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My Body, My Life, My Rights: Addressing Violations of Women’s

Sexual and Reproductive Rights

Copyright © 2010, Asia Pacific Forum on Women, Law and Development

(APWLD)

Reproduction of this publication for educational and other non-commercial

purposes is authorized, without prior written consent, provided the source is

fully acknowledged.

Documenter : Tatjana Bosevska, (Intern, Grounding the Global Programme,

APWLD)

APWLD Editorial Team: Misun Woo (Programme Officer, Grounding

the Global Programme), Kate Lappin

(Regional Coordinator) and Tina Lee

(Information and Communications Officer,

APWLD)

Copy Editor: Rachael McGuin

Cover Design: Kornchai Thitasuta

Layout and Printed by: Blue Print Design

Funded with the generous support of the Ford Foundation, (New Delhi

office), Global Fund for Women, United Nations Development Fund for

Women (UNIFEM) East and Southeast Asia Regional Office and Amnesty

International Australia.

Asia Pacific Forum on Women, Law & Development (APWLD)

 Girl Guides Association Compound

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Fax: +66 (0)53 280847

Website: www.apwld.org

LIST OF ABBREVIATIONS

AICHR ASEAN Inter-governmental Commission on Human Rights

AIDS Acquired immune deficiency syndrome

ACWC ASEAN Commission on the Promotion and Protection of the

Rights of Women and Children

APWLD Asia Pacific Forum on Women, Law and Development

ASEAN Association of Southeast Asian Nations

ARVs Antiretroviral drugs

CEDAW Convention on the Elimination of all Forms of Discrimination

against Women

CMW Convention on the Protection of the Rights of All Migrant

Workers and Members of Their Families

CRC Convention on the Rights of the Child

CRPD Convention of the Rights of Persons with Disabilities

DAWN Development Alternatives with Women for a New Era

DVAW Declaration on the Elimination of Violence against Women

FGM Female Genital Mutilation

GBV Gender Based Violence

HIV Human Immunodeficiency Virus

ICCPR International Covenant on Civil and Political Rights

ICERD International Convention on the Elimination of all Forms of

Racial Discrimination

International Covenant on Economic, Social and Cultural

ICESCR

Rights

ICPD International Conference on Population and Development

ICPD PoA International Conference on Population and Development,

Programme of Action

IDPs Internally Displaced Persons

IPPF International Planned Parenthood Federation

KRC Karen Refugee Committee

LBTIs Lesbian, Bisexual, Transgender and Inter-sexed

MDGs Millennium Development Goals

MFLO Muslim Family Law Ordinance, 1961

MTCT Mother-to-Child Transmission

NGOs Non-Governmental Organisations

PMCT Prevention of mother-to-child transmission

SAARC South Asian Association for Regional Cooperation

SBAs Skilled Birth Attendants

STDs Sexually Transmitted Diseases

TBAs Transitional Birth Attendants

UDHR Universal Declaration of Human Rights

United Nations

UN

United Nations High Commissioner for Refugees

UNHCR

United Nations Commission on Human Rights

UNCHR

United Nations Human Rights Council

UNHRC

United Nations Children’s Fund

UNICEF

UNSRVAW United Nations Special Rapporteur on Violence against

Women, its causes and consequences

UNTOC United Nation Convention against Transnational Organised

Crime

VAW Violence against Women

WHO World Health Organisation

WOREC Women’s Rehabilitation Centre, Nepal

CONTENTS

FOREWORD

INTRODUCTION

CHAPTER 1: CRITICAL ISSUES FROM ASIA PACIFIC

1.1 Neo-liberal Globalisation and Women’s Sexual and

Reproductive Rights
 1.2 Fundamentalisms and Women’s Sexual and Reproductive

Rights

1.3 Militarisation/Armed Conflict and Women’s Sexual and

Reproductive Rights

CHAPTER 2: THE UNSRVAW AND THE INTERNATIONAL

FRAMEWORK

CHAPTER 3: STRATEGIES AND RECOMMENDATIONS

1.1 Recommendations for the UNSRVAW

1.2 Recommendations for State

1.3 Recommendations for Non-State Actors

1.4 Recommendations for Civil Society

ANNEX A: Consultation Programme

ANNEX B: List of Participants

ANNEX C: Supplementary Documentation (see CD attached to this report)

C1: Table of Contents of Documentation on disc

C2: Presentations and Papers of Speakers at the Consultation

C3: Papers/Submissions of Participants

C4: Supplementary information of the UN Special Procedures

mechanism and the mandate of the Special Rapporteur on

Violence against Women, its causes and consequences

C5: Miscellaneous Supporting Documents

FOREWORD

The Special Procedures of the United Nations have often been

referred to as the ‘eyes and ears’ of the Human Rights Council.

Without the Special Mechanisms the eyes of the Council fix mainly on

State representatives and the ears are filled with carefully orchestrated

statements on the efforts of states to meet human rights obligations.

Non Government Organisations (NGOs) with the resources and

means to travel to Geneva do their best to be seen and heard but the

limitations of the inter-governmental system mean they rarely move

from the peripheral vision of the Council members.

The Special Mechanisms move the line of sight from States to people,

to civil society, to the structural causes of violations. However

the limitations of the mandate allow for limited country visits

(generally only two per year) and require a state to invite the Special

Rapporteurs. The annual regional consultation with the Special

Rapporteur on Violence against Women, its causes and consequences

(UNSRVAW), facilitated by the Asia Pacific forum on Women, Law and

Development (APWLD), magnifies the vision and amplifies the hearing

of the Council.

The consultations, held annually since 1995, allow us to think, discuss

and voice our collective anger about the causes of women’s inequality

in Asia Pacific without the constraints and rules of treaty bodies. They

place women and women’s rights organisations at the heart of the

conversation, not on the periphery as observers. The consultations

give women the opportunity to tell their stories of pain, of courage,

of success and of repression in a supportive environment, but an

environment that matters to the ‘ears’ of the Human Rights Council.

 7

The theme of the 2009 consultation was ‘Violations of Women’s

Sexual and Reproductive Rights‘. Fifty four women, and one man, from

twenty one countries in Asia Pacific came together to affirm women’s

sexual and reproductive rights as fundamental human rights. In doing

so they claimed women’s autonomy to make decisions on issues

concerning their own bodies and sexuality.

It is never easy for local NGOs or individual women to be heard

at UN level. It is particularly hard, and often even threatening, for

women to speak about strengthening sexual and reproductive rights.

Conservative groups have vigorously contested efforts to progress

recognition of sexual and reproductive rights. These difficulties were

poignantly illustrated by a participant who, through tears, spoke of

her bitter disappointment after the CEDAW Committee did not

address systemic violations committed against lesbian women in

its concluding comments to Japan. The efforts of many activists and

NGOs to produce a shadow report detailing such violations felt

wasted. But, even more devastating, deliberate ignorance of sexual

and reproductive violations seemingly provided tacit approval – these

matters, it seemed to the participant, were not regarded seriously

enough to warrant comment.

This growing conservatism made the regional consultation a rare

chance for women to provide evidence of systemic violations of sexual

and reproductive rights to a UN representative in a safe environment.

It also provided an opportunity for women to share strategies, tactics,

networks and resources and, importantly, solidarity.

APWLD is careful to interrogate the underlying causes of violations.

We recognise that the human rights framework is only of use where

it can name and challenge the conditions and ideologies that enable

violations to occur. We are particularly concerned about conditions

that fuel and feed from patriarchy – militarisation, neo-liberal

globilisation and fundamentalisms. Through this lens participants

provided evidence of violations but were also able to locate solutions

and strategies. This analysis frames the structure of this report.

This year was the first consultation with the newly appointed SRVAW,

Rashida Manjoo. Unfortunately an unexpected illness prevented

Rashida from making her flight to Bangkok to join the Consultation.

We were very ably assisted by Gloria Carrera Massana from the

Office of the UN High Commissioner for Human Rights Special

Procedures Division - Violence against Women mandate and Rashida

was able to dial into the consultation and address participants by

phone which was very much appreciated. I thank both Rashida and

Gloria for their support, their ears and their contribution.

Having joined APWLD as the Regional Coordinator in October of

2009, the Consultation was my first APWLD event and a wonderful

opportunity to meet members, partners and human rights defenders

from the region. The Consultation very much affirmed my decision to

move my family, including my three-month-old baby who periodically

 joined the participants for a feed, to Thailand to support the

courageous and inspiring women who comprise APWLD. I came away

from the Consultation both inspired and enraged. Importantly though

I came away hopeful, hopeful that the Consultation and this report will

be heard and will fuel the efforts of women and men worldwide to

claim and advance sexual and reproductive rights.

I thank all the participants for their time, efforts and generosity. They

educated and inspired me and allowed me to see the importance of

the consultations as well as ways they can be further improved. The

strength of APWLD is in its engaged and active membership. The

Consultation would not have happened without them, particularly

Madhu Mehra and Heisoo Shin. I also thank Secretariat staff for

their dedicated efforts and long hours to ensure the Consultation

went smoothly. Particular thanks to our Programme Officer Misun

Woo who had to educate and guide me through the preparations

and Tatjana Bosevska who took on the job of preparing for and

documenting the Consultation as an intern. This report is testament to

the collective efforts of our members and staff.

We would also like to acknolwedge the following organisations: Ford

Foundation (New Delhi), Global Fund for Women, United Nations

Development Fund for Women (UNIFEM) East and Southeast Asia

Regional Office and Amnesty International Australia, for their generous

financial and moral support, which made this consultation possible.

APWLD looks forward to continuing our long engagement with the

SRVAW. If she is the eyes and ears of the Human Rights Council then

our Consultation should be the mouth – bringing the voices of women

from Asia Pacific to the United Nations.

Kate Lappin

Regional Coordinator

Asia Pacific Forum on Women, Law and Development (APWLD)

10

INTRODUCTION

The Asia Pacific Forum on Women, Law and Development (APWLD) has

been facilitating consultations with the United Nations Special Rapporteur

on Violence against Women, its causes and consequences (UNSRVAW) since

1995, following the inception of the UNSRVAW mandate and appointment of

the first Rapporteur in 1994.

These annual consultations provide an important forum for women from the

region to contribute to the UNSRVAW mandate by detailing the regional

specificities of violence against women in the Asia Pacific. The consultations

strengthen the capacity of women’s organisations to engage with the United

Nations (UN) Special Procedures mechanism and provide an opportunity for

women to collaborate with other women’s rights activists in the region.

In 2009 the consultation1 focused on women’s sexual and reproductive rights.2

Sexual and reproductive rights are human rights, intrinsically linked to other

basic human rights, such as the right to life, expression, privacy, health, education,

and work. Even though these rights are fundamental to individuals, couples

and families, as well as to the social and economic development of communities

 and nations,3 they are the most contested.

Conservative forces are quickly marshalled whenever there is a hint that

sexual and reproductive rights may be on the UN agenda. In response, a much

APWLD organised the Asia Pacific NGO Consultation with the Office of the UNSRVAW entitled
“My

1.

Body, My Life, My Rights: Addressing Violations of Women’s Sexual and Reproductive Rights”
on 7-8 December

2009 in Bangkok, Thailand.

2. Due to unforeseen circumstances, the UNSRVAW, Rashida Manjoo was unable to attend the

Consultation. Ms. Gloria Carrera Massana, Human Rights Officer providing support to the
mandate

of the UNSRVAW at the Office of the UN High Commissioner for Human Rights, participated in
the

discussions and delivered a statement on behalf of the UNSRVAW. APWLD arranged for the
UNSRVAW

to participate via tele-conference, which provided an opportunity for the UNSRVAW to address
all

participants, provide comments, detail her concerns, and reflections, and outline her intentions in
moving

forward with respect to her mandate.

3. “Sexual and reproductive health are integral elements of the right of everyone to the enjoyment
of the

highest attainable standard of physical and mental health.” Commission on Human Rights,
resolution

2003/28, preamble and para. 6. See also the Conclusion of the Keynote Statement by
UNSRVAW,Yakin

Ertürk, “Changing Attitudes to Combat Violence against Women,” Council of Europe Campaign
to

Combat Violence against Women, Including Domestic Violence, Madrid, 27 November 2006.
 11

`safer’ and less contested way to advocate for sexuality and reproduction has 6.
The historic sharp

demarcation between the

been through a health lens. While there are purposeful and strategic reasons

‘private’ world of family

to emphasise the health aspects of these rights, a purely health-centred

and domestic life which

approach does not give women autonomy over their own bodies. The health-
is defined as the women’s

sphere and the ‘public’

world

centred approach also tends to conflate sexual and reproductive rights rather
of market place which is

than understanding them as separate, albeit intersecting, rights. The persistent

defined as the men’s sphere

has been rejected by the

coupling of these rights has to some extent served to reinforce the notion
women’s movement. The

that women’s sexuality is necessarily linked to reproduction.

definition of “private” based

on a political decision of

the male dominant society

Both sexual rights, particularly the right to determine one’s own sexual
based on social and cultural

assumptions of what is

orientation, and reproductive rights, particularly in relation to contraception

valued, has been reinforcing

and reproductive autonomy, are yet to be fully and adequately defined.

women’s oppression and
 subordination. For instance,

violence within the family

Sexual Rights including sexual

violence

has long been assumed

Sexual rights can be defined as the right of all people to decide freely and to
be a “private” matter

responsibly on all aspects of their sexuality, including protecting and promoting

leaving women without any

legal remedies available.

their sexual health;4 and freedom from discrimination, coercion or violence in

Similarly, international law

their sexual lives and in all sexual decisions.5 The realisation of sexual rights is
has been slow to develop

jurisprudence on women’s

an integral part of women’s full enjoyment of all rights as well as being integral
sexual rights as it has been

to gender equality, development and social justice. Sexual rights have always
regarded as one of the

most “private” areas, and

been however, inextricably linked to and constructed by social and religious

particularly when it comes

mores and patriarchal values, which reinforce the subordination of women

to women’s sexuality it has

been treated as an area not

through different forms of violence against women, coercion and deprivation

valuable enough to be legally

of legal and other protections of women. protected or

regulated. For

further discussion on how

 the private-public
dichotomy

Sexual rights have long been relegated to the `private realm,’ and associated
has adversely affected the

with male ownership over women’s bodies, whether it is by fathers, brothers,

realisation of women’s rights,

also see E. M. Schneider,

husbands or even communities or society at large.6 To maintain this unequal

“The Violence of Privacy”

in Application of Feminist

power relationship between men and women, marriage and family are used to

Legal Theory to Women’s

institutionalise and perpetuate the logic of the appropriation of women’s

Lives: Sex,Violence,Work

bodies, by legitimising rape and other forms of violence by husbands and

and Reproduction, Temple

University Press,
Philadelphia

(1996) at pp. 388-401.

For further information please see Sexual Rights: a Declaration of International Planned Parenthood
Federation

4.

(IPPF) Article 7:‘Right to health and to the benefits of scientific progress, October 2008.

P. Ilkkaracan and S. Jolly, Gender and Sexuality: Overview Report, Institute of Development
Studies (2007), at

5.

p. 1. Also see the World Health Organisation (WHO) working definition of sexual rights (2004)
and the

statement of the SRVAW.

12

intimate partners. Furthermore, this has allowed sexual coercion and violence

9. Women with disabilities may

be particularly at risk due to against women to occur on a mass scale, in multiple forms, and in a
myriad of

stigmas associated with body

contexts – always with virtual impunity. Women’s lack of sexual rights reveals

disability and gender, and are

itself in both active acts of violations as well as passive acts such as the

more likely to suffer from

discrimination than able-

systematic denial of protection, assistance and redress in cases of violence

bodied women or men with

against them.

disabilities.

Failure to ensure equal

11.

The most serious violations of women’s sexual rights are related to this implied

property rights upon divorce

discourages women from

male ownership of women’s bodies or sexuality. Violations can include violence

leaving violent marriages, as

with either explicit or covert sexual undertones, such as in the case of marital

women may be forced to

choose between violence rape, honour crimes, and `corrective rapes’7 of lesbians, bisexuals,
transgender
 at home and poverty in the

and inter-sexed persons (LBTIs)8. The consequences of such sexual violence

street. In either situation

are catastrophic.

women’s human rights,

particularly her access to

treatment/health care is

Discrimination and stigma pose a serious threat to sexual rights for many

significantly violated.

vulnerable and marginalised groups including; sexual minorities, migrant

workers, sex workers, indigenous women, women with disabilities,9 non-

citizens including refugees and internally displaced persons (IDPs),10 single

mothers, unmarried women and those living with HIV/AIDS. Many cases have

been reported, for example, that once women are diagnosed with HIV/AIDS,

they experience physical, psychological or verbal abuse from their husbands,

family and community members and in many instances are forced to get

divorced without any right to their property or inheritance.11 This applies

even when they are infected through their husbands or intimate partners.12

Harmful but culturally tolerated practices such as `dowry’13 or `bride price’14

7. “Corrective rape” is a criminal practice, where LBTIs, especially lesbian

women are raped by a member

of opposite sex, purportedly as a means of “curing” or “correcting” their

sexual orientation.

8. LBTIs refers to lesbians, bisexual, transgender and inter-sexed persons

and/or sexual minorities as

defined in the Yogyakarta Principles on the Application of International

Law in Relation to Issues of Sexual

Orientation and Gender Identity, March 2007.

10. According to the UNHCR half of the world’s refugees are in Asia, the
largest increase of internally

displaced people in 2008 was in South and Southeast Asia with the
largest new displacement in 2008

being in Southern Philippines.

13. A dowry is the money, goods, or estate that a woman brings to her
husband in marriage.

12. The social norms of women based on patriarchal gender hierarchies, to

provide sex as their marital

duty, invisibly force women to have sex with their husbands, in many cases
without using protection as

a sign of trust and faithfulness. UNSRVAW report, E/CN.4/2005/72, paras

29-31. UNAIDS reports in its

fact sheet on “Women and AIDS: A Growing Challenge”

(http://www.unaids.org/bangkok2004/factsheets/

FS_Women_en.pdf) that in Thailand, 75 per cent of women living with HIV

were likely to have been

infected by their husbands.

14. Bride price is an amount of money, property or wealth paid by the groom
or his family to the parents

of a woman upon the marriage of their daughter to the groom. The same
country may simultaneously

practice both dowry and bride price.

13

continue to occur in the region. These practices reinforce the concept that a

man is purchasing his wife, allowing men to exercise power over women

making it almost impossible for women to leave abusive relationships. Forced/

early marriage hinders girls’ abilities to decide on their sexuality (including

sexual orientation), whether to be sexually active or not, as well as to enjoy

other fundamental human rights such as their right to education, work and to

choose a partner.

Constrictive identities of women as appendages to men - wife, mother,

daughter, sister - permeate legal discourses in the region. Laws and legal

practices are variously employed to cement male control of women’s bodies.

Non-criminalisation or legalisation of marital rape,15 criminalisation of adultery,

defences for so-called `honour’ crimes, virginity tests or other chastity

provisions, female genital mutilation (FGM) for marriage-ability and even dress

codes designed to regulate women’s sexuality are all premised on the notion

that the sexual rights of women lie with her male proprietor. The practice

among many communities to force a rape survivor to marry her rapist or

`bride kidnapper’ in order to save the family’s honour is a further example of

the patriarchal foundations lying behind the control of female sexuality.

The lack of legal protection of sexual rights has also been reported in the

workplace in the form of sexual harassment, with the situation of female migrant

workers being of particular concern. The social and political construction of

male and female sexualities based on unequal power relationships creates the

market for trafficking of women. Furthermore, the public/private dichotomy

coupled with a strictly sex-segregated job market is reinforced by the lack of

legal protection for women who work as domestic workers. Not recognised

by industrial laws as workers, domestic workers can be subjected to sexual

harassment, rape and abuse with little hope of a remedy.

Reproductive Rights
Reproductive rights include the right to decide when and if to get pregnant,

the number and spacing of children, and the right to voluntarily marry and

establish family. It also includes the right to attain the highest standard of

15. Annual report of the SRVAW, E/CN.4/1995/42, paras 58-62

14

sexual and reproductive health.16 Equal relationships between women and

19. Not only is premature

pregnancy from forced men in matters of sexual relations and reproduction, including full
respect for

early marriage a violation of

the integrity of the person, require mutual respect, consent and shared

reproductive rights. It also

responsibility for sexual behaviour and its consequences.17 Reproductive rights

in many cases results in the

devastating and preventable

can only be realised when a commitment to equality and women’s autonomy

tragedy, that is obstetric

permeate social and development policies. Access to optimal health care,

fistula, which primarily

affects young, poor women

housing, education, employment and property rights as well as freedom from

who lack the means to

physical abuse, harassment, genital mutilation and all forms of violence against

access quality maternal care.

Women and young girls living

 women are required to enable reproductive rights.

with fistula are constantly

wet from the leaking of urine

and often experience genital

Women’s reproductive rights in multiple ways intersect with sexual rights, and

ulceration, infections and

are linked to the control over women’s sexuality. Forced pregnancy, forced/

a humiliating odour. They

are typically shunned by

early marriage, forced abortion and forced sterilisation/impregnation

their partners, families and

(particularly as a tool of genocide) all represent serious breaches of women’s

communities because they

are considered unclean, and

reproductive rights,18 deeply intertwined with sexual rights. Forced/early

may live in near complete

marriage, predominant in South Asia where over 50 per cent of girls are

isolation. Without support

many women with fistula are married by the age of 18, is itself a breach of sexual rights but also
heightens

forced to beg for a living and

the risk of premature pregnancy19 and the inability to determine the number

are especially vulnerable to

and spacing of children.

malnutrition and violence.

 For further information, visit

www.endfistula.org/.

Reproductive rights can be seriously impeded by lack of adequate health care

22. Securing women’s access

or lack of access to basic and universal health care services. It is reported20

to safe, legal and affordable

abortion and contraception

that an estimated 74 percent of maternal deaths,21 for example, can be averted

is another way of enhancing

if all women had access to reproductive health care, in particular emergency

women’s sexual rights as

women’s control over

obstetric care, including access to safe abortion.22 Women living in poverty

their own body integrity

and in rural areas and women belonging to ethnic minorities or indigenous

has been violated under

the family planning which

populations are among those particularly at risk.

conforms to conservative

but socially acceptable lines 16. International Conference on Population and Development
(ICPD) Programme of Action, Cairo, Egypt,

of reproduction. September 1994, at para 7.3. Also see

www.unfpa.org/rights/rights.htm

17. Beijing Declaration and Platform for Action, Fourth World Conference
on Women, 15 September 1995,

A/CONF.177/20 (1995) and A/CONF.177/20/Add.1 (1995)

 18. Annual report of the UN Special Rapporteur on the right of everyone to
the enjoyment of the highest

attainable standard of physical and mental health, E/CN.4/2004/49, para.

25.

A. Wagstaff, and M. Claeson, The Millennium Development Goals for

Heath: rising to the challenges, World

20.

Bank, 2004.

21. WHO defines maternal death as the death of a woman while pregnant or
within 42 days of termination

of pregnancy, irrespective of the duration and site of the pregnancy, from

any cause related to or

aggravated by the pregnancy or its management but not from accidental or

incidental causes.

15

On the other hand, access to contraceptives and prophylactics enables

women to claim their sexual and reproductive rights. It allows them to

determine the number and spacing of their children as well as prevents HIV

and sexually transmitted diseases (STDs). However, in reality, women’s access

to contraceptives is controlled by and subjected to the policies of dominant

groups in society, including fundamentalist groups who oppose these rights,

placing women at considerable health risk.

In particular, women experience discrimination and violence in relation to

their reproductive rights based on their HIV status; in being pregnant, giving

birth/family planning, and medical care, especially with regard to mother-to-

child transmission of HIV.23 The choice of whether or not to have children and

information on the means of avoiding transmission of the disease to an unborn

child or a newborn infant, makes women the focus of intense scrutiny.

Pregnancy, lactation and childcare are areas around which multiple stigmas

regarding family, community and health care converge. HIV-infected pregnant

women may be advised or pressured to terminate their pregnancy which in

many cases occurs in a form of forced sterilisation, another fundamental

violation of women’s reproductive rights.

Empowering Women: Positive Affirmations of Sexual and

Reproductive Rights

Sexual and reproductive rights should include both the right to freedom

from sexual violations as well as positive sexual and reproductive rights.

Positive rights include the rights to determine ones own sexual life (self-

determination), freedom of thought and expression, right to information and

access to reproductive health care services. Protection and promotion of

sexual and reproductive rights must be accompanied by both legal and social

interventions which aim to achieve gender equality in law and in practice.

23. Mother-to-child transmission (MTCT) may take place during pregnancy, childbirth, or while
breastfeeding,

in which mothers with HIV are held to be solely responsible for infecting their child, thus
constituting

another source of gender discrimination for women with the virus, despite in many cases being
infected

by their husbands and/or intimate partners. The term ‘mother-to-child’ transmission itself was
debated at

the Consultation. Refer to page 22 of this report.

16

There is a need, as a first step, for positive affirmations of sexual and reproductive

rights. Unless sexuality is deconstructed, reconceived and articulated from a

feminist perspective, women’s bodies and sexuality will be used as a means of

subordination and oppression by dominant society, including both men and

women. Exploring and affirming sexual and reproductive rights, including the

right to sexual pleasure and fulfilment outside of the heterosexual norm, is an

essential part of breaking the control of and violence against women.

Fulfilling sexual and reproductive rights requires that states provide enabling

environments. For instance, integrated crisis centres, places where violated

and abused women and children can utilise the information, services and

resources they need in one place, including medical treatment, police services,

counselling, forensic tests and shelter services is imperative.

International Framework for Women’s Sexual and Reproductive

Rights

Several international instruments within the UN and special agencies can be

used to advance women’s sexual and reproductive rights. Specifically, the UN

Commission on Human Rights (UNCHR)24 has recognised the link between

violence against women and sexual rights in the Programme of Action of the

International Conference on Population Development (ICPD) and ICPD+5.

International human rights instruments incorporating sexual and reproductive

rights include, inter alia: Universal Declaration of Human Rights (UDHR)25;

International Covenant on Civil and Political Rights (ICCPR)26; International

Covenant on Economic, Social and Cultural Rights (ICESCR)27; International

Convention on the Elimination of All Forms of Racial Discrimination (ICERD)28;

Constitution of the World Health Organisation29; Convention on the

Elimination of All Forms of Discrimination against Women (CEDAW)30;

24. UN Human Rights Council since 2006

 25. Articles 3, 16 and 25.

26. Articles 3, 6 and 7.

27. Articles 3, 10 and 12.

28. Preamble and article 5(iv)

29. Chapter II, article 2, (l)

30. Articles 1, 5, 12, 16,

17

Declaration on the Elimination of Violence against Women (DVAW)31; General

Recommendation Nos. 1432, 1933 and 2434 of CEDAW Committee.

These instruments together with others pertaining to human rights need to

be creatively employed and considered in conjunction with one another, to

achieve a broader and holistic approach and to address the intersectionality of

rights violation experienced by women. In the event of violations for instance,

together with CEDAW, women can utilise other international human rights

treaties to seek protection and redress. Women from racial minorities can use

the ICERD which provides extra protection for people of racial or ethnic

decent. Likewise the rights of girl children are protected by the Convention

on the Rights of the Child (CRC); and the rights of women who are migrant

workers themselves or family members of the migrant workers are protected

by the Convention on the Protection of the Rights of All Migrant Workers and

Members of Their Families (CMW). Similarly, for women with disabilities, new

international standards were adopted by the UN General Assembly in 2006 as

the Convention for the Rights of Persons with Disabilities (CRPD). However,

it is notable that for women of particular sexual orientation and gender

identity, as of yet there is no human rights treaty established.35 This redirects

our attention to the fact that sexual and reproductive rights have not yet been

fully defined highlighting the need to positively formulate and define `sexual

and reproductive rights.’ Such a formulation will contribute to the empowerment

of women and combat the root causes of multiple forms of violence and

discrimination against women.

31. Articles 1, 2 (a), (b), and (c)

32. on female circumcision

33. on violence against women

34. on women and health

35. Yogyakarta Principles on the Application of International Human Rights Law in Relation to
Sexual

Orientation and Gender Identity (2006) provides mechanisms for the various international human
rights

law to be applied to the rights related to sexual orientation and gender identity. See also Heisoo
Shin,

National Movement for Eradication of Sex Trafficking, Korea, in her paper Sexual and
Reproductive Rights

and International Framework: Achieving Fundamental Human Rights during the Consultation.

18

CHAPTER 1:

CRITICAL ISSUES FROM ASIA PACIFIC

APWLD situates its understanding of women’s realities in the context of neo-

liberal globalisation, fundamentalisms, and militarisation.36 These three major

global trends have fused with patriarchy to constitute new patterns of

subordination and oppression of women in the region. Expressions of these

three ideologies are often articulated through pernicious contests over

 women’s bodies and sexuality that are manifested through a myriad of

discriminative practices that deny and violate women’s sexual and reproductive

rights.

1.1 Neo-liberal Globalisation and Women’s Sexual and Reproductive

Rights

In the last two decades neo-liberal theories have dominated economic policy

in Asia Pacific. The international architecture of neo-liberalism is mandated to

raise standards of living and has embraced neo-liberal economic orthodoxy as

the path to prosperity. While economic growth may have been achieved

through this approach, there is an absence of evidence to indicate that it has

led to improved standards of living or improved human rights climates for the

majority of the world’s poor. Conversely, research conducted by APWLD and

others suggests that unconstrained neo-liberalism has exacerbated the gap

between rich and poor, and in many cases, has led to further feminisation of

poverty. The essence of globalisation is to enable monopoly capitalists

represented by transnational corporations to maximise their profits from the

exploitation of the labour of working people and natural resources of countries,

both in developing and developed countries.37

The biggest price of such neo-liberal economic policies has been paid by the

36. The overall framework of Chapter 1 of this report is framed based on Madhu Mehra’s paper on

‘Introducing APWLD’s analytical framework: fundamentalisms, militarization and globalisation

and women’s

human rights during the Consultation.

37. Judy M Taguiwalo, Rural and Indigenous Women Task Force, APWLD, Globalisation and
Women: A
 discussion guide for Trainers, 2006 (page 21)

19

rural poor, small farmers and indigenous communities and is manifested in

large scale displacement and loss of livelihoods often without any adequate

rehabilitation plans or compensation. These developments have also created

hubs of employment, bringing about the largest inter and intra state migration

in recent times and likewise in trafficking of women and children. Younger

women form a large part of migrant labour, employed as contract based

unorganised workforce. Even as younger women have gained mobility and

employment in wake of these sweeping economic changes, the security is no

more than a tenuous foothold in the unorganised low paid unskilled workforce,

with no employment security, and with increased vulnerability to violence and

exploitation as a migrant.

Indigenous women are of particular concern in this regard and there are

many reported cases of sexual violence against indigenous women who

migrate to urban areas or to developed countries. For instance, two young

girls (who had migrated from the north western part of India to the cities

with their families), a six year old and a 19 year old were raped and murdered

in April and in October 2009 respectively.38 Not only are women at risk as a

result of this vulnerability, state laws and policies such as those implemented

to combat trafficking and human rights violations often put them at risk of

further violence and exploitation. For example, it is often the case that national

anti-trafficking legislation uses a criminalisation approach to attempt to

eradicate prostitution. In practice this increases the risk of violence for sex

workers by putting them in a more vulnerable situation via harsh crack downs
which push them underground, creating more complicated barriers and access

to legal, social and health services.

Women migrant workers are also of concern as they are faced with multiple

forms of violence due to their undocumented status or due to the

discriminatory laws and policies in destination countries. There was a reported

case of a woman, one amongst thousands of undocumented migrants

from Burma, working as a domestic worker in Thailand.39 She was

38. Reported by Atina Gangmei, Asia Indigenous Peoples Pact (AIPP) Foundation, Thailand,
during the

Consultation.

Usa Lerdsrisuntad, Foundation For Women, Thailand, in her paper ‘Migration and Trafficking and
Women’s

39.

Sexual and Reproductive Rights,’ during the Consultation

20

sexually exploited and abused by her employer but decided not to report the

abuse to the police in fear of losing her job and being deported back to her

country of origin. Although the Thai criminal law protects everyone without

discrimination, those migrant women who have no legal status cannot seek

legal redress since they cannot afford to lose the opportunity to earn a living

in Thailand.

Pla, a Thai woman, in order to pay off a large debt after her

husband left her to start a new family, was persuaded to

become a housemaid abroad only to end up working as a sex

worker in Italy. She did not know how to use a condom, fell
 pregnant and was forced to have an abortion, the expense of

which was added to her already large existing debt. When she

returned to Thailand she cooperated with authorities to

prosecute the trafficker, who was from the same village as her

however the trafficker left the country whilst on bail and has

never been prosecuted. 40

Women domestic workers are further discriminated against

in countries such as Singapore where they are the only

category of workers who are not permitted to marry

Singaporean nationals. Further they are not allowed to fall

pregnant and should this occur they are automatically

deported to their countries of origin. 41

These migration trends have seen a steep increase in international marriages. It

has become one of the choices women make to seek better economic and

social opportunities as well as a way to free themselves from forms of

oppression faced in their own countries. In some cases, women are trafficked

and forced into international marriages where they face multiple forms of

violence including marital rape and other forms of physical and psychological

40. ibid

Mara T Quesada, Action for Health Initiatives, Inc (ACHIEVE), Philippines, in her paper ‘Sexual
and

41.

Reproductive Health Issues Faced by Women Migrant Domestic Workers during the Consultation

21

violence, limited freedom of movement and slavery-like situations. Countries

such as Cambodia reported increased international marriage which is deeply

rooted in a tradition whereby a woman marrying into a good family is

considered to be a way of returning `gratitude’ to her parents. Forced arranged

marriage is common in such patriarchal and male-dominated societies where

women are expected to conform to traditions. Furthermore, women are

often forced by their husbands to give birth to a son, after which in some cases

the women are forced to return home without their children and with little

money.42

With the acceleration of globalisation, new markets have opened for women

where in most cases they find jobs in cheap and unregulated labour markets

with minimal monitoring and protective mechanisms, leaving them exposed

to new forms of sexual and reproductive exploitation or abuse. Such an

avenue is commercial surrogacy, i.e. surrogacy for strangers with an explicit

cash transaction, made possible through the advent of newer technologies for

assisted reproduction, for domestic and international markets.

Commercial surrogacy is gaining ground in many urban and semi-urban centres

in India. Patriarchic families and communities have always regulated and

controlled women’s sexual and reproductive labour for the maintenance and

sustenance of the hetero-patriarchical family. Women have lived with this

control through loss of freedom, curtailment of their mobility, and restricted

access to the public world and been offered instead notions of security,

protection and status. Their reproductive rights have been trampled upon in

the name of the welfare of the family, the community and the nation state.

Their sexuality is defined in terms of the norms of the hetero-sexual

monogamous family not in terms of rights43. The lack of rights, including: the
lack of development, education, social security and an adequate standard of

living such as adequate food, clothing, and housing, are compounded by the

lack of choice, resources and the political and economic oppression of women.

Eart Pysal, Khmer HIV/AIDS NGO Alliance (KHANA), Cambodia in her paper ‘International
Marriage and

42.

Women’s Sexual and Reproductive Rights’ during the Consultation

43. Chayanika Shah, Forum Against Oppression of Women and Lesbians and Bisexuals in Action,
India in her

paper, ‘Surrogate Motherhood and Women’s Sexual and Reproductive Rights’ during the
Consultation

22

These factors come together to place women in the position where

employment as a surrogate appears to be the best of all possible options and

can place already vulnerable women at risk of further exploitation.

Hetero-patriarchal relations have shaped not just women’s status in the family

but also economic opportunities in the market and the workplace. This has

over the last decade, combined with global capital to shape international trade

and the global market – manifested in international marriages, trafficking,

reproductive technology, and the growth of the surrogacy industry.

Furthermore, neo-liberal economic policies have been in many contexts a

major factor for the exacerbation of poverty and marginalisation, making basic

social services even more inaccessible for women. The increasing privatisation of

health services in countries in the region is a particularly worrying phenomenon,

which limits access to health services for more vulnerable groups such as the

poor, HIV positive, sex workers, rural and indigenous women and migrant
women amongst others. It makes sexual and reproductive health services

accessible only to the women who can afford the cost as customers, leaving

women who need the services the most in a more vulnerable position. The

privatisation processes, most often imposed by donor/multilateral policies

in the neo-liberal global environment, also reduces the accountability of

governments to actively promote and fulfil sexual and reproductive rights

as mandated in their obligations as signatories to international agreements

such as the International Conference on Population and Development, Plan

of Action (ICPD PoA), Millennium Development Goals (MDGs) and human

rights instruments.

23

In Bangladesh, denial of services by the state, through the

lack of adequate health care or lack of access to basic and

universal health care services is reported as a major factor

responsible for preventable deaths, and lifelong or long lasting

injuries of women. Public institutions subsidise private service

when public services are neglected due to private practice.

For instance, doctors working in the public health sector

devote large amounts of time and energy to private practice,

arriving late for their duty and leaving early, prohibiting them

from performing their government jobs in a professional,

effective and accountable manner. Patients are pushed

towards private clinics by doctors and other staff who profit

from increased private patients, even when there are available

 public facilities. Affordable universal health care access is

being undermined by less regulation and accountability in the

private health care sector, which patients are turning to due

to the lack of alternative options and the weakened public

health institutions.44

Increasing privatisation of health is a concern also in

Mongolia. Government doctors are sending clients or

patients to their own private hospitals to earn more money

from the provision of private services. The corruption and

lack of political will to provide universal health care services

further impedes women’s access to basic health services.45

Sadaf Saaz Siddiqi, Naripokkho, Bangladesh in her paper, ‘My Body, My Life – Whose Rights?’
during the

44.

Consultation

45. Dr. Semjidmaa Choijil (PhD), Mongolian Family Welfare Association (MFWA), Mongolia, in
her paper,

‘Violations of Women’s Sexual and Reproductive Rights in Mongolia’ during the Consultation

24

The exclusion of Traditional Birth Attendants (TBAs) either trained or

untrained from the category of skilled health workers by international agencies

such as the World Health Organisation (WHO) can have detrimental effects

on women’s reproductive health rights particularly in rural areas.46 TBAs are

still a choice for women living in rural areas or in indigenous communities,

who have very limited or sometimes no access to health services and who are

not being reached by government/public services, as they are the only form of
 assistance available.

In Bangladesh, 85 percent of deliveries take place at home

attended by relatives and TBAs. The remaining 15 percent are

handled by the public sector, non-government organisations

(NGOs) and private sector. Although UNICEF has undertaken

to identify young women working as family welfare assistants

and have them trained on a six month programme to become

skilled birth attendants (SBAs), SBAs are few and far between

at the local level as the training process has not been

completed yet in many areas nor is it completely

comprehensive.47

46. According to WHO, a skilled attendant refers to “an accredited health professional-such as a
midwife,

doctor or nurse-who has been educated and trained to proficiency in the skills needed to manage

normal (uncomplicated) pregnancies, childbirth and the immediate postnatal period, and in the

identification, management and referral of complications in women and new born.”

(http://www.who.int/

making_pregnancy_safer/topics/skilled_birth/en/). For further information on skilled attendants in

Asia,

see Asian-Pacific Resource and Research Centre for Women (ARROW), Reclaiming &
Redefining Rights:

Status of Sexual and Reproductive Health and Rights in Asia, pp. 61-63 (2009).

Sadaf Saaz Siddiqi, Naripokkho, Bangladesh in her paper, ‘My Body, My Life – Whose Rights?
during the

47.

Consultation

25
Service providers are not reaching out to indigenous

women, the majority of whom live in remote areas and do

not have adequate, accessible and affordable health care

services. Government policies follow the instructions of

international agencies, including WHO and UNICEF, which

most often reject and deprive indigenous communities of

their traditional rights of giving birth, effectively practiced by

TBAs and traditional healers. This will only have further

detrimental impacts on the reproductive health rights of

indigenous women. Support from governments to upgrade

the knowledge and skills of TBAs as well as to enhance the

delivery of public sector services are critical in enhancing

reproductive health rights of indigenous women.48

In Papua New Guinea, a country where 85 percent of the

population lives in rural areas with no roads available due to

its mountainous topography, TBAs are the only ones in the

communities to assist women in delivery, family planning or

basic reproductive health services. Denying access to

reproductive health care to women who have no access to

government/public facilities or even private facilities is a

serious form of violence and discrimination against women.49

The role of TBAs is of note in the context of militarisation. In

Burma, particularly in the eastern military zone, TBAs are

the only ones that can assist women as a result of the on-
 going fighting and limited or no access to health care services.50

48. Reported by Atina Gangmei, AIPP, Thailand during the Consultation.

Juliana C Riparip, Marie Stopes Papua New Guinea, (PNG) in her report, ‘Violence against Women
and the

49.

HIV/AIDs Epidemic in Papua New Guinea’ during the Consultation

Reported by Naw K’nyaw Paw, Karen Women’s Organisation, Karen State Burma, during the
Consultation

50.

26

The contestations to maintain and assert control over women’s sexual and

reproductive rights in the wake of globalisation have had the strongest political

currency when couched in the language of fundamentalist cultural identity

politics, based on religion, ethnicity, and nationalism. These contestations have

relied upon violence as a strategy and means of control over women’s sexual

and reproductive rights.

1.2 Fundamentalisms and Women’s Sexual and Reproductive Rights

APWLD uses the term ‘fundamentalism’ to refer to monolithic, rigid narratives

adopted by movements in their quest for power, particularly through

deployment of cultural, religious, ethnic and nationalist discourses. These

movements are distinct from other movements in that the power they seek

is absolute and in opposition to plurality, difference, debate or dissent. In the

context of culture/religious based fundamentalisms, power is inevitably and

most easily exercised by targeting women, through regulation of their bodies,

roles, freedoms and rights.

Nowhere is this more evident then in the sphere of sexual and reproductive
 rights. Harmful but culturally tolerated practices such as dowry or bride price,

which reinforce the concept that a man is purchasing his wife and allows him

to exercise complete power over her, are often justified as honouring ‘religion’

or ‘culture.’ Women’s sexual and reproductive rights are closely tied with

notions of the family name, honour and esteem with the result that great

control is exercised over it by the latter, as any violations of the set traditional

norms of the society are commonly accompanied by severe punishment,

disability and even death.

27

52. Marriage to the Quran

In Pakistan51, even though the law has persistently made an [known as

Haq Bakshish], a

attempt to promote sexual and reproductive health rights practice that

is widespread

in the Sindh province in the

and discourages practices like child marriage through the south of

Pakistan where

establishment of various laws (e.g. the Muslim Family Law young

girls are asked to

dedicate themselves to

Ordinance (MFLO), 1961), they remain commonplace. In

memorising the Holy

many cases, a child marriage is contracted with a much older Quran.

Their families hold

man and negotiations on sexual and reproductive health a ceremony

to marry the

girl to the Holy Book. A

issues including use of condom or discussion on family size girl places

her hand on the

are well beyond the capacities of the child bride. It is reported Quran and
takes an oath

that she is married to it until

that pregnancy related death is a leading cause of death for death. The
phenomenon has

girls between 15 and 19 years of age. Furthermore, women caused

much controversy

throughout Pakistan with

are prevented from marrying or bearing children, if they are some

families encouraging

`married to the Holy Book’ (Quran);52 women (usually young

“marriage to Quran” to

prevent a woman from

girls) are traded for peace between warring factions; and marrying any
person.

women are subjected to extreme violence justified by the Women

who are married

to the Holy Book are

practice of punishing ‘honour crimes’ whenever women not

allowed to have a

transgress traditional norms. For instance, pre and extra relationship

with a man or

to marry anybody. Moreover,

marital sexual activity is considered a stain on the honour of men fear

being cursed if

the man/family and a rightful provocation to violence. What they have

a relationship with

a woman who is married

is worse is that on many occasions, the perpetrators are to the Quran.

The trend is
 excused by traditional para-legal bodies in the name of more notable
amongst the

upholding patriarchal tradition. In many instances, the alleged rich and

feudal families in

Sindh. It was first devised

transgression of the woman is not actual but merely used as to deny

women their rights

an excuse to achieve a motive such as stealing away property of

inheritance and out

of fear of property being

from the woman. passed on to outsiders

through the daughters or

sisters (i.e. their spouses

or children). According to

independent sources in the

Pakistani capital, Islamabad,

approximately 10,000 girls

are married to the Quran in

the Sindh province.

Saman Yazdani, Shirkat Gah, Pakistan in her paper ‘Harmful Cultural Practices and Women’s
Sexual and

51.

Reproductive Rights - Pakistani Perspective’ during the Consultation

28

Papua New Guinea has the highest incidence of HIV/AIDs

and sexually transmitted diseases (STDs) in the Pacific which

are associated with an increase in sexual assault including

 rape. Three of the seven major practices linked to the high

incident of HIV/AIDs were identified as violence against

women (including: sexual coercion and gender-based

violence); accepted practice of polygamy; and early onset of

sexual activity, often where first experience involves violence,

abuse and coercion. In Lae, the capital of the Morobe

Province, Papua New Guinea’s second largest city, it is

common for women who travel the Highlands Highway to

wear the female condom as protection against STDs or HIV/

AIDs from infected gang rapists as it is expected that they will

be raped. Survivors of violence are further violated by the

practice of paying ‘compensation,’ in many cases in the form

of the rapist’s family paying to the victim’s family an agreed

sum in lieu of prosecution which is accepted as ‘justice,’ and

further justifies repeated rape incidents by the same

perpetrators.53

In Sri Lanka, religion or culture plays a dominant role in

controlling women’s bodies and sexualities. A 30-year-old

Muslim woman, mother of three children, was killed in the

name of ‘honour’ allegedly by men from the same Muslim

community for having ‘bad character and connection with

men.’ 54

53. Juliana C Riparip, Marie Stopes Papua New Guinea, Papua New Guinea (PNG) in her report,
‘Violence

against Women and the HIV/AIDs Epidemic in Papua New Guinea’ during the Consultation
 Segaruban Vijayalachumi, Suriya Women’s Development Centre, Sri Lanka in her report
‘Reproductive

54.

Health and Rights Issues for Women in Conflict Affected Areas’ during the Consultation

29

In many parts of the Asia Pacific region, religious institutions play an influential

role in reinforcing violations or suppression of women’s sexual and reproductive

rights in law and policy-making and/or by obstructing positive developments in

women’s rights. Religious fundamentalisms promote a dominant, male-centred,

patriarchal and hetero-normative model of the family, claiming to be “pro-

family” and ”pro-life”, subsequently exercising and reasserting absolute control

over women’s bodies. In the Philippines, the Catholic Church has been

extremely vocal in its opposition to the draft Reproductive Health Bill (which

if passed will allow the use of artificial contraceptives, while not decriminalising

abortion) with some local governmental units establishing an affirmative policy

of promoting natural family planning as the only acceptable form of family

planning.55 This places women, particularly poor women, in a situation where

the only remaining solution is abortion, which is mostly clandestinely practiced

in and under unsafe places and conditions, in turn resulting in a high rate of

maternal mortality.

Alnie G. Foja, Gabriela Women’s Party, Philippines, in her paper ‘Beyond “Pro-Life versus Pro-
Choice” Debate

55.

The Status of Reproductive Health and Rights in the Philippines’ during the Consultation

30
Similarly, in Timor-Leste, which reports the highest rate of

maternal mortality in the Asia region deriving from unsafe

abortion, law-making is also strongly influenced by the

Catholic Church. A review process of the Penal Code in

October 2008 resulted in Parliament approving the draft

Penal Code which was to be reviewed by civil society. Article

142, of the draft Penal Code permitted termination of

pregnancy on grounds of illness, including mental or

psychological trauma from rape or incest, and risk to life of

the mother. During the review, NGO advocacy networks

made additional recommendations to consider broadening

the article to include permitting abortion in the incidences of

rape, incest and economic social issues as exception for

interruption of pregnancy. The Catholic Church simultaneously

sent a petition to the National Parliament requesting that the

recommendations not be implemented into the Penal Code

with the reason that it was against Catholic morals and the

rights of the foetus, since conception is considered the

moment of human life. As a result, the current Penal Code,

article 141 criminalises termination of pregnancy in all

circumstances only with the exception of risk of death under

strict conditions which includes three doctors being required

to agree to the procedure and sign a certificate with the

written consent of the women seeking the abortion. Consent

from a women’s spouse is also required. A fourth doctor (not

 one of the original three) should perform the abortion and

one of the doctors should be trained in obstetrics/gynaecology.

There should be a delay between gaining consent and

performing the actual procedure which puts women at

further risk of complications. Furthermore, medical

practitioners may conscientiously object to performing an

elective abortion however in this instance they must refer the

woman to another doctor.56

Veronica Correia, Alola Foundation, Timor - Leste, in her paper ‘Maternal Mortality, Unsafe
Abortion and

56.

Women’s Reproductive Rights in Timor-Leste’ during the Consultation

31

In Fiji, women and girls’ sexual and reproductive rights are strongly influenced

by traditional cultural and religious values. Abortion is criminalised with

criminal penalties ranging from two years to life imprisonment for women

who are convicted. The penalty also applies to those who perform the

procedure whether it is using traditional or medical means, and a medical

practitioner can be imprisoned for 14 years.57 The lack of appropriate facilities

places women at greater risk and those conducting the abortions are general

practitioners who do not have sufficient knowledge or expertise in this area

and use this as a money making exercise. The resistance to making abortion

legal, coming mainly from faith-based organisations, only increases clandestinely

practiced abortions without appropriate health care services reaching women

in most need.
On the other side of the spectrum, the current realities of abortion practices

in Korea raised the concern that the primary beneficiary was not the women

seeking the abortion but the hospitals and practitioners profiting from

providing the service. Abortion in Korea is permitted to save a woman’s life,

in instances of rape, incest and foetal impairment with the condition that

spousal approval is required. It is estimated that there is more than half a

million abortions per year, 340,000 of these in South Korea alone which has

raised much debate over whether Korea’s low birth rate to some extent

correlates with the high abortion rate.58 In comparison the realities in

Kyrgyzstan, where abortion is legal and permitted without restriction,

medical services are not accessible for most women. Women in rural areas

are unable to access services as a result of not being able to travel the long

distance (sometimes up to four hours) to reach a medical facility and in most

instances are unable to afford the treatment. In Kyrgyzstan, to receive medical

treatment, citizens are required to produce evidence of medical insurance and

identification cards, which discriminates against sex-workers as most do not

have such documentation as a result of having been trafficked or forced into

57. Naeemah Khan,Virisila Buadromo and Edwina Kotoisuva, Fiji Women’s Rights Movement/
Fiji Women’s

Crisis Centre, Fiji, in paper ‘Women-centred Services: from Individual Empowerment to Social
Change Sexual

Reproductive and Health Rights’ during the Consultation

58. Reported by Heisoo Shin, National Movement for Eradication of Sex Trafficking, Korea during
the

Consultation.

32
prostitution.59 Sex workers are unable to access abortions free-of-charge and

there is currently no Acts or laws that specifically protect or support them.

Cultural attitudes and practices cultivate an environment where violence against

women persists and is used as a way to control women. The perception is

reinforced through cultural attitudes that women should be kept in their place

if they are not seen to conform to the ideal notions of being female or are not

judged by the prevailing cultural traditional attitudes to be a ‘good woman.’

For instance, in many cases of sexual assault in Fiji, the female victim may be

blamed by the community and it is commonly reported that a community may

victimise a survivor of sexual violence for reporting the matter to the police

giving no space for the survivor to seek justice.

‘A 15 year old girl, lodged a complaint with the police for being gang-raped.

That Sunday when she went to church with her family the members of the

congregation moved to sit apart from her family, as they were upset with her

for reporting the matter and bringing shame onto the community.’60

Discrimination and stigma poses a serious threat to the sexual and reproductive

rights of many vulnerable and marginalised women. For instance women

with disabilities face triple discrimination within society in general: not only

because of their disabilities but also because they are women and often from

lower socio-economic circumstances. Even within each of the three categories,

prejudice against women with disabilities prevails, i.e. among women; women

with disabilities are seen as inferior and, among people with disabilities; disabled

women are not considered equal to disabled men. In particular, the sexual and

reproductive rights of women with disabilities are neglected simply because

 of the fact they are women with a disability. Most of the time, women with

disabilities are likely to be treated as asexual, sexually inactive or unable to

have sexual relationships. They are forced to undergo sterilisation and/or to

have abortions in some cases by their family and service providers. Women

with disabilities are at high risk of being abused physically, sexually and mentally

59. Reported by Irena Ermolaeva, NGO Asteria, Kyrgyzstan, during the Consultation.

60. Naeemah Khan,Virisila Buadromo and Edwina Kotoisuva, Fiji Women’s Rights Movement/
Fiji Women’s

Crisis Centre, Fiji, in paper ‘Women-centered Services: from Individual Empowerment to Social
Change Sexual

Reproductive and Health Rights’ during the Consultation

33

at home, within their community and within the institutions established to

support and protect them.

In Korea, access to justice and/or health services is limited.

For instance, Korean courts recently rejected a case of sexual

abuse against a girl with an intellectual disability on the

grounds that the evidence provided by her or the testimony

of a mentally ill or retarded young girl was not credible. Often

in such cases, women with disabilities are blamed but not

protected from violence. A young woman with intellectual

disabilities who was repeatedly sexually assaulted on her way

to school was blamed by her mother for the assault and was

prohibited from attending school denying her also the right

to an education.61

Similarly, women living with HIV/AIDs are ‘recommended’ not to have

a child even by doctors and often forced to undergo sterilisation against

their will. Forced sterilisation is not a new concept and is a violation that

many women have voiced concern about. Yet sterilisation without a woman’s

knowledge or consent continues to be an unnerving reality for some of the

world’s most marginalised women, such as those living with HIV/AIDS. Blatant

discrimination and denial of reproductive choices is a common experience

for many women living with HIV. Dwi Surya Kusuma from Indonesia, in her

testimony spoke courageously of living with HIV and the pain of discovering

she had been sterilised:

‘The doctor recommended that I should terminate my pregnancy given that I

was HIV positive ... however I insisted on continuing the pregnancy, I was four

months pregnant at the time. I underwent prevention of mother–to–child

transmission (PMCT)62 treatment on the advice of my doctor. My child was

born HIV negative however I was sterilised forcibly after delivery.’

Mijoo Kim, Women with Disabilities Arts and Culture Network, Korea in her paper ‘Women and
Girls with

61.

Disabilities, Sexuality and Reproductive Rights’ during the Consultation

62. PMCT refers to Prevention of Mother -to- Child Transmission

34

Dwi’s story highlights what is really at risk: respect for fundamental human

rights of all women regardless of their HIV status including their sexual and

reproductive rights; the right to make choices about reproduction free of

discrimination, coercion and violence and; the right to attain the highest
standard of sexual and reproductive health. HIV positive women can and do

lead fulfilling, safe, pleasurable sex lives and women who have access to PMCT63

services such as antiretroviral drugs (ARVs) can give birth to healthy infants

as is evident in Dwi’s testimony. The concept of mother-to-child transmission

in and of itself sparked much debate as the terminology once again holds

women accountable for transmitting the virus to their children and absolves

their husbands and/or partners of any responsibility, even though in many

cases the virus is transmitted to the women by their husbands and/or partners.

HIV positive women have less access to reproductive health care systems than

non-HIV positive women. Furthermore, fear not receiving funding for proper

treatment if they do not conform to their doctors’ advice in relation to their

pregnancy, HIV positive women are left without a choice but to undergo

sterilisation in many cases. In addition, women with HIV/AIDs are reluctant to

see doctors when they are unwell in fear of discrimination. Their HIV status

prevents them from having appropriate medical treatment as the doctor would

often not offer services when informed of their HIV positive status. Therefore,

the lack of dissemination of accurate information and accessible medical

treatment and health care services are key contributing factors to the

discrimination of women living with HIV/AIDs. In India, it was reported that

women are able to access health facilities for HIV treatment only when their

husband felt that his wife should receive the treatment.64 HIV positive women

in Vietnam face a similar situation of very limited access to health care

facilities and treatment65.

Fundamentalisms are particularly dangerous for women who identify as lesbian,

 bisexual, transgender or intersexed. Culture, religion or tradition is used to

63. Some nations in Africahave chosen to adopt the terminology of ‘parent -to- child transmission’
to ease

this debate

64. Reported by Anuradha Mukherhee, Naz Foundation, India, during the Consultation.

65. Reported by Vu Song Han, Centre of Creative Initiatives in Health and Population,Vietnam,
during the

Consultation.

35

justify hate, discrimination, persecution and abuse against sexual minorities.

While sexual health is an integral and essential component of reproductive

rights; sexual rights are distinct from reproductive rights since many of the

expressions of sexuality are non-reproductive and include the right of all

persons to express their sexual orientation, with due regard for the well being

and rights of others, without fear of persecution, denial of liberty or social

interference.66

In Malaysia, where there is an increase in Islamic conservatism,

a Malaysian transgender woman who is now living in

England recently married her English boyfriend. When her

story came to light in Malaysia the government threatened to

punish her if she returned to the country because she is

Muslim and has insulted Islam, the government and her family.

Unnatural offences is found in Section 377 of the Malaysian

Penal Code where it explicitly states that “whoever voluntarily

has carnal intercourse against the order of nature with any

man, women or animal shall be punished with imprisonment

 for a term which may extend to 20 years and shall also be

liable to fine or whipping/canning.” Malaysia stands under the

heavy influence of Islam and LBTI Malaysians are often seen as

immoral and treated as deviants and criminals. This particular

Malaysian transgender individual now remains in a situation

where she is not able to return to Malaysia due to likely

persecution. At the same time the home office in England is

unable to accept her because her passport photo displays a

male face. In Malaysia, as in most other countries, even if she

was to have an operation or obtained letters from medical

professionals confirming her gender as that of a `woman’, she

would not officially be able to change her identity card nor

her passport to identify as a woman. 67

66. Statement of Special Rapporteur on Violence against Women, its causes and consequences, Ms
Rashida

Manjoo

67. Reported by Ivy Josiah, Women’s Aid Organisation (WAO), Malaysia, during the Consultation

36

In Fiji, with a rise in religious and cultural fundamentalism, the

Methodist Church (the largest denomination which wields

considerable political and religious power) has advocated

against homosexuality. Methodist priests have called for the

stoning of homosexuals and have organised a public march

against homosexuals, often quoting the Bible as a source of

justification for its stance. 68

 Neo-liberal globalisation has fuelled fundamentalist movements based on

cultural identity politics, alongside the use of violence by state and non-state

actors as forms of resistance and means of maintaining law and order – in the

process, eroding democratic spaces of debate, dissent, difference and plurality

on which democracy and respect for human rights rests. The fall out for

women has been enormous in the context of increasing fundamentalist identity

politics and militarization, adversely impacting gender equality and protection

from violence. Women have been central to identity politics as the bearers

of identity, which makes them the subject of additional patriarchal controls

and the target of attack in violent conflict between communities. The control

over women’s reproduction, sexuality and bodies are key to patriarchy, and are

aggravated in fundamentalist discourse – so as to draw boundaries between

communities, to mark ‘us’ from ‘them’.

1.3 Militarisation/Armed Conflict and Women’s Sexual and

Reproductive rights

Armed conflict, the threat of armed conflict and the militarisation of societies

affects women in a multitude of ways. APWLD is particularly concerned about

the impact on women’s human rights – both as an immediate consequence of

hostilities and the legacy of militarisation that makes it harder for women to

claim their human rights.

68. Naeemah Khan,Virisila Buadromo and Edwina Kotoisuva, Fiji Women’s Rights Movement/
Fiji Women’s

Crisis Centre, Fiji, in paper ‘Women-centred Services: from Individual Empowerment to Social
Change Sexual

Reproductive and Health Rights’ during the Consultation

 37

The Asia Pacific region is experiencing increasing militarisation69 with clear

consequences for women’s rights. Rape has been deliberately used as an

integral part of military and war strategy to humiliate, demoralise or depose

the `other’ side in many countries in the region. Militarisation also increases

population displacement, a factor that places women at higher risk of sexual

violence and trafficking.. In the last two decades, especially, the region has seen

military play a greater role in governance and an increasing militarisation of

state and non-state actors contesting for political power.

In Burma, militarisation and attack by the government against

its own people has resulted in approximately 150,000

Burmese refugees in Thailand70, an estimated two million

migrant workers in neighbouring countries and over half a

million people have become internally displaced in eastern

Burma alone. Even for women living in the relative safety of

refugee camps, sexual violence such as rape, domestic violence

and sexual assault are of serious concern with little legal

recourse available for survivors. When sexual violence is

perpetrated by Thai authorities, women’s rights are often

traded for peaceful relationships between refugee communities

and the host country. 71

In Sri Lanka, women in conflict affected areas especially

those living in IDP camps are particularly vulnerable to

violence and violations of their sexual and reproductive rights.

Women are abducted, sexually assaulted and abused by

 military personnel. 72

69. J. Scholte,‘The Sources of Neo-liberal Globalisation’, Overarching Concerns Programme Paper

Number 8,

UN Research Institute for Social Development, October 2005.

70. In Thailand, there are nine refugee camps for Burmese refugees.

71. Reported by Naw K’nyaw Paw, Karen Women’s Organisation, Karen State Burma, during the

Consultation.

Segaruban Vijayalachumi, Suriya Women’s Development Centre, Sri Lanka in her paper
‘Reproductive Health

72.

and Rights Issues for Women in Conflict Affected Areas’ during the Consultation

38

The culture of explicit impunity especially in the context of militarisation and

armed conflict was stressed, which in most cases results in women having very

little, if any, access to justice. Inside Burma, particularly in the IDP areas, the

military often establish their posts outside of a village and demand the women

of the village attend the post to serve them. On 18 August 2009, in Toungoo

district, women were forced to drink alcohol and asked to massage the soldiers

in the military post. One soldier raped two women. Although the case was

reported to the authorities, no action was taken.73 In Shan state, Burma, it

was reported that a woman was gang raped in front of her husband. .74 There

was no justice sought for the women in either of these cases. In Nepal, there

have been many reported cases of sexual abuse occurring within custody

during times of violent political conflict. Thousands of women especially young

girls have been displaced from their communities in search of security and
 forced into different forms of exploitative work. Many have been internally

trafficked for sexual exploitation. Even though the peace process has now

began in Nepal, access to justice and the ending of impunity still remains

unaddressed.75

Violence against women in this militarised context is compounded by the

traditional view of women which regards women as second-class citizens as

well as by a culture of impunity, lack of laws and weak implementation of

existing laws. Furthermore, lack of resources and infrastructure in conflict/

war-torn areas to protect and support survivors of sexual violence as well as

basic health facilities was another area of concern. For instance, in refugee

camps for the Karen people of Burma in Thailand, there is no adequate

detention centre that could retain perpetrators of sexual violence for long

periods of time, so often a perpetrator is not detained for more than two to

six months. The current Karen Refugee Committee (KRC) Rules and Law,

Serial No 7 states that punishment of rape is a penalty of 2,000 Thai baht and

six months detention.76 In Nepal, many cases of sexual violence have also

Naw K’nyaw Paw, Karen Women’s Organisation, Karen State Burma, in her paper ‘Refugees and
Internally

73.

Displaced Peoples (IDPs): Sexual Violence against Burmese Refugees in Thailand’ during the
Consultation

74. Reported by Nang Hern, Shan Women’s Action Network, Burma, during the Consultation

Reported by Renu Rajbhandari, Women’s Rehabilitation Center (WOREC), Nepal, during the

75.

Consultation.

76. Naw K’nyaw Paw, Karen Women’s Organisation, Karen State Burma, in her paper ‘Refugees
and Internally

Displaced Peoples (IDPs): Sexual Violence against Burmese Refugees in Thailand’ during the
Consultation.

39

been reported in Bhutani refugee camps. Although there are on-going efforts

particularly made by the UN High Commissioner for Refugees (UNHCR) to

end sexual abuse in refugee camps, there are still significant difficulties in

seeking justice for the survivors of violence. In cases where refugee girls/

women are married to Nepali men in particular, the legislature turns a blind

eye and fails to respond when physical or sexual abuse is committed by Nepali

husbands regardless of the fact that marital rape was criminalised in Nepal in

May 2002.77 In North Korea, under the military government, women have

limited access to legal redress on violation of their rights. On public

transportation in North Korea, particularly trains, women are exposed to

sexual harassment and are groped by passing men, to which they cannot

protest as speaking out incurs further violence upon them. Appealing to a

Public Safety Agent would be just as gratuitous as they would dismiss the claim

with incredulity. 78 On 30 August 2009, in Timor-Leste, the President released

perpetrators that attacked people in the community in 1999, in election–

related violence related to the political turmoil in the country’s transition to

independence. These attacks involved sexual violence against women (including

rape, binding of the vital organs of the victims, and inserting objects in women’s

genitals) on the grounds of national/political interest.79

Women’s reproductive health rights cannot be separated from exacerbated

poverty and vulnerability in the context of militarisation and armed conflict,

which in turn hinders women’s access to fundamental health care services. In

Sri Lanka, women in resettled areas are facing transport difficulties. There is

no clinic facility in the resettled areas and midwives will not visit mothers

whilst pregnant nor once a child is born. Women face other challenges

including lack of access to contraceptives and are often forced into sex work

to fulfil their basic needs such as food for themselves and their children.80

77. Reported by Renu Rajbhandari Women’s Rehabilitation Centre (WOREC) Nepal, during the
Consultation

Testimony of Myungsook Lee, North Korean defector, ‘Unforgettable Misery in North Korea’
during the

78.

Consultation

79. Reported by Veronica Correia, Alola Foundation, Timor-Lesge, during the Consultation.

Segaruban Vijayalachumi, Suriya Women’s Development Centre, Sri Lanka in her report
‘Reproductive

80.

Health and Rights Issues for Women in Conflict Affected Areas’ during the Consultation

40

North Korean women undergo extreme forms of rights violations not only

inside North Korea but also when they try to seek refuge in neighbouring

countries such as China. In order to hide from authorities in fear of deportation

and earn a living, these women are highly exposed to trafficking which often

results in forced prostitution and/or forced marriage where they are at risk of

sexual assault and/or domestic violence. Once discovered by the authorities

they are sent back to North Korea and placed in detention. Violence against

women in detention including forced abortion and infanticide, are common

violations of women’s sexual and reproductive rights. Pregnant women in

detention are often assigned to hard labour or beaten by camp guards to

induce an abortion. A North Korean defector provided her testimony of the

severe hardship she underwent when she was detained in a political prison

camp (Kwalliso), including her new born baby being murdered in front of her.

“I, together with six other North Koreans were taken to the Manpo Security

Agency where the guards started to search our bodies. To find any hidden

money, agents made us do so-called pumping which involved us sitting and

standing repeatedly whilst naked. They then called a female member of the

catering staff to check our uteruses. She did not put any gloves on, nor did

she wash her hands, before each check-up. Even the pregnant and girls could

not avoid this.... I gave birth on 29 November 2005. On the way to work

that morning, I was hardly able to walk because the time was near. As the

prison guards kicked me to make me walk faster, my water broke. I told the

guards that I was sick and they took me to the hospital outside of Kwalliso.

They said unless I gave birth on that day they would kill me. I had my baby

in the aisle in the hospital. One of the prisoners said it was a girl and cut the

umbilical cord with her teeth. The guards put the baby face down and asked

me if I would want to let the baby die. They started to kick me all over when

I said I could not let my baby die. As a result, my back teeth were broken and

I received injuries to my face. I kept saying that the baby had to be saved. My

baby cried for hours even whilst she lay face down. Then I fainted. I wanted

to cover her body with my underwear but I decided not to. It was before

midnight when I delivered my baby. I got back to the Kwalliso at 3:00 am and

started to work again at 5:00 am. I was still bleeding. I used my socks to stop
 41

it as there was nothing else to use. Other prisoners quietly cut their blankets

and let me use them too.81”

The issue of sexual harassment and violence in immigration detention centres

and while women were held in custody was also raised. The North Korean

defector testified that in the detention centre in Bangkok,Thailand, Thai

police would give money to female North Koreans, especially young girls to

touch their bodies and sexually harass them. Sometimes, when female inmates

took showers, the Thai police and other male inmates enjoyed watching them.

Although these violations are reported to relevant authorities, including the

Korean Embassy in Thailand, no appropriate measures have been taken.82 A

serious issue as to the sexual abuse occurring in detention centres or custody

is the impunity that perpetrators enjoy. In Nepal, many women political

prisoners were raped and although some of those women are now

parliamentary members, they can neither speak of their experiences nor seek

any legal redress.83

Some efforts made by women’s groups to advance women’s access to justice

in detention centres were shared. In Karen refugee camps in Thailand,

women’s organisations have been attempting to establish separate detention

centres for women and men. They have been advocating that women should

be trained as security guards but to date there is only one camp that has

female security personnel.84 The importance of monitoring detention centres

and granting full and unconditional access to NGOs and UN agencies to

examine and rectify human rights violations, as well as preventing such

violations, was also highlighted.

It is important to recognise the connection between the hegemonic politics

of fundamentalist movements and those of militarisation and neo-liberal

globalisation, that interlock to undermine democracy and underlies violations

Testimony of Myungsook Lee, North Korean defector, ‘Unforgettable Misery in North Korea’
during the

81.

Consultation

82. ibid

83. Reported by Renu Rajbhandari, Women’s Rehabilitation Centre, Nepal, during the
Consultation.

84. Reported by Naw K’nyaw Paw, Karen Women’s Organisation, Karen State Burma, during the

Consultation.

42

and non-recognition of sexual and reproductive rights. All the three trends are

based on the ‘single truth’ approach that holds that there is only one correct

way to approach and view the construction of culture, management of the

economy, and addressing of security and conflict.

The norms of chastity for women and of heteronormativity underlie sexual

and bodily controls over women during peace and in times of conflict.

Assertion of women’s sexual autonomy and bodily integrity therefore requires

challenging the norms that underlie sexual controls and grading of women on

the basis of sexuality, sexual conduct and orientation.85 Challenging sexual

norms that privilege some women over others is therefore central to

addressing sexual violence and to the articulation of sexual rights.

A focus on violations, particularly egregious violations is critical, and remains

 an area of challenge. However, alongside violations, the norm defining

sexuality must also be challenged. The purpose of focusing on the norms

rather than the violations is an important one. For even as we take stock

of sexual violence, we must not lose sight of challenging the root causes of

sexual control that underlie the spectrum of violence in peace and during

conflict.Therefore strategies that challenge a hegemonic model of sexuality to

promote inclusive and plural discourses are essential to finding solutions. For

instance we cannot seek to criminalise marital rape without asserting sexual

autonomy for all women, regardless of their marital status, sexual preference

or work. Only if our strategies and human rights advocacy challenges these

norms, the routinised violations, as it does the egregious forms, can we move

towards a truly transformative discourse on sexuality and reproduction – one

that moves beyond ‘protection/redress’ towards ‘prevention’ and ‘recognition

of sexual and reproductive rights’.

85. Chastity and procreative sex within heterosexual marriage are the highest in the sexual
hierarchy,

followed by lesser or deviant forms, ranging from inter caste/ inter religious/ inter racial unions,

widowhood, non marital sex, same-sex desire and sex work - carrying varying degrees of stigma,

exclusion and violence. See Madhu Mehra’s paper on ‘Introducing APWLD’s analytical
framework:

fundamentalisms, militarization and globalisation and women’s human rights during the
Consultation.

43

1.4 Successful Stories Advancing Women’s Sexual and Reproductive 86.

“The reproductive health field

Rights burst upon the scene in the

 years leading up to the historic

ICPD in 1994 and the Fourth

The articulation of women’s reproductive and sexual rights and the linking of
World conference on Women in

Beijing the following year.With

this to the human rights framework arose significantly in the 1990s.86 Almost its
roots in population and

family planning, the new world

two decades later and with many discussions in the intervening years, the

of reproductive health reached

participants at this regional consultation once again made connections between out
to bring in important

women’s rights, sexual rights and reproductive rights; discussed the violations new
perspectives on human

sexuality, women’s health,

of women’s sexual and reproductive rights, including the changing global

women’s rights, sexual rights,

political and economic landscape; and strategised on how to attain protection, and
women’s empowerment.

Reproductive health spurred a

promotion and fulfilment of sexual and reproductive rights, and how to address
major rethinking about human

impunity for violations in this regard.87 reproduction and its

biological,

social, economic, cultural and

political determinants and

The region has recently seen initiatives and strategies taken by women’s groups
outcomes. Separate from other

primary health care services, a

to make women’s sexual and reproductive rights a reality. These include: new
paradigm was launched,

- one-stop-crisis centres, places where violated and abused women and but
one connected to a broader

vision of factors, especially

children can seek all the services they need in one place, including those
related to development

medical treatment, police services, counselling, forensic tests, and J. Kaufman

‘Measuring

Reproductive Health: from

more; contraceptive prevalence

- shelter and telephone counselling services set up by women’s to

human development

indicators’ in Reproductive

organisations in some countries in the region; Health and

Human Rights –

- challenging discourse on women, reproduction and sexuality by The

Way Forward, editors

L. Reichenbach & M.J.

questioning the predominant beliefs and language of honour and

Roseman,- University of

chastity; and Pennsylvania Press, 2009.

- landmark court decisions in Korea with `wife rape’ being declared

as sexual assault and in India, with the decriminalisation of same sex

relationships.

In Malaysia, shelters and service centres serve as a space for women

survivors not only for protection but also for individual empowerment. These

shelters and service centres have become a drive for positive change to achieve

substantive gender equality. Empowerment of women survivors at these

centres are facilitated by ensuring women’s participation in decision making

87. Statement of Special Rapporteur on Violence against Women, its causes and consequences, Ms
Rashida

Manjoo during the Consultation?

44

within the refuge, an open door policy, and raising awareness through

information sharing and education on human rights, including sexual and

reproductive rights. This enables these women to assert and claim their rights,

which in turn allows them to regain the power over their lives and make

decisions in the best interest of themselves and their children.88 The importance

of documenting cases was stressed, as it provides a better understanding on

abused women’s lived realities including their daily challenges as they weave

their way to free themselves from violence, from the initial response of the

police, to the welfare and court response. It also provides insight into the

dynamics of the violent situations endured by these women. As a result this

understanding and insight propels women’s organisations in influencing

legislation, policy making and public education.

The need for funding support from governments to establish safe spaces for

women survivors was reiterated. In Nepal, to obtain government support,

women’s rights defenders organised a campaign and ran a hunger strike which

resulted in the government approving 15 additional safe houses in the country.89

Furthermore, 2010 has been declared as `Violence against Women Free Year’

by the Nepali Government, followed by national campaigns on violence against

women initiated by different women’s groups.

In Thailand, crisis support centres for women facing several forms of violence
 were established by a Burmese women’s organisation. A case of a Burmese

migrant worker who was raped by her employer and fell pregnant without

receiving any compensation was brought to the court with the assistance and

support of one of these crisis support centres. The court convicted the

perpetrator and he was ordered to compensate the Burmese woman for the

loss of her daily wages. 90

In Bangladesh, women’s groups including Naripokkho have been challenging

the discourse on women, reproduction and sexuality by questioning the

Ivy Josiah, Women’s Aid Organisation (WAO), Malaysia, in her paper ‘The WAO Refuge:You
Can’t Beat a

88.

Woman’ during the Consultation

89. Reported by Renu Rajbhandari Women’s Rehabilitation Centre (WOREC) Nepal, during the
Consultation

90. Reported by Nang Hern, Shan Women’s Action Network, Burma, during the Consultation.

45

predominant beliefs and language of honour and chastity particularly in relation

to rape, in order to change the mindset of the community. Slogans include: “it

is my body and my decision”; “we will break the curfew of the night and move

freely”; “rape is a crime not a loss of honour”; “the person subjected to sexual

violence doesn’t lose her honour, rather the perpetrator does”.91

Two successful legal battles challenging laws, policies and cultures were shared

from Korea and India. In Korea, a momentus decision which declared `wife

rape’ as criminal assault was rendered by the Busan District Court challenging

society’s attitude and belief that rape cannot occur in a familial setting. The
court decision clearly stated that the law on rape is to protect women’s rights

to sexual self determination and not the chastity of women.92 In India, the

High Court of Delhi declared Section 377 of the Indian Penal Code which

criminalised same-sex consensual sexual acts of adults in private as violating

the rights to privacy, liberty, health and equality enshrined in the Constitution

of India. Prior to this ruling the law was used to harass people, particularly

“it is my body

men who have sex with men, lesbians and transgender individuals and

and

heterosexual couples who participate in sexual activity against the order of

my decision”

nature. The monumental judgment is a huge leap rejecting the hetero-

normative and homogenous conception of sexuality and reemphasising

diversity and inclusiveness to address homophobia, transphobia and stigma

faced by sexual minorities.93 Further, it ensures that essential health, social

services and support, specifically for people with HIV/AIDs, is available and

accessible by all. It is noteworthy how the two court decisions cited

international human rights laws and standards to uphold fundamental human

rights of women and other marginalised people.

The importance of awareness raising and mobilising public opinions for strong

support and placing pressure upon governments was highlighted. In Korea,

the rape of an eight year old girl was reported. As a consequence of the rape

Sadaf Saaz Siddiqi, Naripokkho, Bangladesh in her paper, ‘My Body, My Life – Whose Rights’
during the

91.
 Consultation

Soojeong Kim, Korea Women’s Hotline, Korea in her paper ‘A comprehension of wife rape in
Korea from the

92.

viewpoint of a women’s rights defender’ during the Consultation

Anuradha Mukherjee, Naz Foundation, India, in her paper `Section 377:The Legal Battle for LGBT
Rights in

93.

India’ during the Consultation

46

the child’s internal organs were permanently damaged, which has resulted in

the child requiring medical intervention for the rest of her life. The perpetrator

was sentenced to 12 years imprisonment only with his alcohol intoxication as

a mitigating factor. The public outcry over this short term sentence (more

than 400,000 replies to the internet news) has placed pressure on the court,

which is now reconsidering its original decision.94 In India, Partners for Law

in Development took initiative to promote entitlements for women in non-

normative intimate relationships that lack legal recognition and status, through

workshops, consultations and a resource book. An alternative rights framework

was adopted to include women who are excluded from the dominant

framework of family law and socially stigmatised. It challenged, amongst other

things, the grading of sexual norms from the spectrum of ‘normal/ natural/

legal’ to ‘deviant/unnatural’, a grading that is based on brahmanical and

heteropatriachal standards of good and bad sexualities and good and bad

women. The initiative highlighted the need for building a perspective on

women’s rights in the private sphere of the family, regardless of marital status
 “our bodies

or sexuality of the woman, which has immense potential in expanding human

belong to ourselves”

rights in the private arena at the levels of community interventions, case work/

mediations, advocacy, rights education and other forms of crisis intervention.

In Nepal, women’s groups including Women’s Rehabilitation Centre (WOREC)

have been working nationally to challenge the existing social beliefs and norms

towards women’s bodies and sexuality. The concept of ‘our bodies belong to

ourselves’ has been initiated and women health counselling centres have been

established. Women’s groups in Nepal are advocating to replicate these

initiatives.

Despite the progress achieved in advancing women’s human rights, subtle and

indirect barriers to the enjoyment of sexual and reproductive rights still remain

which include the non-existence of legal mechanisms, discriminatory laws and

the lack of initiative by the states to implement such mechanisms, policies

and/or laws. In Pakistan, for instance, despite the full range of laws including

the 1976 Dowry Restriction Act, Child Marriage Restraint Act, Muslim Family

Law Ordinance and Penal Code, women continue to face multiple forms of

94. Reported by Heisoo Shin, National Movement for Eradication of Sex

Trafficking Republic of , during the

Consultation

47

violations of their sexual and reproductive rights such as dowry violence, early

marriage, domestic violence and honour killings to name a few.

The challenge women’s organisations and women’s human rights defenders

now face is identifying whether the normative framework, including laws and

policies pertaining to sexual and reproductive rights, as it stands is sufficient

or not. If the normative framework is sufficient women’s organisations should

be campaigning to advance and ensure the implementation of laws and policies

and holding perpetrators, whether it is state or non-state actors, accountable

for rights violations. If the framework is not sufficient, identifying where

the disparity lies is imperative, i.e. whether there are gaps in the normative

framework that should be considered or whether international and national

laws are not interpreted sufficiently, broadly and creatively enough to address

the issues of discrimination based on gender identity and/or sexual orientation.

48

CHAPTER 2:

THE UNSRVAW AND THE

INTERNATIONAL FRAMEWORK95

Standards in relation to sexual and reproductive rights have their basis and

draw upon a wide array of provisions in a variety of international human rights

instruments, including the Declaration on the Elimination of Violence against

Women (DEVAW), the Convention on the Elimination of All Forms of

Discrimination against Women (CEDAW), the Convention on the Rights of

the Child (CRC), the International Covenant on Civil and Political Rights

(ICESCR), the International Covenant on Economic, Social and Cultural Rights

(ICCPR), as well as other important international commitments such as those

contained in the Beijing Platform for Action, the Millennium Development

Goals and the Cairo Programme of Action of the 1994 International Conference
 on Population and Development (ICPD)96.

These standards are complemented by other efforts at interpreting and

furthering these rights through guidelines, resolutions, the policy and field work

of key international organisations addressing these issues, and the work of the

various treaty bodies which have elaborated both general recommendations

on provisions relevant to sexual and reproductive rights as well as concluding

observations on particular country situations.

The ICPD recognised gender as a key determinant of a person’s health, as well

as women’s disproportionate burden in these areas, and shifted the focus on

population growth to one based on individual rights and individual choice. It

further recognised the importance of addressing women’s needs and rights,

including the particular needs of different groups of women. In doing so, the

ICPD made explicit the link between sexual and reproductive health and the

advancement of women’s rights, and provided a broad framework as well as

The overall framework of Chapter 2 of this report is framed based on the Statement of the Special

95.

Rapportuer on Violence against Women, Its Causes and Consequences, Rashida Manjoo for the
Consultation.

96. For further details of international instruments, see paper of Heisoo Shin, National Movement
for

Eradication of Sex Trafficking, Korea, ‘Sexual and Reproductive Rights and International
Framework: Achieving

Fundamental Human Rights’ during the Consultation.

49

specific targets for achieving universal reproductive health by 2015. Despite the 97. The principle
of ‘due

diligence’ is an international
progress made, many millions of people, including in particular disadvantaged

legal standard which deems

women and adolescents, still do not have access to sexual and reproductive that States are
accountable

health services or information as detailed earlier in this report. for preventing,

investigating

and punishing human rights

abuses perpetrated by both

Violence against women (VAW) and girls which is based or impacts on their State and non-
state actors.

The State is obliged to both

sexual or reproductive rights takes many forms and often infringes upon many prevent violence
against

rights at the same time. Forced or early marriage which violates a girls’ right women and
investigate and

punish any acts of violence

to marry a partner of her choice may deprive her of access to education, and that have occurred
under its

may involve (marital) rape, a lack of access to sexual and reproductive services jurisdiction.
Furthermore

the due diligence obligation

and information, as well as a life of servitude, thus violating her rights to non- must be implemented
in

discrimination, physical integrity, health, and a series of other socio-economic good faith with a
view to

preventing and responding

rights. to violence against women.

This entails taking positive

steps and measures in order

On a deeper level, sexual and reproductive rights also relate closely to: to ensure that women’s

fundamental issues of discrimination (including multiple intersecting forms of human rights are
protected,

respected, promoted and

discrimination); to gender stereotypes and unequal power relations; and to

fulfilled and it necessarily

gender-based violence (including domestic violence, honour crimes and rests on the
principle of

violence committed for transgression of gender roles, sexual mores, or dress non-discrimination
such

that States must use that

codes). In this regard international state obligations exist both with respect to same level of
commitment

harm done through state actions, as well as by harm done through state failure in relation to
addressing

violence against women as

to meet international and domestic obligations – i.e. the failure to meet the other forms of
violence.

due diligence standard97 Failure of state protection, including the investigation

and prosecution of crimes committed against sexual minorities, is often

invoked by groups working in this field. This lack of state protection extends

to human rights defenders of sexual minorities.

The scope of sexual rights is much broader than sexual health or reproductive

rights, and is not specific to women alone. Sexual rights require further

attention from a human rights perspective. Future work and frameworks in

relation to sexual rights should be developed in terms of respect, protection

and fulfilment within human rights law, and should move beyond its current
violation-centred approach to one which challenges gender inequality and

affirms sexual rights.

50

Root causes of VAW lie in unequal power relations between men and women

and are founded upon differential gender-based norms. Ideologies sustaining

unequal gender relations derive from the dominant notions of women’s

sexuality and of masculinity that establish dual moral standards for women and

men.98 Male ideologies of honour (which can nonetheless also be attributed

to female and family honour) are closely associated with the fear of violence

or actual violence perpetrated upon women for real and perceived sexual

transgressions. This ideology is also strategically deployed during armed

conflict to perpetrate systematic sexual violence against women belonging to

the other community/nation as a means of humiliating the opposition and as

part of genocidal violence.99

Dominant notions of female sexuality have also slipped into the law. This is

evident in rape and sexual assault laws that refer to women’s chastity, require

corroboration in the form of other witnesses or place the victim on trial by

questioning her sexual history. Other examples include the non-criminalisation

of marital rape, adultery laws, and restrictions regarding relationships outside

ethnic, religious or class boundaries.100

It is important to articulate the linkages between culturally justified VAW and

control of female sexuality, observing that women’s emotional and sexual

expression is seen to destabilise the unequal social order.101 Alongside the

notions of female sexuality are notions of masculinity that valorise violence in

and of itself, as an expression of male sexuality, and as a means of conflict

 resolution.102

Indeed gender-based violence impacts women and girl’s sexual and reproductive

health as well as their sexual rights throughout their life cycle. Discrimination

98. See E/CN.4/1995/42, paras 58-62; E/CN.4/1997/47, para 8; E/CN.4/2002/83; E/CN.4/2003/75;

and E/

CN.4/2004/66.

99. 15 years of the United Nations Special Rapporteur on violence against women, its causes and

consequences (1994-2009): a Critical Review, p. 37 (2009).

100. E/CN.4/1995/42, paras 58-62; and E/CN.4/1997/47, paras 8 and 34.

101. Statement of the SRVAW at the fifty-eighth session of the Commission on Human Rights, 10
April 2002.

102. E/CN.4/1995/42, para 64; E/CN.4/2002/83, paras 105-108; and E/CN.4/2004/66, para 35.

51

in the nutrition provided during their early years, child battery, the practice of

FGM and early or forced marriage can affect their enjoyment of sexual rights

and their reproductive health throughout their lifetime, and potentially result

in complications leading to maternal mortality. Studies have also shown the

detrimental effects of domestic violence on women’s health, including their

sexual and reproductive health,103 while in wartime the devastating effects of

rape as a weapon of war can leave generations of women and girls deeply

traumatised and their reproductive capacities destroyed.

A critical analysis of the structural causes of violations to sexual and reproductive

rights poses important challenges to established patriarchal institutions and

gender identities (both personal and collective, since gender roles are often a

key component of group identity). Thus there is a need for strategies which
reach out and work at the level of local communities in the re-articulation of

these identities. This is equally applicable to so called `developed’ societies as

it is to developing ones, despite the fact that the challenges and manifestations

of these violations may take different forms or magnitudes.

There is much work to be done, especially in the articulation of the sexual

rights of women and the multiple forms of discrimination which they face and

which affect their enjoyment of both sexual rights and reproductive health/

rights. At the practical level, more attention must be paid and standards

elaborated in relation to the sexual and reproductive rights and health of

adolescents, as well as the accountability of states to meet their international

and domestic obligations in this field, including through the proper allocation

of budgets for this purpose and programmes and policies which are evidence-

based and respond to the actual needs and aspirations of women and girls.

In addition, an intersectional approach has to be adopted as an analytical

tool.104 This enables a better understanding of how multiple layers of

discrimination combine to heighten the vulnerability of women and their

experience of violence (including violation of their sexual and reproductive

103. For example, see the WHO multi-country study on women’s health and domestic violence
against

women, initiated in 2007.

104. Resolution 7/24 of the Human Rights Council and the Durban Review document (September
2008)

confirms intersectionality as a mandatory prism for human rights analysis and inquiry.

52

rights), often resulting in a continuous cycle of violence for marginalised

women. This approach, adopted as part of the working methods of the

 UNSRVAW mandate, marks a conceptual shift from the tendency to treat the

diverse experiences of women within a single homogeneous category.105 At

the same time, it provides a conceptual paradigm that allows one to see the

universality in VAW, without losing sight of the particularities in women’s

experiences. Similarly, the continuum approach makes visible the linkages

between violence in different contexts, such as in peace and in war. The

application of an intersectional framework also strengthens human rights

analysis, allowing for better program and policy responses at the state level.

The mandate of the UNSRVAW has clearly noted this, emphasising that

“integrating an intersectional approach to gender analysis will enhance the

analytical capacity of gender analysis in better identifying the multiple forms of

discrimination and link State accountability for human rights under various

treaty bodies.”106 This approach makes visible the continuum of violence and

discrimination that captures more fully the consequences of intersectional

discrimination.

105. 15 years of the United Nations Special Rapporteur on violence against women, its causes and

consequences (1994-2009): a Critical Review p. 42 (2009).

106. Ibid, p. 44, referring to E/CN.4/2004/66, para 73 (f).

53

CHAPTER 3:

STRATEGIES AND RECOMMENDATIONS

One of the most important outcomes of the consultations every year is the

collective strategies and recommendations by the participants to advance

women’s human rights, particularly relevant to the focused theme of the

year. This year, participants identified key regional issues and subsequently,

strategies and recommendations were developed based on the identified key

issues to collectively respect, protect, promote and fulfil women’s sexual and

reproductive rights in Asia Pacific.

The three key regional issues identified during the discussions included:

 Fundamentalism - identified namely in the context of religion, culture

and stigmatisation. Particularly manifested in the criminalisation/

illegalisation of abortion, lack of access to reproductive health services

and violence against marginalised/minority women including LBTIs,

women with disabilities, HIV positive women, indigenous women and

sex workers;

 Globalisation - identified in the context of trafficking and migration,

gender-based violence and women living with HIV/AIDS; and

 Militarisation - including armed/post conflict. Of concern was the

increasing level of impunity and military presence in certain regions,

the lack of resources and gaps in addressing sexual and reproductive

health needs of IDPs particularly women, women living in conflict

areas and post-conflict situations and emerging and increasing armed

groups in conflict and post-conflict areas targeting women.

Participants identified strategies to end violations of women’s sexual and

reproductive rights which include:

 Lobbying for ratification and domestication of international human

rights instruments, particularly the UN Convention on the Protection

of the Rights of All Migrant Workers and Members of Their Families

(CMW);
  Advocating for the establishment of monitoring mechanisms for

gender-based violence (GBV) in existing regional bodies as well as

54

submitting communications on GBV to regional and international

mechanisms, including ASEAN Inter-governmental Commission on

Human Rights, (AICHR), ASEAN Commission on the Promotion and

Protection of the Rights of Women and Children, (ACWC) and South

Asian Association for Regional Cooperation, (SAARC); and

 Building and strengthening networks and sharing information,

experiences and strategies.

Recommendations for the UNSRVAW include:

• Explicit recognition and development of sexual rights within the

mandate and wherever possible, in conjunction with other mandates.

• To call for governments, national human rights institutions and other

agencies to review laws, policies and practices and their impact on

women’s sexual and reproductive rights.

• To critically analyse discriminatory laws, policies and practices

toward women, which hinder their ability of realising their sexual and

reproductive rights with particular attention given to the marginalised

groups. Specifically, the UNSRVAW supports a transparent and

inclusive review mechanism to the United Nation Convention against

Transnational Organised Crime (UNTOC).

• To conduct country visits in the Asia Pacific with full access to all

facilities as a follow up to the consultation and specifically inquire on

 issues and situations raised at the consultation.

• To closely work with other Special Rapporteurs on the issue of

women’s sexual and reproductive rights, including the Special

Rapporteur on religion; Special Rapporteur on contemporary forms

of slavery, its causes and consequences; Special Rapporteur on

contemporary forms of racism, racial discrimination, xenophobia and

related intolerances; Independent Expert in the field of cultural rights

and Special Rapporteur on the right of everyone to the enjoyment

of the highest attainable standard of physical and mental health. In

light of the testimony provided by the North Korean defector and

testimonies from Burma, closely work with the Special Rapporteur on

the situation of human rights in the Democratic People’s Republic of

Korea and the Special Rapporteur on the situation of human rights in

55

Myanmar.

• To engage with emerging regional human rights mechanisms,

particularly with ASEAN Intergovernmental Commission on Human

Rights, Commission on Women and Children and Committee on

Migrant Workers to ensure women’s human rights are not negated in

the name of culture.

• To facilitate regional dialogues/discussion between and among

countries regarding the issues raised at the consultation.

Recommendations for States include:

• To allocate resources to advance women’s sexual and reproductive

rights, including basic health care services, shelter services and recovery
 services, and for these to be regularly monitored by independent

agencies.

• To ensure people’s access to information, justice and facilities including

medical facilities pertaining to women’s sexual and reproductive rights.

• To integrate information regarding sexual and reproductive rights into

the curriculum of educational institutions geared toward attitudes and

behaviour change.

• To effectively implement its human rights obligations, including repealing

of oppressive and discriminatory laws that violate women’s sexual and

reproductive rights.

• To ratify and fully implement international human rights treaties.

• To remain secular, as it was noted that only a secular state can protect

the rights of all individuals, regardless of their religion or beliefs, to

enjoy their sexual and reproductive rights.

Recommendations for Non-State Actors include:

• Provision of funding and introducing a more rights based approach to

eliminate violence against women pertaining to sexual and reproductive

rights.

Recommendations for Civil Society include:

 Relentless campaigning, networking, alliance building, documentation,

information gathering and sharing to ensure the necessary engagement

56

with international, regional and national actors including the UNSRVAW

and UN agencies/bodies in order to ensure that women’s sexual and

 reproductive rights are protected.

 More collaborative and holistic advocacy and networking amongst

NGOs particularly to share good examples, mobilise public opinions,

and put pressure upon governments.

The consultation was successful in giving space to women/human rights

defenders including APWLD’s partners, regional and international NGO’s,

to speak out about their experiences and provide input on the solutions

necessary to improve the protection of women’s sexual and reproductive

rights. It was also successful in engaging participants in Asia Pacific with the

UN Special Procedures mechanism.

57

ANNEX A: Programme of the Consultation

DAY 1: MONDAY, 7 DECEMBER 2009

08:30 – 09:00 Registration

09:00 – 09:30 Welcome and Introductions

Kate Lappin, Regional Coordinator, APWLD

• Welcome remarks

• Introduction of participants

• Introduction of the objectives, methodologies and

programme

SESSION 1: MAKING THE CONNECTION: WOMEN, SEXUAL

RIGHTS AND REPRODUCTIVE RIGHTS

The objective of this session is to review and assess how women’s sexual and

reproductive rights have been developed, addressed and challenged at international

 level within the framework of VAW and outside it. The session will give an overview

of how today’s resurgence of fundamentalisms, globalisation and militarisation

makes work on sexual and reproductive rights more difficult and challenging. The

session also aims to increase the participants’ appreciation of the UNSRVAW

mandate and her approach to the issue on women’s sexual and reproductive

rights.

09:30 – 11:15 Session 1: Making Connection: Women, Sexual Rights

and Reproductive Rights

Moderator: Kate Lappin, Regional Coordinator, APWLD

• Introducing APWLD’s analytical framework:

fundamentalisms, militarisation and globalisation and

women’s human rights (20 mins)

o Madhu Mehra, Partners for Law in Development,

India

58

• Sexual and reproductive rights and international

framework: achieving fundamental human rights (20

mins)

o Heisoo Shin, National Movement for Eradication of

Sex Trafficking, Korea

• SRVAW’s approach to women’s sexual and reproductive

rights

o Gloria Carrera Massana, Office of the UN High

 Commissioner for Human Rights for and on

behalf of Rashida Manjoo, UN Special Rapporteur

on violence against women, its causes and

consequences (30 mins)

Open Forum (35 mins)

11:15 – 11:30 Tea Break

SESSION 2: ADDRESSING VIOLATIONS OF WOMEN’S

SEXUAL AND REPRODUCTIVE RIGHTS

The objective of this session is to bring out critical emerging issues in Asia Pacific

on sexual and reproductive rights, including within national legislation, policies

and customary laws and practices and to identify the intersections of women’s

sexual and reproductive rights and structural causes of VAW within the context of

hetero-patriarchal systems as manifested in fundamentalisms, militarisation and

globalisation. To facilitate the discussion, the session has been subdivided in three

frameworks – fundamentalisms, militarisation and globalisation where systematic

violence by the state, within the community, within the family and at transnational

arena will be addressed.

* Each plenary session will have 4-5 country presentations (10 mins each) which will be

followed by participants’ sharing of other experiences from the region and discussions.

11:30 – 13:30 Session 2.1: Fundamentalisms and Sexual and

Reproductive Rights in Asia Pacific

Moderator: Ivy Josiah, Women’s Aid Organisation, Malaysia

59

• Harmful cultural practices and women’s sexual and

reproductive rights from the Pakistan perspective

 o Saman Yazdani, Shirkat Gah, Pakistan

• Women with disabilities, sexuality and reproductive

rights

o Mijoo Kim, Women with Disabilities Arts and

Culture Network, Korea

• Beyond “Pro-Life versus Pro-Choice” debate: the status

of reproductive health and rights in the Philippines

o Alnie Foja, Gabriela Women’s Party, Philippines

• Forced sterilisation of HIV/AIDS positive women

o Dwi Surya Kusuma, Ikatan Perempuan Positif

Indonesia, Indonesia [ interpretation]

• Maternal mortality, unsafe abortionand women’s

reproductive rights in Timor-Leste

o Veronica Correia, Alola Foundation, Timor-Leste

• Violence against women and the HIV/AIDS epidemic in

PNG

o Juliana C Riparip, Marie Stopes Papua New Guinea,

Papua New Guinea

Open forum (sharing experiences, question and answers) –

55 mins

13:30 – 14:30 Lunch

Session 2.2: Globalisation and Sexual and Reproductive

14:30 – 16:30

Rights in Asia Pacific

 Moderator: Heisoo Shin, National Movement for Eradication of

Sex Trafficking, Korea

• Migration and trafficking and women’s sexual and

reproductive rights

o Usa Lerdsrisuntad, Foundation For Women, Thailand

60

• Surrogate motherhood and women’s sexual and

reproductive rights

o Chayanika Shah, Forum Against Oppression of

Women and Lesbians and Bisexuals in Action, India

• International marriage and women’s sexual and

reproductive rights

o Eart Pysal, Khmer HIV/AIDS NGO Alliance,

Cambodia

• My body, my life – whose rights?

o Sadaf Saaz Siddiqi, Naripokkho, Bangladesh

Open forum (30 mins) & Small group discussion (50 mins)

16:30 – 16:45 Tea Break

16:45 – 17:30 Synthesis

Madhu Mehra, Partners for Law in Development, India

To synthesise the critical and emerging issues relating to women’s

sexual and reproductive rights & VAW in Asia Pacific and to provide

participants with an opportunity to comment on the discussions

during the day.

Solidarity Dinner
 18:30 -

DAY 2:TUESDAY, 8 DECEMBER 2009

09:00 – 10:45 Session 2.3: Militarisation and Sexual and Reproductive

Rights in Asia Pacific

Moderator: Sadaf Saaz Siddiqi, Naripokkho, Bangladesh

• Unforgettable misery in North Korea

o Myungsook Lee, North Korean defector, Citizen’s

Alliance for North Korean Human Rights, Korea

[interpretation]

61

• Women’s sexual and reproductive rights in Sri Lanka

o Segaruban Vijayalachumi, Suriya Women’s

Development Centre, Sri Lanka [interpretation]

• Refugees and internally displaced peoples: sexual

violence against Burmese refugees in Thailand

o Naw K’nyaw Paw, Karen Women’s Organisation,

Karen State, Burma

Open forum (sharing experiences, question and answers) – 1

hr

10:45 – 11:00 Tea Break

SESSION 3: EMPOWRING WOMEN: POSITIVE

AFFIRMATIONS OF SEXUAL AND REPRODUCTIVE RIGHTS

The objective of this session is to bring out specific experiences, initiatives and

strategies taken by women’s groups to make women’s sexual and reproductive

rights a reality. The session will identify many subtle and indirect barriers to the

enjoyment of sexual and reproductive rights, may it be non-existence of legal

mechanisms, discriminatory laws or no will to implement. The session also aims

to move beyond the emphasis on violence in relation to women’s sexual and

reproductive rights and reaffirm positive sexual and reproductive rights, including

sexual pleasure and fulfillment as well recognise women as a drive for positive

change.

Session 3: Empowering Women: Positive Affirmations

11:00 – 12:30

of Sexual and Reproductive Rights

Moderator: Virada Somswasdi, Women’s Studies Center,

Chiang Mai University,Thailand

• Women-centered services: from individual

empowerment to social change

o Naeemah Khan, Fiji Women’s Rights Movement, Fiji

o Ivy Josiah, Women’s Aid Organisation, Malaysia

• Successful story of challenging laws, policies and culture

o Soojeong Kim, Korea Women’s Hotline, Korea

o Anuradha Mukherjee, Naz Foundation, India

62

Open forum (sharing experiences, question and

answers) – 50 mins

12:30 – 14:00 Lunch Break

SESSION 4: PLANNING THE WAY FORWARD:

 RECOMMENDATIONS AND STRATEGIES

The objective of this session is to come up with recommendations and strategic

action plans to ensure women’s sexual rights and reproductive rights are protected,

promoted and fulfilled at national, regional and international levels (closing the

gap between national and international). It also aims to strategise on how to move

forward to strengthen policy-making, law reform and accountability mechanisms

available to women for accessing justice and health services. The session will

outline the key recommendation to the SRVAW for integration of the issue in the

work of the mandate. Follow up points will also be discussed.

14:00 – 15:30 Session 4: Planning the Way Forward:

Recommendations and Strategies

Facilitator: Wanee Thitiprasert, Research and Campaign for

Women Network, Peace and Culture Foundation,Thailand

63

Small group work

Guidelines for group work will be provided to the participants to facilitate discussion.

15:30 – 15:45 Tea Break

15:45 – 17:15 Session 4: Recommendations and Strategies (CONT.)

Reporting Back

15 mins for each group x 4

Synthesis of the recommendations and strategies and

summary of Consultation (30 mins)

 Facilitator: Mikiko Otani, Japan Federation of Bar Associations,

Japan

Closing and Evaluation

17:15 – 18:00

Thank you words from Gloria Carrera Massana, OHCHR

Closing words from Kate Lappin, Regional Coordinator, APWLD

64

ANNEX B: List of participants

Name Organisation Country

1 Ms. Sadaf Saaz Siddiqi Naripokkho Bangladesh

2 Ms. Naw K’nyaw Paw Karen Women’s Organisation (KWO) Burma/ Thailand

3 Ms. Nang Hearn Shan Women’s Action Network (SWAN) Burma/ Thailand

4 Ms. Eart Pysal Khmer HIV/AIDS NGO Alliance (KHANA) Cambodia

5 Ms. Naeemah Khan Fiji Women’s Rights Movement (FWRM) Fiji Islands

6 Ms. Mikiko Otani Japan Federation of Bar Associations Japan

7 Ms. Fumi Suzuki Space Allies Japan

8 Ms. Azusa Yamashita GayJapanNews Japan

Ms. Mijoo Kim Women with Disabilities Arts and Culture Korea

Network

10 Ms. Kim Soo Jeong Korea Women’s Hotline – Bucheon Office Korea
 Korea

11 Ms. Heisoo Shin National Movement for Eradication of Sex

Trafficking

12 Ms. Myungsook Lee Citizen’s Alliance for North Korean Human Korea

Rights (NKHR)

13 Ms. Bang Sang Hee Citizen’s Alliance for North Korean Human Korea

Rights (NKHR)

14 Ms. Irena Ermolaeva NGO Asteria Kyrgyzstan

15 Ms. Anuradha Mukherjee Naz Foundation India

16 Ms. Madhu Mehra Partners for Law in Development (PLD) India

Ms. Dwi Surya Kusuma Ikatan Perempuan Positif Indonesia (IPPI) Indonesia

17

18 Ms. Sri Agustine Ardhanari Institute Indonesia

19 Mr. Thingthong Care International in Lao PDR Lao PDR

Phetsavong

65

Name Organisation Country

20 Ms. Angela Kuga Thas Knowledge and Rights for Young people Malaysia

through Safer Spaces

21 Ms. Ivy Josiah Women’s Aid Organisation (WAO) Malaysia

22 Ms. Semjidmaa Choijil Mongolian Family Wellness Association Mongolia

(MFWA)

23 Ms. Rita Mahato Women’s Rehabilitation Center (WOREC) Nepal

24 Ms. Renu Rajbhandari Women’s Rehabilitation Center (WOREC) Nepal

25 Ms. Saman Yazdani Shirkat Gah: Women’s Resource Centre Pakistan

26 Ms. Juliana Riparip Marie Stopes PNG Papua New Guinea

27 Ms. Alnie Foja Gabriela Women’s Party Philippines

28 Ms. Ana Maria Nemenzo Womanhealth Philippines Philippines

29 Ms.Vijayalukshmi Sekar Suriya Women’s Development Centre Sri Lanka

30 Ms. Bharathy Kennedy Suriya Women’s Development Centre Sri Lanka

31 Ms. Suchada Taweesit Mahidol University Thailand

32 Ms. Usa Lerdsrisuntad Foundation For Women Thailand

33 Ms.Virada Somswasdi Women’s Studies Center, Chiang Mai Thailand

University

34 Ms. Wanee Thitiprasert Research and Campaign for Women Thailand

Network, Peace and Culture Foundation

35 Ms. Kanokwan Tharawan Women’s Health and Reproductive Rights Thailand

Foundation of Thailand (WHRRF)

Ms.Veronica Correia Alola Foundation Timor-Leste

36

37 Ms.Vu Song Ha Consultation for Investment in Health Vietnam

38 Ms. Sonia Wasi Vanuatu Women’s Centre Vanuatu

66

Name Organisation Country

39 Ms. Mara Quesada Coordination of Action Research on AIDS Malaysia

and Mobility (CARAM) Asia

40 Ms. Fleur Dewar Global Alliance Against Traffic in Women Thailand

(GAATW)

41 Ms.Yasmin Masidi International Women’s Rights Action Watch Malaysia

 (IWRAW) Asia Pacific

42 Ms. Bernice P. Aquino Asian Forum for Human Rights and Thailand

See Development (FORUM ASIA)

43 Ms. Atina Gangmei Asia Indigenous Peoples Pact (AIPP) Thailand

Foundaiont

44 Ms. Kirenjit Kaur Asia Pacific Network of People Living with

HIV/AIDS (APN+)

45 Thailand

Ms. Zarah Kathleen Alih Asian Resource Foundation-Asian Muslim

Action Network

46 Ms. Niza Concepcion Committee for Asian Women (CAW) Thailand

47 Ms. Saowalak Thongkuay Disabled Peoples’ International Asia-Pacific Thailand

Region (DPI/AP)

48 Ms. Gloria Carrera Office of the UN High Commissioner for Switzerland

Massana Human Rights (OHCHR), Special Procedures

Division – mandate of UNSRVAW

49 Ms. Sriyani Perera ActionAid International Sri Lanka

50 Ms. Kate Lappin Asia Pacific Forum on Women, Law and Thailand

Development (APWLD)

Ms. Misun Woo Asia Pacific Forum on Women, Law and

51 Thailand

Development (APWLD)

52 Ms. Navarat Nophiran Asia Pacific Forum on Women, Law and Thailand

Development (APWLD)
 67

Name Organisation Country

53 Ms. Punika Shinawatra Asia Pacific Forum on Women, Law and Thailand

Development (APWLD)

54 Ms. Tatjana Bosevska Asia Pacific Forum on Women, Law and Thailand

Development (APWLD)

THE FORUM ROUNDTABLE ON FAMILY PLANNING AND

REPRODUCTIVE HEALTH
To discuss the country’s family planning and reproductive health rights programs in
greater detail, the FORUM organized a virtual roundtable discussion among several
experts and educators. Our discussants for this issue are: Dr. Ma. Antonia G. Tuazon of
the UP Los Baños College of Human Ecology; Chancellor Marita V.T. Reyes, Prof. Fatima
A. Castillo of the Department of Social Sciences, and Prof. Lourdes Marie Tejero of the
College of Nursing, UP Manila; Profs. Mary Barby P. Badayos-Jover and Jessica Dator-
Bercilla, Division of Social Sciences, UP Visayas; and Prof. Elizabeth A. Pangalangan,
College of Law, UP Diliman.

FORUM: What is the current situation of family planning and reproductive health programs in the
country? Why?

Badayos-Jover: There is still much to be desired in the current situation of family planning and
reproductive health programs in the country. Despite gains in the area of women’s rights and
empowerment in the past hundred years, both the government and non-government
organizations recognize that there are still major setbacks where reproductive health and rights
are concerned. This can be attributed to several factors. First, I think that health in general has
never been a priority of our government. Hence, health programs, including those that involve
reproductive health, are always impeded by budgetary constraints, leaving the people no choice
but to seek expensive private means to meet their needs. A specific example is the apparent
inaction of government after the United States Agency for International Development (USAID)
announced its withdrawal of free contraceptive supplies used by public health centers.

Second, to a large extent the concepts of reproductive health and reproductive rights have yet to
be fully understood, appreciated, and propagated from the level of policy makers down to the
grassroots. Policymakers have long subscribed to the narrow view of fertility regulation to reach
demographic targets as a means of alleviating poverty. As such, the concept of reproductive
health as a holistic or life cycle approach is actually undermined since women are seen only as
child bearers whose fertility must be controlled. This is manifested in the fact that government
health programs still focus only on women in their reproductive years despite the government’s
commitments to international agreements that promote reproductive health and rights. For
example, viable structures and mechanisms that address the reproductive health needs of
adolescents, men, the elderly, and other marginalized groups have yet to be put in place in our
public health system, notwithstanding the creation of an Integrated Reproductive Health Program
by the Department of Health. Consequently, people, especially in the grassroots level, are not
even familiar with the term “reproductive health” or “reproductive rights.” Such lack of awareness
hampers popular advocacy for the provision of services.

Third, the Catholic Church’s opposition to anything other than natural family planning methods
has consistently retarded any advancement in the area of reproductive health and reproductive
rights. Going around Iloilo City, I am bound to find streamers bearing the message: “Defend Life
and Family! No to Contraceptives!” The Catholic Church has exhausted all means to influence
policymakers in what should be a state concern. For the church hierarchy, reproductive health and
rights are simply synonymous to the use of artificial contraceptives and abortion, which are
perceived as “grave sins.” This has unfortunately resulted in the demise of the Reproductive
Health-care Act of 2002. Nevertheless, civil society groups are not daunted by the prevalence of
such medieval sentiments and hopefully, the HB 3773 (the Responsible Parenthood and Population
Management Act) and similar efforts will be passed into law.

Bercilla: In the 2004 scorecard of SocialWatch, a global movement of organizations and

individuals tasked with monitoring social development commitments and presenting an annual
alternative social development report to the UN, the Philippines ranked 82nd in the quality of life
index, with an above-average reproductive health situation compared to other countries. The 2004
Report to the Nation of the National Commission on the Role of Filipino Women (NCRFW),
however, specified that population management and reproductive health have not received much-
needed financial and political support.

In 2003, Filipino women from 15-49 years old had a birth rate of 3.5, a rate higher than that of
neighboring Asian countries (e.g., Indonesia, Malaysia, and Vietnam, among others). Although
family planning use was at 49 percent (33 percent use of modern methods and 16 percent use of
traditional methods), Mia Ventura’s summary of the results of the 2003 National Demographic and
Health Survey (NDHS) revealed a 17 percent unmet need for family planning (9 percent limiting
and 8 percent spacing). Those who are poor, live in rural areas and have minimal education have
the highest unmet family planning needs. Young men and women from this group engage in
sexual activity and have children earlier. There is a one-child gap between actual and desired
fertility (3.5 and 2.5, respectively).

The Population Commission acknowledges its limitations in implementing its reproductive health
program because of administrative changes and the failure of the current administration to build
on previous initiatives on reproductive health. Moreover, the Church and pro-life advocates lobbied
against and consequently prevented the passage of the Reproductive Health Care Bill. Dr. Michael
Tan also points out that, other than the political and administrative factors affecting reproductive
health initiatives, there are existing norms and values that fuel the perception of fertility
management and even reproductive health management as unnatural.

Despite these challenges, there are efforts to broaden the concept of reproductive health to
include all aspects of sexuality and reproductive health needs in the life cycles of both women and
men. This development allows advocates to confront the economic, social, and cultural conditions
affecting sexuality and reproductive health needs.

The NGO community has risen to the challenge through programs geared toward women’s
reproductive health and adolescent health. The Women’s Health Care Foundation in UP Diliman,
the Remedios AIDS Foundation (RAF), the mall–based Center for Filipino Youth in Tondo, Manila
and Cebu, the Brokenshire Woman Center in Davao City, and the Manobo Highlander IEC Team in
Sultan Kudarat, for example, are involved in such efforts.

In the First Multi-Sectoral Legislative Policy Conference in March 2005, it was emphasized that a
reproductive health law focusing on reproductive health and not on population management
should be given priority. There was a call for legislative action that would guarantee access to
reproductive, gender, and sexual education and services particularly to women, young people, and
members of the vulnerable sectors (e.g., migrant women, indigenous peoples, and women in
prison, among others).

Castillo: The reproductive health situation is bad and there is no sign that it will get better in the
next two to three years. In fact, gains made in reproductive health in previous years are being
reversed due to local and international policies.

Let us first clarify what we mean by reproductive health. The concept came out of the
International Conference on Population and Development (ICPD) in 1994 in Cairo. It is a
comprehensive concept because it is founded on the World Health Organization (WHO) definition
of health not only as the absence of disease but also as a psychological, social, and biological
state of well-being. This definition is applied to the reproductive dimensions of human life. Thus it
departs from a narrow understanding of family planning oriented toward population control;
instead it focuses on meeting the essential needs of men and women for their reproductive health.

In other words, reproductive health is more than just family planning. Among the key
determinants of reproductive health according to the ICPD declaration of which our government is
a signatory are: (a) comprehensive reproductive health services available and accessible to all;
(b) reduction in maternal, infant, and child mortality; (c) sustained economic growth with a social
development orientation; (d) gender equity and women’s empowerment; (e) access to safe and
effective family planning methods; and (f) universally accessible education. Government
signatories have committed to do their best to fulfill these conditions for reproductive health.

The Fourth World Conference on Women in Beijing the following year provided a stronger basis for
these commitments by emphasizing the principle that health is a human right; and women, like
men, have the right to health. This conference also declared that men and women are entitled to
reproductive rights, which include the autonomy to decide on the number and spacing of their
children, as well as the right to sexual enjoyment. Women’s right to health was underscored
because in societies all over the world, women have less access to social services and suffer from
discrimination in the allocation of resources. Our government is also a signatory to the Beijing
declaration, which means it has agreed with other governments that people are entitled to health
services and it is the government’s duty to ensure that these are prioritized in the allocation of
resources.

We have to clarify these premises in light of the government’s retreat from its social obligations.
Ten years after Cairo, our reproductive health programs are weaker, narrower, and less accessible
to the poor. This can be attributed primarily to three factors: (a) the vacillating policy of the
Philippine government on population management; (b) the conservatism of the current US
government, which women advocates have perceived as a retreat from the liberal policy of the
Clinton administration; and (c) the World Bank’s policies, particularly on health sector reform.

Before I explain these points, let me do a bit of historical review to situate the claim made earlier
that the accomplishments in the first few years after Cairo are being reversed. The brief period of
1994-97, under the Ramos administration and with Dr. Carmencita Reodica (the first woman
Department of Health secretary) at the helm of DOH, commendable efforts were made to
implement the ICPD program of action. An integrated Reproductive Health Program was set up
under her office. Complementing this was the reorientation of the programs of the Population
Commission (POPCOM), an agency then within the National Economic Development Authority
(NEDA), to correspond with the ICPD program.

In family planning, the cafeteria approach was promoted, which basically means providing couples
with a wide range of choices for regulating fertility, including natural methods. Foreign funding
was made available for this program, to ensure that counseling on Natural Family Planning (NFP)
and services, as well as supplies for other methods, such as pills, were accessible to the poor.
Many local health units reported an increase in family planning acceptors and the reduction of
unplanned pregnancies. More importantly, there was a national decline in maternal mortality
partly due to the national immunization campaigns against tetanus. These campaigns made
significant achievements despite pro-life and Catholic Church opposition, which manifested itself
in, among other ways, deliberate public misinformation that tetanus toxoid is an abortifacient.
Providing vitamin and mineral supplements to pregnant women, including those at the lowest
level of the health delivery system, was also a key factor. It should be noted that the foundation
for these breakthroughs was partly laid down during the terms of secretaries Juan Flavier and
Jaime Galvez-Tan. Both secretaries made it clear to the public that the issues of poverty and ill
health are linked to family planning and the health of mothers.

During the short-lived Estrada administration, we already saw a narrowing of vision for
reproductive health because of a perceptible return to a population control bias. When the Arroyo
administration took over, the change became more pronounced. National funds were used only to
promote only NFP. Local governments and NGOs were expected to take charge of the rest of the
reproductive health services.

In the 2004 electoral campaign, despite data showing that women want to use various methods,
including the non-natural methods, in family planning, many politicians were held hostage by pro-
life groups and the Catholic Church, and threatened with electoral defeat should they come out
openly supporting the cafeteria approach. Arroyo herself has adopted the Catholic Church’s
position that promoting reproductive rights is tantamount to legalizing abortion. At the same time,
the POPCOM was removed from NEDA and placed as an adjunct agency of the DOH, which
signifies the down-playing of the development orientation of population policy.

In a study I am currently a part of, which focuses on reproductive health and leadership in eleven
ethnolinguistic groups in the country, we found that poor women who in the past used pills (when
these were still available for free in health centers) are now having difficulty purchasing them. The
amount of P20 for a month’s supply of pills is often spent instead on food or other more urgent
needs. The NFP methods are not popular among the couples. The rural health units confirmed that
there has been a noticeable decline in the number of FP users primarily because of poverty and
lack of government subsidy.

When it comes to maternal health, except for prenatal care, all services are no longer government
subsidized. If there is partial subsidy, then it is because the local government has appropriated
funds for it. In other words, services for the reproductive health of poor women are now
dependent on local politicians who, according to available data, are generally, not inclined to
prioritize such services. There is a clear trend reversal, from a more comprehensive state-financed
reproductive health program to one that is focused only on family planning and prenatal care.

Why is this so? We have indicated that one reason is ideological orientation (such as Arroyo’s
conservatism); another is the electoral interests of politicians. Still another is the swing to the
right in the political spectrum of the US government. A fourth reason is the global policy on health
sector reform of the World Bank.

The Bush administration, for example, has adopted the Global Gag Rule, which includes stopping
or not providing funding to programs of foreign governments that include components legalizing
abortion or educating the youth about safe sex methods aside from sexual abstinence. Very
recently, Brazil refused US aid amounting to several millions of dollars because of the specification
that the money could not be used for providing services to women who induced abortion. The
Brazilian government said that it could not do this and still have a clear conscience because their
clients include sex workers and victims of sexual abuse who, by the circumstances of their life, are
forced to resort to abortion. In the Philippines, the USAID has stopped funding the contraceptive
program, and the government’s response is simply to pass the responsibility to the local
government, the NGOs, and the couples themselves.

In the 1980s, the World Bank pushed for an economic structural reform package in developing
countries that included trade liberalization and privatization of social services. Since the granting
of loans was tied to the adoption of these policies, many developing countries agreed to
implement the policies in order to access the loans. In some countries, like Uganda, the adoption
of certain health sector policies was also made a condition for loan approval. Reeling from the
AIDS pandemic and suffering from price fluctuations of its prime exports, the government asked
for a loan from the Bank. It was told to change some of its health policies, particularly those
pertinent to financing. It was also told to reduce state subsidy for certain health services and to
charge user fees. Initially the government balked, especially because the public roundly opposed
the World Bank conditions. However, due to its financial situation, it finally had to accede.

In the Philippines, health sector reforms began in the mid 1990s, accelerating in the late 1990s.
Using the macroeconomic, neoliberal and market-oriented priority setting approach of the Bank’s
health sector reform program as basis for determining the allocation of public resources, the
government has reduced state subsidy for health and other social services. The privatization of
many of these services has already taken place.

This has a direct, adverse impact on reproductive health. In all the countries that adopted many of
the health sector reform policies, we see a reduction of state-subsidized reproductive health
services. The mandate of the Cairo and Beijing conferences for comprehensive, universally
available reproductive health services is virtually ignored. In the Philippines the situation is even
worse. Due to the combination of local politics, the campaign of the Catholic Church, and
international policy pressures, aside from reducing reproductive health to family planning and
prenatal care, family planning has been further emasculated in the national policy. The
government advocates only NFP. There is no national funding for postnatal care, safe delivery,
sexual health, needs of menopausal women, etc. Breastfeeding, a priority program of the DOH in
the past, has been relegated to the back burner. It is obvious that reproductive health is not only
a health policy issue. It is a political economy issue.

Pangalangan: There is a solid legal framework for reproductive health and rights in the
Philippines. There are constitutional provisions and statute laws which recognize and protect the
right to health, education, information, and the specific right to plan one’s family. However,
government programs are inconsistent and erratic because the government allows politics and
religion to get in the way of these programs.

Reyes: There is much confusion and misunderstanding about the family planning and
reproductive health programs in the country today. The discourses take on different thrusts
(health, rights, ethics, feminist, religious, political, economic), so that the conversations are
garbled and unenlightening. Also, the reproductive process is very personal and discussions about
it can easily become emotional, especially when the issue of abortion enters the picture. For some
reason or another, reproductive health has become synonymous to abortion in particular circles.

Tejero: During the first quarter of this year, I lived in a barangay in Laguna for two months with a
group of college seniors who were there for their course on intensive community health nursing.
The course involved the holistic care of families and the community as a whole and included family
planning and reproductive health as one aspect of care. The students conducted a community
survey prior to planning health activities with the community members to address priority
problems of the barangay.

Based on the survey, family planning sessions with couples, and informal interviews, almost
everyone in the community had heard of the different contraceptive methods and many were
using, or had at least tried to use, such methods. However, some stopped using pills, for example,
because of the side effects that they had experienced. Others were hesitant to use pills because
family, neighbors, and friends had reported side effects. Nevertheless, we found that each family
in the barangay had an average of only three children.

Tuazon: If you look at the data from the 1998 Demographic and Health Surveys, it appears that
the reproductive health needs of Filipino women are not being met. Reproductive health
encompasses all aspects (i.e., physical, mental, and social) throughout a woman’s life cycle, and
the sad reality is that we do not have adequate programs to meet such needs. If you look at
family planning alone, the data and anecdotal accounts gathered in the field confirm that access
to such services is quite limited.

I think one reason why we have not made great progress in the implementation of our
reproductive health program is the lack of political and social (including Church) will and support.
This translates into lack of resources and a poor service delivery system.

Our society has undergone so many changes; and the roles, goals, and aspirations of women have
changed. Women no longer desire to have large families, but there is not much assistance for the
achievement of such a goal.

FORUM: What is the relationship between family planning and reproductive health
programs on the one hand and population management on the other?

Badayos-Jover: Family planning is integral to reproductive health programs and population

management. After all, the reproductive health of couples, especially women, cannot be fully
safeguarded without family planning. We all know that frequent childbearing is damaging to a
woman’s health, economic implications aside. At the same time, a country cannot adequately
manage its population without an effective family planning program. However, population
management should be based on a human rights framework and not merely be concerned with
demographic targets. Otherwise, the government will resort to coercion just to fulfill its set
objectives.

Bercilla: For a very long time, population management has been equated with family planning
and reproductive health in the Philippines. Because of this, attempts at population management
are perceived as population control, which is contradictory to the cultural and religious norms of
many Filipinos. Ideally, fertility management and better reproductive health should allow a
population to be more productive and efficient in the distribution of its resources and, at the same
time, to secure a more sustainable and better quality of life for all.

Castillo: There is need for a holistic approach to family planning and population management in
order to produce concrete and long lasting results. I will use the experiences of Malaysia, the
Philippines, and Sri Lanka to illustrate.

The percentage share of health expenditures in the total public expenditures in the year 2000 was
6.5 in Malaysia, 6.2 in the Philippines, and 6.1 in Sri Lanka. The share of government in overall
health expenditures in 2001 was 53.7 in Malaysia, 45.2 in the Philippines, and 48.9 in Sri Lanka.
The percentage of the population living below the poverty line in 1997 was 15.5 in Malaysia, 37.5
in the Philippines, and 35.3 in Sri Lanka. In the 1970s, people living below the poverty line in
Malaysia comprised almost 50 percent of the population.

Maternal mortality in Malaysia in year 2000 was 30 per 1000 live births. In the Philippines it was
172 per 1000 live births (although some NGOs believe the actual figure is about 200), while in Sri
Lanka it was 92. Maternal mortality is used by the World Health Organization (WHO) as one key
indicator of the status of reproductive health.

It should be noted that in terms of government spending on health, the three countries do not
differ very much. Sri Lanka and the Philippines are very similar in terms of the level of economic
development. In the 1980s, the Philippines and Malaysia were not too far apart economically. Yet
why is there a big variance in maternal mortality?

The statistics show that Malaysia and Sri Lanka prioritized the social sector in resource allocation.
Malaysia invested much in education (with particular emphasis on diminishing the gap in
education between males and females) and strategies to reduce income inequity. Sri Lanka was a
global model for social development in the 1970s and 1980s. Female education and public health
were priority investments of the state. Although Sri Lanka nowadays is experiencing cutbacks in
social spending due to the economic crunch partly caused by the long insurgency, the strategic
effects of the welfare period are still evident. It has been documented that there is a correlation
between female education in Sri Lanka and female autonomy, which is a major factor for
reductions in maternal, infant, and child mortality in the 1980s (Caldwell; Ruizicka).

Population management or family planning must really be developmental in action and not simply
in theory. Poverty, ignorance and the lack of female autonomy in decision-making regarding their
fertility are the true obstacles to the practice of safe and effective family planning.

The current methods of family planning (natural or otherwise, although I think the calendar
method is not truly natural because it is when women are fertile that they have high libido due to
hormonal changes) are biased. They are against women and against the poor.

How are they biased against women? The pills, ligation, IUD, and the injectable, which are the
most popular means of contraception in terms of usage, are women-based. The condom and
vasectomy are among the least popular. These are men-based. Men refuse to use condoms or to
be sterilized. Because it is easier to make women rather than men deal with family planning, there
is greater emphasis on women-based methods, not as a matter of policy but as a matter of
practice. The non-natural methods are safe and effective but they are biased against women
because the responsibility for family planning is virtually shouldered by women.

In one study that we did on men and abortion, we were told by men that one reason they don’t
attend family planning seminars is because these are usually held during weekdays when they are
out working. They suggest that these be done on Sundays, or better still, for service providers to
go from house to house.

How is natural family planning biased against the poor? We see this in the subliminal message of
“responsible parenthood,” the family planning slogan. The message is: if you have the financial
means, you can have as many children as you want; you can have sex any time you want (let me
qualify that AIDS/STD workers will say as long as you use protection). If you are poor, you have
to abstain (at the time that women want it most due to biological factors) or practice withdrawal.
In other words, sexual pleasure in this sense is a function of class. The poor should control their
sexual desires; the rich need not. If the poor don’t discipline themselves, they are irresponsible.
This is what I call the political economy of family planning/responsible parenthood.

Pangalangan: The International Conference on Population and Development (ICPD) defines

reproductive health as the “state of complete physical, mental, and social well-being” which
entails having a satisfying and safe sexual and reproductive life. Given this definition, the
individual must have the knowledge and power to make his or her own decisions regarding these
matters, which includes whether or not to have children as well as when and with whom to have
children. Family Planning (FP) is an element of Reproductive Health (RH). Population Management
is merely a government goal; it is another way (though closely related to FP/RH) by which citizens
can achieve the family size they want.

Reyes: I think Population Management is a strategy of national governments to minimize the

discrepancy between people’s needs and the national economic resources, and, in effect, to
maximize the people’s social benefits. On the other hand, the goal of Family Planning and
Reproductive Health is to address the needs of families and individuals vis-à-vis their own
resources and personal health. In other words, Population Management functions on a macro level
while Family Planning works on a micro level.

If husbands and wives desire smaller families and the national government’s thrust in population
management is to lower population growth rate to match economic growth rate, then it would
seem that the two programs function in tandem with each other at all times. This may not always
be so. For example, reproductive health programs also tackle infertility problems.

Tuazon: Family planning, reproductive health, and population management are inextricably
linked. They have a synergistic relationship, but I think the umbrella program would be
reproductive health since it approaches women’s needs from a life cycle perspective. This should
be the primary objective. Family planning contributes to attainment of RH as well as population
management.

FORUM: How important is population management for the country at its present state of
development?

Bercilla: I personally feel somewhat uncomfortable with using the term “population
management” to refer to population control. Some would even go to the extent of equating
population management with the increasing use of modern contraceptives to curb population
growth and thus secure economic growth. If used in this context, I would consider it a violation of
reproductive rights and would therefore not see it as an empowering development strategy. I
would perceive it as divisive and insensitive to the cultural values many Filipinos hold and would
not see it as the appropriate path to development.

However, if the term “population management” is used to refer to how a population exercises its
sexual and reproductive rights in relation to its use of its potentials of space, environment,
resources, social capital, etc. to secure a more sustainable development and better quality of life,
I would strongly support it. At the household level, a couple that recognizes how their needs as
women and men, as well as their potentials, aspirations and resources may affect their children,
their immediate community, and their lives, will more likely opt to space their children and
manage their fertility through measures of their own choice. Population management must be
strongly supported and implemented to secure not only sustainable economic growth rates but
also a better quality of life for all.

Pangalangan: It is very important to manage our population since our resources are not
sufficient or accessible to all. It should not be the main goal, however, because it can violate
individual liberties when not implemented in conjunction with the exercise of individual rights.
There should be more stress given to the education of citizens on their rights, which recognizes
their power to make their own decisions about how many children to have, given their time,
finances, religion, and other factors. They alone should make these decisions after being educated
and given access to the complete range of methods to plan their families. If the government
supports the right of individuals to family planning, our population will be manageable.

Reyes: Population management is an essential strategy in national development. Given the

present state of our national development which is characterized by very slow economic growth,
we need to manage our population growth in order not to overburden our resources.
Tejero: There has been a decline in the country’s total fertility rate (TFR). United Nations data in
2002 showed that the TFR in the Philippines was approaching 2.93, registering a significant drop
from 6.9 in the 1960s and 4.1 in the 1990s. By 2010, the TFR is projected to drop to below
replacement level. This does not seem to be a favorable condition.

In a 2004 Newsweek article entitled “Birth Dearth,” Michael Meyer writes of a new demography, a
phenomenon that consists of dropping fertility rates and shrinking populations worldwide, as
observed by sociologist Ben Wattenberg. The article states that the governments of many
developed nations are going to be confronted with bankruptcy, aging populations, and reduced
productivity within the next few decades due to declining populations.

We are witnessing this in the case of Singapore, which in the 1970s gave “population
disincentives” and staged the “Stop at Two” campaign. The success of their population program
eventually became cause for alarm because of the country’s aging population. In 1989, the
government started to give financial incentives to encourage childbearing. To this day, we read in
the newspapers about the efforts of the Singaporean government to promote marrying earlier and
having more children. Nevertheless, it seems Singaporeans are unaffected. It is very difficult to
reverse a cultural mindset against larger families.

Considering the TFR figures of the Philippines, the continuous family planning campaign of the
government through the years has made its dent. One wonders, though, how much better off we
are as a nation, knowing that a better quality of life is the promise of population control. It is said
that the more people, the poorer one becomes. According to recent data from the Philippine
National Statistics Office and the National Statistical Coordination Board, this is not necessarily
true. If we look at their data on the top five regions in the Philippines in terms of population and
Gross Domestic Product (GDP), for example, we find that Southern Tagalog, which has the highest
population, also has the highest GDP. The most populous areas of the Philippines are also the
wealthiest. This can also be seen among countries in the world. Taiwan, Singapore, and Hong
Kong have higher population densities than the Philippines, and yet they are much richer and
more developed than we are. This may also be said of the US and Europe compared to sparsely
populated Africa.

Perhaps we have been barking up the wrong tree. The Philippine government has invested and
continues to pour much money and resources on population control, which does not really
contribute to the progress of the nation and may even bring about an impending world population
implosion. Population control curtails an important resource: the human resource, the very
instrument for achieving progress. Meyer reminds us “of what mainstream economists know: that
a country cannot have a vibrant economy without a growing population.”

Tuazon: In my field of nutrition and in the College of Human Ecology, we have long recognized
and have been preaching the importance of population management in achieving sustainable food
and nutrition security in particular, and sustainable development in general.

FORUM: What role can educational institutions play in bringing about a change in
prevailing perceptions and practices which affect population management?

Badayos-Jover: Educational institutions like the UP play crucial roles in changing prevailing
perceptions and practices that affect population management. We know that alongside the family,
the educational institution is perhaps the greatest influence on the formation of perceptions,
attitudes, and practices. I believe that this is precisely the reason why there is a strong advocacy
to integrate gender issues into the curriculum. Now, at least in UP, we discuss matters like
reproductive health and reproductive rights vis-à-vis population management in the classroom. I
think that such efforts will pay off once our students graduate, pursue careers, and have families.
There will be some changes in their perceptions and practices concerning gender equity, women’s
reproductive health, or family planning, at the very least. Also, educational institutions are almost
always tapped for seminars and trainings for policymakers. Faculty members likewise serve as
resource persons, even on television shows. During these occasions for learning and re-learning,
the policymakers’ and general public’s prevailing values are clarified, critiqued, and changed.

Bercilla: Educational institutions are in a great position to change every generation’s perceptions
of what population management is and how a deeper understanding of sexual and reproductive
rights may serve as a development strategy that can guarantee a better life for all Filipinos. As
recommended in the Philippine NGO Beijing+10 Report, schools can strengthen and expand
gender initiatives in school curricula. Dialogues between opposing sectors can be initiated. The
academic community can also provide a venue for voices of the youth, women, and marginalized
sectors to be heard in this long-running population debate. An intensification of its extension
programs at the community level can also hasten the realization of the population management
program and guarantee its implementation at the household level. Beyond research, theory
building, and policy recommendations, the academic community can be a vital force in rallying the
Filipino population toward values and lifestyles and guarantee the realization of each individual’s
potential as a human being.

Castillo: In the late 1980s, there was a snowballing among both policymakers and scientists
(including those from the social sciences) of the opinion that the academe has to be more involved
in making state policies. The sponsorship by the Bank of research and publications on health
sector reform further encouraged this. In fact, the proponents of health sector reform popularized
the term “evidence-based health policy,” but on closer investigation, this referred to a narrow
notion of evidence: macro-economic neoliberal data that support health sector reforms. Health
economists and epidemiologists were among those sponsored by the Bank to write and argue for
these policies. Most health economists and epidemiologists are from academe.

Intellectual autonomy and integrity are pertinent concerns in this regard. The first is difficult to
sustain in a university that requires research output but has meager funds for research, forcing
academics to accept or apply for funding from external sources, even when these are not
particularly interested in the nation’s most pressing needs.

The second is linked to the first. However, it has deeper roots — professional ethics. The
academics’ code of conduct is not only needed for ethical teaching but also for ethical research.

There are alternative external funding sources that support studies that address the true needs of
the people. Perhaps the university can exert more effort in identifying these and establishing
institutional collaborations.

The other area is advocacy. In the Philippines, we see a lot of academics who are doing advocacy
work through NGOs. UP calls this extension work. I suspect, though, that extension work is not as
valued as research work, which is perhaps due to the University’s academic orientation. But
because policy and the academe are becoming more fused, perhaps we need to give a higher
value to the extension work of academics. I see a need for clearer policy guidelines on extension
work that include ethical guidelines.

Lastly, we need to develop the skills to prepare policy briefs for government that are clear,
concise, and supported by good data. So far the UP still enjoys high credibility because of the
perceived independence of its students and faculty. We can start with that resource to influence
policy directions in government.

Pangalangan: A great role is teaching and advocating for the medical, legal, ethical, sociological,
public health perspectives of reproductive rights. In the first place, few know that such rights
exist.
Reyes: Educational institutions as bastions of critical thinking can do much in correcting some
erroneous perceptions and developing frameworks for decision-making on different levels, such as
the national, community, family, and individual levels.

Tuazon: In instruction, key concepts of reproductive health and population management can be
integrated into the relevant courses. For example, we have worked toward the incorporation of
such concepts into some of our courses in nutrition.

The value of reproductive health should be ingrained in both males and females at an early age.
Academe can work with the Department of Education in order to integrate this into elementary
and high school curricula.

Political will and support are all important. Academe needs to advocate, and an effective way to do
this is by providing policymakers and program planners results of its research, action-oriented
research in particular. We should be able to identify what works and what does not in terms of RH,
FP, and population management program implementation.

UP can also help in training service providers as part of its extension function.

Given UP’s reputation for valuing social responsibility, it is important to have our positions heard
through lobbying, policy dialogues, etc. about concerns such as the quality of life of the Filipino
woman.

FORUM: Are you aware of any family planning, reproductive health, and/or population
management initiatives, whether institutional or private, taken by UP faculty, students
and/or alumni? If so, what are those initiatives?

Badayos-Jover: Many UP faculty members, students, and alumni have been involved in such
initiatives, in varying degrees, through the years. I think almost all, if not all, of the members of
this roundtable discussion group have been or are still very much involved in RH-related programs
or projects, not the least of which is research. Usually, such initiatives are pursued through NGOs.
One such NGO that I know of is WomanHealth Philippines, which was organized by Princess
Nemenzo along with other advocates. Since the 1980s, it has consistently been championing
issues related to reproductive health and rights. Of course there is the Health Action Information
Network (HAIN) organized by Dr. Michael Tan and noted for its projects and research in the area
of reproductive health. We have colleagues here in UPV who are involved in HAIN projects. There
is also the Philippine Health Social Science Association organized by Prof. Fatima Alvarez-Castillo
and whose current President, Ms. Azucena Pestaño, is a former UPV faculty and a UPV alumna. Dr.
Jaime Galvez-Tan, its current Vice President is with UP Manila. Likewise, ReproCen (Reproductive
Health, Rights, and Ethics Center for Training and Studies), with which Dr. Pangalangan is
affiliated, is active in promoting reproductive health and rights initiatives. The Reproductive Health
Advocacy Network (RHAN), an alliance of NGOs, also advocates reproductive health and rights.
Many of its active members, even the heads of its member NGOs, are either faculty members or
alumni of UP. Even some of my students are involved in NGO or United Nations Population Fund-
sponsored adolescent reproductive health projects in their respective hometowns.

Bercilla: Several faculty members and alumnae of the University of the Philippines have been
active members of WomanHealth Philippines for over a decade now. WomanHealth’s advocacy has
focused on reproductive health, reproductive rights, and quality health care. It fosters awareness-
raising initiatives around the country (and in communities) regarding women’s bodies, women’s
rights, etc. Woman Health was also one of the first NGOs to discuss the impact of neoliberal
development and globalization on women’s reproductive health and rights in the 1990s. It also led
in legislative advocacy training initiatives among community women and partner NGOs. The
advocacy focused on networking with other concerned sectors to form advocacy groups centering
on women’s issues relevant in the provincial, regional, and national contexts (e.g., the impact of
domestic violence on reproductive health and rights of women in Iloilo). This raised awareness
among community health practitioners, local government units, regional line agencies (such as the
DOH), and even the Philippine National Police, which in turn established women’s desks in key
government service areas. Perhaps of more significance is the fact that the advocacy has inspired
women in local communities (including North Cotabato, Leyte, and Iloilo) to pursue the work in
securing women’s rights.

Faculty members and alumnae of UP Manila, Visayas, and Diliman are also active members of the
Philippine Health Social Science Association. Members of this organization advocate ethics in the
delivery of health service and in the conduct of health research, focusing on reproductive health
concerns. Social Health, the official publication of PHSSA, carries a list of its major publications,
research, capacity-building initiatives, and advocacy work.

Several faculty members of UP Diliman, Visayas, and Los Baños have also been involved in
adolescent fertility and reproductive health research (such as Young Adults Fertility and Sexuality
1, 2, and 3), which has influenced policymaking on the management of adolescent fertility and the
access of youth to reproductive health services.

Pangalangan: The Center I head is ReproCen (Reproductive Health, Rights, and Ethics Center for
Training and Studies). It started as a joint project of the UP College of Law in Diliman and the UP
College of Medicine in Manila and was based in Malcolm Hall for the first five of its twelve years in
existence. It is now based in the College of Medicine in UP Manila. Faculty members from both
Colleges have been engaged in delivering lectures, doing research, helping Congress pass bills on
RH, and training trainors inside and outside of Metro Manila. We’ve also prepared teaching
modules on RH, which have been bought and used by other medical and law schools in the
country.

Reyes: In the early 1990s, a joint project on Reproductive Health, Rights, and Ethics was
undertaken by the UP College of Law in Diliman and the UP College of Medicine in Manila with
support from the Ford Foundation. The project consisted of training in ethics and human rights
especially as they pertain to reproductive health and health care. The proponents also undertook
research on women’s experiences as well as community practices and perceptions on reproductive
health. All these were incorporated into teaching modules in Health Ethics in the College of
Medicine and in Reproductive Rights in the College of Law. Currently, Reprocen (Reproductive
Health, Rights, and Ethics Center for Training and Studies) is a sub-unit of the Social Medicine Unit
at the College of Medicine in UP Manila and is headed by Prof. Beth Pangalangan of the College of
Law.

Tuazon: In the early 90s, through Food and Agriculture Organization’s support, I was National
Coordinator for the training of extension workers on Population Education, Environment, and
Nutrition. This was an integrated, inter-sectoral activity. Currently, we have two extension
programs in the College of Human Ecology, the Barangay Integrated Development Approach for
Nutrition Improvement (BIDANI) and the Regional Training Program on Food and Nutrition
Planning. Both programs deal with reproductive health and population management.

www.up.edu.ph/oldforum/2005/May-Jun05/roundtable.html -