Population Matters

Uzbekistan alleged to carry out forced sterilisations

Uzbekistan alleged to carry out forced sterilisations

Evidence of operations under cover of caesareans as doctors claim targets set to help control population.

Two weeks after Bakhor came home with her newborn son the joy of the new baby was overshadowed by a growing suspicion that something had gone badly wrong. ‘I kept bleeding heavy black lumps, and the pain was unbearable, I thought I had a tumour,’ the 32-year-old Uzbek says. It took Bakhor four months to save up money for an ultrasound. She cries as she remembers the result. During the caesarean section, the doctor explained, she had a hysterectomy. ‘The doctor said ‘you don’t have a uterus any more’. He said: ‘What do you need it for? Two children is enough for you’,’ she says. A two-month long investigation for the BBC World Service and Radio 4 has uncovered what appears to be a systematic state-run programme in Uzbekistan to sterilise women, often against their will and without their knowledge.

Uzbek president Islam Karimov tolerates no dissent in his country and women and doctors who told their stories did so on condition of anonymity. Over secure phone lines doctors and health ministry officials told me that while first recorded cases of forced sterilisations go back to 2004, in 2009 sterilisations became a state policy. ‘All of us have a sterilization quota,’ said a gynaecologist in the capital, Tashkent. ‘My quota is four women a month. We are under a lot of pressure.’ In rural areas, doctors say, the number can be as high as eight women a week. ‘We go from house to house convincing women to have the operation,’ said a chief surgeon in a rural hospital. ‘It’s easy to talk a poor woman into it. It’s also easy to trick them,’ he admitted

Read the full article:  The Guardian

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Philippines needs family planning law: UN

Two United Nations agencies have stressed the urgent need for the Philippines to enact a reproductive health or family planning law especially to reduce its alarmingly high rates of maternal and child deaths.

The World Health Organisation (WHO) and the UN Population Fund (UNFPA) pointed out that such legislation is vital to institutionalise policies and programmes on maternal and child health. Addressing a a press conference, the two agencies said that at least 11 Filipino mothers die every day mainly due to lack of pre and post-natal care. ‘Usually these mothers do not get the proper care they rightfully deserve due to lack of information, access and financial resources,’ a UN fact sheet distributed to media said. ‘The poor,’ the document added, ‘get caught in a poverty trap as most of them marry young, decide to have more children and only get little access to reproductive health.’ In this light, Dr Soe Nyunt-u, the WHO country representative to the Philippines, noted: ‘The bill is of paramount importance for the welfare of the Filipino people.’ The bill, however, has remained stranded in the House of Representatives for the past 10 years.

The bill, sponsored  by Congressman Edcel Lagman of Albay province in the Bicol Region in Luzon, mandates the government to adopt a national policy to reduce the country’s annual population growth rate of 1.9 per cent, considered one of the highest in the world. Lagman noted the Philippines now has a total population of 95 million which makes it the 12th most populous country in the world. But with the unabated growth rate, there would be 100 million Filipinos by 2015, Lagman warned.

The bill allows the government to purchase family planning methods such as the pill and condoms for distribution particularly to poor couples who want to limit the number of their children under the principle of ‘informed choice.’ However, the influential Catholic Bishops Conference of the Philippines (CBCP) continues to strongly oppose the bill, with some of its members threatening to expel or excommunicate Aquino for including it as among his 30 ‘priority’ measures in Congress.

Source: The Gulf Today

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Learning to love the female condom in Uganda

Nebbi, Uganda – Hundreds of women from all walks of life gathered in a school field here recently to celebrate International Women’s Day. As they marched in a parade, carrying placards with messages on the rights of women and girls, many were intrigued by a UNFPA exhibition stall that was distributing both male and female condoms to every adult who asked for them. As women queued to pick up samples of the female condom, many said they were seeing it for the first time. A UNFPA consultant, Loyce Allen Asire, demonstrated to the curious women and men how to use the device correctly.

One woman had heard about female condoms, but didn’t know how to get them. ‘I don’t even know where to buy a female condom,’ she said. ‘And if it were for sale, how much it would cost?’ she asked, grabbing a pack. Currently, the female condom (the newest version is known as FC2) is distributed at no cost in selected public and private-not-for profit health facilities in the country. It is also available for sale in some private clinics in the capital city, Kampala, but at a considerably higher price than male condoms. However, according to a recent report [UNFPA – Contraceptive Commodities for Women’s Health], only one female condom was distributed for every 13 women of reproductive age in sub-Saharan Africa in 2010.

Read the full article: UNFPA

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Dramatic differences in childbearing by age in US, Japan, and South Korea

The very low Total Fertility Rates (TFRs), the average number of children a woman would bear in her lifetime if the birth rate of a particular year were to remain constant) in two developed countries compared with the United States illustrate just how widely childbearing patterns vary. In Japan and South Korea, childbearing below age 20 is nearly nonexistent. In the United States, however, the age-specific fertility rate is 35 births per 1,000 women ages 15 to 19, the highest in developed countries and rivaled only by the United Kingdom.

However, the US teen birth rate has declined since the late 1990s when it was 50. The TFR in the three countries are 1.4 (Japan in 2010), 1.2 (Korea in 2011), and 1.9 (the US in 2010). In the 20-to-24 age group, the increase in Japan is rather modest and very small in South Korea. After that, the patterns are roughly the same. Quite obviously, younger women in those two countries are avoiding childbearing in large numbers and, when they do begin having children, never come close to the two-child ‘replacement’ level. Childbearing is not simply delayed but often shunned.

Source: Population Reference Bureau (Blog 4 April 2012)

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So many mouths to feed: addressing high fertility in famine-stricken Somalia

In Dabke camp for internally displaced persons in Mogadishu, Muno Abukar shares a tent with her eight children. Fleeing the famine, the family left their home in Lower Shabelle five months ago. Since her husband passed away two years ago, Muno has had no means to support her large family. At the camp, she and her children are provided just one meal a day.

This scene, mothers with several children they are unable to care for, is common in camps for internally displaced persons throughout Mogadishu. Averaging more than six children each, women in Somalia have one of the highest fertility rates in the world. Very few women use, or have access to, modern contraceptives – the prevalence rate is around 15 per cent. Despite conflict and famine, the country’s population has nearly tripled in the past fifty years, even with the high rates of mortality: for every 1,000 live births, about 12 women die and 225 children never reach the age of 5. Dr. Nimo Abdi Hassan, a gynecologist at Mogadishu’s Madina Hospital, explained that in Somalia, ‘Giving birth here means that a woman is someone contributing to society … the more [children] you produce the more you save a nation where war has claimed millions of lives.’ Even before the conflict, children represented a form of social and economic capital. Somali society is pastoralist and large families are needed to care for herds. Having a number of surviving children also provides security for parents in old age.

Dr. Hassan believes the only way to effectively deliver family planning messages is through religion. Nearly all Somalis are Sunni Muslim, and religious leaders are deeply trusted. Some believe that limiting family size goes against the will of God, while others assert that no verse in the Quran identifies contraception as haram, or religiously prohibited. In light of the varying interpretations of family planning in the Muslim world, partnering with faith-based organizations can alleviate social (including religious) pressures associated with the practice of child spacing. Natural contraceptive methods such as withdrawal and exclusive breastfeeding are more easily accepted in Somali society. Azza Karam, senior socio-cultural development adviser for UNFPA, said ‘Family planning programmes that disregard the role of religion in shaping behaviour and attitudes in society, will have their outreach and efficiency hampered, as several studies around faith and family planning dynamics increasingly attest to’.  She added, ‘In many instances, a failure to take cultural concerns into account, can lead to misinterpretations about the purpose of family planning and the nature of provision of such services’.

Read the full article: UNFPA

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Indonesia: Cash for vasectomies worries wives

A district in Indonesia is handing out cash to civil servants who volunteer for vasectomies – but the initiative has upset women who fear their sterilised husbands will be more likely to have affairs.

Mukomuko district on Sumatra island is offering one million rupiah ($109) to any of its 2,000 male employees who undergo the operation, in a bid to control population growth in the world’s most populous Muslim nation. District head Ichwan Yunus told AFP on Wednesday that so far nine men had volunteered since the program was launched last week. ‘We hope this cash incentive will motivate more to join,’ he added. ‘This is part of an effort to reduce poverty. With a small family people will be able to live much better,’ Yunus said, adding that annual population growth in the district of 170,000 was a steep 1.9 percent per year.

Indonesia has a population of 240 million, which has been growing at an average 1.49 percent per year for the past decade, according to the country’s central statistics agency. Yunus said that wives – worried that their sterilised husbands would more readily engage in extra-marital affairs as they would not have to worry about contraception – were one of the challenges of the vasectomy scheme. ‘In many cases there is opposition from wives, who are worried that husbands won’t have to think twice about engaging in love affairs,’ Yunus said. ‘We are carrying out a media campaign to encourage more volunteers,’ he said. ‘We may double or triple the cash if it doesn’t attract many participants’.

Source: The Telegraph (Agence France Presse)

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Africa: Family planning – a force for good across the continent

[…] My top priority as a Co-chair of the Foundation I [Melinda Gates Co-Chair of the Bill & Melinda Gates Foundation] run with my husband is making sure that all families have access to safe and effective contraception tools that empower them to make a decision about what’s best for them and their family. And that means encouraging aid donors and governments here in Nigeria and across Africa to make family planning a priority.

Family planning saves lives. In Nigeria, just 10 per cent of married women use modern methods of contraception and women face a 1 in 23 lifetime risk of dying during pregnancy or childbirth. Globally, more than 100,000 women who didn’t want to be pregnant die during childbirth every year. And about 600,000 women who didn’t want to be pregnant give birth to a child who dies in her first weeks of life. Spacing births three years apart is much healthier for mother and child. If all births were spaced at least 36 months, it would save almost 2 million children every single year.

Saving so many lives is justification enough. But family planning doesn’t just save lives; it also makes life better for families and communities, becoming a key driver of economic development. When parents can have the number of children they want, when they want them, they are more likely to be able to care for them properly. They can invest more in their health and education, and in the long run their children have greater opportunity.

The data prove this. In Bangladesh, there is a district called Matlab where researchers have been collecting data on 180,000 inhabitants since 1963. It may be the longest-running, most rigorous study in the field of global health, and it proves in minute statistical detail how access to contraceptives transforms a family’s prospects. Starting in the 1970s, half the villages in Matlab were randomly chosen to get easier access to, and extra education about, family planning. Twenty years later, the people in those villages had a higher quality of life than their neighbors in many ways. They were better nourished, their households had more assets, and their children attended more school. If you multiply these effects times millions of families-and combine them with investments in areas like nutrition and vaccination-the product can be large-scale economic development.

Read the full article: All Africa

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India: Sterilization camps see rural women treated like cattle

Rural women in India have always been dehumanized and the latest case brought to light is that scores of women are being sterilized sans basic sanitary amenities and, perhaps most shockingly, under torchlight.

According to Bikyamasar, an Egyptian-based news organization, health right activist Devika Biswas filed a petition to the Supreme Court of India against the vile conditions that these surgeries are performed under. The court, in return, has issued notices to the state and federal governments, giving them eight weeks to respond to the petition. According to the report, Biswas cited various state-run camps run by doctors, who have no regard for life and treat the impoverished women like cattle. As hospital authorities are required to reach sterilization targets imposed by the government, many of these women got sick and in several cases even died as a consequence of the procedures. Biswas alleged that there were instances where the operations weren’t effective, the report said.

‘Their target is 1 per cent population of the [village] block should be sterilized per year. I have evidence to show that sterilization operations are conducted under torchlight. The operations are conducted without even consent forms and the poor uneducated women are not even informed about other contraception choices which are available,’ Biswas was quoted saying to Bikyamasar.

Read the full article: International Business Times News (US)

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China: Surrogate mums here to stay

For wealthy mainland families, going overseas to give birth is just one of the many ways of evading Beijing’s one-child policy. Using surrogate mothers is another – at least for the time being.

Mainland authorities are now determined to close that loophole, by shutting down a thriving surrogacy industry, particularly after reports late last year brought to light the case of a wealthy Guangzhou couple who had eight babies with the help of two surrogate mothers. Upset by the tycoon’s violation of the one-child policy, Guangdong family-planning and health officials have vowed to arrest the agent who facilitated the surrogate pregnancies. However, they also admitted that a crackdown lacked the support of a legislative framework. The mainland does have a technology code on ”human-assisted reproduction” that was issued by the Ministry of Health in 2001 and bans hospitals from trading in embryos or assisting in surrogate pregnancies. Medical institutions breaching these rules face fines of up to 30,000 yuan [£3,000]. But the mainland does not have other regulations governing surrogacy.

The use of in-vitro fertilisation (IVF) technology to implant embryos in surrogate mothers is a controversial topic around the world. It is allowed in India and some parts of the US, but it remains controversial throughout the world, particularly for enabling surrogate motherhood. In Hong Kong, commercial surrogacy is a criminal offence but no prosecutions have been made under the Human Reproductive Technology Ordinance since it was passed in 2000. Late last year, police declined to press charges after a 10-month investigation into an alleged surrogacy deal involving Henderson Land Development vice-chairman Peter Lee Ka-kit, who had three sons born to him by a woman in the United States.

Read the full article: South China Morning Post

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