Amnesty International USA 16 Days of Activism Against Gender Violence: Let’s Challenge Militarism and End Violence Against Women! (November 25 ­ December 10 2014) South Africa: Pregnancy shouldn’t kill! South African authorities must make better healthcare for women and girls in the Mkhondo Municipality a priority! Pregnant women and new mothers in Mkhondo Municipality in eastern South Africa are dying needlessly because they are not getting vital health care. Maternal mortality rates are far too high, and Mkhondo is in one of the worst­performing health districts in the country. To reduce the risk of dying, pregnant women and girls need medical care from the early stages of pregnancy. But many avoid clinics because they fear the lack of privacy and patient confidentiality. Others are put off by nurses who shout at girls for getting pregnant too young. What’s more, many can’t reach the clinics because public transport is scarce or too pricey. To make matters worse, many women and girls aren’t aware of the maternal health issues and the benefits of early antenatal care. Many also struggle to get advice and information about contraception, and some find it difficult to make their partner wear a condom. All this leads to unplanned pregnancies and an increased risk of contracting HIV. The risk of maternal death for women and girls who are HIV positive is almost five times higher than for those who are HIV negative. For women and girls living with HIV, early access to antenatal care is especially important to ensure that they receive antiretroviral treatment for their own health as well as to prevent the transmission of the virus to their unborn child. Stigma against people living with HIV still exists. Women and girls feared that if they test positive, they might be abandoned by their partners and even their families. Discrimination against women and girls living with HIV, including physical and verbal abuse and mistreatment in the home, is a constant fear, especially for those living in poverty who rely on support from partners and family members. The South African government must recognize the existence of gendered barriers to accessing healthcare services and implement a multi­department approach to combating maternal mortality, HIV/AIDS and gender­based discrimination and ensure that adequate budgetary resources are allocated to the necessary health and transportation services by all departments and that regular feedback is provided to Parliament on progress in line with resources allocated and commitments made. Take Action Now! Write to the South African government, urging the authorities to prioritize better healthcare for pregnant women and girls. You can take online action at: http://tinyurl.com/ov8d3kn Or youwrite a letter and mail it to the Provincial Minister for Health. A sample letter: Mr. Gillion Mashengo
MEC for Health, Mpumalanga Province
No. 7 Government Boulevard
Riverside Park, Building No. 3, Extension 2
Nelspruit 1200, South Africa
Fax: 27 13 766 3475
Send copies to: Mr. David Mabuza Premier, Mpumalanga Province Office of the Premier Riverside Park, Extension 2 Nelspruit 1200, South Africa Fax: 27 13 766 2494 Email: [email protected] Dear Minister Mashego: As a member of Amnesty International, a global movement of more than three million people who campaign for human rights, I am writing with deep concern about the risks faced by pregnant women and girls in Mkhondo Local Municipality in relation to their maternal health and the gender based discrimination they experience. I applaud the Department of Health’s commitment to improving maternal health outcomes and commend the many advances made in combating preventable maternal deaths. It is distressing to learn however that maternal mortality has more than doubled in Gert Sibande District from 76.4 deaths per 100 000 live births in 2011/12 to 187.6 deaths in 2012/13. The reasons they provided for this decision were varied including the way that they were spoken to and treated by medical staff at the clinic and a lack of privacy and confidentiality. Understaffing, leading to long waiting times and patient overcrowding, along with clinic processes that are specific for people living with HIV, increase women and girl’s fear that their HIV status will become known to their families and communities, which may result in them being stigmatised. Physical access to the clinic can also be a problem. The central call service system for ambulances in Mkhondo Local Municipality often result in lengthy ambulance response times, which puts pregnant women and girls at further risk. There is also great concern that a mobile clinic service that had once served the community has been suspended in some areas. Government authorities, including at provincial and municipal levels, have obligations to respect, protect and fulfil women and girls’ right to health and their sexual and reproductive rights. Amongst other things, this requires the removal of all barriers interfering with their access to health services, education and information, contraception and family planning, including financial barriers and barriers related to accessing necessary transport. In respect of these obligations, I urge the Honourable MEC to: 1.
Ensure that the Department of Health implements effective measures to improve ‘Caring and Positive Attitudes’ in health facilities in Mkhondo Municipality as recommended by the National Healthcare Facilities Baseline Audit 2012/2013, including introducing accountability mechanisms for breaches of confidentiality and privacy in clinics. 2.
Prioritise providing additional training for healthcare workers, including in Mkhondo Local Municipality, on patient rights and how to provide professional, non­discriminatory and confidential services, particularly to adolescents. 3.
Ensure the provincial Department of Health takes immediate measures to remove all barriers that women and girls in Mkhondo Local Municipality face in accessing ante­natal care and emergency health services, including by purchasing an obstetric ambulance for the Municipality and reinstating the mobile clinic programme in all communities in Mkhondo Local Municipality. Yours sincerely, Questions? Please email us at [email protected]! Published by Amnesty International USA’s Women’s Human Rights Coordination Group Find us on Facebook: https://www.facebook.com/AIUSAWomensHumanRightsNetwork Follow us on Twitter: https://twitter.com/AmnestyWomenRts