them. The network is supported by the International HIV/AIDS Alliance.

Feature image credit: Sheikh Rajibul Islam/International HIV/AIDS Alliance

In-post image credit: Julie Mellin/GYCA

By Nina B. Kouassi

30 July 2014

Source: http://stayingalivefoundation.org/blog/2014/07/young-people-demand-their-sexual-and-reproductive-health-rights/