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As you know we are always struggling to get more financial support. So at the beginning of summer we were very happy to get an extra donation by a Swiss foundation, but it was explicitly intended for new projects. Thanks to this donation we now can covers almost all costs of three “new schools” We already knew that two IAW organizations wanted to reach out to schools in precarious condition. Both Anne Yotchou of CEFAP and Quinta Ka of RENATA voiced their great concern about the situation of many school children in their country Cameroon. They both wanted to reach out to high school students (age 12-16). CEFAP was contacting a school at Doumbai Ngaoundéré. This rural region situated in the far North is bilingual (French and English) and is always threatened by gang attacks. RENATA got in touch with a secondary school at Bikok, also a poor area in the region of Yaoundé.

Already last year we had been in touch with Thérèse Akakpo, the coordinator of LA COLOMBE organization. Many of our IAW colleagues might know Thérèse from former IAW meetings. Since many years Gudrun Haupter mandated by Deutscher Frauenring is working very closely with this organization, and so she knew that Thérèse also wanted to join the WP project.

 

Last year LA COLOMBE had been engaged helping vulnerable women during the pandemics at Togo, see WP-website. The new WP activities will be carried out at the Complexe scolaire “Le Guide” at Agbémavo, a high school in a very poor part of Southern Togo.

New planning

With all this we had to adapt our planning. We had to get all necessary information about the specific “new schools”. This is crucial for establishing a good collaboration on all levels, be it teachers, parents, medias.

We also had to organize reprints of all “our booklets”. At the beginning of August Heidi Bodmer, Rolf Keller and me could prepare the parcels for the shipping. Now we hope that they will reach their destination in time for the new school term in early fall!

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Deutscher Frauenring, DFR, for decades kept carrying on this project. In the years 1982 to 1985 I was travelling in Togo with Brigitte Pross, then a Vice-President of IAW. I soon became the main responsible  for the project CJDA, the Youth Centre at Danyi Atigba which first had as its mission to promote young people who looked for work in the cities. Stopping  the rural exodus was a priority with UNESCO and, more or less by chance, I got gift bonuses amounting to 6000 Deutschmark. This fund completed funds obtained from the German Development Ministry, BMZ, earmarked for the training of carpenters and for the salaries of two instructors. The buildings, planned and overseen by a German architect whose wife worked nearby for the German Development Service, DED, is the result of all these efforts. Our priority remained the training of seamstresses and the first eight machines were collected by my collaborators and sent to Togo on the sea route. This is the history of the CJDA in short. DFR up to now remained the only sponsor. Julia represented the DFR at the Centennial celebrations of EEPT, Evangelical Presbyterian Church in Togo, District of Danyi Atigba.

Togo’s women are famous for their clothes made of imported cotton fabrics –the preferences vary  from year to year.  Men’s gowns are also tailored from these fabrics. Festive clothes use fabrics in the traditional “royal” colours gold, red, green, blue.

Much has changed since Julia was in Atigba in 2011 as our intern. On the other hand she met friends from that time, for example. la Reine-Mère In the traditional hierarchy of a village she is the « first lady».

Officially men govern the village.

FODA, an administration unit for the promotion of the village facilities like the CJDA and the health clinic, did not convene during the discord about who should be  the next village chief after the death of the old one.

Technical progress Julia documented in her report is the electrification of the village and running water. The CJDA needs the e-current for the overlock machine acquired one year ago, the fridge to cool beverages, the TV set with DVD player for educational purposes and for the guests of the motel.

To reduce the cost, water from the cistern () is used in the sanitary facilities which belong to them–with a total of 8 guestrooms.

Income from the motel helps to balance the budget. This is also true for the fees paid by the apprentices

Julia had a full program including speeches in the hall of the the CJDA’s main building.  For example, the Director was in action as one of the speakers at the festivities which started in the morning with a festive service in the EEPT. A light meal followed in a nearby school, with more speeches and plenty of guests. An extraordinary meeting of our partners with Julia, a thorough visit of the CJDA and a stop to chat with the apprentices and to encourage them, as well as visiting the local Health clinic with its village pharmacy which is also on our list of donations. Togo’s health system lacks the means to provide enough medicine, we help with generics.

The wish to have many children persists, above all with male inhabitants. Women who rear them, have to cope with everyday chores and earn money, often cultivating a patch of land, could do with fewer children.

To change their lot we recommend to work in Atigba and elsewhere, with the picture box

The future belongs to those who get up early

At this time of the year downpours are frequent, in Atigba, in Lomé, nearly everywhere in Togo

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Dr Ehrhardt’s book offers background information on the onset of UNPFA and the World Conferences on Population artfully linked to the negative role of the Vatican. The author also recalls personal friendships with individuals in the clerical, the German and the international bureaucratic hierarchy and provides a wealth of background information.

The ICPD, International Conference on Population and Development, which remains the last one in a series of four global population conferences under the leadership of UNPFA substantiated the concept that family planning was no longer to be seen as a means of population control but as an individual issue.  Ahead of the ICPD the Vatican had succeeded in becoming a states party with all the rights this status conferred. The Holy See’s standpoint as laid down in the encyclica Humanae Vitae (John Paul I), strongly influenced by his successor John Paul II (1978 – 2005), allows only the natural family planning method generally deemed risky and hardly practicable by women with little education.

Dr Ehrhardt’s conclusion as a critical inside observer of the ICPD is that in the light of the Vatican‘s blockage of modern contraceptives including the financial means required, the “Right to family planning“ in the outcome document is a victory – though diminished by the integration into the large concept of Reproductive Health and Rights.

I attended the ICPD and strongly agree. And I hold that the visibility of family planning suffered from other international decisions as well. In the SDGs, Sustainable Development Goals, family planning is deeply embedded in No. 3, the „Health goal“. You have to look hard for the indicators presented as late as March 2017. IAW endorsed the indicators.

Target 3.7 reads: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs.

On our issue they read: 3.7. By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs; Indicator 3.7.1:  Proportion of women of reproductive age (aged 15–49 years) who have their need for family planning satisfied with modern methods; Indicator 3.7.2:  Adolescent birth rate (aged 10–14 years; aged 15–19 years) per 1,000 women in that age group. https://medium.com/sdgs-resources/sdg-3-indicators-43806cbf63e9

That’s perfect. But who is aware, who monitors? Who collects data from the UNFPA member states and other sources to report in a comprehensive and well researched way? The UN Commission on Population and Development in New York is in charge, the data can be downloaded. However, you need to be a statistician or, at the least, an xlsx whizz to get utilizable country information from the huge scientific compilation of data.

My Californian friend did a bit of research on her own. On Earth day 22nd April she volunteered once more in her hometown Watsonville (population 83% Mexican) as a Spanish speaking link for visitors of the Population Connection (booth) during the annual (Day of the Child Earth Day) fair. After four hours of talking and listening she now believes that the Mexicans understood that they can no longer have families of 10, 12 or more as did their parents. The preferred method to keep to a maximum of 3 children is tubal ligation. Economic necessities brought about much of the change because of the small incomes as strawberry pickers or holding 2 jobs to make ends meet as well as sky high rents for very modest living quarters.

How comes myths are so hard to dispel? My example is the affirmation that African families provide for the parents and therefore need to be large. Dr Ehrhardt comments that while in Kenya as the UNFPA representative he found no evidence that looking and planning ahead was a social virtue or category.

As Convener of the Commission on Health I periodically mail LETTERS to the ten members in different parts of the world on issues fitting into the current Program of Action, mainly on reproductive health rights. Here are some facts on the situation of Family Planning which has become part of women’s Reproductive Health and Rights. Neutral facts are available from sources like the Guttmacher Institute’s report ”Investing in contraceptive, maternal, and newborn care, Adding it Up“ published in Dec. 2017. It shows small improvements in some areas, but the unmet need for modern contraception remains widespread. An estimated 214 million women in developing regions would like to avoid pregnancy but are not using a modern method. This includes 155 million who practice no contraception at all. The number has decreased from 225 million in 2014, but 43% of the estimated 206 million pregnancies in developing regions are still unintended or unwanted. Of these, 84% in developing regions occur in women who had an unmet need for modern methods of contraception, and 74% in women who use no contraception at all. I agree with the remark that it is one thing to contest abortion as a method of family planning, and another to deny “that women are often unable to negotiate when or with whom they have sex or choose when and by whom they get pregnant.”

In its July 2017 volume the Lancet had a 1-page article on Sexual health and reproductive rights at a crossroad, with recent figures on the present situation and new obstacles from the US administration. More is on http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(17)31750-6.pdf

A report on Sexual and Reproductive Health Needs of very young adults of the Guttmacher Institute from July 2017 says “For many, first sexual intercourse happens as a result of coercion or violence. Between 3% and 23% of adolescent females aged 13–17 report experience of sexual violence in the past year; it is 0–13% among adolescent males.” And “Very young adolescent females had an estimated 777,000 births in 2016; 58% of these births took place in Africa, 28% in Asia and 14% in Latin America and the Caribbean. Slightly more than one-third of births to mothers younger than 15 in developing countries were unplanned.” https://www.guttmacher.org/report/srh-needs-very-young-adolescents-indeveloping-countries

Two contrasting facts about UNFPA are: The UNFPA’s mission is to deliver “a world where every pregnancy is wanted, every childbirth is safe, and every young person’s potential is fulfilled”. You have to utterly stretch this concept to make it match with the fact that UNFPA is a multilateral organization in which the USA has a key role although it never ratified CEDAW, (spell out the name of organization) one of the prime sources of women everywhere to know their rights? CEDAW includes the right of women to determine freely and responsibly the number and spacing of their children. The CEDAW General Recommendation 24 from 1999 on Women and Health, says in § 23: In their reports, States parties should state what measures they have taken to ensure timely access to the range of services that are related to family planning, in particular, and to sexual and reproductive health in general. Particular attention should be paid to the health education of adolescents, including information and counselling on all methods of family planning.

Each of us has concerns about the bearing capacity of our planet. To put it mildly, omissions of the past to secure women’s right to plan the size of their families in all countries and societies, prevented them to become an active part of solving the problem.

The post Family Planning for All appeared first on International Alliance of Women.

The statement is on http://www.who.int/reproductivehealth/STAG-STATEMENT.pdf?ua=1

The signatories of the statement are “deeply concerned at the growing opposition to sexual and reproductive health and rights. Current global trends – increasing stigmatisation of essential information and health services, continued support for harmful practices such as child marriage and FGM, increasing restrictions on contraceptive services and abortion care, and decreasing funding – threaten the provision of life-saving care needed by women and girls, especially the poorest and most marginalised.”

The statement ends with “Now, more than ever, it is critical to ensure access to comprehensive sexual and reproductive health services and information and to guarantee that scientific evidence is developed, shared and used by decision-makers to ensure the promotion and protection of sexual and reproductive health of all individuals everywhere, so that no one is left behind.”

Gudrun Haupter, Convener of the IAW Commission on Health, adds: The Global Gag rule, also known as Mexico City Policy, does not only ban abortion-related activities. The strings attached to receiving funding from USAID, the Agency for International Development, negatively impact the access to family planning, mother and child care, sexual education and the other components of SRHR. NGOs that sign the Global Gag rule memorandum also pledge not to use their own funds for any activities linked to abortion. NGOs with USAID as main source of funding have to choose between two evils.

Unfortunately the backlash is manifest in many countries. I just call to memory the recent attempt of the Polish government to get through with a quasi complete ban of abortion.

Read the whole letter in the Guardian

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 “

Among the 30 members of INTEGRA are the National Committees of UN Women and of Unicef, the BMZ (Federal Ministry of Cooperation) and the GIZ, the Agency for German International Cooperation. In the 1990es the Agency had set up in Ouagadougou, Burkina Faso, the Supra-Regional Project to support government and NGO initiatives. They researched and published Best practices and Lessons learnt for the abandonment of the harmful traditional practice, kept track of the situation in many African francophone and some anglophone high-prevalence countries, held a conference in Sierra Leone where 9 out of 10 women are circumcised, to name but a few of the Supra-Regional Project’s activities. Early on GIZ experts invited NGOs working on FGM/C in Germany and/or in Africa – among them my organization Deutscher Frauenring – to meetings. Thus, a German network Government/ NGOs came into existence in 2000.

To learn more about how INTEGRA works in program countries go to The WHO fact sheet on FGM/C updated in 2016 is available in all official UN languages. For the English text see http://www.who.int/mediacentre/factsheets/fs241/en/index.html . I recommend reading it, not only for the medical information but also for the different explanations why it is practiced. It also has a resume of International Response and of WHO Response. As to the violation of the human rights of women and girls it states that FGM/C constitutes an extreme form of discrimination.

The IAW standpoint is: The Zero tolerance request repeated each 6^th February means: no loopholes like medicalization, no pricking or other “minor” Type 4 procedures to conform with social norms. Women’s sexual and reproductive health rights have to be respected. To avoid complications at birth access to contraception is of particular importance.

This also means deep-rooted beliefs have to be abandoned. These are myths about dire consequences if the woman is not circumcised:

– Her health is jeopardized, so is that of the man and the child

– She develops excessive libido, is prone to marital infidelity and prostitution

– She gets sick and infertile

– The man gets impotent because of the woman’s “penis” – her clitoris which also interferes with sexual intercourse and birth and kills the baby.

Author’s comment re this compilation: “Myths are created to cover up what is basically always behind them: controlling women’s sexuality.”

Myths and reality are far apart. FGM/C is internationally recognized as a public health issue. However, weaknesses in a government’s health structure present obstacles to follow through with an issue.

The UNDP/ UNFPA/WHO/ World Bank Special Programme of Research, Development and Research Training in Human Reproduction promotes, coordinates, supports, conducts, and evaluates research on sexual and reproductive health, with particular reference to the needs of developing countries.

http://www.who.int/reproductivehealth/topics/fgm/progress72_fgm.pdf published in 2006 deals with FGM/C and has a map of Africa showing the prevalence among women aged 15 to 49. A study involving 28 393 women attending 28 obstetric centers in rural and urban areas of Burkina Faso, Ghana, Kenya, Nigeria and Sudan, brought solid evidence that FGM/C has a negative impact on obstetric outcomes for the mother and the newborn. The risk of an adverse outcome increases with more extensive FGM/C (Type 2 and 3).

http://www.stopfgmmideast.org/ is the best Internet address I know to get condensed information about FGM/C in countries and regions outside Africa. There you also find a map on these areas of concern including country information. And you find a note on Russian religious leaders endorsing FGM/C this August. To read more go to http://www.premier.org.uk/News/World/Disgust-as-religious-leaders-endorse-FGM-in-Russia

New surgical techniques including clitoral reconstruction after (FGM/C) offer hope. In several countries including Burkina Faso and Senegal doctors trained to perform surgery to reduce clitoral pain, improve sexual pleasure, and restore a vulvar appearance similar to uncircumcised women.

Most women in Africa cannot afford the surgery, nor are they able to travel far. Quote from the story of a nurse in Ouagadougou seeking relief : “Contrary to the repair of consequences of the circumcision (obstructed menstruation, impossibility to give birth etc.) which is done in many health centers at no cost (except for a standard medical kit), the government does not pay for clitoris restoration associated primarily with the quest for pleasure.” Donations and bona fide action help a limited number of women. In European countries costs of the surgery performed on circumcised women are mostly covered by health insurance systems.

To ensure funding on an international scale the International Donors’ Working Group on FGM/C has been meeting for annual workshops since the year 2000. The EU is involved, too. Research, programs, campaigns and projects are expensive, particularly those with a holistic approach. In affluent societies cost is reduced by voluntary workers. In low and middle income countries, according to my experience, poorly or irregularly paid administrative authorities receive a small compensation for their cooperation, and other groups involved such as experts and professionals, need the income to survive.

Conclusion: No one has ever added up the cost of all the efforts – national and international. No one ever tried to establish a list of all the jobs created by awareness-raising and following through with agreed-upon action on how to free girls and women from undergoing FGM/C and empowering them to make decisions of their own. Accountability and evaluation are a must. Even for small scale projects we should insist on accountability and – at least – self-evaluation.

International action, for ex. the UNFPA joint programme on FGM/C, also aims at eliminating other harmful traditional practices like child marriage.

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IAW, an International Women’s rights organisation, commends WHO on the response to the challenges arising from the ZIKA virus which has spread to as many as 55 countries and territories.

This recent health emergency of international concern has many facets and IAW would like to voice concern on one of them – ZIKA and pregnancy.

Mothers bear the brunt of caring for children born with microcephaly and other neurological disorders which may show only later. According to Dr. Sonja Rasmussen of the US Centres for Disease Control what we see now could only be the tip of the iceberg. Few countries have care infrastructures to cope with this emergency. Thus for women who already have children this burden means additional mental and physical stress.

Women including adolescent women, who would rather delay a pregnancy often cannot access modern contraceptives let alone safely terminate a risky pregnancy.

This means their right to health and to development is severely thwarted in all countries where the threat of ZIKA infection exists but Governments and Society disregard these essential reproductive health rights.

Women either have to carry unwanted pregnancies to term or resort to unsafe abortion.

In March 2016 women’s and girls’ right to sexual and reproductive health has been strengthened by General Comment No. 22, on the article 12 of the International Covenant on Economic, Social and Cultural Rights. [i]

The introduction reads “Due to numerous legal, procedural, practical and social barriers, people’s access to the full range of sexual and reproductive health facilities, services, goods and information is seriously restricted, especially for women and girls.”

May the ZIKA emergency prompt countries to revise restrictive laws as appropriate, and abandon traditional norms which make for unequal power relations between women and men. Governments who act now can count on healthier and empowered women who will contribute to their country’s development.

[i] http://tbinternet.ohchr.org/_layouts/treatybodyexternal/TBSearch.aspx?TreatyID=9&DocTypeID=11

The IAW Commission on Health chaired by Gudrun Haupter wrote the statement, and – as in former years – Seema Uplekar, our current Main representative at the WHO  addressed Governments and other participants of the WHA.

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Att. Melinda Gate.
info@gatesfoundation.org

Re: World Contraception Day 2015

Dear Melinda Gates

The International Alliance of Women, Equal Rights – Equal responsibilities, IAW, is an international NGO comprising 41 member organizations involved in the promotion of women’s human rights, of equality and of the empowerment of women. The IAW has general consultative status at the UN Economic and Social Council and is accredited to many specialized UN agencies, has participatory status with the Council of Europe and is represented at the Arab League, the African Union and other international organizations.

In the health field IAW has a focus on Women’s and girls’ reproductive health and rights. Back in 2007 to 2009 our representative at the Human Rights Council advocated for the HRC Resolution on “Preventable Maternal Mortality and Morbidity and Human Rights” making statements at the UN level and working with governments and WHO to obtain the resolution adopted in June 2009.

In May 2014 our representatives at WHO had the privilege to listen to your speech as invited guest at the World Health Assembly Opening ceremony. We learnt for example that the Bill & Melinda Gates Foundation is funding research into the demographic dividend that shows the connection between family planning, maternal and newborn mortality, child survival, nutrition, and economic growth.

An interview you granted to TIME for the issue December 1-8, 2013 on the London Family Planning Summit, had informed us of your decision to devote the rest of your life to improve access to family planning all over the globe.

We wish to congratulate you on this decision and hope the global movement launched at the summit will succeed in giving an additional 120 million women in the world’s poorest countries access to lifesaving family planning information, services and supplies by 2020.

2.3 billion $ had been raised, we learnt, and used in part for research on contraceptives, working with manufacturers and bringing prices down. Progress for the long-term solution of implants has been made you said. And you announced that the Bill & Melinda Foundation is increasing its investment in family planning by $560 million over the next eight years bringing the total figure to more than $1 billion from now until 2020.

We hope the World Contraception Day 2015 gets all the national and international attention it deserves. IAW will alert public attention on our website www.womenalliance.org

Within the Ouagadougou Partnership resulting from the October 2012 Conference in Burkina Faso, your foundation is supporting the introduction of the long-term contraceptive Sayana Press in Senegal, Niger and Burkina Faso in collaboration with the other core donors of the Ouagadougou Partnership. Unfortunately the Training Materials for facility- and community-based providers both in English and French are available only as PDF. We know the situation of women in rural Burkina Faso because one of our members is involved in a project for women in rural Burkina Faso. We therefore would like to plead for making hard copies available, too, because that is what health workers need in the first place.

In the Department of Kongoussi, Province of Bam, Counseling capacity exists only at the maternity of the Provincial Hospital, and the current situation is : Once the woman has the prescription in hand she needs to spend time waiting to obtain the commodity, maybe having to return the next day. In the system known as “social marketing” she often does not have the money to pay her share. Women in that part of Burkina Faso still have an average of six children, and their husbands all too often think it is up to the wife to prevent a pregnancy if she thinks that’s too many.

We are grateful to your foundation for all the good work that you do.

Very truly yours,
Joanna Manganara
President

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For a long time WHO used to speak of sexual and reproductive health but not of “rights”. Progress has been made mainly by action of the Human Rights Council and NGO pressure. Due to the reform process, WHO now has a Gender, Equity and Human Rights Team. In the words of Director-General Margaret Chan in May 2012, the goal is “to achieve a WHO in which each staff member has the core value of gender, equity and human right in his/her DNA.”

The Cairo Conference on Population and Development in 1994, better known as ICPD, has been a milestone for individual SRHR. Some texts, including that on abortion, have been copied into the Beijing Platform for Action and remain the internationally valid reference. CEDAW had paved the way for changes in marriage and family matters. The findings of the WHO Commission on Social determinants of Health raised awareness about health inequities and asked for ways in which to tackle the inequitable distribution of power, money and resources between men and women. From here it is easy to establish the linkages between SRHR and poverty.

At the global level we have come a long way toward equal rights for the enjoyment of SRHR. What about the national and community levels?

Governments used their right to make reservations, particularly on the CEDAW Art.16, which deals with marriage and family matters. Moreover, in many countries traditional norms prevail at community levels in spite of legislation harmonized with international treaties and standards. Traditional barriers are often reinforced by moral and religious rigidity. Thus, if you happen to be poor and uneducated and live in a village, you have few, if any, choices!

This situation is a big threat to women’s and girls’ sexual and reproductive rights, all the more so if they happen to be poor.

I’ll devote my speaking time to going through the main sections of sexual and reproductive rights and try to clarify what the burden of poverty or lacking resources mean to women’s enjoyment of these rights. As to men, they are not expressly mentioned but are, of course, included where appropriate.

Information on and access to family planning
I belong to those who consider family planning to be the bottom line for women’s empowerment as well as for poverty alleviation. I simply cannot imagine how, with a daily income of 1 or even 2 US $, large families can send all their children to school or pay for the health care they need. And free education and health care are not around the corner! As long as a country’s women, and particularly its poor women, continue to have many children because of lack of empowerment and access to family planning, development problems cannot be solved, and women’s hardship persists.

In the film Empty handed, Population Action International deals with the frustration of women in sub-Saharan Africa who are faced with shortcomings in the supply chain for contraceptives. “Men mostly consider family planning to be women’s responsibility and none of their business,” an intern in our rural FGM project answered to a question passed by the Project Committee of my German organization, Deutscher Frauenring.

Urban women are more likely to be near a reliable source for contraceptives of their choice. A UNICEF report of March 2013 says the unmet need for family planning is higher amongst rural, poor and uneducated women in Africa. And in some countries in Latin America the poorest 20 percent of women are twice as likely to have an unmet need compared to the wealthiest 20 percent. Currently an estimated 220 million do not wish to become pregnant now – or to have any more children.
Six years ago IAW adopted in New Delhi a resolution on the unmet need. My draft said “unmet need of married women” which was the term used by UNFPA and others. However, IAW women insisted that “married” be scratched. The restriction now seems out-dated. The discussion runs rather about health services that need to become more youth friendly.
This clearly means helping adolescents to prevent sexually-transmitted infections including HIV and untimely pregnancies, as well as to obtain safe abortion where legal. In addition, care and curative measures which include mother and child care should be provided.

IAW has actively participated in the recent discussions at the UN level on maternal mortality and morbidity as human rights issues. According to the 2006 UN Special Rapporteur’s report on health, for every woman who dies from obstetric complications, approximately 30 more suffer injuries, infection and disabilities.
Over 90 % of maternal deaths occur in developing countries where public health systems tend to be weak, a high percentage of girls and women are poor and lack the right to terminate an unwanted pregnancy in a safe way – while well-off women often have access to both abortion and emergency contraception.
According to research of the Guttmacher Institute, maternal deaths for all causes could be slashed by 70 % and abortion substantially reduced if investment in family planning and maternal and child health services was doubled.

Child marriage
“Let girls be girls not brides” is the slogan UNICEF has chosen to campaign against the harmful tradition. Online research for the resolution on Child Marriage, and for a French article in International Women’s News, revealed that the connection between child marriage and poverty could not be clearer. This data is from the UNICEF country survey though by far not all countries where child marriage is practiced, responded.
Guess where the empty lines are! A number of countries indicated only the national prevalence. Others added figures on the frequency of child marriage in urban and in rural settings. These show that in all countries rural girls are much worse off. Family wealth levels play a crucial role. The poorer a family is, the higher the risk that their girls are married away early.

To illustrate this I have examples from several continents, however they are awkward to read out.

Female Genital Mutilation is another harmful cultural practice which, in the past, got far more publicity than early marriage.

The brutal ritual continues to be practiced in 29 countries. The latest UNICEF report reveals that compared with the generation of their mothers the percentage of genitally mutilated girls is significantly lower for the present generation. However, we have to be distrustful of percentages, as they do not necessarily mean a reduction in absolute figures in countries with a high number of live births per women. All the more so if child bearing starts early as programmed by child marriages.

With FGM the poverty link is not quite as evident. Well-off families take their girls to be “operated on” by skilled people, under anesthesia and hygienic conditions.

This does not make it any more acceptable to FGM activists and the international community! Affluence may not guard against FGM but, as a rule, the physical consequences will be less severe. And: girls and boys who have been sensitized at school, will probably not have their own girls mutilated, particularly in urban settings where the extended family’s influence is less strong. From our project in rural Burkina Faso we know that despite poverty and illiteracy among women, anti-FGM activities can be successful.

HIV / AIDS and poverty
– In most countries poverty prevents the infected victims from accessing Antiretroviral medicine. WHO has made the prevention of mother-to-child transmission a priority. However, in poor countries with a high incidence, progress is far from satisfactory.

– Sexualized violence including rape hits poor segments of a population particularly hard and often puts women at an increased risk of HIV/AIDS.

– Prostitutes in low and middle income countries are no doubt the largest risk group for getting infected.
I read the story of a 34-year old divorced mother of three who worked as hard as she could as a prostitute in a seedy quarter of Djakarta. Every few months she returns to her village with the small net profit of what she earned. Otherwise her children and her mother could not survive. An NGO pays for the condoms included in the package price, but most lovers refuse to use them. She was lucky in that she did not test HIV positive till now. Soon she’ll be too old for the trade so she tries to scrape together as much as she can.

Conclusions
I could go on pointing out situations and settings where poverty and social status decide whether or not a woman can avail herself of her sexual and/or reproductive health rights or not. Dividing countries into rich and poor ones does not really work. Even in affluent countries poverty exists and is aggravated if there are no adequate social systems. Out-of-pocket payments for reproductive or sexual health (and of course for other health conditions) can turn well-off citizens into poor ones.

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