Our Bodies, Ourselves (168 page)

Lack of access to safe, legal abortion has a dramatic impact on women's health.
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• There are 19 million unsafe abortions each year.

• An estimated 5 million women are hospitalized each year for treatment of abortion-related complications, such as hemorrhage and sepsis.

• Complications due to unsafe abortion procedures account for an estimated 13 percent of maternal deaths worldwide, or 50,000 per year based on new WHO estimates of maternal deaths.

• Almost all abortion-related deaths occur in developing countries. They are highest in Africa, where there were an estimated 650 deaths per 100,000 abortions in 2003, compared with 10 per 100,000 abortions in developed regions.
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Violence against women takes many forms around the world and can occur at any stage in the life of a female from infanticide to abuse of widows.
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Among women ages fifteen to forty-four, acts of violence cause more death and disability than cancer, malaria, traffic accidents, and war combined.
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Violence against women destroys lives, fractures communities, and inhibits development.

Women's rights advocates and the UN system—including the newly formed UN Women (unwomen.org), which acts as a focal point for women's issues within the UN—have succeeded in raising awareness globally about the problem of gender-based violence. The 16 Days of Activism Against Gender Violence Campaign launched by the Center for Women's Global Leadership at Rutgers University is one example. Since 1999, this campaign has symbolically linked November 25, the International Day for the Elimination of Violence Against Women, to December 10, International Human Rights Day.

This campaign is now marked in all regions of the globe (see: 16dayscwgl.rutgers.edu). However, awareness-raising alone cannot address the problem; we also must ensure that resources are in place to protect women and address social norms that foster violence.

In many societies, patriarchal values and traditional ideals of masculinity condone violence against women as a means of asserting authority. Men may perceive that they have the right to dominate their wives and partners physically and sexually, and the cultural and legal environment supports that perception. Intimate partner violence is often underreported because of assumptions that it is merely common practice, or because of perceptions of stigma on the part of women who are victimized. Globally, an estimated one-third of all women have experienced physical, sexual, or emotional intimate partner violence at some point in their lives.
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Intimate partner violence is a leading cause of femicide—the murder of women because they are women. In South Africa, a woman is killed every six hours by an intimate partner.
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In India, there are twenty-two dowry-related murders each day.
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And in Guatemala, an average of two women are murdered each day.
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In many settings, there is very little recourse for women experiencing domestic violence—no legal action, no safe houses, and no option for divorce—and in countries where these protections exist, they are in insufficient supply. In some societies, women are blamed, punished, or even killed for being victims of sexual violence. Without the economic means and the cultural support to live independently of men, women cannot leave abusive situations.

Increasingly, intimate partner violence is recognized as a pervasive public health problem demanding attention and action. Spurred by
the WHO study, research on gender-based violence has increased substantially. Today, more than three hundred studies in ninety countries have documented the extent of intimate partner violence and some have illuminated its consequences for the health and well-being of women,
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including the recent International Men and Gender Equality Survey, IMAGES, conducted among 8,000 men and 3,500 women in six countries.
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Numerous recent publications document promising interventions,
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and several global organizations are raising awareness and involving men in fighting gender-based violence. The White Ribbon Campaign (whiteribbon.ca), an effort by men to end violence against women, began in Canada in 1991 and is now in place in sixty countries. Men Engage (menengage.org), begun in 2004, is a global network of four hundred nongovernmental organizations and a number of UN agencies working to engage boys and men to achieve gender equality, promote health, and reduce violence.

War disrupts the social and health care services that women need and can make travel to clinics or hospitals dangerous or impossible. Poor obstetrical care during wartime can lead to high rates of maternal and infant mortality, while access to contraception and abortion may be restricted as women's fertility is recruited in the national mission of producing future soldiers. Long-term wars can inure men to violence. Indeed, studies suggest that intimate partner violence increases during and immediately after wartime.
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Violence targeted at women in association with political or military conflicts seems to be growing, especially in so-called ethnic or civil wars. Rape of women as a weapon of war has been documented in countries such as Rwanda, the Democratic Republic of Congo (DRC), Sierra Leone, Zimbabwe, Sudan, Liberia, Uganda, Bangladesh, Vietnam, and Bosnia. Between 250,000 and 500,000 women and girls, for example, were raped during the 1994 Rwandan genocide alone.
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And in the DRC, at least 200,000 cases of sexual violence, mostly involving women and girls, have been documented since 1996, though the actual numbers are considered to be much higher.
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In some circumstances, sexual violence is condoned by the government.

When women survive wartime rape, they still must deal with forced pregnancies or dangerous abortions, sexually transmitted infections (including HIV), and the social stigma of having been “spoiled” for marriage. In 2002, the International Criminal Court in The Hague defined sexual offenses during war as a crime against humanity.
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For more information, visit Say No—UNITE (saynotoviolence.org) and V-Day (vday.org).

In developing countries, poor women and women with little or no formal education have few means of support. Economic need drives some women to become commercial sex workers. Other women, particularly undocumented immigrants in developing and industrialized nations, are forced into the sex trade. All of these women are at an elevated risk of a host of STIs, including syphilis, gonorrhea, hepatitis, chlamydia, and HIV/AIDS, as well as violence perpetrated by clients and others who market and profit from the women's sexual services.

Policy responses to commercial sex have generally fallen into one of two camps. A harm reduction approach focuses on protecting the sex worker and her clients from STIs and treating any infections she acquires. Although such practices may protect the health and safety of
sex workers and clients, they ignore the circumstances that lead women into commercial sex—poverty, marginalization, addiction, and limited education and employment opportunities. The clients of commercial sex workers may prefer that society place emphasis on reducing the transmission of infections and stop there.

Rehabilitation approaches focus on creating alternative employment opportunities for women in sex work. While some of these approaches open new doors for women, many do not provide sufficient income for women to be able to leave sex work.
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Further, staged raids on commercial sex establishments to rescue sex workers, common to some rehabilitation programs, are generally more disempowering to women who have been “rescued” than effective as a means for women to leave commercial sex work.
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Decriminalizing sex work and ensuring that sex workers are protected from violence and abuse are essential for fulfilling all women's human rights. Some advocates believe the most sensible solution is to formally recognize sex work as an occupation, so sex workers can access labor rights and benefits workers in other industries receive.
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This would entail removing laws and policies that prevent sex workers from finding safe places to live and work. By bringing the sex industry out of the underground economy, sex workers could obtain greater protection and access needed health and social services. At the same time, steps are needed to ensure that women have feasible options for leaving the sex industry.

Child prostitution is a particularly heinous aspect of the commercial sex industry. UNICEF estimates that approximately 1 million children (mainly girls) enter the multibillion-dollar commercial sex trade every year. Parental abuse and neglect cause children to run away from home; homeless children may be sold to commercial sex organizations; the trade might seem to offer a chance for a lot of money; and in an environment of armed conflict, children who become separated from their parents may seek protection from the military in return for sex.

Human trafficking—the illegal buying and selling of human beings—is the fastest-growing criminal industry in the world.
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Because this trade is underground, accurate statistics are elusive, but the 2010
Trafficking in Persons Report
estimates that 12.3 million people are enslaved in forced labor, bonded labor, and forced sex work around the world. Women and girls make up 80 percent of all people trafficked annually,
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with the majority of women (79 percent) trafficked for sexual exploitation.
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Many trafficked people are targeted for various forms of exploitation in the sex industry, including sex work, pornography, stripping, live-sex shows, and sex tourism. However, people may be trafficked for other forms of labor exploitation, such as sweatshop labor, domestic servitude and maid service at motels and hotels, and agricultural work.