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Guatemala: The day-after pill and conservative quarters

By Alba Trejo

Guatemala City, May.– There has been growing opposition to the Ministry of Public Health’s decision to support the free distribution of the day-after pill in the country.

This emergency contraceptive method has not been well received by most people. They have told local media representatives that the pill is used to induce abortion.

A National Protocol establishes that the pill should be administered to rape victims because it prevents the fertilized ovule from adhering to the uterus. The procedure has been applied since 1984, but the Ministry of Public Health has so far made no other use of the pill.

It is being administered at social-security and public hospitals in cases of rape, but it is not available at pharmacies or healthcare centers.

The emergency method is being applied because of the growing number of sexually abused girls, teenagers and women in the country (over 5,000 cases a year).

Hilda Morales, representative of the Network to Fight Violence against Women, indicated that this information is not accurate because 75 percent of sexual-abuse cases are never reported. "Women remain silent out of shame", she added.

Médecins sans frontières has a mobile clinic operating in the country to provide healthcare and assistance to sexual-rape victims in places other than the capital city, and administer the pill in such cases. Alain Rias, head of the Swiss NGO, indicated that it is up to these women to take it or not.

Free distribution, however, has sparked controversy because religious beliefs are deeply rooted in this 14-million-inhabitant nation.

Fifty percent of the local population is Catholic; 40 percent is Evangelic; and the remaining 10 percent belongs to other sects.

Some people feel that the widespread use of the pill is tantamount to the death penalty, while some others think that it is easier for the government to supply the pill than to invest time and resources on education.

Edilzar Castro, representative of the Family Welfare (APROFAM) NGO, said that they supply the pill to sexual-rape victims. "We always explain to them that it is not effective when the ovule has been fertilized", she stressed.

"APROFAM provides reproductive and sexual-health services to women of all ages, especially those who have more than five children", she added.

"Out of 100 childbirths we served last year, 23 involved girls under 18 years of age", she commented.

Rossana Cifuentes, member of the Guatemalan Group of Women Physicians, feels that the use of the pill has not been addressed in a scientific manner. "Most people ignore that it is not an abortive method", she added. The Group is promoting discussion on the issue over the Internet.

"As contraceptive methods are not widely promoted in Guatemala, the number of abortions is on the upswing, especially illegal abortions that jeopardize women’s health", she noted.

Induced abortion is forbidden in the country. It is only performed at private clinics and by witch doctors who cause a lot of pain and infection to destroy embryos, officials said.

There is one abortion every six live births, a Guttmacher Institute representative announced. This institution is monitoring sexual and reproductive health services in the country.

According to Induced abortion and unplanned pregnancy in Guatemala, 557,000 women get pregnant every year. Out of this total, 12 percent end up having induced abortions; 16 percent, spontaneous abortions; and 72 percent, giving birth.

The day-after pill has been approved by the World Health Organization and drug-regulating agencies in Europe, Asia and the Americas. It has not been promoted, however, as widely as condom and contraceptive pills have in Guatemala.

Ana Cofiño, of The Cord feminist magazine, highlighted the importance of information campaigns in all languages. A total of 23 Mayan languages are spoken in the country.

Cifuentes is of the view that the pill can help reduce the number of pregnancies, mostly unwanted. Fertile-age women (14 to 49 years old) make up 51 percent of the total (3,032,114).

They have up to four children each and initiate sexual life when they are 13. Public health institutions were involved in 1,239 deliveries by 14-year-old, 10,797 by 17-year-old, and 14,732 by 19-year-old girls only in 2006.

Teófilo Cabrestrero, a local theologian and anthropologist, said that 30 percent of childbirths in Guatemala involve single mothers.

Last year, the National Institute of Statistics asked both public and private institutions to provide young people with information on reproductive health and family planning methods.

Colombia: Growing recognition of homosexual rights

By Ángela Castellanos

Bogotá, May.– The recognition of homosexual rights in Colombia is no longer a dream. In the last 12 months, the Constitutional Court has made three decisions granting the same patrimonial and social-security rights to both homosexual and heterosexual couples.

There is still much intolerance, but our rights are being increasingly recognized. A growing number of people are supporting us, including political-party leaders and broadcasters, said Marcela Sánchez, director of Diverse Colombia. This NGO defends the rights of the Lesbian, Gay, Transsexual and Bisexual (LGTB) community.

Last January, two young girls in Manizales village were expelled from school because they were a couple. This had not been big deal in the past, but sparked national protests four months ago.

The case was submitted to court and the school principals were forced to accept them back on May 25. The court decision was well received in Bogotá and many other cities.

LGTB rights in Colombia, Canada and other countries are being recognized by jurisdictional rather than legislative bodies.

Four bills seeking to recognize homosexual civil rights have not been signed into law, but the Constitutional Court has made three decisions favoring gay and lesbian couples all over the country.

Sánchez indicated that this has been due to the fact that Court rulings are based on juridical considerations while Congress decisions are influenced by moral, religious and political interests.

In February 2007, the Court established that homosexual couples who have been living together for over two years have the same patrimonial rights as heterosexual couples. Capital and goods are thus under common heritage, and both members are entitled to them in case of divorce or death of any of them.

Last October, the Court also decided that homosexuals can register their permanent partners as health-policy beneficiaries with any healthcare provider, just as heterosexual couples do.

A third achievement involves the right to receive life annuity, that is, transfer the pension of the deceased to his/her couple. Filed by Diverse Colombia, the claim was under intensive consultation before it was adopted. The Attorney General expressed full support for it.

These decisions are already being implemented. Homosexual couples are registering with notary offices and healthcare providers, and demanding pensions of deceased partners.

"We are very happy with these developments, but we can not marry yet. We can not put together life projects the way heterosexual couples do", Camilo Vargas told SEMlac. He is the academic coordinator of the LGTB Club at the Andean University in Bogotá.

Homosexual couples do not have the same rights as heterosexual couples in many other fields, including family-violence protection, the right to refrain from making depositions against their partners in court, and the opportunity to take work leaves.

There are no statistical data about the LGTB community in Colombia. Vargas indicated that six to 10 percent of Andean University students are gays or lesbians (1,000 to 1,200 students).

Out of this total, only 10 percent are activists. "We are not as united as we would desire, but we are making headway. We are establishing partnerships with LGTB groups in other universities", he added.

"In fact, legal and social recognition has been growing in the last five years. We have been widely supported by women and human-rights organizations as well as academic institutions", Sánchez stressed.

"Public policies are being developed in Bogotá. Last March 14, the first LGTB Consultative Board was established to help formulate, monitor and evaluate policies toward the local LGTB community", she concluded.

Chile: Women’s pensions

By Ángela Castellanos

Santiago de Chile, April.– The local government has enacted a new law establishing the same age for men and women to retire, and an allowance per child born alive or adopted.

Passed last month, the legislation introduces changes in the social-security system and will come into force next July.

Promoted by Michelle Bachelet’s government, the reform makes it possible to set up a pension fund for people whose income is not enough to make any contribution to retirement pensions. The move will benefit mostly women, officials said.

The pension will amount to 60,000 pesos (140 U.S. dollars) a month as of July 1 and will reach 75,000 pesos (175 dollars) on July 1, 2009. This does not cover basic food needs for one single person a month.

The most controversial measure, which has a direct impact on women, has to do with retirement age (from 60 to 65 years).

According to the Autonomous Central Organization of Chilean Workers (CAT), it will not increase women's pensions. It is a step backward because increasing compulsory savings will not automatically lead to higher retirement pensions, said Magdalena Castillo, CAT assistant secretary general.

To be entitled to a pension unit amounting to 19,851 pesos, you must have saved three million pesos in your individual account. If you make an estimate based on a 150,000-peso wage, you will see that the amount saved in five years will never reach such a sum. We believe this is a trick and only raises false expectations, especially among women, she told SEMlac.

The State will save more and women will get more affected. We do not agree with this move because all fund resources come from contributions by workers and the State. Not a single penny comes from the profits made by private pension fund administration companies, she stressed.

Karina Doña, a professor at the University of Chile’s Institute of Public Affairs, told SEMlac that increasing retirement age does improve pensions, but does not solve the main problem. It is just a factor, she added.

For gender reasons like maternity and care for children and sick/older people, women get in and out of the labor market quite often. This negatively affects their contributions and savings. As many Chilean women work in the informal sector or as self-employed, they make no contribution to pension funds, she stressed.

The wages of women are one third smaller than those of men for the same jobs. And the higher the training, the bigger the difference, she emphasized.

A study on women and employment in Chile, which was conducted by the International Labor Organization and Comunidad Mujer NGO last December, showed that pension contribution rates start to decrease after working men and women turn 30. The lower the socio-economic standing, the smaller the contribution (made by women), it also revealed.

The main problem mentioned above has to do with gender inequalities at work, including wages and social-security allowances, Doña indicated.

When women quit their jobs to look after their children, they are punished by the system. Being a mother and a worker at the same time should not be socially sanctioned, she indicated.

The allowance for children born alive or adopted covers all Chilean women, regardless of their social status or contribution to pension funds. It will not apply to those who retire before July 1, 2009, however.

It will be equivalent to 10 percent of 18 minimum monthly wage units, as set for workers aged 18 to 65, at the rate in force when the child is born. It would amount to 259,200 pesos (603 dollars) today.

Mexico: Breast cancer, an enemy lying in wait

By Alicia Yolanda Reyes

Guadalajara, Mexico, April.– Felicia (41) was diagnosed with breast cancer in late 2007. She is a senior official at the Mexican Health Foundation and is married to former Mexican Health Secretary Julio Frenk. They are both experts in public health and preventive medicine.

She went for an ultrasonic test when she turned 40, as it is required. She was really surprised to hear the doctor recommend a mastectomy (amputation of affected beast) as soon as possible.

She has ever since been actively involved in campaigns to make women understand how important it is to have tests performed on a regular basis. "There is no need to wait until we get ill or have some symptoms", she said.

Breast cancer is silent and does not hurt, but reproduces at an accelerated pace.

Felicia was going through a difficult family situation before her diagnosis. "I was about to get divorced", she confessed.

The situation radically changed, however, when her condition was revealed. Her husband has been by her side throughout the process and they have re-built their relationship. "It is like having a new, loving boyfriend", she indicated.

They have worked together on breast-cancer-information and early-detection campaigns to raise awareness among women, urging them to have self-exploratory and ultrasonic tests performed every three years before they turn 50 and every year after this age.

Another story: Sara (37) has two daughters. She went to the doctor’s in January 2007 when she saw a small bump on her breast. When he recommended a biopsy, she hoped that her irregular-shape mass would only be some accumulated fat.

She was taken to the operating room. When she woke up, her husband told her that she had had her breast and neighboring ganglions removed. A couple of days later, she had exploratory tests conducted, including tomography and blood and bone-density tests.

The oncologist went over test results. They are all negative, but you should undergo radio- and chemo-therapy, he told her.

The first sessions were really hard. The situation got gradually better; she was able to resume all her normal activities and learn to value small things in life and family support.

Breast cancer is the main cause of death among Spanish-American women. It ranks higher than cervical cancer in Mexico today.

Most breast cancers are detected at an advanced stage and the survival rate is very low (three to five years). If they are diagnosed early, they can be cured.

Susan G. Komen was already an older woman when she was diagnosed with the disease. It was so advanced that she died a few months later. She made her sister promise she would establish a foundation to provide information about it.

Supported by various national governments, the Susan G. Komen for the Cure Foundation was set up 25 years ago and has become a global initiative to raise awareness about breast cancer.

It reached Mexico in early 2008 and has made it possible to train men and women in early detection and ways of reducing mortality.

The Foundation is the largest organization of breast-cancer activists in the world. It has 75,000 members in the United States, has turned this pathology into a national priority and has raised one billion dollars for information campaigns and research works.

It is currently working in 10 countries. It is active in three Mexican cities, implementing training actions, disseminating information and promoting early detection.

The breast-cancer incidence rate has been growing at an alarming pace lately, said Dr. Celina Kishi, head of the Research Department at the Reconstructive Surgery Institute in Jalisco.

Recent studies have shown that fat-based diet, sedentary living, alcohol consumption and smoking play a key role in this pathology. Inheritance is also important, especially when the mother or a sister has suffered from it, she told SEMlac.

"Women who are often sad or depressed tend to develop the disease because stress and depression have a negative impact on the immune system", she added.

Outstanding Mexican oncologist Francisco Alexander indicated that most cancer patients have experienced family losses, stress and depression in the past.

This view is also shared by gestation-therapy specialist Pedro Ávalos. He feels that these people are prone to develop cancer or other incurable diseases. His therapy is based on humanistic psychology and seeks to maximize human potential.

He usually sees highly dissatisfied women who are convinced that the entire world is against them and some others who turn small obstacles into huge barriers. "If they do not redress these situations, they will probably develop some disease", he stressed.

Sad and depressed people should change their living styles, do things that give them pleasure, exercise and eat fiber-rich food. "They should, above all, learn to enjoy the small things of life", he concluded.

Venezuela: Teenage pregnancy

By Aline Castellanos

Caracas, April.– Yurimi (15) speaks in a low voice and, as if she were revealing a secret, says: "I thought nothing would happen the first time". She puts her hands on her belly and smiles. She will give birth within three months and wants to have a girl.

Yurimi has quitted school because that is not important to her. Her 19-year-old boyfriend has not called her over the phone in the last couple of months. He got scared. "I think most men behave that way", she stressed.

"I will go on, with or without him. My daughter will have everything she will need", she categorically said.

She lives with her mother, three younger brothers and a female cousin in a small, modest house in a Caracas neighborhood. The three women support the family by working in a store and a cell-phone-rental stand.

One every five pregnant women in Venezuela is a teenager. The country ranks on top in teenage pregnancies in Latin America (20 percent of total) and is well above Chile, which exhibits the lowest percentage (10 percent).

The current situation has resulted from lack of information and contraceptives, sexual abuse, rape, poverty and violence. These pregnancies are absolutely preventable and unwanted, according to the Latin American Center on Women and Health (CELSAM). Out of the total number of pregnancies in Venezuela, 50 percent are unwanted, it indicated.

Although this situation is very serious, it is not a priority to the federal government, said Mercedes Muñoz, president of the Venezuelan Association for Alternative Sexuality (AVESA).

The government has not attached utmost importance to information, contraceptive methods and ways of curbing violence against women, she told SEMlac.

"We do have, however, public policies and laws on women’s rights and violence", she added.

"They are not being implementing as they should; they are based on individual will rather than State commitment", she stressed.

As many pregnant women are very young, mother mortality and morbidity rates are going up. There is also a social cost involved because these young women quit school, the number of single mothers and women-supported households grows, and violence and poverty cycles go on and on, a CELSAM report indicated.

Although there are no government data available on mother mortality rate among teenage pregnant women in the country, deaths due to obstetric complications in women aged 10 to 19 occupy the second and fourth positions in the total number of women deaths, she explained.

Teenage mothers are faced with the risks of preclampsia, eclampsia, premature births, anemia, high-blood pressure, puerperal endometritis, neonatal septicemia, abortion, fetus-pelvis disproportion, and new-born respiratory disorders.

As abortion has not been legalized, there is no accurate information. It is assumed, however, that abortion-related complications account for one third of teenage pregnant women deaths.

Social risks are associated with poverty, violence and gender stereotypes. "We tend to believe that only women are responsible for child bearing and rearing", Muñoz emphasized.

Over 60 percent of Venezuelan mothers are single and had their children when they were adolescents, she added. "The role of men is limited to procreation", she noted.

"Such a situation leads to irresponsible paternity, and there is no State policy to redress it", she commented.

Specialists in sexual and reproductive health believe that the causes behind teenage pregnancy include lack of information and contraceptive methods, family instability, sexual abuse, rape, and media messages promoting early sexual activity.

Poor pregnant teenagers simply re-produce the poverty cycle with fathers abandoning their families and young girls quitting school. There are not enough part-time jobs and day-care centers available. Teenage mothers have little or no opportunity to live with dignity, indicated the final document of the Venezuelan Women’s Congress.

Hugo Chávez’ government is seeking to redress this situation by providing free healthcare at all levels.

A Pan-American Health Organization (PAHO) report indicated that teenage fertility rates in developing countries are higher than in developed nations. The fact that the United States exhibits the highest rate (11.1 percent) among industrialized countries highlights the need to include sexuality in the concept of citizenship, the document stressed.

This has not been seen to date because a new, inclusive sex-education policy needs to be formulated and implemented, Muñoz feels.

"The approach to this phenomenon has been inadequate. There is moral Satanism rather than social commitment. We often hear people say that teenage girls get pregnant because they are going crazy. Teenage pregnancy is a social evil affecting women. The battle is still to be waged", she concluded.

The Women's News Service from Latin America and the Caribbean (SEMlac), International News Agency, offers this weekly service.

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