Sexual and Reproductive Health

Kay Eady, Community-Based Researcher, Baker County:

Do I go to the doctor or do I buy groceries? You shouldn’t have to make that kind of decision. 

Olivia Coley-Pearson, Community-Based Researcher, Coffee County:

Black women are being left out of healthcare infrastructure and resources. African American women are twice as likely to die from cervical cancer, as opposed to white women. To find out these alarming numbers about Black women dying from something that is preventable, is very disturbing.

Community-Based Researchers:

Hi. How’s everybody doing?

Kay Eady, Community-Based Researcher, Baker County:

When approached about becoming a community-based researcher, I just knew I was going to be asking questions and surveys to women in the community about cervical cancer issues and health issues.

So, when I heard about the barriers of transportation, health care and finances, I must admit I was a little shocked.

Teretha White, Research Participant, Baker County Resident:

The health insurance I applied for was like over $200 [a month] and that’s just too much.

I can’t afford, how would I live? A lot of times, you know, I don't go to the doctor because then if I did come down with something, I wouldn’t be able to treat it. So, I just don’t go.

Kay Eady, Community-Based Researcher, Baker County:

Baker County is located in southwest Georgia, away from Interstate 75. in southwest Georgia, away from Interstate 75. So, there’s not a lot of industry or trade or anything there.

It has a community of individuals that are supportive of each other. Unfortunately, it's an area dominated by poverty. The income is low. There are not really any jobs within Baker County.

Sometimes the health center only has one physician to see all of the patients. There is not a regular OB-GYN in Baker County.

Janet Anderson, Nurse, Baker County Primary Health Care:

When we talk about reproductive cancer, when you reach a certain age, making sure that you get your mammograms, your Paps, all of that should be done.

But if you don’t have health insurance, nobody’s going to do it for you.

If you don't get the health care you need for one problem, it could lead to another problem.

I've seen this happen with a patient. She was turned down for Medicare or Medicaid. She didn't get the health care that she needed. I think she may have lasted maybe two or three years [and] passed away. And that's the kind of stuff that really just bothers me.

Olivia Coley-Pearson, Community-Based Researcher, Coffee County:

Based upon the research that we conducted, Black women in Georgia are more apt to be diagnosed with cervical cancer in the later stages because they have not received preventive treatment.

And we found out that the majority are not aware that there is the HPV vaccine, which would actually prevent cervical cancer.

Most of them are not informed by their doctors. What do you do if you feel that you're being discriminated against where you feel that you were not given the information you should have been given because you're Black or because you're low-income?

That's a great barrier and it has a traumatic effect on Black women in rural communities.

Kay Eady, Community-Based Researcher, Baker County:

Coming up with resolutions at the grassroot level is key in any community because everybody in that community knows everyone, especially when you're talking about a community as small as Baker.

Grace Miller, Baker County Resident:

We need to have some programs to educate the women about how to take care of their body, how to go to the doctor and get themselves seen about it. Because one thing about it, cancer don’t care who it is.

Kay Eady, Community-Based Researcher:

It doesn’t care. 

Grace Miller, Baker County Resident:

You’ve got to keep yourself checked. 

Olivia Coley-Pearson, Community-Based Researcher, Coffee County:

On the federal level, we need to have more accountability. So, the government's responsibility is to make sure that all women, regardless of their socioeconomic status, are afforded resources and solutions. 

Kay Eady, Community-Based Researcher, Baker County:

Shouldn’t have a high incidence of cervical cancer. It’s one of the few diseases that we have that can be eradicated. I strongly believe in you take care of the people that need it most. We cannot afford to repeat the cycle of cervical cancer. 

Voiceover:

“Maria” was 20 years old when she spent four months in a prison cell with her three-year-old son. While at work one day, she slipped and fell down the stairs. She started bleeding and was in pain.

She went to the hospital and learned she was having a miscarriage. Prior to this moment, she didn’t know she was pregnant.

The doctors told her everything was okay, but she was later arrested for allegedly having an abortion.

Ana Vera, Lawyer:

In Ecuador, women cannot be arrested for having an abortion in certain cases.

The first is when the life or health of a woman is in danger that cannot be avoided by other means. And the second is when the pregnancy is the result of rape.

However, what usually happens is that mental and social health, for example, are not taken into account.

Voiceover:

“Soledad” was 38 years old when she found out she was pregnant with her first child. This was a wanted, planned and welcomed pregnancy for “Soledad” and her husband.

One day, she felt a sharp pain which made her go to the bathroom. She gave birth prematurely there and lost her daughter.

When she got to the hospital, the doctors assumed she had induced an abortion and they called the police. She was taken to prison.

From the 148 cases reviewed by Human Rights Watch, 73 percent of the prosecutions for alleged abortion were initiated after a health care provider reported a patient to the police in violation of medical confidentiality.

Dr. Susana Guijarro:

The professionals working in the health system are very afraid of being prosecuted of being imprisoned because they are also unclear about the law.

Voiceover:

In the cases where health care workers reported their patients, they were violating legal requirements protecting medical confidentiality.

Women and girls accused of abortion are often deprived of proper post-abortion care and encounter violations of their due process rights as well as barriers to accessing good quality legal representation.

Even though “Soledad” continued to bleed for days in prison, no doctor came to care for her or make sure she was safe.

The prosecutor charged her with aggravated homicide. She faced being sentenced up to 26 years in prison. She was found not guilty at her trial. By then, she had already spent five months in jail.

Ana Vera, Lawyer:

The criminalization of abortion is a matter of social injustice, where the most impoverished women suffer the most consequences.

Dr. Susana Guijarro:

The poorest women don't have any access (to abortion) and they have to seek methods, the most inadequate methods, which lead to infections which can even lead to death.

Voiceover:

“Elena” was 21 years old, married, living in poverty, and with a child when she was raped and became pregnant. She knew her reputation would be ruined if word got out that she was pregnant with someone else's child.

“Elena” took medication to end her unintended pregnancy. In Ecuador one in four women experience sexual violence.

Until April 2021, abortion after rape was criminalized unless the pregnant person had an intellectual disability.

Ana Vera, Lawyer:

Women are very afraid to report situations of sexual violence when they become pregnant because they think that they are the ones who may be prosecuted.

All the fear and the stigma that exists for victims of sexual violence is compounded by the fear and the stigma that exists about abortion.

Voiceover:

When “Elena” started having severe stomach pain and cramps, she went to a public hospital. The doctors who were treating her reported her to the police. She was arrested and placed on trial.

She told the judge: “Yes I used the pills. I didn’t want to have [the baby] because it was the product of rape. I didn’t want my family to find out.”

She was sentenced to 12 months in prison and was released after seven months due to good behavior. Her allegations of sexual violence were never investigated.

Ana Vera, Lawyer:

I believe that the criminalization of abortion is not an effective measure for anything; neither to reduce the number of abortions, nor to prevent women from getting pregnant, nor to prevent sexual violence.

I think it is a violation of human rights, but the denial of legal abortions could even constitute a form of torture, cruel, inhuman and degrading treatment, according to international standards.

Voiceover:

The criminalization of abortion has a devastating impact on the lives and health of women and girls.

The Ecuadorian Constitutional Court’s ruling to decriminalize abortion in all cases of rape is an important step.

Newly elected legislators and resident Guillermo Lasso should remove all criminal penalties for abortion and guarantee effective access to abortion on all legal grounds. 

Voiceover

Afghanistan's future looks uncertain as US troops prepare to leave the country before September 11, 2021.

In the years after the US-led military invasion and the defeat of the Taliban government in late 2001, the Afghan government and international donors gave priority to developing an effective health system, including extending access to basic health care to all parts of the country.

This led to significant improvements for women’s health. But even with two decades of effort and hundreds of millions of dollars spent, delivery of health services for women and girls remains far below international standards.

Dr. Najmusama Shefajo, Head of Afghanistan Ob/Gyn Society

Our maternal mortality rate nowadays is 638 per 100,000 live births. It is a shocking number.

 Voiceover

In the last several years, donor support to Afghanistan has been falling. Services that were already inadequate are further deteriorating. 

Women and girls often struggle to access even the most basic care. Access to contraception. Access to prenatal care. Access to safe birthing services. The cost for transportation, as well as medications and the supplies patients are obliged to pay for because government hospitals no longer have enough funding, keeps women from receiving care, with sometimes deadly consequences.

Insecurity and fighting due to the war in Afghanistan also create major barriers to women and girls accessing health care. Health facilities and workers are often caught in the middle of the conflict or even targeted themselves, making it almost impossible at times to provide services.  

In May 2020, attackers killed 24 people including mothers, children, and a midwife in a hospital maternity ward operated by MSF.

Shaharzad Akbar, Afghanistan Independent Human Rights Commission

With the conflict and the uncertainty about the outcome of the peace process, donors are more hesitant about committing funding to NGOs or Afghan governments. In the midst of uncertainty, it’s the most vulnerable, it’s the women, the children, the displaced communities, who are losing out. 

Voiceover

Over 75% of the Afghan government’s budget comes from international donors. Afghanistan cannot afford decent health services without help.

Donor countries should fully appreciate how deep and urgent are Afghanistan’s humanitarian needs, including for women’s health care. They should not use the withdrawal of foreign troops as a justification for disengaging when the need for international assistance is greater than ever.