María Cecilia Espinosa
SANTIAGO, Mar 7 2006 (IPS) – The first annual report by the Chilean Observatory of Gender Equity in Health calls for legislation on sexual and reproductive rights for women, making therapeutic abortion legal once again, and making emergency contraception available to all women.
The lengthy report, which is prefaced by a health profile of Chile from a gender viewpoint, reflects progress on previously existing inequality and invisibility of health differences between men and women, researcher Margarita Iglesias, of the Centre for Studies on Gender and Culture in Latin America, told IPS.
With the aim of improving health policies, programmes and plans in Chile, the Observatory analysed questions like social participation, unremunerated health care, work-related health problems, gender violence, and sexual and reproductive health, reporting evidence of both progress and setbacks.
The study was carried out by civil society organisations backed by the Pan-American Health Organisation (PAHO), and was presented on Mar. 2 by the PAHO representative in Chile, Juan Manuel Sotelo, the minister of the National Service for Women, Cecilia Pérez, and the deputy minister for Health, Cecilia Villavicencio.
The report shows that non-confrontational, consistent social vigilance is possible, in dialogue with government institutions, which paves the way for gradual improvement of public policies with the participation and influence of civil society, María Isabel Matamala told IPS. Matamala coordinates the PAHO-WHO (World Health Organisation) Gender, Equity and Health Reform project.
Sexual and reproductive health is one of the most complex and controversial areas in the gender debate between the State and civil society, said Pérez.
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Conservative pressures affect the poorest women, who are excluded from what is available to rich women, she added, alluding to the ban on therapeutic abortion in Chile since the last year of the dictatorship of Augusto Pinochet (1973-1990), and the restrictions imposed by the Ministry of Health on the distribution of emergency contraceptives.
The report also approaches sexual and reproductive health from a human rights perspective, focusing on men and women of all ages, recognising joint responsibility for reproduction, respecting the right to autonomy and physical integrity, and including sexuality as an issue that can be discussed independently from reproduction.
This approach was first formulated at the International Conference on Human Rights in Teheran (1968), which established that parents have a basic human right to determine freely and responsibly the number and the spacing of their children.
Since then, several international conventions have safeguarded sexual and reproductive health as an integral part of human rights, and they were definitively enshrined at the International Conference on Population and Development (Cairo, 1994) and at the Fourth World Conference on Women (Beijing, 1995).
These pronouncements are not legally binding on the Chilean State. However, the Convention on the Elimination of All Forms of Discrimination against Women (1979), the Convention on the Rights of the Child (1989), the International Covenant on Economic, Social and Cultural Rights and the International Covenant on Civil and Political Rights (1966) are all legally binding, and have not been fully met by this country.
One of the main setbacks has been the blockage of the draft framework law on sexual and reproductive rights, submitted to Congress in 2000.
A second attempt was made four years later, when a new constitutional guarantee of sexual and reproductive rights was included in a draft law to reform the Constitution. However, this initiative is still awaiting approval by the lower house of Congress.
Nor has there been progress in making therapeutic abortion legal again under the Health Code. Therapeutic abortion was banned in 1989, even though surveys show that more than 65 percent of the population is in favour of a law that would allow abortion when the mother s life is at risk, or when the foetus is severely deformed.
Chile is one of the few countries that penalises abortion in such extreme circumstances, in contravention of international agreements adopted by the Committee on Human Rights and the Committee for Elimination of Discrimination against Women (1999), and the Committee for Economic, Social and Cultural Rights (2004), which have demanded that the Chilean State revise the law in order to permit therapeutic abortion.
The Observatory documented extremely limited progress with respect to emergency contraception, since the Ministry of Health approved free distribution by public health services to victims of rape in March 2004.
In late 2005, the Supreme Court of Justice authorised the sale of Postinor II, a morning after pill, which is sold in some pharmacies against medical prescriptions that are retained on file.
Marcela Ferrer, a sociologist at the University of Chile Institute of Public Affairs, told IPS that the (outgoing) government (of President Ricardo Lagos) lacked the courage to restore therapeutic abortion, in this country where the Roman Catholic Church has great influence.
A proportion of Catholics, mainly in the (co-governing) Christian Democratic Party, are opposed to therapeutic abortion because it goes against the principles of the Church. But they forget that they are the public servants of all Chileans, not just Catholics, she said.
Ferrer said people in Chile, most of whom identify themselves as Catholics, are in favour of therapeutic abortion, just as they were in favour of divorce, because it s indescribably cruel to force a women to have a child she does not want, especially in cases of rape or incest, or when (the mother) might die.
According to Ferrer, who presented the chapter on sexual and reproductive health, the main problem discovered by the Observatory was the lack of a law on sexual and reproductive rights that would ensure, guard, protect and guarantee those rights for all Chileans.
With respect to therapeutic abortion, Matamala said the United Nations is trying to preserve the agreements in every country, so that progress can be made in accordance with the reality of each country, because PAHO cannot impose its own criteria.
The fact that abortion is not accepted under any circumstances is a violation of the human rights of the poorest sectors of society, and of adolescent girls, said Iglesias.
The mortality risk in adolescents is evidence for accepting (therapeutic abortion), not only as a values issue, but also from health and epidemiological points of view, as much for women of reproductive age as for future generations, she said.
This is a pending debt of democracy, which requires social mobilisation, she added. Sexuality is a way of exercising power, and power is what has been used to prevent a larger flow of new energy into society, which, she said, is important to recognise as president-elect Michelle Bachelet gets ready to take office on Mar. 11.
Ferrer hopes that the 2005 Report will obtain a response from the next government. Bachelet should set aside political correctness, be progressive, and not disappoint Chilean women, because she is qualified twice over: she is a doctor and knows the system, and she is a woman, she maintained.
