Gender and Health in Latin America: Official Document, Women’s Status (Latin America)
The right to life is a basic prerequisite to definitions of the right to live a healthy life. However, because of violence against women and various other stringent challenges to their daily lives, neither women’s health nor their daily lives are fully secure.
This document offers insights into the work of the Organization of American States (OAS), an international agency which helps establish regional guidelines on human rights, health, and gender equity in the Western Hemisphere. While addressing health and healthcare on this level, the organization has long made reports on the status of women a priority. The reports are significant as standard-bearers to measure the state of human rights and health. Although they are not legally binding for the nations which are part of the OAS, these guidelines allow us to measure the progress in the effort to secure basic women’s rights as human rights.
The document encourages conclusions regarding the state of women’s health reflected both in the text of the document and “between the lines.” Consider what achievements have been made and what areas in women’s health still need to be addressed. All of these issues, including but not limited to issues of implementation of health standards, are tied to the politics of globalization, the status of nation-states, and the place of Latin American countries in this context.
This source is a part of the Gender and Health in Latin America, 1980-2010 teaching module.
C. RIGHT TO LIFE, PERSONAL INTEGRITY, AND HEALTH
1. Right to life (Article 1, American Declaration; Article 4, American Convention; Articles 1, 3 and 4, Convention of Belém do Pará)
The responses from the States demonstrate that there are no laws whose purpose is to formally discriminate against women from a legal standpoint in the protection of these important rights. With respect to the protection of the woman’s life, however, the Inter-American Commission has been able to confirm that there are no accurate statistics in any of the countries showing the causes of feminine mortality.
In accordance with the information submitted, the Commission has been able to establish that a high proportion of maternal mortality is attributable to abortion, with levels of 29.1% in Argentina and 26% in Chile. It has also been able to confirm that a high proportion is also due to pregnancy and child birth. For Bolivia, child birth accounts for 58% in urban areas and 63.5% in rural areas, and pregnancy 26.8% in urban areas and 20.4% in rural areas; for Chile, the figure is 39.7%. For Peru, maternal mortality averages 261 deaths per 100,000 births. Peru is third behind Bolivia and Haiti. In rural areas, the maternal mortality rate is double the rate in urban areas. In the Dominican Republic the maternal mortality rate is 185 per 100,000 live births. In the United States the maternal mortality rate is 12 per 100,000 live births.
2. Right to personal integrity and protection from violence against women (Article 1, American Declaration; Article 5, American Convention; Articles 3 and 7, Convention of Belém do Pará)
In the different countries in the region, legislation has been adopted and steps have been taken to afford protection from violence against women. In Argentina, law 24,417 was passed for Protection against Family Violence in 1994, and the Convention of Belém do Pará was ratified in 1996. In Belize, special legislation on domestic violence was passed in 1992 (Domestic Violence Act), and the Convention of Belém do Pará was ratified in 1996. In Bolivia, Law 1,674 on Domestic or Family Violence was adopted in 1995, and the Convention of Belém do Pará was ratified in 1994. In Brazil, the Federative Constitution of 1988 incorporated an explicit commitment by the State to create mechanisms to address and repudiate violence in the family, and the Convention of Belém do Pará was ratified in 1995. In Canada, the elimination of systemic violence against women has been a government priority, as a principal objective of the Federal Plan for Gender Equality. In 1993, the Canadian Panel on Violence Against Women reported the results of its extensive study on the dimensions and impact of violence against women. Federal action has included the Family Violence Initiative which provides economic resources to nearly 3000 projects and the establishment of emergency shelters and housing for battered women and their families. In Chile, the Intrafamilial Violence Act was passed in 1994, protecting all members of the family group that may have suffered aggression or mistreatment by any other family member, and the Convention of Belém do Pará was ratified in 1996. In Colombia, there is special legislation that punishes violence against women within the family, law 294 having been adopted in 1996 to prevent, remedy, and punish intrafamily violence, and the Convention of Belém do Pará having been ratified that same year. In Costa Rica, Law 7,586 on domestic violence at the national level was passed in 1996, and the Convention of Belém do Pará was ratified in 1995. In Ecuador, women’s precincts were created in 1994. The law on Violence against Women and the Family was passed in 1995, and the Convention of Belém do Pará was ratified in 1995. In Guatemala, the Law for the Prevention, Punishment, and Eradication of Intrafamily Violence was passed in October 1996 and the Convention of Belém do Pará was ratified in 1995. In Guyana, violence against women is classified as a crime punishable under the Domestic Violence Act of 1996. Also, the Convention of Belém do Pará was ratified in 1996. In Honduras, the Convention of Belém do Pará was ratified in 1995, and at the completion of the questionnaire by the Commission, a law on domestic or intrafamily violence was in the process of being adopted. In Jamaica, cases of physical violence are punishable under the Offenses against the Person Act; some of its provisions relate specifically to crimes against women. In Mexico, an Intrafamily Violence Protection and Assistance Act was enacted in 1996. In Panama, the Convention of Belém do Pará was ratified in 1995, and intrafamilial violence and mistreatment of minors were classified as crimes by Law 27 of 1995. In Paraguay, the Convention of Belém do Pará was ratified in 1995. In Uruguay, violence against women is regulated by Law 16,107 or the Citizen Safety Act, and the Convention of Belém do Pará was ratified in 1996. In Peru, the Convention of Belém do Pará was ratified in 1996, and Law 26,260/93 was passed, regulating family violence. In El Salvador, Decree 902 of the Intrafamily Violence Act was issued in 1996. In the United States, the Violence Against Women Office was established in 1994. It leads the comprehensive national effort to implement the Violence Against Women Act, which is part of the Violent Crime Control and Law Enforcement Act of 1994. The Pam Lyncher Sexual Offender Tracking and Registration Act, signed into law in 1996, requires the Attorney General to set up a national registry of sex offenders within the FBI. The Interstate Stalking Punishment and Prevention Act, signed into law in 1996, makes it a crime for anyone to cross state lines intending to injure or harass another person. In addition, the Advisory Council on Violence Against Women, consisting of 47 experts representing law enforcement, media, business, sports, health and social services, and victim advocacy groups, works together to prevent violence against women. Venezuela ratified the Convention of Belém do Pará in 1995.
From a legislative or regulatory standpoint, regulations and services have also been established in different countries in the region to make it possible and/or easier to file complaints in cases of violence. Since the mid-1980s, Brazil has developed and implemented assistance services through offices and precincts set up to provide protection for women across the country. Starting in the 1990’s, other countries have adopted similar mechanisms. In Argentina, a Specialized Police Unit was set up within the Federal Police to assist judges and victims of family violence. In Chile, Caribinero (police) personnel receive training in how to assist and protect victims. In Colombia, the women’s precincts and legal offices for the family and other bodies take complaints of intrafamily violence. In Costa Rica, police officials are required to intervene de oficio at the request of the victim or third parties, including entering the victim’s home, to apprehend the aggressor, and many even testify as witnesses during the trial. Also, the Delegación de la Mujer of the Ministry of Justice may file complaints and offer legal assistance. Ecuador set up women’s precincts in 1994. In Mexico, Therapy Centers to care for the victims of intrafamily violence, that report to the Attorney General (Procuraduría General) of the Federal District, were set up commencing in 1996. Also in Mexico, the Technical Judicial Police established a center to provide care to victims of violence and a Department to take Complaints of Sexual Abuse. In the United States, in 1996, the National Domestic Violence Hotline was established to provide crisis assistance and local shelter referrals to victims of domestic violence throughout the country. The Department S*T*O*P* (Services, Training, Officers, Prosecutors) Violence Against Women Formula Grant program provides direct services to victims of domestic violence, stalking and sexual assaults. It also assists law enforcement officers and prosecutors in developing the criminal justice system’s response to violence against women.
As well, the Commission received information on legislation that makes it possible for judges to grant protection, including prohibiting the aggressor from entering the victim’s home and approaching the victim’s place of work as well as temporary decisions on payments for food and maintenance for children. In varying degrees this is the situation in Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Ecuador, Guyana, and Jamaica.
Notwithstanding the merits of these developments, the responses to the IACHR questionnaire shows that serious problems of a general nature exist, that are exacerbated by a lack of resources, poverty, and the marginalization of broad sectors of the population in the region. In this respect, the following points need to be stressed:
a. There continues to be an absence of appropriate personnel or a failure to train personnel properly to process complaints of violence. For instance, in its response, Ecuador reports that for this very reason it is difficult to follow up on investigations of domestic violence and to conclude judicial proceedings. In other countries, there is no information on subsequent status of cases after complaints have been filed (i.e. Chile, Guatemala, Honduras, Mexico, Paraguay, Peru and Venezuela), or there is no suitable training for police officials, judicial authorities, and professional health workers in treating women who are the victims of violence (i.e. Honduras, Guatemala).
b. The existence of legal limitations that restrict women from exercising their rights. In some countries, for instance, domestic violence is seen as a crime which must be brought as a private action, or limited and understood as pertaining to the private sphere as is the case for instance in Brazil and Ecuador. In other countries, domestic violence is not considered a crime but a health problem (Guatemala).
With respect to crimes that are of special interest to women, such as rape, statutory rape, abduction, and sexual abuse, the responses show that specific criminal classifications exist in Argentina (crimes against decency), Bolivia and Peru (crimes against sexual freedom), Brazil (crimes against good morals), Chile (crimes against family order and public morality), Colombia (crimes against freedom and sexual decency), Costa Rica, Ecuador, Guatemala, Guyana, Honduras, Jamaica, Mexico, Paraguay, El Salvador, Uruguay and Venezuela that similarly classify this conduct, protecting juridical interests related to public decency and morality.
One widespread problem concerning these crimes is that the right being protected in the legislation of several of these countries continues to be “honor”, which means that only “decent women” may be victims, for example, of rape. Rape by one’s spouse is not classified as a crime uniformly across the region, and the laws governing persecution or sexual harassment are minimal. Based on the information provided, legislation exists only in Argentina in the public sector, in Costa Rica under a national law, in Mexico under a labor law and in the public sector, and in Peru under labor legislation.
One other matter of importance that adversely affects the rights referred to in this section has to do with inspections and body searches conducted of women who are detained in jail, or visiting prisoners. This procedure practiced as security measure on entry into a penitentiary in some countries in the region is only regulated in exceptional instances to ensure respect for mental and physical integrity and require the presence of specialized medical personnel (see Law 65 of 1993, Colombia, and its implementing regulations, 1995). In responding to the questionnaire, some countries did not supply information on existing legal safeguards for this procedure (Argentina), or indicated that it is practiced without specifying whether or not it is regulated with respect to the requirements mentioned earlier (Brazil, Uruguay, Peru, Venezuela).
3. Right to health and reproductive health (Article 11, American Declaration; Articles 5 and 26, American Convention; Articles 4 and 5, Convention of Belém do Pará)
Based on the information forwarded by the States, it can be seen that in general integral health care for women depends primarily on the organization and structure of adequate services, which are implemented as a result of regulations and programs set up for this purpose. Second, the right to health also depends on whether women are familiar with the laws which protect this right and regulate medical health service. The reproductive health if women should occupy a place of importance with respect to legislative initiatives and rational and provincial health programs.
Some countries have reported on the regulation of family planning services granting individuals or couples the option of using and selecting methods. This is the case, for instance, of the 1984 Resolution issued by the Ministry of Health in Colombia. Also, Colombia’s Law 100 of 1993 provides for free, mandatory, and universal family planning in basic health services. In Argentina, the Ministry of Health and Social Action offers a program on responsible procreation and its aim is to provide information on this right in order to make a responsible decision on having children and to provide advice to the public and families on this subject although there are not yet any regulations governing the use of methods and the provision of these services.
In the responses forwarded by some States, the serious difficulties facing women’s health care in the public sector were described. These problems are attributable to the lack of resources, the absence of norms with respect to reproductive health, the precariousness of service delivery, and a lack of professional personnel and essential supplies.
Organization of American States (OAS). Report of the Inter-American Commission on Human Rights on the Status of Women in the Americas, Washington DC, 1998.