Blog: Women Living with HIV

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July 31, 2012

The Day After Victory: More Work Needed to Protect Rights of Namibian Women Living with HIV

Posted by Mindy Roseman

Yesterday the Namibian High Court issued its ruling in LM&MI&NH vs. The Government of the Republic of Namibia, finding that the three plaintiffs had been coercively sterilized. Shortly after Judge Elton Hoff read his decision from the bench, women’s rights advocates praised the outcome, which they said could herald a settlement in many more cases of forcible sterilization.

Certainly the ruling is a welcome result; however, the judge denied the plaintiffs’ contention that they had been sterilized because of their HIV-positive status.  He found no evidence supporting that claim.

And yet, in a report we released at the International AIDS Conference last week, “At the Hospital There Are No Human Rights,” our International Human Rights Clinic, the Namibian Women’s Health Network, and Northeastern University School of Law detail widespread instances of discrimination against women living with HIV in Namibia: segregation in health facilities, neglect during labor and delivery, inadequate counseling about HIV testing, and coerced consent to sterilization procedures.  In meetings and interviews in Namibia, we were told both by public health care providers and former patients that a government protocol authorized the sterilization of women living with HIV.

It was clear from our research that forced and coerced sterilizations arose out of a larger context of discrimination against women living with HIV.  Unless and until this discrimination is recognized by the Namibian executive, the legislature, and the courts, the necessary policy and programmatic steps to address it will fall short.

Our report offers a range of recommendations to the Government of Namibia, donors, and civil society to address the sexual and reproductive rights violations of women living with HIV. Specifically, we:

–      Urge the Government of Namibia to act immediately to stop ongoing forced and coerced sterilization, including holding accountable those who have committed such acts and issuing guidelines to ensure informed consent is obtained before the performance of any sexual and reproductive health care test or treatment.

–      Call on donors to provide financial and technical support to grassroots efforts, especially organizations of women living with HIV, in advocating for and monitoring legal, policy, and programmatic reforms.

–      Encourage civil society to build capacity to document discrimination against women living with HIV in Namibia, with a particular focus on recognizing and investigating violations of sexual and reproductive rights, especially forced and coerced sterilization.

The Namibian court’s decision opens a new and encouraging chapter in the struggle to protect the sexual and reproductive rights of women living with HIV.  Yet there remain many challenges ahead—not only in ensuring that the judgment makes the three plaintiffs whole, but also in addressing the ongoing stigma, discrimination, and other rights violations facing women living with HIV.  There are many pages to turn before this chapter is closed.

July 26, 2012

Namibian Women Living with HIV Report Violations of Sexual and Reproductive Rights

PRESS RELEASE

26 July 2012, Washington DC — Despite repeated calls for reform, the Government of Namibia’s inaction raises serious concerns about violations of the sexual and reproductive rights of women living with HIV, according to a report released today at the International AIDS Conference by Harvard Law School’s International Human Rights Clinic, the Namibian Women’s Health Network, and Northeastern Law School.  The 49-page report, entitled “In the Hospital There Are No Human Rights,” examines discrimination and neglect that women living with HIV are subjected to in the public health care system.

“We often assume that hospitals are healing places, where people living with HIV receive medical services in a safe facility, from trustworthy health practitioners,” Aziza Ahmed, an assistant professor at Northeastern Law School said.  “While this can be the case, women living with HIV in Namibia often report serious mistreatment in hospital settings.”

In the report, based on interviews conducted in Namibia in 2010, women describe being unable to give their informed consent (or make an informed refusal) to medical treatment either because information was withheld, or categorically denied to them.  Time and again, they said, their HIV status exposed them to mistreatment and discrimination.

“No one wanted to touch me,” said one woman, describing her birthing experience at the hospital.

Equally alarming, women interviewed for the report described experiencing forced or coerced sterilization.  The majority of reported cases involved the failure of medical personnel to provide women living with HIV with a description of the nature of the sterilization procedure, as well as its effects, consequences, and risks.  In some cases, medical professionals obtained consent under duress or based on misinformation, and demanded consent to sterilization in order for female patients to access other necessary services—including abortion and child delivery.  In other cases, medical professionals demanded or obtained consent for sterilization without providing information about other contraceptive options.

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