Recent Resources for Feminists
Global: Gender inequality - scourge of the 21st century, with systemic change warranted via UN 2015 Print E-mail

 Thursday January 01 2015

Women need to thrive, not just survive

By Meena Menon
Instead of strengthening women's rights in the Asia Pacific region and in the rest of the world, governments are whittling them away in some cases

There was one significant photograph missing in the lobby of the United Nations (UN) Economic and Social Commission for Asia and the Pacific (ESCAP) hall in Bangkok where an important regional review of the Beijing plus 20 goals was under way from November 17-20. While many women leaders in the region, including former Indian Prime Minister Indira Gandhi, were represented, Thailand's first woman Prime Minister Yingluck Shinawatra, ousted in a military coup in May, didn't find a place. The Thai Deputy Prime Minister for Social Affairs, Yongyuth Yuthavong, in his inaugural address, confessed to being the odd man out in a women's meeting just a few years ago, but today the scene is different; there were more men in the room, he said. Yes, there are certainly more men for gender equality meetings now but there are also many elephants in the room.

Twenty years after the Beijing Declaration and 35 years after the Convention on the Elimination of All Forms of Discrimination against Women was adopted, some countries like Iran don' recognise feminist organisations, Russia has a problem with sex education, India conveniently denies armed conflict and caste, and everyone is reluctant to acknowledge sexual rights for women, differences in sexual orientation and gender identity (SOGI).

As a result, the Asia Pacific ministerial declaration on gender equality and women's empowerment, which was accepted in November, was a tame affair. Peace is inextricably linked with equality between men and women, according to one of the critical areas of concern in the Beijing Platform for Action. Yet only six countries in the region have development national action plans on women, peace and security. Survivors of armed conflict are still fighting for transitional justice with very little mechanisms in place for post-conflict situations and also for internally displaced persons. The Indian government, backed by Indonesia, managed to get the words 'armed conflict' out of the final declaration, the second important change it succeeded in making without much ado. That caste has deep implications, especially on women, was lost on the Indian government and it preferred the term 'social origin' instead; this was not opposed by any other country. The term 'sexual orientation' was replaced with 'men and women in their diversity,' angering activists who had fought for SOGI to be recognised.

A global concern
Two major UN meetings to review the Beijing Declaration and Sustainable Development Goals are coming up in 2015. Right from the Universal Declaration of Human Rights in 1948, gender equality has been a global concern. The Fourth World Conference on Women in Beijing in 1995 and the Declaration and Platform for Action set the global standard for promoting women's issues.

Reviews by governments of the Beijing goals 20 years later reveal many shortcomings. The UN Secretary General's campaign 'Unite To End Violence Against Women' cites data to show that 50 per cent of sexual assaults in the world take place against girls who are under 16 years of age, 603 million women live in countries where domestic violence is not considered a crime, between 15 and 76 per cent of women are targeted for physical and/or sexual violence in their lifetime, and 60 million girls are married before they are 18 years old.

On the positive side, a significant change in the last 10 years has been the increasing focus on involving men as partners in gender equality. The MenEngage programme and the HeforShe movement are some of the initiatives by UN Women to rope in men to speak up against violence and be partners rather than adversaries in the process. Many countries in the Asia Pacific region are only now conducting studies and coming up with policies. Nicolas Burniat, deputy representative at the Multi Country Office for the Pacific at UN Women, says, "There is a recognition that we need to spend much more energy on this issue. There is a broader community realisation that gender equality cannot be achieved without involving men and boys, and in the last ten years the region has seen laws passed against violence and for stronger political commitment."

The Pacific Islands Forum Secretariat, one of the two intergovernmental bodies, elected a woman as a secretary general. The Pacific region, which has reported a high rate of violence against women, is now realising the power of its collective voice on gender.

Speaking in a collective voice
However, attitudes to violence in a region where communities are matriarchal are hampered by kinship ties. Abacca Anjain-Madisson, chief of the community division from the government of Marshall Islands, says even recognising that violence exists is a challenge. The first study of women and violence in the Islands reported that one in two women experienced partner violence and only ten per cent were able to seek help. When women complained to the police or the church or community leaders, it was found that the violence was related in "some way to their husbands and [the leaders] refused to take cognisance of complaints." She added: "We are taking ownership of the data and will soon have a gender policy."

Climate change impacts, the rights of indigenous people and the vulnerability of women emerged as major issues at the conference. Land grabbing by corporates and struggles over land ownership were also identified as critical areas. There is a recognition that the region can speak in a collective voice on gender just as it did on climate change as part of the Alliance of Small Island States, Mr Burniat said. Even while there is progress in addressing violence against women in the region, promoting leadership and political participation of women, improving gender parity in primary school net enrolment and attendance rates and parity in secondary school education, high rates of violence, lower work participation, and threats to health and maternal mortality also persist. Roberta Clarke, UN Women regional director, asks, "Why are we underachieving so consistently?" She called for a reaffirmation of political will and financial commitment to deal with gender inequality.

According to ESCAP, for every hundred employed men, there are only 62 employed women in the Asia Pacific region, the average wage gap is 10 to 30 per cent, and women are still concentrated in low-paid, low-status and low-skilled work. The Asia Pacific region's child sex ratio, which is in favour of boys, is one of the highest in the world. As a result of this, gender-biased practices including prenatal sex selection exist. Yet, comprehensive sex education is nonexistent in many countries and the ministerial declaration took a retrograde step by not recognising the sexual rights of women, which was an important right contained in the Beijing Declaration. In 17 Asia Pacific countries, less than 10 cent of seats in Parliament are held by women.

As the world is looking to set new goals post 2015, financial and political commitments assume more importance than ever. Governments have to step up investment in gender equality and do more than recognise that it is an important area for improvement. As Laisema Ralika, an official from the Fiji Ministry of Education asks, "If it's not now, then when?"

Women in the region and in the rest of the world are demanding their rights, already guaranteed to them in various global and national instruments of law. Instead of strengthening that, governments are whittling them away in some cases. "A very big part of the women's agenda is that financing is the key to the post-2015 development goals and there is a need to step up existing commitments. Gender inequality is the scourge of the 21st century, and it is a systemic change that is called for," says Noelene Nabulivou from Diverse Voices and Action for Equality. Women, as Marshallese poet Kathy Jetnil Kjiner aptly sums up, "need to do more than just survive, we deserve to thrive."
 

Mexico: 6 women slain daily, but misogyny & corruption inhibit justice for pandemic of VAW Print E-mail

America ~ Sunday January 4, 2015

Six women murdered each day as femicide in Mexico nears a pandemic

by Judith Matloff
The carnage isn't just in border town Juarez, with the largest number of victims in province of Mexico state
A shrine dedicated to Rosa Diana Suarez Torres in the home of her father, Jose Diego Suarez Torres, Dec. 11, 2014. (Alicia Vera for Al Jazeera America)

ATIZAPAN DE ZARAGOZA, Mexico: Jose Diego Suarez Padilla has converted his home into a shrine to his daughter, Rosa Diana. Windows fashioned  after her blue eyes stare out on the street. A painting of the girl in a white party dress covers a living room wall, overlooking an altar with offerings of chicken and chewing gum. The food has lain there so long that the red chili sauce has congealed.

Suarez Padilla explains to a visitor that he normally puts out fresh food but lately hasn't had time. That's because he's busy all day  consulting with lawyers and politicians to seek justice for her death.

 

 Four years ago on New Year's Eve, a jealous ex-boyfriend stabbed to  death the 22-year-old secretarial student and bashed her face into a  purple pulp. Suarez Padilla spent 10 months hunting down the youth when he went on the lam - authorities would not make the effort. Even though the young man confessed, he has not been sentenced. Suarez Padilla wants to see him behind bars, alongside the police who denied a restraining order two months before the murder when the youth burst into the house, stole her cell phone and threatened to kill her.

"They said it wasn't a crime. What are public servants for if they don't serve justice? They could have prevented her death," says the anguished father, showing a file of documents a foot high that he has assembled to press his case.

His anguish resonates across Mexico, which local United Nations officials say ranks among the world's 20 worst countries for violence against women. Newspapers routinely report "crimes of passion" or unidentified female body parts floating in sewage canals. Misogyny and corruption prevent most cases from seeing justice.

According to the National Citizen Femicide Observatory, a coalition of 43 groups that document the crime, six women are assassinated every day.

Yet only 24 percent of the 3,892 femicides the group identified in 2012 and 2013 were investigated by authorities. And only 1.6 percent led to sentencing.

"Femicides are a pandemic in Mexico," asserts Ana Guezmes, the local representative of United Nations Women, the agency devoted to gender issues.

The word "feminicidio" first entered the vernacular in the 1990s, with explosive rates of disappearances and murders of women in the border town of Ciudad Juarez. In fact, more women have been killed in the state of Mexico, which surrounds the capital city of the same name. The number doubled from 2005 to 2011, when the current national president, Enrique Pena Nieto, was governor of the state. Today he has  pledged to combat drug violence overall but has not spoken out against femicides.

Impunity is the main motor of the gender crime, Guezmes says, as well as social norms that allow the violence to be ignored or accepted as a normal part of life. She describes femicides as the extreme end of a society where 63 percent of women have suffered abuse by male hands. She estimates that maybe a third or half of the cases involved sexual partners. The balance - abductions, rapes and discarding the bodies like garbage - are probably linked to the generalized drug violence that is tearing Mexico apart.
 

Guezmes says the government needs to put more effort toward prevention, and improve access to justice. "These are the biggest problems."

To counter the lack of reliable government statistics, the Observatory trawls through press clips and conducts interviews door-to-door in  marginalized neighborhoods, like this one on the edge of the capital city, where cases normally take place.

 Newspaper clippings related to the killing of Mariana Lima Buendia are kept by her mother. (Alicia Vera for Al Jazeera America)

The group issues regular reports and provides pro bono lawyers to relatives seeking to prosecute killers. They also erect pink crosses at death scenes, but these rarely last more than a day before
unidentified men take them down.

Most of these cases get lost in Mexico's dysfunctional justice system, where police officers can't be bothered to probe, or claim it's the woman's fault, or can be bought off by criminal gangs, says Maria de la Luz Estrada, head of the group. When the murders are investigated, incompetence and failure to follow due process often allow murderers to escape punishment.

Activists say the distinction of femicide in the law is important, because the sexual nature distinguishes the killings from ordinary homicide.

"Hate is what marks these crimes. The bodies show 20 or 30 blows," de la Luz says. "They slice off breasts and faces and throw the fragments in the garbage. In a macho society like Mexico, authorities are always questioning what the women did. What was she wearing? Was she sexually active? This helps the impunity and lack of action."

The victims are generally vulnerable young women, impoverished single mothers or teens. Attackers frequently seize victims on empty streets as they leave school or work, force them into cars, and then rape and torture them and dispose of the bodies.

Families in poor areas like this one generally lack the money or clout to seek legal action, says de la Luz. "The parents are scared to give photos and details to the police, because that can make them vulnerable to extortionists, who say, 'We have her,' when in fact they don't. Corrupt authorities often say, 'If you speak out, your case won't advance.'"

Suarez Padilla is one of the few parents who have pressed charges, but he has had to confront misogynist cops, who implied that his daughter was responsible for her own death because her cell phone contained 200 nude photos taken by the killer.

He takes solace in the international pressure that convinced Mexican lawmakers in 2007 to approve new laws aimed at preventing violence against women. The law called for a data bank and gender violence alerts, to encourage national, state and local governments to catch perpetrators and prevent murders. Yet neither has been activated effectively.

The special prosecutor for violent crimes against women, Nelly Montealegre Diaz, admits that no femicides were prosecuted in 2014. She blames impunity and corruption, but says the government is addressing the problem in a gradual overhaul of the legal system.

Harder to combat, she says, is social acceptance of gender violence. "If a worker sees a [female] colleague with a black eye or the father hitting the mother, they think it is normal. Women are seen as objects."

 Irinea Buendia demonstrates the thickness of the rope her daughter supposedly used to hang herself. (Alicia Vera for Al Jazeera America)

This brings no hope to Irinea Buendia, one of many mothers who has carried a pink cross on marches in her rough neighborhood of Nezahualcoyotl. Her daughter, Mariana, died in June 2010. The husband, a police officer, had beaten her repeatedly during two years of marriage, and tried to shoo away colleagues who arrived to investigate her death. The body lay prostrate on the bed covered in bruises. After 10 minutes, the inspectors bought his story that she had committed suicide with a thin cord, sitting down across the room.

Buendia holds out a red silk string of the type allegedly used. "How could this flimsy thing sustain her weight?"

The Observatory's lawyers have taken up the case, and are seeking a hearing at the Supreme Court. But the family is not hopeful. The husband has been promoted to police commander.

 

Vandana Shiva: GM's legal constructs of personhood deny common freedoms of democratic electorates Print E-mail
 Tuesday January 6 2015, page 11

Corporate fiction

By Vandana Shiva

 

To claim that by adding one gene a corporation creates the seed and all future generations of that seed is an ontological flaw, a scientific outrage and an ethical violation
As the New Year begins, I feel compelled to reflect on how fictions and abstract constructions are ruling us; the nature of being and existence is being redefined in such fundamental ways that life itself is threatened. When corporations that were designed as legal constructs claim "personhood", then real people who stand in line at polling booths, eke out livelihoods, and raise families lose their rights.

This has happened recently in Vermont and Maui. Residents of Maui County, Hawaii voted on November 4 to ban the growing of genetically modified crops on the islands of Maui, Lanai, and Molokai until scientific studies are conducted on their safety and benefits. Monsanto and Dow Chemical's unit Mycogen Seeds have sued the county in federal court to stop the law passed by the people. And Vermont, which passed a GMO labelling law through a legal, democratic process, is being sued by a conglomerate of corporations on the false premise of corporate personhood, and the influence of money as corporate "free speech".

This is at the heart of new free trade treaties based on "investor rights". Denying citizens the right to know violates the fundamental principles of food democracy. Dow and Monsanto sued Maui, thus subverting the democratic process that rests on the will of people, not on the power of corporations. This corporate jurisprudence needs to be reversed if human rights and the rights of Mother Earth are to be protected.

Corporate fictions that have already had disastrous impacts on the biodiversity of the planet, nations and on farmers whose time immemorial rights to save and exchange seeds are being criminalised under patent law and new seed laws.

When biotechnology corporations claim to have "invented" the seed and courts and governments uphold this fiction, millions of years of evolution and thousands of years of agricultural history gets erased.

Seeds are not automobiles or circuit boards; life cannot be manufactured. It is not an invention. It is not engineered, piece-by-piece, by a worker on an assembly line. Living organisms are self-organised complexity. Chilean scientists Maturana and Varela differentiated between two kinds of systems autopoietic and allopoietic. Autopoietic systems are self-organised and make themselves. Allopoietic systems are put together externally. A seed is an autopoietic system constantly self-organising, evolving and adapting to changing contexts. To claim that by adding one gene a corporation creates the seed and all future generations of that seed is an ontological flaw, a scientific outrage and an ethical violation.

India's laws have a clear articulation that biological and living systems are not inventions. Article 3(d) of India's patent laws states clearly that the discovery of a new property or a new use of a known substance is not an invention.

When corporations claim ownership of a seed that contains a gene from a Bt-bacteria, it is, in fact, a new use of a known substance. When they introduce the gene into a plant by "shooting" the gene through a gene gun into the cell of a plant, the reproduction of the cells and the life cycle of the plant is a biological process. The biotech industry is not assembling the organism, nor are they assembling future generations of seeds.

Section 3(j) of Indian Patent Act is a legal interpretation of the scientific principle of the self-organisation of life. That is why the Appellate Board of the Indian Patent Office ruled in the case of Monsanto's climate resilience patent application: "the claimed method is considered as a series of generic steps modified by the plant cell... In the case like the present which does not involve a simple leap from prior art to the invention but rather entails a journey with many generic method steps that are essentially biological taken in sequence and we have found the invention is not involving inventive step, mere fact of human intervention would not change the position as we have otherwise found it not patentable in view of obviousness and new use of known substance."

While the Indian law recognises that seeds make themselves, including future generations of transgenic seed, which have a gene introduced from an unrelated organism, the American laws treat the transgenic seed as a "machine" invented by corporations. This position of seeds as machines and corporations as inventors was elaborated in the US Supreme Court case of Bowman vs Monsanto. Bowman had bought mixed soyabean seeds from a grain elevator and planted them. Monsanto claimed that the seed being planted to get a crop was not the natural reproduction of a seed sprouting into a plant, which then produced the next generation of seed. The US Supreme Court upheld Monsanto's claim that the reproduction of the plants in Bowman's fields was a "replication of a machine" invented and patented by Monsanto.

From the very beginning, Monsanto's push for GMO seeds has been for claiming creation and ownership of seed.

India's Protection of Plant Varieties and Farmers' Rights Act, 2001, has a clause on farmers' rights, which states, "a farmer shall be deemed to be entitled to save, use, sow, re-sow, exchange, share or sell his farm produce including seed of a variety protected under this act in the same manner as he was entitled before the coming into force of this act."

The US would like to force India to adopt a false science and laws that dictate that seeds have been created by Monsanto and are therefore Monsanto's property.

US President Barack Obama will be the chief guest at our Republic Day celebrations. It is time to start a planetary dialogue and a civilisational exchange based on us all being part of the Earth family; and based on our inalienable right to Swaraj, including "bija swaraj" (seed democracy).

We hope Mr Obama's visit will enhance and deepen the common freedoms of the people of India and the US, and not just the freedoms of corporations, which are undermining the freedoms of citizens in both countries and across the world.

The writer is the executive director of the Navdanya Trust

India: Chhattisgarh government's "Rat Poison Theory" to explain sterilisation deaths a farce Print E-mail
 December 31, 2014

Operation cover-up

By Jyotsna Singh

Rat poison theory offered by the Chhattisgarh government to explain the sterilisation deaths is a facade, finds an investigation by Jyotsna Singh. The deaths have exposed deep flaws in India's approach to family planning

 Survivors of the tubectomies recuperating in a Bilaspur hospital

As the news of the deaths of women sterilised at a camp at Takhatpur block of Bilaspur district started to filter in on November 10, officers in Chhattisgarh's health department pro-actively called all the 83 women present at the camp to hospitals in the district headquarters. Then, news came that women who had attended other camps too were feeling unwell. Within hours, the operation to gather all the 137 women who were sterilised in four camps-one on November 8 at Nemi Chand Jain hospital in Sikri, Takhatpur, and three on November 10 in Gaurella block-was initiated. (See `How the tragedy unfolded').

Once the women's health stabilised, they were sent home with a bag of goodies that included a shawl, blanket, saree, salt and a kit of toiletries for their babies. The administration began brainstorming the cause of deaths. It sought the list of medicines given to the women post-surgery in all four camps. Four drugs were common in the list-diazepam, ibuprofen, ciprofloxacin and povidine iodine. Looking at the symptoms of the affected women, they zeroed in on two drugs, namely ibuprofen and ciprofloxacin. Of these, ibuprofen tablets were manufactured in 2013 and were in circulation for some time and, therefore, considered safe.

How the tragedy unfolded

An account of what happened in Takhatpur from November 8 onwards

November 8
First camp held at Takhatpur. Eighty-three women sterilised
November 10
Three camps at Gaurella, Marwahi and Pendra villages. Fifty-four women sterilised
The first death occurs. Six women taken ill
Compensation of Rs 2 lakh for the deceased
November 11
Seven more women die
R K Gupta, surgeon who operated upon women in Takhatpur, arrested by police
Compensation increased to Rs 4 lakh for the deceased and Rs 50,000 for survivors
November 12
Three more women die
November 13
Two more die, one from Pendra town
Medicines come under scanner
November 14
One-member judicial commission under retired judge Anita Jha appointed
November 15
Zinc phosphide found in ciprofloxacin
MahawarPharma promoters arrested
November 18
Private Delhi laboratory confirms presence of zinc phosphide in medicines
Fixed deposit of Rs 2 lakh announced for each child of the deceased

"We found that ciprofloxacin, on the other hand, was manufactured in October 2014. This made us suspicious and we tested it," said Ayyaj Fakirbhai Tamboli, mission director, National Rural Health Mission (NRHM), Chhattisgarh. Preliminary tests of ciprofloxacin tablets showed they were contaminated by zinc phosphide, commonly used as a rodent killer. The state government says the labs in Delhi, Nagpur and Kolkata have confirmed the presence of rat poison but it has not made the reports public. The owners of Raipur-based Mahawar Pharmaceutical Private Limited and Bilaspur-based Kavita Pharma were arrested for culpable homicide.

The culprit had been found. The poison that killed the women had been discovered. Or so it seemed.

A COVER-UP?

Dularin Patel, 27, of Lokhandi village in Takhatpur was one of the 13 women who died. "She was fine till Monday afternoon when she visited us. She had taken medicines on Saturday night and twice on Sunday," says Gorabai, Dularin's mother. "She started vomiting from 4 o' clock in the evening. Then, we got a call from her in-laws, who stay 70 km away, that the mitanin (local health worker) has asked her to go to the hospital. By 3 o'clock on Tuesday morning, she was in Chhattisgarh Institute of Medical Sciences (CIMS)."

"I fed my daughter black tea and bread toast before she left home. I did not know that was going to be her last meal," says Dularin's mother, not being able to contain tears in her eyes. By early evening on Tuesday, Dularin was declared dead.

Ranjeeta Suryavanshi of Nirtu village in Takhatpur block died on the night of November 10. Her husband said he was not given the post-mortem report despite asking the doctor. Her one-month-old child has no option but to live on powdered milk (Photographs: Jyotsna Singh)Preliminary results of the post-mortems of the victims have been submitted to the investigating agencies. They have not been disclosed to the public but a senior medical officer who closely monitored the post-mortems told Down To Earth (DTE) that Dularin had developed septicaemia. "She had inflammation of the peritoneum, the membrane forming the lining of the abdominal cavity. There was half-a-litre of thick yellowish fluid in her lungs and septic foci was found in all organs," said the source, requesting not to be named. "This is a clear-cut case of postoperative infection."

DTE has accessed seven post-mortem reports. Five of these are of women who died on November 11, one of a November 12 victim and one of November 13. All five reports from the first day showed infection of the abdomen. The report from the second day showed high infection in the body. The report from the third day showed septic shock.

"This shows the infection kept increasing among women who were sterilised on November 8. The results show definitively that the women got infection which must have come through unsterilised instruments," says a forensic expert at Lady Hardinge Medical College in Delhi.

The administration's beautifully crafted story of contaminated medicines collapses. The women were prescribed one tablet each of two medicines, twice a day for five days. One of the medicines was the antibiotic ciprofloxacin, which the administration claimed was contaminated with rat poison, zinc phosphide.

Zinc phosphide is linked to kidney failure. "We did not get any renal failure in our post-mortems," informed the source. He said the infected laparoscope must have been the reason for the deaths.

As the forensic expert in Delhi explains, zinc phosphide poisoning shows up as ulceration of the gastrointestinal tract. The source confirmed that signs of this were missing in post-mortems. However, confirmation of poisoning can only be through viscera report, which is awaited.

The health department's second assertion too falls flat. It said apart from the women who underwent sterilisation operations, 26 more people fell sick after consuming the same medicine. Six of them died.DTE accessed the post-mortem reports of three of the six. "There was no peculiar finding in their post-mortems. These can only be confirmed after the chemical analysis of viscera," said the source.

Though the officials claim that medicines are the culprit, they refuse to provide the details, saying the matter is sub judice. The only information they are ready to part with is that two laboratories have confirmed that the medicines were contaminated with zinc phosphide. They would not say what was the concentration of the contaminant.

Experts do not believe this theory. "According to standard books, an adult female needs to consume 4.5 g of zinc phosphide to die," says B L Chaudhary, from the Department of Forensic Medicine and Toxicology at Lady Hardinge Medical College. The Chhattisgarh administration claims that 500 mg tablets of the antibiotic were contaminated. For the sake of argument, even if one assumes that the entire 500 mg was zinc phosphide, a woman would have to consume nine tablets for the poison to prove fatal. Most women started to complain from Monday. By this time, they had taken three to five doses of the antibiotic. This casts doubt on the poisoning argument.


Citing some of these gaps, this reporter asked the officials about an alternative line of investigation. "This seems quite conclusive to us. We are not looking at any other theory. The rest, the lab reports and other tests will tell," said Tamboli of NRHM.

The state government has set up a one-member judicial commission to investigate the deaths. It has to collect testimonies of the survivors. But the commission seems to have placed the responsibility of reporting grievances on the survivors. People wishing to give testimony will have to visit the commission's office in Bilaspur city which remains closed most of the time. "It is impossible to understand how the poor, uneducated and sick women will travel to this place," says Sulakshana Nandi, Raipur-based member of Jan Swasthya Abhiyan, the India chapter of People's Health Movement.

The Bilaspur fiasco has also exposed irregularities in drug procurement. The much-maligned ciprofloxacin was purchased locally by Chief Medical and Health Officer (CMHO) R K Bhange. An official in the health department informed DTE that Chhattisgarh Medical Services Corporation Limited (CGMSCL) has written to at least one inquiry team, stating that the antibiotic stock was available with the authority on November 8.

"The CMHO has the discretion to buy medicines or procure from CGMSCL. Following good practice, he should have chosen the government agency, where the tenders are invited from companies that have been certified by accredited labs," said the official.

"It was a double whammy for the women. The tragedy happened due to multiple reasons. Firstly, the operations were conducted in pathetic and absolutely unsafe conditions, leaving the women medically vulnerable. Then they were fed contaminated medicines," says T Sundararaman, founding director, Chhattisgarh State Health Resource Centre and faculty, Jawaharlal Nehru University (JNU), Delhi. "All these factors should be investigated by an independent team. The state should be held responsible for bungling on all the fronts."

Things don't change

The manner in which the operations were conducted paints a disturbing picture. It resembles a scene straight out of the documentary on sterilisation, Something Like a War, by Bengaluru-based filmmaker DeepaDhanraj, where a gynaecologist boasts:

This year, I have done more than 2,000 operations. I could do these in school classes, college rooms and zilaparishad halls. These operations are so easy. [A woman moans in severe pain in the background.] I thought of this particular method and I took 45 minutes for the first operation... Now, I can finish this operation in 45 seconds.

This was 1991. Cut to 2014. Like the gynaecologist in the film, R K Gupta, operating surgeon at Takhatpur, performed surgeries like an assembly line (see ‘Evil of efficiency'). He was awarded by the state government on January 26, 2014, for a record 50,000 surgeries in his career.

 

Accounts of healthcare providers at the Takhatpur camp show gross violation of the 2006 guidelines, Standards for Female and Male Sterilisation (see `Flouting of norms on November 8'). Even basic medical ethics went for a toss. According to the accounts, women started coming to the camp from 10.30 am. Their blood and urine tests were conducted by junior doctors. It was only at around 3.15 pm that R K Gupta came and he was gone by 5.00 pm after operating 83 women, giving less than one-and-a-half minutes to each woman. The same syringe and suture needle were used for all the women. The staff did not even change their gloves. The hospital floor was just mopped, on which the operated women lay down in the absence of beds. "This is a sure-shot recipe for fatal infection. The women could have acquired infection at any stage," says Subha Sri, member, Common Health, a non-profit working on maternal and neonatal health.
Flouting of norms on November 8

What happened at the camps and what should have happened
 Event at the camps
83 women sterilised
One doctor sterilised them all
Each woman sterilised in one to one-and-a-half minutes
One laparoscope used
No woman knew of the side effects
Nemi Chand Jain hospital was shut since April
No woman knew of other methods of avoiding pregnancy
Operation theatre was cleaned with a mop
Guidelines of 2006
Only 30 persons to be sterlised in one camp
One doctor cansterlise only 10 in a day
Prescribed standards would take an average of 5-6 minutes per case
Three laparoscopes to be used for a maximum of 30 patients
Women should be counselled about side effects
Camp should be conducted in a working hospital
Women have to be counselled about contraceptives and IUDs
The operation theatre should be fumigated thoroughly by burning formaldehyde tablets and liquid ammonia 48 hours before the surgery

Fatal planning

India has always leaned heavily on sterilisation, neglecting other methods of birth control
 
Although contraceptive pills are advertised on house walls in Lokhandi village, few women are aware of these options

On being asked if she knows about spacing methods like intra uterine device (IUD) or contraceptive pills, Takhatpur survivor Rina Patel answered in the negative. She also said that no one counselled her at the camp about side effects and post-operation precautions after sterilisation. (See ‘Sterilisation overdrive'.)

Overemphasis on sterilisation has its roots in the policy followed by India since 1952 when it became the first nation to adopt an official family planning programme. A United Nations Advisory Mission visited India in 1965 and persuaded the government to fix targets for widespread use of IUDs. The next year, the government set up a department of family planning within the health ministry. While IUDs did not become popular, India embarked on a target-driven, camp-based approach. Incentives in the form of money and goods like transistors were offered to sterilisation candidates.

The first camp was organised in 1970 in Ernakulam, Kerala, for vasectomies. Other parts of the country followed and in 1970-71, nearly 1.3 million vasectomies took place in India. During Emergency, scores of men were coerced into vasectomy. Addressing the joint conference of the Association of Physicians in India in January 1976, then prime minister Indira Gandhi said, "We must now act decisively and bring down the birth rate...Some personal rights have to be held in abeyance for the human rights of the nation." Nearly 6.5 million men were sterilised by the end of 1977.

Gandhi had to pay a price after 1,774 sterilisation-related deaths and her party lost the elections after the Emergency. "The lesson learnt was: don't touch the men. And then, the focus shifted to women," says Mohan Rao, professor of public health at Jawaharlal Nehru University in Delhi.

The department of family planning was also renamed department of family welfare to make it sound more agreeable. Following a spurt in female sterilisations and irregularities in operations, the ministry issued guidelines for sterilisation. By the late 1990s the expenditure on family planning overtook the health budget (see ‘Skewed Investment'). "It is a lopsided priority," says Rao. "Better health will help control birth rates, too. Healthier people, especially children, will mean low infant mortality rate, encouraging people to reproduce less."

The National Population Policy of 2000 discouraged targets. But in reality it is targets that hold sway. The target for Takhatpur block, which has 39 sub-centres, for 2014-15 was 2,121 sterilisations, including 1,800 women, explains Poonam Muttreja, executive director of the national non-profit, Population Foundation of India, that recently released a fact-finding report on the Bilaspur deaths. It was further divided among local health workers, so the average target for female sterilisation per worker was 46.

 

By the time each state's budget is decided under National Rural Health Mission (NRHM) and the money reaches the block, half the year is lost. As a result, most of the camps are crammed into a narrow period of October to February. The camp approach is being questioned after the Bilaspur tragedy in the new guidelines on sterilisations to be released in 2015.

Incentives continue to be the norm. A letter by NRHM issued in October says that family planning is crucial to meet Millennium Development Goals. Citing the Family Planning 2020 document, it explains that the recently computed global goals also underline the importance of sterilisation in family planning. It, thus, revised compensation for sterilisation­from Rs 600 to Rs 1,400 for each sterilisation candidate, and from Rs 75 to Rs 150 for the surgeon. The budget for each sterilisation was doubled from Rs 1,000 to Rs 2,000. The revision made tubectomy a lucrative option for surgeons, luring them into the number game.

The role of foreign agencies

International agencies too have played a role in shaping India's policy. In 1952, international agency Ford Foundation gave $9 million to India for family planning. When Indira Gandhi spoke of national rights over personal rights, she was under instructions from the World Bank to bring down India's population growth if the country wanted food for its hungry.

From 2007-2012, India's family planning was primarily funded by USAID, World Bank and Department for International Development of the UK government. They contributed $1 billion. The funding came under attack in 2012, after sterilised women of a camp in Bihar's Araria district complained to the police of irregularities. At present, family planning is funded only by the Indian Government.

But international agencies continue to influence policies of the developing world. In November this year, pharma major Pfizer and non-profits Bill & Melinda Gates Foundation (BMGF) and Children's Investment Fund Foundation announced expansion plans for injectable contraceptive, Sayana Press. This is part of BMGF's $1 billion project on population control. Sayana Press is made of the same chemical as Depo Provera, medroxyprogesterone acetate. Depo Provera has been criticised for adverse health impacts. "Side-effects of Depo Provera include heavy bleeding, amenorrhoea, depression, weight gain, breast tenderness, bone thinning, liver damage and cancers," says Subha Sri of Common Health.

BMGF is sponsoring trials in Africa to see if it is practical for women to inject themselves. "This makes it scarier. If self-administered, the hazards include increased chances of HIV transmission," says Sri. Though India has not yet been mentioned by Sayana Press's promoters, it is a matter of time before the discussions begin, experts think.

Analysts believe the reasons for international agencies' interest in developing countries' populations are much deeper. "Population policies shift the blame for poverty, climate change and food crises on to the poor and suggest that existing development models which benefit corporate capital and which are intensifying poverty and inequality don't need to be changed," says Kalpana Wilson, who teaches at the Gender Institute, London School of Economics.

 

Time for a change

The Bilaspur tragedy calls for an overhaul of policy on reproductive health

Son of Dularin, who died after sterilisation, still thinks that his mother is at his maternal grandmother's house and will return in a few days

Since the the tragedy in Chhattisgarh, doctors, policy-makers and public health experts have been trying to find ways to avoid a repeat. A team of doctors from AIIMS in Delhi went to Bilaspur to help the doctors there provide the best treatment to the ailing women. Teams of non-governmental organisations too went on fact-finding missions. The state government has set-up a judicial inquiry, as well as a health department probe while police investigates the case. While the probe reports are yet to be released, public health experts and other concerned people have suggested some short-term and long-term solutions.

Asking for the operations to be shifted from camps to proper health facilities, Brinda Karat, former member of Parliament and a prominent voice on women's issues, said, "The choice of whether to reproduce, method of birth-control and time should rest with the individual. Sterilisation as an individual's choice has to be provided in a proper health facility through the year."

Consensus among the experts is that in the long-term India needs a thorough review and overhauling of its family planning programme. An overwhelming demand is to stop using monetary incentives to attract people to unsafe family planning practices. Target-based sterilisation must end. Instead of camps, family planning programmes should be available as part of regular healthcare services. It has to be ensured that women alone are not targeted for sterlisation and a basket of contraceptive methods is made available to families. They demand that the women in Bilaspur be provided justice and their healthcare needs be met. They also suggest that government doctors be trained to carry out such surgeries safely. In the light of the alleged role of contaminated medicine, experts suggest that drug procurement policies should also be reviewed.

It is being pointed out that the rate of population growth in India has now decreased and the anxiety for speedy population control must stop. According to census of India, the decadal population growth from 2001-11 came down to 17.6 per cent. It remained above 21 per cent for the preceeding five decades.

"There is a concept called population momentum. It means that population is growing because of a large number of people in the reproductive age group. So, even if they have two to three children only, population growth will be high. We can't do anything about it," Rao says. Around 60 per cent of the population growth today is due to population momentum, 20 per cent due to unmet demand of family planning services and 20 per cent is due to unwanted reproduction, according to a Planning Commission report. Still, India continues to spend a large part of its population control budget on sterilisation (see ‘India's lopsided approach').


This iterates the need to give up the camp approach to family planning. "The goalpost of the family planning debate has shifted. Now women themselves seek family planning services. They do not want more than two-three children. We have to see to it that their demand is met," says T Sundararaman, founding director, Chhattisgarh State Health Research Centre. Integrating family planning with the rest of the public system would remove the need for incentives to meet targets. "We do not need separate camps. The government can fix one day a week when a laparoscopic surgeon would be present for sterilisation," he says.

The main challenge is shortage of trained surgeons. "Bilaspur has two surgeons in the district hospital who are trained in laparoscopy. These surgeons perform other surgeries too. How can we start a weekly service?" asks S K Nanda, superintendent, Bilaspur District Hospital. To this, Sundararaman suggests training more doctors.

Alok Banerjee, member of technical committee on family planning of Government of India, says that minilaptubectomy should be encouraged. "It is a simple and inexpensive procedure. While laparoscopy requires high competency, this can be learnt faster. Also, equipments for minilaptubectomy cost a few thousand rupees, while one laparascope costs Rs 10 lakh. Its success rate is also higher. It is not promoted because even a trained surgeon would take 10-15 minutes to perform one surgery. But it is time we cared for meeting demands and providing safe operations than rushing to sterilise more people," he says.

Jashodhara Dasgupta, convenor of National Alliance for Maternal Health and Human Rights, says it is disappointing that India has not been able to provide basic human rights to women. A pledge to ensure this was taken 20 years ago. In 1994, at the UN conference on population and development held in Cairo, a 20-year action plan was adopted. This action plan asked countries to consider women's needs instead of blindly following demographic demands when planning population control strategies.

Basket of different options for sterilisation also includes male sterilisation which does not receive any focus. Apart from the fact that women are seen as easy target for motivation to sterilise, awareness is also an issue. "Vasectomy is surrounded by many myths like impotency. Government should create awareness and motivate more men to opt for it," says Sri.

A report by a fact-finding mission says that the tragedy in Chhattisgarh was waiting to happen. In 1974, Karan Singh, the then health minister had declared: "development is the best contraceptive". This was ignored at that time. The time has now come to understand this basic concept.

 `Phase out the camps'

Alok Banerjee,a member of the technical committee that is redrafting the 2006 guidelines on family planning, spoke to Down To Earth about the impact of the deaths. Excerpts
 
What challenges does India face in family planning?
There is non-adherence to national standards and guidelines. The camp sites are not cleaned properly, patients are not screened by surgeons and many other violations are rampant. Quality of drugs, their procurement, storage and supply are also compromised.

Would the Bilaspur deaths impact the new family planning guidelines?
Indeed. Earlier, the new revised guidelines were to be released on November 18-19. Now, they would be released in 2015. According to the proposed guidelines, doctors are to be trained for sterilisation at MBBS level. More emphasis is to be put on spacing methods. Having a counsellor at district hospitals and community health centres would be made mandatory.

Did your Bilaspur visit force a rethink on any suggestions you were planning to recommend in the committee?
I will see to it that strong emphasis is placed on phasing out the camps. Also, I will ensure more focus on minilaptubectomy.

What is the way forward?
If we can successfully implement the position of counsellor in public health facilities and ensure proper follow-up care, then long acting hormonal methods like injectables, implants and vaginal rings can be introduced. In any case, spacing methods have to be widely promoted

China: Kong Ning, brave woman jailer-turned-lawyer-turned-artist, urges speedy end to death penalty Print E-mail

 Wednesday December 31, 2014

Will China abolish death penalty?

By Lijia Zhang, INYT

Only two decades ago, capital punishment was simply not discussed. Now, it has become a public issue.

There was an ear-splitting whistle and Kong Ning, a young supervising officer from Beijing, saw blood spurt from the bodies of the 34 prisoners, all men in their 20s and 30s, kneeling in a row in front of her. One man's head was blown off completely. She collapsed on the muddy ground.

Kong was traumatised by the executions, which she watched over on a bitterly cold day in November 1983, when China's first wave of "strike-hard" campaigns against rising crime was in full swing.

After the event, she quit her job and became a lawyer in the hope of defending people unjustly accused of crime. But over the years, she suffered several mental breakdowns, at one point being admitted to a psychiatric hospital for a few months. Now, she always dresses in black - and she always wears a bulletproof vest.

In 2006, she started to paint, primarily as a way to cope with the trauma that had changed her life.

Kong Ning holds a Smog Baby oil painting on the street. Photo: Courtesy of Kong Ning

She has also staged performances, reliving that terrifying incident. Beyond the forays into art, Kong tells her story every chance she gets, hoping to expose the cruelty of the death penalty, calling for its abolition in China and the rest of the world. Her story and interviews have been published in art magazines and have been circulated on the Internet.

This jailer-turned-lawyer-turned-artist may be one of a kind. But Kong is not alone. In addition to a band of committed and courageous human rights lawyers, there are others publicly advocating the abolition of capital punishment.

The subject has also caught on with the general public. In the past decade, there has been increased debate among Chinese people, often triggered by high-profile cases such as those involving a cop-killer, Yang Jia, or an illegal fund-raiser, Wu Ying. Only two decades ago, a topic like the death penalty - involving the state's administration of justice - was just not part of the public dialogue.

But people now have greater freedom to express themselves, especially on the Internet. Also, since everything regarding the death penalty is shrouded in secrecy (the number of executions is still a state secret), the public is interested in any small bits of information that slowly emerge. At the end of 2011, images of prisoners on death row at a Wuhan prison were leaked on the Internet and sparked a fresh round of discussion.

A majority of Chinese people support capital punishment, often citing the traditional saying "to repay a tooth with a tooth and to pay back blood with blood." Such an attitude isn't too surprising for a culture that places less importance on individual life than does the Western humanist tradition.

But as China's engagement with the rest of the world deepens, views are changing. Many Chinese have learned that most European countries and many states in America have banned capital punishment. And more and more people, particularly those who are better educated, have accepted the concept of respecting human life, human dignity and human rights, even the rights of a criminal.

This change of attitude is reflected in a steady decline in public support for capital punishment. In 1995, a survey conducted by the Chinese Academy of Social Science indicated that 95 per cent of ordinary Chinese supported the death penalty; in 2003, an online survey showed that some 83 per cent of those polled opposed abolition, but by 2008, the percentage of opposition was reduced to 67 per cent, according to an online survey by Sina, a popular website.

In this survey, some 22 per cent indicated that they believed China ought to reduce the use of the death penalty, especially for nonviolent crimes. In addition, the death penalty happens to be one of the topics for open discussion that is now tolerated by the authorities.

Capital punishment has always been used by the Chinese Communists to maintain social stability, political order and to curb crime. In 1983, as a result of the strike-hard campaign, the power to approve capital punishment was given to the high court of each province - and it is believed that 24,000 death sentences were issued that year. Some criminals met their deaths for nonviolent offences, such as selling fake train tickets.

Prisoners on death row were also treated badly. Kong recalls how the 34 prisoners killed on her watch were awoken at 4 am on the day of their execution, told bluntly that their appeals had been rejected and that they would be shot that very day.

On way to death
Prison officials then tied the hands of the condemned men behind their backs, and the cuffs of their uniform pants were tightly fastened with hemp string - this way if a prisoner lost control of his bowels he would not soil the floor too much. To calm them down, prisoners were injected with a tranquiliser through their padded cotton pants. Then officials force-fed them steamed bread rolls for a last meal.

There has been progress since then. Prisoners on death row are now allowed to wash and even order their favourite dishes before heading to the execution ground. And more importantly, China has carried out fewer and fewer executions over the years. This trend has become more pronounced since 2007, when the Supreme People's Court took back the power to review death sentences from the provincial courts.

Perhaps the authorities are making an effort to minimise the fact that China executes more people than the rest of the world combined. Perhaps our leaders are reducing the use of the death penalty to showcase their determination to shift toward the rule of law.

In October, Beijing announced a proposal to remove an additional nine nonviolent crimes from the list of offences punishable by capital punishment, including illegal fund-raising and weapons smuggling. Other intended reforms include reducing the judicial use of capital punishment and amending procedural law to control its use.

Such positive measures are clearly in response to changing public opinion. "We must learn to respect life and slowly abolish the death penalty in China," said the artist Kong Ning. The public and the authorities are coming around, but we shouldn't move too slowly.

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