Tag Archive | Reproductive Health Rights

Protest and collaboration

Nov19

‘we will sue ya, we will sue ya, we will sue ya, we will sue ya…’

Protest – I have ‘witnessed’ three youth related protests since my stay in this country. The first was student protests against fee increases and funding cuts to the education system. The second was the widely publicised protest against police killing of Mark Duggan in London. The third against the planned closure of UEA’s music school by 2014. The students ‘collected’ around 7,000 signatures and organised a protest rally on November 8 featuring various speakers. Their call was simple, leave the music school open, as a cultural legacy and for posterity.

I have been thinking about the student movements here and in my country and the similarities and differences between them. In both countries, students are averse to fee increases; the Unions receive some kind of subvention from their home ‘authorities’ and students use protests to express their grievances. However, there are marked differences in their approaches, for example the difference between a well researched signature campaign versus break the window ‘aluta continua’ which ends in wanton destruction of University facilities (that is not to say this does not happen here, but it is not the ‘norm’ as in my country). Many thoughts are running through my mind: is it a result of differing education systems?; an outcome of the different social, economic and political environments?; is it just ethical? An outcome of deprivation and frustration on the other side? Or is it history? Student activism here started during the 1880s, ours only started in 1945. Perhaps the long history has created a ‘system’ here, which is yet to manifest in ours? I wish we could borrow a thing or two from this side and share on the order in the pursuit of various desirable causes.

Collaboration – HIV remains a humongous public health challenge in Nigeria and the government adopted a multi-sectoral approach bringing together various actors to tackle the challenge. HIV counselling and testing (HCT) is an important medium to encourage people to know their status, and reduce progression to AIDS, since people could be put on anti-retroviral medicine once they know their status. It also contributes to reducing further infections as positive people are encouraged to adopt safer sex practices like condomising in order to prevent others from being infected, or themselves from being re-infected. However, counselling psychologists appear to be missing from the action. As long ago as I remember, I have been calling for better engagement of counselling psychologists in the provision of HIV counselling and pre-test and post-test services. This is pertinent because counselling psychologists deal with a range of issues from the psychology of learning, behaviour modification to adjustment.

So beyond HCT, they could play important roles in other areas like: monitoring drug adherence and factors that inhibit or promote the behaviour. Their roles can also extend to the study of life quality of life of PLHA, for which I am yet to encounter any data from Nigeria. QoL data serve important purposes in health policy decision-making and have been found to provide guidance in medical decision-making. It would serve some purpose in AIDS related care within hospital settings. QoL data could also provide needed information to understand the relationship between post traumatic stress disorders, other co-occurring psychological conditions such as depression and HIV. So far, I do not personally see clearly how the counselling association of Nigeria is engaging to play any significant role in tackling HIV, but I believe that their role is crucial, and a collaborative effort between health professionals, counselling psychologists and other actors would produce valuable results.

On the ‘Abia rape’ and sundry reproductive health rights issues in Nigeria

Oct2

Much has been said and written about the recent ‘Abia rape’ and the spate of rape incidences across Nigeria. My heart goes to the Abia rape victim in particular and also to the many other victims, known and unknown, reported and unreported, across the country. I would like to add my thoughts to what has already been said on rape, and on sundry associated reproductive health rights issues, in three facets: power, access to services and law.

On power, I think rape reflects a deep rooted behavioural pattern associated with power, which is manifested through aggressive behaviour. Hostility is also associated with masculinity and reflects a situation where the menfolk feel superior, a phenomenon which in our clime has been passed down across generations. It’s as if the idea of ‘man’s world’ permeates the minds of our young men (and older one’s too), and they appear to believe that a woman never really means ‘no’, or as if she is communicating the opposite when she does, and as if she has to be somehow compelled to comply to their wishes. This type of behaviour also manifests itself in the largely under-discussed domestic violence. The situation underscores the vulnerability of the womenfolk to disease- including STIs and HIV/AIDS, and they lack the power and ability to negotiate safe sex even within established long term relationships like marriages. Directly or indirectly, the women are always the biggest loosers and something needs to be done urgently.

But when a woman gets raped, what kinds of services are available to her? Health services, psychological support or counselling? How about protection from further abuse by relocating her to a safer place? And legal representation? Beyond the minimal efforts of civil society organisations, what does the state do to support these victims? If a woman becomes HIV positive as a result of sexual violence and abuse, does she automatically qualify for antiretroviral treatment? How about pregnancy and access to legal abortion? What are the relevant agencies, including the human rights commission, doing to ensure the victim is safe and receives needed medical, psychological and legal support? To what extent is Nigeria complying with its international obligations under the CEDAW and Beijing commitments?

Unfortunately, there are legal prohibitions to how a woman can respond to even the outcomes of an un-consensual intercourse. By the provisions of the law a woman is not allowed to have induced foetal termination unless it is meant to save her life. Prison terms for the ‘offence’ range from 14 years for the health provider and seven years for the women. But what does ‘save her life’ entail really? Does it only imply physical safety from death? What about emotional effects which could affect the overall quality of her life in both the short and long term? What about the long term effects of keeping the outcome of a process in which she did not consensually partake and in which she was a victim? It appears that in the long run, the law endangers more women than can be imagined and whatever its intent the law has largely been overtaken by events.

Around 660,000 women aged 15-49 seek abortions every year and as many as 60 percent of these get services from unqualified individuals. Unfortunately, many of these abortion services end up in fatal damage to the uterus and sometimes even the death of the woman. This in part contributes to Nigeria’s high maternal mortality level currently at 840 per 100, 000 live births as abortion alone contributes to around 30 to 40 percent of maternal deaths.

So what good does it do to maintain a law which criminalises and endangers the lives of young women? The aim of this article is to stimulate dialogue within the framework of the current national outrage on rape to the broader reproductive health rights issues in Nigeria. If the truth be told, our young people are having sex, and unless these laws are revised, more and more young people face imminent danger at the hands of unqualified ‘abortion service providers.’ Thus, rather than criminalise abortion, what we must do urgently is to put the discussion on comprehensive sexuality education back on the table and discuss better means of protecting our young from disease and unintended pregnancies. On a cost-benefit scale, it will save our country more than it will cost us. It could contribute to reducing the spate of chronic poverty –transfer of poverty from one generation to another, which thrives in our land; reduce the cases of broken careers for our young; reduce the number of children without needed parental support and care; and reduce the spate of broken personal development opportunities. We must respond urgently by revising the relevant legislation to ensure that it protects all citizens, especially young women. In the absence of a strong social sector, it’s the best we can do.

In concluding, I return back to the subject of rape and the law. What is the penalty for rape? The criminal code offers the maximum sentence of life imprisonment for ‘unlawful canal knowledge of a girl or woman without her consent’ and 14 years imprisonment for attempted rape. The penal code, as applicable in the north, also offers similar sentences. However, the snag is that the onus lies on the woman to prove that these incidences occurred. The Penal code also excludes rape within marital relationships. These provisos are very problematic, and could stigmatise the victims and obstruct the law from taking its course. Consequently, while the criminal and penal codes address some of the rape issues, they don’t provide sufficient grounds to take cases to prosecution. Thus, the national assembly needs to revise the relevant sections of these laws to make it even easier to pursue legal cases related to rape, and to bring the perpetrators of this heinous act to face the law, while protecting the victims. The law must make it easier to pursue prosecution, and the police needs to be better trained to investigate professionally and take cases to prosecution, regardless who is involved. Perhaps its also time we started seeing high profile rape cases in court and on national TV. The days of ‘nothing happened’ should belong to the past really. Its time to act and all hands must be on deck.