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Human Rights Watch
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A pregnant woman
receives condoms from an NGO medical team working conducting mobile clinics in
the camps around
© 2010 Nadia Todres
"More than a year and half after the earthquake, some women and girls give birth unattended on the muddy floors of tents or trade sex for food without any protection from unwanted pregnancy."
Kenneth Roth, Executive Director of Human Rights Watch
August 30, 2011 - (
The 78-page report, “‘Nobody Remembers Us’:Failure to Protect Women’s and
Girls’ Right to Health and Security in Post-Earthquake Haiti,”
documents the lack of access to reproductive and maternal care in
post-earthquake Haiti, even with unprecedented availability of
free healthcare services. The report also describes how hunger has led women to
trade sex for food and how poor camp conditions exacerbate the impact of sexual
violence because of difficulties accessing post-rape care. It looks at how
recovery efforts have failed to adequately address the needs and rights of
women and girls, particularly their rights to health and security. Haitian
authorities and donors should take concrete steps to improve access to services
and to protect the human rights of these women and girls, Human Rights Watch
said.
“More than a year and half after the earthquake, some women and girls give
birth unattended on the muddy floors of tents or trade sex for food without any
protection from unwanted pregnancy,” said Kenneth
Roth, executive director of Human Rights Watch. “Despite gains made
due to free healthcare services, the government and international donors have
not addressed critical gaps in access to health services or addressed
conditions that may give rise to maternal and infant deaths.”
More than 300,000 women and girls currently live in camps for displaced
persons. Human Rights Watch interviewed more than 100 women and girls ages 14
to 42 in 15 displacement camps who were pregnant or had given birth since the
earthquake.
Some described delivering their babies in tents, in the street, or alleys on
the way to the hospital, or, in one case, on the street corner after a hospital
turned her away for not being able to pay for a Caesarean section.
“I just gave birth on the ground…I had no drugs for pain during delivery,” one
woman told Human Rights Watch.
The January 2010 earthquake caused an estimated 222,000 deaths, injured 300,000
people, and displaced between 1.3 and 1.6 million people. Approximately 300,000
homes and much of the country’s infrastructure were damaged or destroyed,
including 60 percent of hospitals in the affected areas.
Donors pledged $5.3 billion in recovery aid in line with a government-drafted
post-earthquake recovery plan, with $258 million dedicated to health care.
Although only $118.4 million of the health money has been disbursed, $130.6
million more is committed and nearing disbursement.
Aid agencies have worked hard to provide care, but many women and girls
have not benefited, due to lack of information, poor transportation
infrastructure, and unaffordable charges on services not covered by free care.
As a result, women’s basic rights to health and security are being jeopardized,
Human Rights Watch found.
Moreover, lack of coordination and data sharing on the part of donors and
nongovernmental organizations (NGOs) working to provide health services has
made it difficult for human rights monitors, and the government itself, to
assess progress.
Many poor women and girls cannot pay for transportation to facilities providing
free care, Human Rights Watch found. Some stop seeking care if they cannot
afford tests they are told to obtain, such as a sonogram, or because they
think, wrongly, that they cannot return to the hospital without the sonogram.
“With almost $260 million earmarked for health care, no woman should have to
give birth on the street,” Roth said. “Women and girls have a right to
life-saving care, including in adverse circumstances.”
The extreme vulnerability and poverty in the camps has led some women and girls
to form relationships with men for the sake of economic security, or to engage
in transactional or survival sex, such as the exchange of sex for food, Human
Rights Watch found. This transactional sex takes place without adequate access
to contraception and other reproductive health services, increasing the
long-term vulnerability of the women and girls to unplanned pregnancies and
sexually transmitted infections.
The vulnerability of Haitian women and girls to rape was a concern even before
the earthquake. It is an even greater concern in the displacement camps, where
some women’s groups have reported an especially high incidence of rape and
sexual violence.
Emergency contraception and other post-rape care is available in some health
facilities, but many rape victims don’t have access to this care for the same
reasons that women and girls have difficulty accessing other health services:
they lack basic information about what is available and where, or they have difficulty
paying for transportation to reach the services. Some women and girls told
Human Rights Watch they were too scared, ashamed, or traumatized by rape to
seek care in the timeframe necessary for emergency contraception to be
effective.
The government should do a better job of protecting women and girls from
violence, and ensure that they have information on and access to post-rape
care, Human Rights Watch said.
“Attention to human rights should be an essential part of
SELECTED TESTIMONY
Mona
Mona moved to a camp in Delmas 33, a suburb of
Gheslaine
Gheslaine is a single mother of three who lost everything in the earthquake.
She recently gave birth, but has no way to feed her two children and young
infant:
People will try to survive by the way they can. Women have relationships
with men so they can feed their children. That happens a lot. My daughter is 12
and does not have friends in the camps, because it happens that even girls are
pressured to have sex for things. I don't work. I don't have parents to help.
Many times women get pregnant, and they don’t have anyone to take care of them.
So, for US$0.60 or $1.25, you have sex just for that. Unfortunately, women
sometimes get pregnant, but if we had access to planning, we’d protect
ourselves.... It's not good to make prostitution, but what can you do? You have
to eat.
I went one time to the doctor who gave me a prescription. I don't have
money to get the blood test and stool sample. The doctor said to come back, but
he advised me to come back with the test results…. I don't have a mother or
father, I live with an “aunt (her employer),” but she doesn't take care of me
now. Now I live in the camp with someone else, since I was raped.
Yvonne
Yvonne, 30, from a camp in Croix-des-Bouquets, thought she could not give birth
at the same place she visited for prenatal care. She received a prescription
for a sonogram, but could not afford it, so she was scared to go back for
additional check-ups or for delivery.
I went to several different hospitals before I gave birth for check-ups
[because] ... when they asked me to do a sonogram, and I didn't have money to
the sonogram, I changed hospitals…. No one told me that I would have a
difficult birth … [but] I had pain when I went into labor. I arrived at the
hospital at 9, at 10 I had not given birth, and by 11 I had the C-section.