Latin America Resets Its Strategy against Femicides

Part of a mural of bloody handprints, with the names of some of the women victims of femicide, during a demonstration in the Argentine capital held under the slogan #NiUnaMenos (Not One Woman Less). In Latin American societies, awareness of gender-based murders is growing, while new measures are being promoted to curb them. Credit: Fabiana Frayssinet/IPS

Part of a mural of bloody handprints, with the names of some of the women victims of femicide, during a demonstration in the Argentine capital held under the slogan #NiUnaMenos (Not One Woman Less). In Latin American societies, awareness of gender-based murders is growing, while new measures are being promoted to curb them. Credit: Fabiana Frayssinet/IPS

By Fabiana Frayssinet
RÍO DE JANEIRO, Apr 4 2019 – Several initiatives are seeking to strengthen the fight against femicides in Latin America, a region which, despite growing popular mobilisation and pioneering legislation against gender-based murders, still has the world’s worst rates in what has been described as a “silent genocide,” says U.N. Women.

“The normalisation of violence against women and girls, the lack of comprehensive and quality services that identify patterns of violence that could end in femicide, the lack of data and research without a gender perspective are common to all countries,” U.N. Women Regional Director Luiza Carvalho said, summing up the situation in Latin America, in an exclusive interview with IPS.

“Ending impunity is critical. There are countries in the region where up to 95 percent of all cases go unpunished,” Carvalho said from U.N. Women’s regional headquarters in Panama City.”We must also place great emphasis on prevention because, even if we put all aggressors in jail, if we don’t change the structural causes, attitudes and perceptions that give rise to violence against women, we will never put an end to the phenomenon.” –Luiza Carvalho

One of the new strategies is the Spotlight Initiative, launched by the European Union and the United Nations for the elimination of femicide. Of an initial investment of 500 million euros (562 million dollars), 55 million euros will go to Latin America.

Spotlight addresses the phenomenon of gender-based killings holistically through six pillars: gender equality legislation, the strengthening of the institutional framework, primary prevention, quality services, data collection and the strengthening of the women’s movement.

The campaign launched in Argentina on Mar. 21 also includes El Salvador, Mexico, Guatemala and Honduras, which was the first country where it was launched worldwide.

The selection of these countries, Carvalho explained, was based on factors such as the prevalence rate of femicide, the commitment of the authorities to implement national laws and policies to improve the situation of victims, and the strength of the country’s civil society movements.

In the case of Argentina, “the #NiUnaMenos (Not One Woman Less) movement drew attention to this phenomenon as an unacceptable situation, demonstrating that it has much to teach the region and the world,” noted the senior Brazilian official regarding the mass demonstrations against femicide that have spread to other countries in the region.

Since 1994, the region has had the Inter-American Convention on the Prevention, Punishment and Eradication of Violence against Women, adopted in the Brazilian city of Belém do Pará, Brazil, which formalised the definition of violence against women as a violation of their human rights.

This international instrument, signed by 32 countries, provided for the first time for the development of mechanisms to protect and defend women in the fight to eliminate violence against their physical, sexual and psychological integrity, in both the public and private spheres.

In 2013, it incorporated the crime of femicide.

According to Carvalho, the Convention made the region “a global pioneer in legislation on violence against women.”

Femicide has been incorporated into the criminal code in 12 countries (Argentina, Bolivia, Brazil, Chile, Colombia, Dominican Republic, Ecuador, Honduras, Mexico, Panama, Peru and Uruguay). Six others typify it in laws outside these codes (Costa Rica, El Salvador, Guatemala, Nicaragua, Paraguay and Venezuela).

Luiza Carvalho, U.N. Women Regional Director for Latin America and the Caribbean. Credit: UN Women

Luiza Carvalho, U.N. Women Regional Director for Latin America and the Caribbean. Credit: UN Women

In addition, the 32 countries participating in the Convention have laws that protect the rights of women and girls who experience domestic or intra-family violence.

To advance these achievements, on Mar. 15, in Washington, DC, U.N. Women, the Organisation of American States (OAS) and the Committee of Experts of the Follow-up Mechanism of the Belem do Pará Convention (Mesecvi) officially launched an Inter-American Model Law on the Prevention, Punishment and Eradication of the Gender-Related Killing of Women and Girls.

They also presented an Analysis of Legislation on Femicide in Latin America and the Caribbean and Inputs for a Model Law on this type of sexist or “machista” homicide.

The model law “seeks to serve as a basis for creating or updating legislation on the violent death of women in the region, as well as strengthening actions for prevention, protection, care, investigation, prosecution, sanction and integral reparation,” explained Carvalho.

A study by Small Arms Survey shows that Latin America has 14 of the 25 countries with the highest rates of femicide in the world per 100,000 women, in a list headed by El Salvador, Honduras and Guatemala.

Carvalho attributed this to the lack of comprehensive measures, “which creates a gap between formal rights and women’s effective access to justice.”

“The Pará Convention was clear in pointing out that an integral view of violence against women is needed, that is to say, in addition to penalising it, States must develop actions for prevention, protection, investigation and reparation, both for the families of the victims and for the survivors,” she said.

But, she criticised, “the States do not have figures for reparations, for missing women, for genetic data that would enable the location of victims, or other mechanisms to make it possible to guarantee their rights.”

“We need comparative statistics to analyse and compare between countries what works and what doesn’t to eradicate femicide. When we have better statistics we can see the patterns and severity of the situation and formulate well-founded policies,” she said.

Mobilisations against male violence have taken to the streets of Latin America on the most diverse occasions, including the popular carnival parades in Brazil. In this comparsa of "Las carmelitas de Santa Teresa," a traditional neighborhood in Rio de Janeiro, a group represented this year's femicides. Credit: Fabiana Frayssinet/IPS

Mobilisations against male violence have taken to the streets of Latin America on the most diverse occasions, including the popular carnival parades in Brazil. In this comparsa of “Las carmelitas de Santa Teresa,” a traditional neighborhood in Rio de Janeiro, a group represented this year’s femicides. Credit: Fabiana Frayssinet/IPS

In addition, according to the regional director of U.N. Women, the penal codes of the region continue to be “androcentric”, which translates into “an adverse normative context for the adequate classification of crimes involving specific forms of violence against women.”

This problem is aggravated, she said, by “a criminal doctrine that has not integrated a gender perspective and resists doing so.”

“When women are murdered, these cases should be investigated immediately under the presumption that the case is a femicide, as is the case in Mexico. Cases should be properly investigated without gender stereotypes and prejudices, and reparations should be made,” Carvalho urged.

According to Mesecvi, States Parties spend less than one percent of their total budgets on actions to combat gender-based violence.

“Comprehensive laws need budgets in order to be implemented,” Carvalho said.

“We must also place great emphasis on prevention because, even if we put all aggressors in jail, if we don’t change the structural causes, attitudes and perceptions that give rise to violence against women, we will never put an end to the phenomenon,” she added.

For Carvalho, “despite some promising changes, led by the region’s youth, social tolerance of violence against women and girls continues, and a shift in social norms is needed to address harmful masculine mentalities.”

The expert cited the example of Colombia, which in 2015 passed a law involving the educational system in prevention activities.

“Understanding that femicide is the ultimate act in a chain of violence against women means understanding that the health sector, social services, the police and the judicial system must work together,” she said.

In that respect, she mentioned “successful” projects such as one in Uruguay that brought together the courts, the police and the National Women’s Institute.

In a situation where a woman is at risk, a judge can order the abuser to wear an electronic ankle bracelet connected to a device that the at-risk woman carries with her. If the abuser approaches her, the ankle monitor automatically alerts the police. During the programme, both parties receive psychological support as well.

“So far, none of the women who form part of the programme have been murdered,” Carvalho said, with hope.

Fastest in Asia-Pacific

Bangladesh to log fastest economic growth in the region next year: ADB

By Editor, The Daily Star, Bangladesh
Apr 4 2019 (IPS-Partners)

(The Daily Star) – Bangladesh is on track to log in the fastest economic growth in the Asia-Pacific region in fiscal 2019-20, said the Asian Development Bank in its latest report — in a resounding endorsement of the government’s economic policymaking.

The economy is expected to grow at 8 percent next fiscal year, which is the same as this year, said the Manila-based lender in the latest edition of its flagship publication, Asian Development Outlook 2019.

Manmohan Parkash, country director of the ADB, speaks at the unveiling of the Asian Development Outlook 2019 at his office in Dhaka yesterday. Photo: Star

Earlier in September last year, the ADB had forecasted that the GDP growth in 2018-19 would be 7.5 percent.

But thanks to the robust private consumption, increased public investment, strong export performance and expansion in industries the ADB has revised upwards its growth forecast by 50 basis points.

The higher forecast though is less than the government’s own forecast of 8.13 percent.

“Bangladesh’s economy is in a good shape,” said Manmohan Parkash, country director of the ADB, at the unveiling of the report at its Dhaka office in Agargaon. The country’s macroeconomic management remains generally sound. Inflation edged up slightly to 5.8 percent but remained in check.

Although budget revenue underperformed its target, the fiscal deficit was well within the budgetary target.

The current account deficit widened due to the surge in import demand, but it was mainly from the increase in imports of intermediate and capital goods, which will boost short- to medium-term production, Parkash said.

Continued favourable trade prospects, stronger performance of exports and remittances and heightened public investment for expeditious implementation of large infrastructure projects account for the multilateral lender’s sanguinity on the Bangladesh economy in the near term.

“Bangladesh’s economic outlook remains optimistic in the short-run. But to sustain this momentum in the medium- to long-term, there are several challenges we need to overcome,” Parkash said.

The country needs expanded industrial base, diversified export basket, improved business environment for vibrant private sector development, expanded tax base, better revenue collection for increased resource allocation and human capital development.

“Continued focus on prudent macroeconomic policies, sound debt management, strengthening the banking sector, removing infrastructure constraints and reducing the cost of doing business are important to help achieve the long-term development vision of the country,” Parkash added.

Soon Chan Hong, senior economist at the ADB, expressed concerns about the state of the banking sector.

The high non-performing loan ratio, low profitability, weak governance, widening capital shortfall, operational inefficiency and ineffective legal framework are worrying, he said.

This story was originally published by The Daily Star, Bangladesh

Invested in Gender Diversity

The “Fearless Girl” statue in the heart of New York’s financial district serves as the public face of efforts to raise awareness about the importance of gender diversity in corporate leadership.

By Rakhi Kumar
WASHINGTON DC, Apr 4 2019 – Over the past decade, there has been mounting evidence that greater levels of gender diversity can have a positive impact on corporate performance and economic growth.

Most relevant for investors, MSCI (American financial service provider) found that companies with strong female leadership at the board level generated a return on equity 36.4 percent higher than companies without a critical mass of women on their boards.

For both economic and social reasons, there has been a surge in interest from investors about how they can encourage gender diversity on corporate boards, in the C-suite, and at other levels of management.

To support these efforts, State Street and asset managers of all sizes are developing new tools that empower investors to promote gender diversity at the companies in which they invest.

In March 2017, we placed the “Fearless Girl” statue in the heart of New York’s financial district to serve as the public face of our efforts to raise awareness about the importance of gender diversity in corporate leadership. This campaign, however, is about much more than raising awareness.

As shareholders, we cast votes on candidates to a company’s board of directors and other important issues facing the company. Through this proxy voting process, we have voted against nominees to all-male boards that are not taking adequate steps to add female representation.

In addition, we are engaging directly with companies about diversity and other thematic environmental, social, and governance (ESG) topics and publishing thought pieces to educate boards about effective pathways to increasing diversity at all levels of the organization.

Since March 2017, we have called on more than 1,200 companies with no women on their boards to take action. We are pleased that more than 300 of those companies have now added a woman to their boards and 28 more have committed to doing so.

But we know there is more work to be done. In September 2018, we announced an escalation of our board diversity voting guidelines.

Beginning in 2020 in the Australian, UK, and US markets and in 2021 in Canada, Japan, and continental Europe, we will vote against the nominating committee’s entire slate of nominees if a company does not have at least one woman on its board and has not engaged in successful dialogue with us on the matter for three consecutive years.

Why are we giving companies three years to implement changes that we believe would have an immediate positive impact for investors before taking escalated voting action?

Our goal is to ensure effective independent board leadership, which involves achieving the right skill sets as well as a diversity of views. We realize that achieving this can’t happen overnight and that adding qualified candidates should be a thoughtful process that can take upward of a year.

While having only one female director on a board shouldn’t be seen as the end of a company’s diversity journey, we believe that adding a female perspective to the boardroom is an important first step.

The Fearless Girl campaign is about changing the mind-set of boards on diversity—moving the conversation from “Why do we need gender diversity?” to “Why don’t we have board diversity?”—and we believe that adding even a single female director helps to shift this mind-set.

Diversity is a relevant issue for all companies regardless of sector, market, or size. We found that many large companies today are making a concerted effort to include women on their boards, but among smaller companies the lack of female representation on boards continues to be significant.

Most boards lacking gender diversity cite a limited pool of suitable female director candidates as a primary obstacle. However, we believe that current practices for nominating directors, as well as behavioral biases that continue to undervalue the contributions of women in the workplace, are among the leading obstacles. As an example, some boards require that all director nominees have CEO experience.

Fortunately, these roadblocks and biases can be overcome. One best practice commonly used by companies with higher levels of board diversity is to ensure that every candidate pool of board nominees includes diverse candidates.

Also, we are calling on companies to monitor and disclose the level of gender diversity not only on their boards but at all levels of management. We believe this increased transparency will help create a stronger pipeline of qualified female board candidates.

Inspired by a conversation we had several years ago with a client about how to advance the gender equity discussion and capture potential excess return from companies with gender-diverse leadership, State Street created an index that allows investors to achieve the dual purpose of impact and return.

Launched in March 2016, the SSGA Gender Diversity Index is designed to promote gender diversity and harness the potential elevated returns of companies with greater gender-diverse leadership. The index can even be combined with a charitable component to contribute a portion of the advisor’s revenue to support charities that focus on science, technology, engineering, and math programs for young women.

For decades, asset owners have sought to effect change by using negative screening, which means avoiding investing in companies whose practices don’t align with the investor’s personal values or companies with poor ESG ratings. Increasingly, many investors are moving beyond this exclusionary approach and embracing ESG-focused investing as a tool for potentially improving a portfolio’s risk-adjusted returns.

One of the biggest barriers to ESG integration is a lack of reliable and uniform data about a company’s practices and their impact on financial performance. We believe that our stewardship initiatives calling on companies to improve disclosure about gender diversity at all levels of management should play an important role in giving investors the information they need to integrate gender considerations into their analysis of a company.

We are pleased to observe the growing awareness of the benefits of gender-diverse leadership across the investment ecosystem—from asset owners to asset managers to corporations themselves.

According to the Wall Street Journal, as of March 2018—the one-year anniversary of the launch of Fearless Girl—asset managers and owners controlling more than $13 trillion had joined us in making gender diversity a stewardship priority.

But this is just a start. At State Street, we believe that companies throughout the asset management industry should continually look for new ways to use their expertise to further empower investors to promote gender diversity at all levels of leadership around the world.

*The article was first published in Finance & Development, the IMF’s quarterly print magazine and online editorial platform, which publishes cutting-edge analysis and insight on the latest trends and research in international finance, economics, and development.

Ambitions Are Affordable for Asia and the Pacific

Armida Salsiah Alisjahbana is United Nations Under-Secretary-General and Executive Secretary of the United Nations Economic and Social Commission for Asia and the Pacific (ESCAP).

By Armida Salsiah Alisjahbana
BANGKOK, Thailand, Apr 4 2019 – Three years of implementation of the transformative 2030 Agenda for Sustainable Development in Asia and the Pacific shows the region has some catching up to do.

Despite much progress, the region is not on track to reach the 17 Sustainable Development Goals set out in the United Nations 2030 Agenda for Sustainable Development. We are living in a time of booming prosperity, yet many are getting left behind. Basic needs, such as the freedom for all from hunger and poverty, ill-health and gender-based discrimination, and equal opportunity for all are elusive. Economic, social and planetary well-being has a price tag. Calculations by the United Nations Economic and Social Commission for Asia and the Pacific (ESCAP) show that it is mostly affordable for the region.

Armida Salsiah Alisjahbana

Realizing ambitions beyond growth

What will it take to realize the ambitious 2030 Agenda focused on strengthening the three pillars of sustainable development?

The 2019 edition of the ESCAP’s flagship publication Economic and Social Survey for Asia and the Pacific is asking for the region to raise ambitions beyond mere economic growth. Countries facing high and growing levels of inequality and environmental degradation will have to change course from pursuing a growth path that neglects people and the planet.

The 2019 Survey forecasts continuing robust growth in the region which remains the engine of the world economy. Amid rising global uncertainty that challenges the Asia-Pacific region’s economic dynamism, there is a need for investments that not only sustain growth but also build social and environmental capital.

ESCAP analysis shows the region needs to invest an additional $1.5 trillion every year to reach the Goals by 2030. This is equivalent to about 5 per cent of the region’s GDP in 2018, or about 4 per cent of the annual average GDP for the period 2016‒2030.

At $1 per person per day, this investment is worthwhile. It could end extreme poverty and malnutrition for more than 400 million people. A quality education for every child and youth would become possible, as would basic health care for all. Better access to transport, information and communications technology (ICT) as well as water and sanitation could be ensured. Universal access to clean and modern energy, as well as energy-efficient transport, buildings and industry could be achieved. Climate and disaster-resilient infrastructure could be built. Resources could be used more effectively, and the planet protected.

Most of this investment is needed to protect and nurture people and the planet. Making a better world for our people by ending poverty and hunger and meeting health and education Goals, requires some $698 billion per year. Protecting our planet by promoting clean energy and climate action and living in harmony with nature, requires $590 billion per year. Another $196 billion per year is needed to invest in improving transport and ICT infrastructure as well as access to water and sanitation services.

Of course, in a region as diverse as ours, investment needs vary considerably. Least developed countries need to invest the most at 16 per cent of GDP while South and South-West Asia has an investment need of 10 per cent of GDP to reach the Goals by 2030. More than two-thirds of the investment in these countries will be in reducing social deficits – poverty, malnutrition, lack of health care and education as well as job creation. Landlocked developing countries need to invest most in improving transport and ICT infrastructure as well as water and sanitation services. East and North-East Asia and, to a lesser degree, South-East Asia, need to focus on clean energy and climate action investment.

Paying the bill

It should be remembered that the Goals support each other and an investment in one area has a positive effect on another. Good health depends not only on access to healthcare services but also nutrition, safe water, sanitation and good air quality. Education for all also promotes gender equality. Resource efficiency supports climate change mitigation.

Besides harnessing these synergies, sustainable development financing strategies will have to turn to public and private finance. The good news is that most countries in the region have the fiscal space to invest in the Goals. There is also a massive untapped pool of private financial assets estimated at $51 trillion in developing Asia-Pacific countries alone. Enhanced regional cooperation would also help the region offset external risks and build resilience by tapping into regional resources.

Above all, leadership will be crucial in making the transition to a development strategy that balances all dimensions of human and planetary well-being. The 2019 Survey aims to stimulate a regional dialogue and offers guidance on accelerating progress towards the Goals in the region.

Women Activists Protest Torture & Imprisonment Under Repressive Regimes

By Thalif Deen
UNITED NATIONS, Apr 4 2019 – Faced with an uneven battle against right wing nationalist governments, repressive regimes and extremist groups, scores of civil society organizations (CSOs) are gearing themselves to fight back.

Expressing grave concern over a widespread crackdown on activists, 118 leading CSOs, scholars and women’s groups – focusing largely on the rights of women in predominantly Muslim countries– joined hands last week to co-sign a letter of protest to 48 leaders of Muslim-majority countries.

The letter seeks support for equality of women, condemns the torture of women human rights defenders and calls for the immediate release of those detained in Saudi Arabia and Iran.

Spearheaded by Equality Now and Musawah, the letter says they are particularly alarmed at the imprisonment in Saudi Arabia of numerous women’s rights activists, including Loujain Al-Hathloul, Hatoon Al-Fassi, Aziza Al-Yousef, Eman Al-Nafjan, Nouf Abdelaziz, Samar Badawi, Nassima Al-Sadah, Amal Al-Harbi, and Shadan Al-Anezi.

The Saudi government has accused the women of “coordinated activities to undermine the security, stability and natural unity of the kingdom.”

According to Saudi law, the women could face up to 20 years in prison or sentenced to death.

The recipients of the letter include 48 presidents, reigning monarchs and heads of government of Iraq, Chad, Kuwait, Bahrain, Nigeria, Sudan, Iran, Maldives, Niger, Tunisia, Turkey, Saudi Arabia, and the United Arab Emirates, among others.

The letter says: “We write as over 100 women’s rights and human rights organizations and activists from the Muslim world, who are deeply concerned over the crack down on women’s rights activists in some countries”.

“We respectfully request leaders of the Muslim world to raise their voices to support equality for women, to recognize the critical role that women’s rights defenders play in this regard, and to condemn the imprisonment and torture of women human rights defenders.”

The activists say they are also “extremely troubled by the egregious treatment of women’s rights activists in Iran, including internationally renowned lawyer Nasrin Sotoudeh, who has reportedly been sentenced to 38 years in prison and 148 lashes, and Narges Mohammadi, sentenced in 2016 to 16 years in prison”.

The 118 activists who signed the letter are from CSOs in Algeria, Afghanistan, Egypt, Indonesia, India, Canada, Pakistan, Jordan, Malaysia, Morocco, Mali and Somalia, among others.

The role of CSOs in fighting back repression and human rights violations will be one of the primary issues on the agenda of the International Civil Society Week (ICSW), scheduled to take place in Belgrade, April 8-12.

The theme of this year’s ICSW is “The Power of Togetherness” focusing on harnessing collective action to respond to rights restrictions and rightwing globalism.

Yasmeen Hassan, Global Director of Equality Now, a CSO which advocates the protection and promotion of the human rights of women and girls worldwide, said: “It is disheartening to see how low down the rank Muslim countries come in the UN’s global Gender Inequality Index

She said the arrests, imprisonment and alleged torture of women’s rights activists in Iran and Saudi Arabia should be condemned by all Muslim States.

“We cannot achieve peace, prosperity, and progress without committing to equality for women and girls, and taking active steps to make this a reality,” declared Hassan.

Zainah Anwar, Executive Director of Musawah, a global movement for equality and justice in the Muslim world, said: “It is high time Muslim leaders speak out about equality and justice being Islamic values, support women’s rights groups in their countries, and take action to end laws, policies and practices made in the name of Islam that continue to discriminate against women until today.”

If Muslim countries had been true to the teachings of Islam that granted women rights considered revolutionary 1,400 years ago, she said, the Muslim world today would be at the forefront of the women’s movement, instead of at the bottom of all gender equality surveys.

Asked for an update, Tara Carey of Equality Now, told IPS: “It is extremely disappointing that the women’s rights activists still detained in Saudi Arabia have not been freed from prison following Wednesday’s court hearing”

“We call for their immediate, unconditional release, with all charges against them dropped, and for the Saudi authorities to ensure an impartial and independent investigation into allegations of torture.

She said defending women’s rights is not a crime and these women should never have been imprisoned in the first place.

Meanwhile, addressing the Human Rights Council in Geneva last September, the UN Commissioner for Human Rights Michelle Bachelet said the recent crackdown on peaceful human rights defenders, especially defenders of women’s equality and women’s rights, in Saudi Arabia was “deeply disturbing”.

“Samar Badawi and Nassima Al-Sadah were, according to our sources, arrested on 30 July 2018 and have been held incommunicado since then.”

The prosecutor’s recommendation of the death penalty for Israa al-Ghomgham, reportedly on charges related to participation in protests, is of serious concern.

“These and other arbitrary arrests of peaceful activists for the collective good sharply contradict the spirit of the country’s proclaimed new reforms. We call on the authorities to release all individuals detained for exercising their fundamental freedoms,” she warned, as she singled out more than 45 countries for human rights violations.

The writer can be contacted at thalifdeen@ips.org

Greater Skills Equals Greater Ability to Combat Leprosy

Dr Ken Jetton (left) and Dr Arturo Cunanan (centre) with a patient who has been cured of leprosy in the Majuro leprosy clinic in the capital of the Marshall Islands. The patient is now seeking further help due to post-treatment complexities. Credit: Stella Paul/IPS

By Stella Paul
MAJURO, Apr 4 2019 – It’s a Friday morning and Dr. Ken Jetton, the only doctor who treats leprosy in Majuro, the capital of the Marshall Islands, is seeing a patient recently cured of the disease.
David, 32, has received multidrug therapy (MDT) treatment for a year already. But he is back in the doctor’s office because of a reversal reaction that has occurred.

David, who asks to be referred to only by his first name to protect his privacy, has a stiffness in his fingers. A carpenter by profession, the stiffness is causing David greater financial loss than leprosy did as he cannot hold the tools of his trade in his hand any longer.

“This is the kind of patient I typically attend to…people who have been cured of leprosy, but have physical disability due to reversal reaction to the treatment,” Jetton tells IPS.

According to authors Francisco Vega-Lopez and Sara Ritchie in ‘Manson’s Tropical Infectious Diseases’, reversal reaction is one of two distinct reactions that occur after becoming infected by the bacterium that causes Hansen’s disease, also known as leprosy.

“Reversal reactions may cause acute inflammation causing rapid loss of nerve function and require prompt initiation of treatment with oral steroids,” the authors note. They also note that this reaction can occur before, during or after treatment.

Dr. Arturo Cunanan, a world expert on Hansen’s disease, tells IPS that almost everyone shows some symptom of reversal reaction. However, the degree to which it presents varies from person to person. Those who are diagnosed and treated late have more visible signs of disability than those who were diagnosed and began treatment early.

Resource crunch limiting services
But Jetton tells IPS that he is restricted by a lack of resources and unable to reach out to other patients who, like David, need his services as a doctor.

“It is at this stage that they need me even more because they are puzzled by this [disability] and they also suffer financially. But I cannot see all of them, especially those living in the outer islands,” Jetton explains.
The physician is based in Majuro, the capital of the island nation. But Marshall Islands has 28 other atolls, where there are many active cases of leprosy reported.

But while some of these islands are a short boat ride away, the others are not so easily reachable.
“There is a car for our office use but I do not get an allowance to buy petrol for the car. Who will pay for the boat and the visits to the outer islands?” Jetton asks.

The resource crunch seems a direct result of the decreasing budgetary allocation for health in the country’s five-year funding plans. According to government records, in 2016 the Department of Health was allocated just over 25,000 dollars for its budget. However, this year the amount was 23,000 dollars.

Even for a tiny nation like the Marshall Islands, which has a population of just over 53,000, the health budget is considered small.
There are reportedly 65 healthcare centres across the various atolls. And according to Jetton there are only a handful of staff managing these.

While MDT is provided free by Novartis, through the World Health Organisation (WHO), there are no funds to staff a leprosy centre outside of Majuro. And the country records some 75 new cases of Hansen’s disease each year.

Dr. Ken Jetton, is the only doctor who treats leprosy in Majuro, the capital of the Marshall Islands. Credit: Stella Paul/IPS

New leadership, new approach
The constraints of working with an inadequate budget goes beyond fuel allowances, Jack Niedenthal, the Secretary of Health and Human Services in the Department of Health, tells IPS.
The biggest challenges of the department, says Niedenthal who took over the post early this year, are the lack of skills, capacity and infrastructure required to fight endemic diseases in the island nation.

“All the staff here are underpaid and overworked. They need skill-building training, and we need infrastructure, including new facilities to detect, diagnose and treat,” Niedenthal is heard saying during a meeting with a team from the Sasakawa Health Foundation led by its CEO, Takahiro Nanri.

There are several areas where the staff would benefit from further training. Data and record keeping is one of them, points out the secretary before making an appeal to international experts.
“Instead of inviting us abroad, visit us here and train our staff right here,” says Niedenthal. He was formerly the Secretary General of the country’s Red Cross Society and has a strong human rights approach to health.

Addressing the right audience
Niedenthal’s appeal could potentially bring some positive changes as Yohei Sasakawa, WHO Goodwill Ambassador for Leprosy Elimination, and chair of the Nippon Foundation, the parent body to the Sasakawa Health Foundation, is expected to visit Marshall Islands later this month.

Sasakawa, who is also Japan’s Ambassador for the Human Rights of People Affected by leprosy, and recent recipient of the Gandhi Peace Prize, is keen to understand the situation of combatting leprosy in the country and wants to extend his support to both those providing healthcare as well as those affected by leprosy here.

Jetton is positive that with the help of the foundation they will be able to improve their services to leprosy patients.
In the meantime he prescribes prednisolone, a drug generally used to treat reversal reactions, to David.

Freshwater Canada’s Dirty Water Secret

Water jugs in the community water center in Grassy Narrows, Canada. April 13, 2016. © 2016 Human Rights Watch

Water jugs in the community water center in Grassy Narrows, Canada. April 13, 2016. © 2016 Human Rights Watch

By Marcos Orellana
WASHINGTON DC, Apr 4 2019 – While residents across Prince Rupert, British Columbia are once again able to get safe drinking water from their taps, the boil-water advisory lifted there in late January should not be forgotten. Canada is a freshwater-rich country, but the time for complacency on essential water issues has long passed. Most people living in Canada have access to safe water. But drinking water advisories in the country about unsafe water have been concentrated in First Nation communities.

As of December 31,  there were six “boil-water advisories” and three “do not consume advisories” affecting eight First Nations Indigenous communities in British Columbia.

The Prince Rupert boil-advisory responded to an increase in the levels of cryptosporidium and giardia, two parasites that cause intestinal health problems. The contamination is thought to have been brought on by the combination of a severe drought in British Columbia during the summer and a large storm surge that soon followed.

Similar environmental and health problems can be expected to recur.  According to the Intergovernmental Panel on Climate Change, the onslaught of extreme weather patterns caused by intensifying climate change will only continue. The water crisis in Prince Rupert lasted for nearly six weeks and left 12,000 people without drinking water, according to CBC News. It has overwhelmingly affected Indigenous communities.

Tom Kertes, a volunteer organizer with Community for Clean Water–a grassroots organization in Prince Rupert  —  told CBC, “The city almost treated it like an inconvenience. Clean water is not about convenience or inconvenience. It’s about life and death and access to clean water is a human right.”

In June 2016, Human Rights Watch published a 92-page report that found that the Canadian government had failed to meet a range of international human rights obligations toward First Nations  people and communities in Ontario by failing to remedy the severe water crisis.

 

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A child in Grassy Narrows First Nation, Ontario, Canada brushes her teeth with bottled water. Water on First Nations reserves is contaminated, inadequately treated or hard to access. April 14, 2016. © 2016 Human Rights Watch

A child in Grassy Narrows First Nation, Ontario, Canada brushes her teeth with bottled water. Water on First Nations reserves is contaminated, inadequately treated or hard to access. April 14, 2016. © 2016 Human Rights Watch

 

We found that the water crisis in First Nations communities in Ontario has persisted for decades. A primary contributor to the problem is the legal discrimination that exists related to the regulation and protection of drinking water for First Nations reserves.

Access to water is a human right under international law, and Canada’s Constitution Act of 1982 provides for “essential public services of reasonable quality.” This means that the authorities have an obligation—as well as a moral imperative—to uphold this right.

Provincial and territorial regulations governing safe drinking water and sanitation, which operate to protect the health of most Canadian residents, do not extend to First Nations reserves. Other factors compounding the problem include insufficient and unpredictable funding, tainted source water, and lack of capacity and support for water system operators. As a result, water on many First Nations reserves is not safe.

In 1976, Canada became a party to the International Covenant on Economic, Social and Cultural Rights. In 2016, the UN Committee that monitors compliance with the treaty expressed concern about “the restricted access to safe drinking water and to sanitation by the First Nations as well as the lack of water regulations for the First Nations living on reserves.”

The Canadian government has taken measures to address the water crisis in First Nations reserves. In 2018, the Federal government began direct engagement with the Assembly of First Nations to repeal and replace flawed drinking water legislation passed in 2013. Funding to address the problems has increased since our Ontario report was issued, with the 2018 budget including an additional $173 million. In Ontario, 26 advisories were lifted in 14 communities as of mid-2018.

But as of February 4, 2019, there were 62 long-term drinking advisories throughout Canada. The Neskantaga First Nation in Northern Ontario, for example, has had a water boil advisory in place for the last 23 years.

Access to water is a human right under international law, and  Canada’s Constitution Act of 1982 provides for “essential public services of reasonable quality.” This means that the authorities have an obligation—as well as a moral imperative—to uphold this right. It also empowers people to demand that their governments take concrete and deliberate steps to ensure access to safe and affordable water for the population.

Canada still needs to do more to secure the right to water for all of its people and to  live up to its commitments to First Nations communities.

The right to safe drinking water is indispensable to a healthy life.  Putting out a water advisory alerts residents to the problem, but doesn’t do anything to solve it. The federal government should be working closely with First Nation communities to ensure that money allotted for water improvement is used efficiently and that sustainable solutions are created. The provincial government can help by engaging indigenous communities and advocating for their right to clean water.

The Canadian government still has a lot of work to do, but it is critically important for the health of indigenous people to get the job done.