Round-Up

First international tribunal on sexual Council and the NGO CIETAfrica. The survey
assault as a war crime in The Hague found that 60 per cent of rapists knew their victim,
more than 50 per cent of young women thought
HE first international tribunal focusing
they were partly responsible for causing sexual
T exclusively on sexual assault as a war crime
violence and over 10 per cent said they had no
opened on 20 March 2000 in The Hague. It heard
right to avoid sexual abuse. These high levels of
testimony from ten Muslim women from Foca,
rape and the attitudes underlying them highlight
Bosnia-Herzegovina on the organised gang rape,
the urgent need to address this widespread
forced prostitution and domestic and sexual
problem. This also has important implications for
slavery that they and more than 20,000 other
HIV/AIDS prevention programmes.’
women suffered from 1992 0nwards.l
In Uganda a comment by the Minister of Justice
This sexualised violence triggered off unprece-
that: ‘The law existing as of now does not know
dented indignation around the world, but there is
marital rape. Husbands should not be worried,
currently a lack of media interest in this trial.
produced heated debate in the media. The Law
Being the first tribunal in history to deal with these
Reform Commission had apparently raised the
forms of violence against women, the ruling in this
issue in a report, but the Cabinet had not taken
trial will establish a precedent and become a part
action on it. Marital rape is a crime in Zimbabwe,
of customary international criminal law. Thus, its
where a woman recently won a case against her
importance cannot be emphasised too much.
husband. Namibia adopted the Combating of Rape
The three defendants have denied the charges
Bill in February 2000, which also acknowledges
against them. The last defendant was cross-
that rape can occur within marriage.z
examined on 10 November and the trial is
expected to close before the end of November
1. Reuters/Dubai Khaleej Times, 26 June 2000.
2000. A verdict is not expected until end 2. GAIN Listserv, 2000. Controversy about marital
December 2000.z rape in Uganda. Sister Namibia. 12 (1):ZO.

1. Violence against women. Women’s Watch. 2000;

13(3):6.
2. Medica mondiale e.V. Information by telephone and Violence against street children,
Internet, 10 November 2000. Guatemala
WO 15-year old female street children in
T Guatemala were sexually molested by a
Rape in South Africa, Uganda and policeman. Staff from Casa Alianza, a member of
Zambia the Organisation Mondiale Contre la Torture
(OMCT) network, accompanied the girls to the
survey on sexual violence among more than
Office of Professional Responsibility where they
l4 27,000 men and women in South Africa
identified the policeman. The Guatemalan
showed a high prevalence of rape and of
Human Rights Ombudsman has ordered the
dangerous attitudes regarding sexual violence.
authorities to bring the legal case against the
One in four men said they had committed rape by
man to a swift conclusion. The Ombudsman
the age of 18, while 80 per cent said women were
declared that the human rights of the girls had
responsible for causing sexual violence, 30 per
been violated, and that the public prosecutor had
cent said they thought women who were raped
been negligent in her handling of the case by
‘asked for it’, 20 per cent thought women enjoyed
repeatedly not showing up in court.*
being raped, and 10 per cent thought gang-rapes
were ‘cool’. The survey was conducted in
1. Organisation Mondiale Contre la Torture (OMCT),
Johannesburg, Soweto and a number of informal
8/Z/00, omc@omct.org
settlements by the Southern Metropolitan Local

180
 Reproductive
Risk factors for domestic violence
among women, USA
WO case-control studies conducted in the USA
T explored risk factors associated with injuries to
women from domestic violence, the most com-
mon cause of non-fatal injury to women in the
USA. One study at eight large, university-affili-
ated emergency departments collected informa-
tion from 256 intentionally injured women and
659 controls. The intentionally injured women
had a total of 434 contusions and abrasions, 89
lacerations and 41 fractures and dislocations.
Risk factors included male partners who abused
alcohol or drugs, were unemployed or inter-
mittently employed, had less than a high-school
education and were former husbands, estranged
husbands or former boyfriends of the w0men.l
A study at three emergency departments in an
inner-city community in Philadelphia collected
information from 405 adolescent girls and
women who had been intentionally injured and
520 controls. Injured women were much more
likely to have male partners who used cocaine,
and women’s use of illicit drugs and alcohol were
also associated with an increased risk of
violence. Over half of the violent injuries to
women had been perpetrated by persons other
than their partners. Neighbourhood character-
istics such as low median income, high rate of
change of residence and poor education were
also risk factors.*
There is a possibility the US Supreme Court will
strike down the 1994 Violence against Women Act
as unconstitutional. The Act has resulted in the
distribution of US$l.6 billion in grants to improve
work by law enforcement agencies and services to
assist victims of domestic violence, and promote
research. The Act is being challenged on grounds
related to the powers of the US Congress to pass
federal laws and to the constitutional guarantee of
equal protection.3
1. Kyriacou DN, Anglin D, Taliaferro E et al, 1999. Risk
factors for injury to women from domestic violence.
NewEngland Journal ofMedicine. 341(25):1892-98.
2. Grisso JA, Schwarz DF, Hirschinger N et al, 1999.
Violent injuries among women in an urban area.
New England Journal ofMedicine. 341(25):1899-
1905.
3. Minow M, 1999. Violence against women-a
challenge to the Supreme Court. New England
Journal ofMedicine. 341(25):1927-29.
Health Matters, Vol. 8, No. 16, November 2000
Gynaecologist practising 14 years in
UK had had licence revoked in Canada
hearing was held by the General Medical
A Council (GMC) in Britain to investigate
complaints against a gynaecologist who prac-
tised in the UK for 14 years after his licence had
been revoked in Canada. The tribunal investi-
gated over 60 complaints of botched operations,
incompetence and negligence, and fraudulent
qualifications. It became clear from this case that
action was needed to ensure that doctors who
have been forbidden to practise in one country
cannot work in another country either.’
1. Boseley S, 2000. A rude and incompetent botcher.
Guardian (UK). 13 June.
Parental leave policies around the
world
HIS paper gives an overview of the history and
T development of parental leave policies, as well
as how they are implemented in different
countries. Eighty-two per cent (129 of 158) of
countries reporting to the International Social
Security Association in 1997 provided at least
some paid maternity leave, with an average leave
of 16 weeks. Paternity leave, which was first
established in the 197Os, is still rare; only seven
countries provide paid paternity leave, and apart
from Scandinavian countries, only a few days.
Many countries now provide benefits to adoptive
parents. Parental leave is unpaid in the USA,
Australia and New Zealand, but is only 12 weeks
in the USA as compared to one year in the other
two countries. These policies usually began out
of concern for the physical health of mother and
child, but since the 1960s the importance of the
emotional and psychological well-being of
children, as well as the job and economic security
of the parents have also been emphasised.’
1. Kamerman SB, 2000. From maternity to parental
leave policies: women’s health, employment, and
child and family well-being. Journal ofAmerican
Women’s Medical Association. 55(2):96-99.
181
Law and Policy Reproductive Health Matters, Vol. 8, No. 15, May PO00

Debate over anonymity of sperm Namibian Women’s Manifesto

donors, Netherlands
HE Namibian Women’s Manifesto was
HE Dutch parliament approved legislation in T compiled in August 1999 by Sister Namibia, a
T March 2000 to maintain the rule of anonymity women’s NGO, in consultation with government
of existing sperm donors for another two years. members, political parties and NGOs. At a
This move is viewed as a compromise measure, meeting in December 1999, the Namibian
as the majority of the parliament want to move Women’s Manifesto Network decided that a
towards transparency and putting the interests major focus of its efforts over the coming three
of the child first. Starting with new donors, years would be on increasing women’s partici-
children aged 16 or older will have the right to pation in government. The Network will also
know the identity of their biological father. In the focus on the issue of women’s human rights, in
past when donors were given the choice of part through further dissemination of the
anonymity, 85 per cent chose this option. The Manifesto in multiple languages. A third focus
new rule has already had a serious impact on will be on empowering women and girls in the
sperm donation; since opposition to anonymity fight against HIV/AIDS. Activities will include
began to be expressed ten years ago, the number conducting research and developing training
of sperm donations has decreased, the number materials to challenge harmful cultural practices,
of sperm banks has halved, and waiting time for such as dry sex, and assisting women to take
donor insemination is now more than two years. more control over their own lives. Sister Namibia
Opponents of the change point out that only 10 in will lead the activities of the Network.’
45,000 children conceived as a result of donor
insemination in the Netherlands have gone to the 1. Frank L, 2000. Women on the move with the
courts to seek the identity of their fathers. After Namibian Manifesto. Sister Namibia. 12(1):8. March.
Sweden abolished the guarantee of anonymity of
donors in 1985, pregnancies from donor
insemination decreased from 1,000 to 30 per Debate on abortion, Northern Ireland
year.’
N June 2000, the Northern Ireland Assembly
1. Weber W, 2000. Dutch sperm donors will remain
IIdebated a motion to extend the British
anonymous for another two years. Lancet. 355 Abortion Act of 1967 to Northern Ireland.
(9211):1249-52. Currently, abortions are only allowed in
Northern Ireland when the pregnancy could
endanger the woman’s life, when the woman is
mentally handicapped, where there was proven
Controversy over programme for
contact with rubella or where there is high risk of
unwanted babies, Germany
the child being born mentally handicapped.
T is estimated that 20 newborns are abandoned During heated debate, a majority of speakers
1 in Germany each year and about half of them were against changing the law. Some spoke in
die. In order to address this problem, a youth- favour, emphasising the need also to provide
help organisation is setting up a ‘baby slot’ at a adequate information on sexuality and
day care centre in Hamburg. Women will be able reproductive hea1th.l Only half of the members
to place their baby in a chute, after which the of the Assembly turned up for the debate, while
baby will fall into a warm bed and be registered the public gallery was filled to capacity.2 The
into the programme. The mothers are resolution reached at the end, without a
guaranteed anonymity and have up to eight recorded vote, was to oppose any law change.
weeks to change their minds. While some argue
that this will help the problem of abandoned 1. Debate in Northern Ireland Assembly on Abortion:
babies, others feel that it is inhuman.’ Extracts. 20 June 2000.
2. Birchard K, 2000. Northern Ireland resists
1. AP in Hamburg, 2000. Condemnation for German extending abortion act. Lancet. 256(9223):52-54.
‘baby slot’ Guardian (UK). 8 March.

182
 Reproductive Health Matters, Vol. 8, No. 16, November2000

Debate over extent of trafficking in is also important to ensure that women can and
Guatemalan children do access safe services instead of continuing to
seek out untrained providers. Raising public
United Nations report recently concluded that
awareness that safe abortion services are
A the sale of children from Guatemala was
available and providing these at locally
widespread and that legal adoption was the
accessible primary level health service delivery
exception rather than the rule. Guatemala has
points are both important elements in this
become the fourth largest international provider
transition, particularly for adolescent and single
of children for adoption after Russia, China and
women, who tend to have less access to
South Korea. In 1999, there were 1,645 inter-
reproductive health services generally.’
national adoptions, up from 731 in 1996. This
article cites examples of children being forcibly
1. Berer M, 2000. Making abortions safe: a matter of
taken from their parents. However, some say good public health policy and practice. Bulletin of
that the UN report exaggerates the situation and World Health Organization. 78(5):580-92.
is not based on any statistical evidence. They
blame sensationalism in the media for fuelling
the rumours. One example of extreme con- Catholic Church in Bolivia threatens
sequences from this situation is given. In a small judge with excommunication
village, after the murder of a 15-year-old girl
there were rumours of a satanic cult using local fter a judge in Bolivia agreed that a Q-year-
children as sacrifices. When a Japanese tour bus A old girl who had been raped should be
came to the village, one tourist patted a child on allowed to have an abortion, leading Bolivian
the head, a local woman screamed that the child church leaders threatened him with excom-
was being stolen, and hysteria spread, leading to munication. Doctors in the girl’s hometown had
the death of the tourist and the bus driver. There refused to perform an abortion, but the judge
are good intentions among those looking to allowed the abortion in La Paz after protests and
protect vulnerable mothers from exploitation petitions led by women’s organisations. This was
and those wanting to help find caring homes for only the second legal abortion in Bolivia. The La
the many children in institutions. What is lacking Paz diocese has said that the judge should
is actual evidence of the extent of the problem.’ consider himself excommunicated ‘in the event
he does not repent’.’
1. Campbell D, 2000. Guatemala babies ‘sold to highest
bidders’. Guardian (UK). 13 June. 1. Church leaders in Bolivia threaten judge with
excommunication. In Catholic Circles: An
International News Roundup. 2000; 5(2):4.

Making abortions safe

REVENTING mortality and morbidity from
Mifepristone for abortion approved in
P abortion in countries where these remain high
USA
is a matter of good public health policy and
medical practice, and constitutes an important IFEPREX@ a brand name of mifepristone -
part of safe motherhood initiatives. This paper I4 also known as RU 486 or the abortion pill -
discusses the changes in policy and health received approval for use with a prostaglandin to
service provision required to make abortions induce early abortion from the Food and Drug
safe, based on a wide-ranging review of Administration (FDA) in the USA in September
published and unpublished literature. In order to 2000. This has taken a long time, given that
be effective, public health measures must take France (19881, UK (1992), Sweden (1992) and
into account reasons why women have more recently other European countries first
abortions, the kind of abortion services required approved the method.l,* This approval provides
and at what stages of pregnancy, the types of an important new option to US women. It poten-
abortion service providers needed, and training, tially offers improved privacy and increased
cost and counselling issues. Changes at national access to early abortion, since doctors such as
policy level, including in the law, are essential. It family practitioners and obstetricians will be able

183
Law and Policy

as well as abortion clinics. It also allows

to offer it Human rights abuses in Peru’s health
women to have abortions earlier than with care system
surgical abortions,3 and to choose between
N the first case of its kind, the Peruvian
medical and surgical abortion4 Interest in this
I government accepted international responsibi-
new method seems high among many providers;
lity for the rape of a poor indigenous woman by a
those who had not been willing to wait for
doctor in the country’s public health care system.
mifepristone approval to come through can now
The case was brought before the Inter-American
stop using the more controversial alternative of
Commission on Human Rights, with a settlement
methotrexate for early medical abortion.5
reached in March 2000. The government has
However, it is unclear how many doctors actually
agreed to provide the woman with psychological
will offer the method, whether due to legal
care, as well as land and materials to build a
issues, concerns for their own safety from
house and property in a public marketplace to
harassment or other reasons. In addition, some
sell her wares. The doctor has been dismissed,
highlight the need to reduce the cost of medical
and officials have agreed to consider the creation
abortion, currently pegged as high as surgical
of centres for sexual abuse victims and to review
abortion.6
proposals to change the health service and
judiciary systems with regard to such abuse.’
1. Population Council, 2000. Population Council
Welcomes FDA approval of Mifeprex@ Another case alleging human rights abuses in
(mifepristone). News Release, 28 September. Peru’s health care system was submitted to the
www.popcouncil.org Inter-American Commission on Human Rights,
2. Population Council, 2000. Mifepristone: A following the death of a woman who underwent
Chronology. www.popcouncil.org a sterilisation procedure at a public health clinic.
3. www.msnbc.com Peru has a national programme that encourages
4. Kolata G, 2000. US approves abortion pill; drug doctors to perform a certain number of sterili-
offers more privacy, and could reshape debate. New
sations each year. This woman was pressured
York Times. 29 September.
repeatedly by public health officials to undergo a
5. Medical Women’s Association, 2000.
sterilisation, finally being told that she was
6. Gorney C, 2000. New York Times. 29 September.
violating national law on family size by having
more than five children, though no such law
exists. She underwent the procedure in March
Abortion on request in Switzerland
1998, was allegedly refused follow-up care when
HE Upper House of Parliament in Switzerland she experienced complications and told to go to
T approved a bill granting abortion on a another facility, but she was unable to travel the
woman’s request in the first 12 weeks of long distance and died.2
pregnancy, by 21 to 18 votes, in September 2000.
This follows the approval of this bill in the Lower 1. Settlement for Peru women’s rights case, 2000.
House in October 1998, where a 14-week time Reproductive Freedom News. 9(5):7.
limit had been approved. It is expected that the 2. Peruvian case submitted to Inter-American
two Houses will reach a consensus and that new Commission on Human Rights, 2000. Reproductive
Freedom News. 9(7):6.
legislation can take effect by 2002. Anti-choice
groups will be attempting to collect 50,000
signatures to hold a referendum against the
measure, but the Swiss Union for Decriminali-
sation of Abortion believes that most Swiss
citizens will support the bil1.l

1. Rey A, 2000. Abortion in Switzerland. Press release,

Swiss Union for Decriminalisation of Abortion.
www.svss-uspda.ch

184
 Reproductive
New reproductive health law, Buenos
Aires, Argentina
new reproductive health law was passed in the
A city of Buenos Aires in June 2000, marking an
important turning point in the history of repro-
ductive health and rights in Argentina. The law is
based on the City’s Constitution of 1996 which
‘recognises sexual and reproductive rights free of
violence and coercion as basic human rights’. The
law: 1) guarantees women’s and men‘s access to
contraceptive information, methods and services
needed for the responsible exercise of their sexual
and reproductive rights; 2) guarantees holistic
care for women during pregnancy, delivery and
puerperium; and 3) establishes actions to reduce
maternal/child mortality and morbidity. The law
generated heated debate and street demonstra-
tions, particularly regarding whether adolescents
should have access to contraceptives without
parental authorisation, whether the IUD should be
included among the methods provided at public
facilities (as many opponents claimed the IUD is
an abortifacient), and the duty of public health
care workers to provide family planning services
even if this is against their principles or religious
beliefs. When the law was passed, the provision of
IUDs was included along with other reversible
and temporary methods; sterilisation, therefore,
appears to have been excluded. Parental authori-
sation for adolescents requesting contraception
was not required, but instead the law encouraged
the participation of parents in everything to do
with the reproductive health of their children,
where possible. Finally, the law encouraged the
use of condoms for dual protection. There was no
reference to conscientious objection.’
1. Summary by N Zamberlin of the Reproductive
Health Law of Buenos Aires, personal
communication, 2000.
Change in sterilisation law in Costa
Rica leads to increase in demand
INCE a decree in May 1999 which allows
8 sterilisation on request to anyone 18 years or
older in Costa Rica, there has been a marked
increase in demand. The National Hospital for
Women, for example, has a waiting list of over
1,000. A letter in the national newspaper La
Nacidn expressed a strong negative reaction
Health Matters, Vol. 8, No. 16, November 2000
towards this news, describing sterilised men as
‘eunuchs‘ and sterilised women as ‘whores’,
showing that such attitudes still exist.l
1. Calvo Y, 2000. Fear of truth or of intolerance?
Increase in sterilisation creates violent misogynist
reaction. Mujer/Fempress. 221:8.
The US global gag rule violates human
rights
ROHIBITION of the use of US funds for abor-
P tion services and for lobbying on abortion,
whether for or against, has been in force since
1984 under the ‘Mexico City policy’ announced at
the ICPD in Mexico without the consent of the US
Congress. This was only rescinded in 1993, along
with a domestic version of the restriction, by
President Clinton two days after he took office
and was followed by increased funding for inter-
national family planning assistance. In 1995, how-
ever, a conservative majority in Congress began
to search for ways to reimpose some form of the
Mexico City policy through riders on fiscal bills
tied to US dues to the United Nations. At the end
of 1999, faced with losing the US seat in the UN
General Assembly for nonpayment of dues,
Clinton was forced to back down and accept
legislation restricting funding for anyone provid-
ing abortion services once more. The law stipula-
ted that in exchange for US family planning
assistance, non-US groups must certify in writing
that they will not use their own funds to provide
abortion services (except to save the life of the
woman or in cases of rape and incest) or to en-
gage in efforts or activities aimed at changing
abortion laws. These restrictions would apply for
the fiscal year to September 2001. The president
was permitted to waive the restrictions against as
much as US$ 15 million (4 per cent) of the total
funding of US$ 385 million. These restrictions
have been referred to as the new ‘global gag rule’.
The US president waived these restrictions imme-
diately, but the penalty was a US$ 12.5 million
reduction in the overall funds for the population
programme, which had to be spent on child
survival. The US Agency for International Devel-
opment now requires non-US NGOs to fill out a
certification form regarding their abortion activi-
ties. By May 2000 a large number of NGOs had
certified as required in anticipation of receiving
funds for the coming year. Many did so under
185
Law and Policy
protest, e.g. Movimiento Manuela Ramos in Peru
and PROCOSI in Bolivia. Fewer than a dozen
organisations have declined to certify. Only two
have made statements in public - the World
Health Organization, that they could not respond
to a request from an individual state about use of
money donated by other states, and the Inter-
national Planned Parenthood Federation, who
defended their commitment to eliminating unsafe
abortion and removing legal and policy barriers
to safe abortion. Accusations of US cultural
imperialism have been rejected by defenders of
the gag rule.l However, in addition to
undermining the promotion of democratic
participation and a negative effect on women’s
access to legal abortion services outside the USA,
this rule would be unconstitutional if applied to
US NGOs and is said to make a mockery of US
claims to support democratic principles abroad
as well as at home.z Whether or not the new
global gag rule is extended after February
depends entirely on the results of the US
elections.
1. Cohen SA, 2000. Abortion politics and US
population aid: coping with a complex new law.
International Family Planning Perspectives.
26(3):137-39.
2. The New Global Gag Rule: A Violation ofDemocratic
Principles andlnternational Human Rights. Center
for Reproductive Law and Policy. New York, 2000.
Obesity more important issue than
thinness among young women
HE problem of anorexia among young women
T has received increasing attention, but over-
weight may be a more widespread problem.
Anorexia nervosa affects two per cent of women
between ages 15-30, while 20 per cent of lo-year-
old girls are overweight. According to the Inter-
national Obesity Task Force, the UK has shown
the most dramatic increase in obesity. This can
lead to non-fatal health effects such as breathing
difficulties, skin problems and infertility, as well
as long-term life-threatening conditions such as
heart disease, high blood pressure, diabetes and
some cancers. Although there is now criticism of
images of thin women in the media, there are no
such warnings on obesity. This may be a class
issue. Anorexia is typically viewed as a middle- or
upper-class, white issue, while obesity is an issue
for the working class. In order to address the
problem of obesity, young people should not be
made to feel bad about themselves, but should be
encouraged to have better diets, offered cheap
alternatives to fast food and more sports activities
in school curricula.’
1. Birkett D, 2000. Fat chance. Guardian (UK). 23 June.
Reducing gender inequity in laws on
marriage and divorce: Morocco, Egypt
HE Moroccan government has recommended
T various legal changes to improve the status of
women, including improving access to divorce,
raising the minimum age of marriage from 14 to
18 and outlawing polygamy. While women’s
groups took to the streets to show their support,
two Islamic political parties rallied against the
government’s proposals, claiming they were
imposed by the West.’
1. Marriage and family rights. Women’s Watch. 2000;
13(3):6.