Archive for the ‘Poverty’ Category

At least 245 million women around the world have been widowed and more than 115 million of them live in devastating poverty, according to a new study launched Tuesday night by Cherie Blair, wife of the former British prime minister.

The most dire consequences are faced by 2 million Afghan widows and at least 740,000 Iraqi widows who lost their husbands as a result of the ongoing conflicts; by widows and their children evicted from their family homes in sub-Saharan Africa; by elderly widows caring for grandchildren orphaned by the HIV/AIDS crisis, and by child widows aged 7 to 17 in developing countries, the report said.

“Across the world, widows suffer dreadful discrimination and abuse,” Blair said. “In too many cases they’re pushed to the very margins of society, trapped in poverty and left vulnerable to abuse and exploitation.”

She said many are cheated out of their husbands’ assets and property and expelled from their family home — and since they have no money they can’t support their children, “so misery is heaped on grief.”

Blair was in New York to launch the report entitled “Invisible Forgotten Sufferers: The Plight of Widows around the World,” commissioned by the Loomba Foundation which works in a dozen countries to help widows and educate their children.

“The plight of widows — in the shadows of the world — is a human rights catastrophe,” said Blair, the foundation’s president. “It’s really a hidden humanitarian crisis.”

She said the foundation had been working on the basis that there were about 100 million widows but decided to do a study from published sources to get a more accurate figure. She said the foundation was surprised to discover there were at least 245 million widows worldwide, almost half living in poverty.

The report stressed that persecution against widows and their children is not limited to the developing world, noting that large numbers of widows are also found in Europe and Central Asia.

According to the report, the countries with the highest number of widows in 2010 were China with 43 million, India with 42.4 million, the United States with 13.6 million, Indonesia with 9.4 million, Japan with 7.4 million, Russia with 7.1 million, Brazil with 5.6 million, Germany with 5.1 million, and Bangladesh and Vietnam with about 4.7 million each.

Blair said women become widows when their husbands are killed in conflicts, die of diseases including HIV/AIDS, or are killed because they work in dangerous conditions, the only jobs available to many poor men.

When their husbands die, she said, some women are required to be “cleansed,” some are erroneously accused of murder or witchcraft, some are required to marry another member of the family, many are disinherited and forced out of their homes and many are raped.

According to the report, over 500 million dependent and adult children of widows are caught in a vicious underworld in which disease, forced servitude, homelessness and violence are rampant and youngsters are denied schooling, enslaved or preyed upon by human traffickers.

The foundation was established in 1997 by Raj and Veena Loomba in honor of Loomba’s mother, who was widowed at the age of 37 in India when her husband died of tuberculosis and raised her seven children by herself.

“There are few resources in the world available to help widows achieve a safer, more comfortable existence and to promote their equality and pursue justice on their behalf,” Loomba said.

He said that’s why the foundation is campaigning to put the plight of the world’s widows on the U.N. agenda and to have June 23 — his mother’s birthday — declared International Widows Day to raise awareness of the crisis.

The United Nations has launched a major campaign for universal adoption of treaty protocols that outlaw the sale of children, child prostitution and pornography, and protect youngsters in armed conflict, with UN Secretary-general Ban Ki-moon calling for full ratification by 2012.

“The sad truth is that too many children in today’s world suffer appalling abuse,” Ban told a ceremony at the headquarters of the UN Children’s Fund (UNICEF) in New York marking the 10th anniversary of the adoption of the two optional protocols strengthening the Convention on the Rights of the Child by providing a moral and legal shield for youngsters vulnerable to prostitution and pornography or caught up in armed conflict.

“Two-thirds of all Member States have endorsed these instruments. On this tenth anniversary of their adoption, I urge all countries to ratify them within the next two years,” he said.

Ban cited recent advances: the release three months ago by the Maoist army in Nepal, under UN supervision, of more than 2,000 soldiers who had been recruited as children; the UN-assisted freeing of children from the ranks of armed groups In Cote d’ Ivoire; the prosecution by the International Criminal Court (ICC) of former Congolese militia leader Thomas Lubanga for war crimes against children.

He noted, too, that fewer and fewer States now permit children to join the armed forces, and reiterated his previous calls to the Security Council to consider tough measures on those States and insurgent groups that still recruit children.

More countries are also reforming legislation and criminalizing the sale of children, child prostitution, child pornography and the sexual exploitation of children, with international cooperation helping to dismantle pedophile networks, remove child pornography from the Internet, and protect children from sexual exploitation by tourists.

“Nonetheless, much remains to be done,” he said. “In too many places, children are seen as commodities, in too many instances they are treated as criminals instead of being protected as victims, and there are too many conflicts where children are used as soldiers, spies or human shields.”

UNICEF Executive Director Anthony Lake said the Optional Protocols “represent a promise made to the world’s most vulnerable children — children born into extreme poverty and despair, children in countries torn apart by conflict and children forced into unimaginable servitude by adults who regard them as commodities.”

The Optional Protocol on the Involvement of Children in Armed Conflict has been ratified by 132 States; 25 States have signed but not ratified it and 36 States have neither signed nor ratified it. “We know from the situation on the ground that much remains to be done. Violence against children in all its forms remains a challenge for societies in the world,” Ban’s Special Representative for Children and Armed Conflict Radhika Coomaraswamy said.

“There are a multitude of conflicts where children are used as soldiers, spies, human shields or for sexual purposes. Every additional ratification of the Optional Protocol would therefore bring us closer to a world in which no child is participating in hostilities and forced to serve the national military or irregular armies,” she said.

The Optional Protocol on the Sale of Children, Child Prostitution and Child Pornography has been ratified by 137 States; 27 have signed but not ratified and 29 have neither signed nor ratified it.

“The Optional Protocol is an important tool for tearing through the mantle of invisibility surrounding the sale of children, child prostitution, child pornography and other forms of sexual exploitation, to mobilize societies and to translate political commitment into effective protection of children from all forms of violence,” Ban’s Special Representative on Violence against Children Marta Santos Pais said, citing significant law reforms to criminalize such crimes.

The proportion of abortion patients who were poor increased by almost 60%—from 27% in 2000 to 42% in 2008, according to “Characteristics of U.S. Abortion Patients, 2008,” by Rachel K. Jones, Lawrence B. Finer and Susheela Singh of the Guttmacher Institute. This shift is the most striking change in the profile of women obtaining abortions.

The growing concentration of abortion among women with incomes below the federal poverty line likely reflects a combination of factors. Between 2000 and 2008, the proportion of women in the overall population who were poor increased by 25%. And a Guttmacher study published in the Fall of 2009 showed that the deep economic recession may also have played a role, as financial concerns led more women to want to delay childbearing or limit the number of children they have. Meanwhile, abortion service providers and nonprofit abortion funds across the country have sought to meet the growing need among poor and low-income women by providing services on sliding fee scales and by subsidizing abortion services through charitable donations, which may have allowed some poor women to access services they might not have otherwise been able to afford.

“Gaps in unintended pregnancy and abortion between poor and more affluent women have been increasing since the mid-1990s, so—sadly—none of this comes as a surprise,” says Sharon L. Camp, president and CEO of the Guttmacher Institute. “Reproductive health disparities, and health disparities more generally, are endemic in this country and stem from broader, persistent economic and social inequities. We need to bridge these reproductive health gaps by ensuring that all women, regardless of their economic circumstances, have meaningful access to the full spectrum of information and services—both contraceptive services to reduce levels of unintended pregnancy and abortion services.”

Aside from poverty, little changed in the profile of women obtaining abortions between 2000 and 2008. A broad cross section of U.S. women have abortions: Fifty-eight percent of abortion patients in 2008 were in their 20s; 45% were never-married and not living with a partner; 61% were already mothers; 42% were living below the federal poverty line; 36% were white; 59% had at least some college education; and 73% were religiously affiliated. But certain groups of women—those who were in their 20s, cohabiting, black or poor—were overrepresented among abortion patients.

For the first time, the survey on which this report is based asked abortion patients about their health insurance status and how they paid for abortion services. Results showed that these women were fairly evenly divided among those with private insurance (30%), those with no insurance (33%) and those covered by Medicaid (31%). Although a majority had some type of public or private health insurance, it is not clear how many of those plans actually included abortion coverage or had a high deductible that discouraged its use for coverage of abortion.

Fifty-seven percent of all women obtaining abortions reported that they paid out of pocket for the procedure, while 12% used private insurance. (Among those with private insurance, nearly two-thirds paid out of pocket, and about one-third used their insurance.) Twenty percent of women relied on Medicaid; almost all of these women lived in the few states that use their own funds to pay for abortions. Among women on Medicaid who lived in states that use their own funds to pay for abortions, more than nine in 10 relied on this method to pay for their abortion. Some 13% of abortion patients relied on financial assistance programs to cover at least some of the cost of the procedure.

This report is based on a nationally representative survey of women obtaining abortions in the United States. While the data permitted the researchers to calculate the proportion of women obtaining abortions in each socioeconomic category, it did not provide the number or rate of abortions in the United States. The Guttmacher Institute’s Abortion Provider Census is currently in the field; results of that survey will provide information needed for calculating abortion numbers and rates in 2011.


Click here for “Characteristics of U.S. Abortion Patients, 2008,” by Rachel K. Jones, Lawrence B. Finer and Susheela Singh.

Click here for Facts on Induced Abortion in the United States.

Amnesty International has urged the Ugandan authorities to provide support for women seeking justice for sexual and domestic violence in its new report released today.

The report entitled I Can’t Afford Justice’ – Violence against women in Uganda(pdf) documents the economic and social barriers to justice, including the costs of criminal investigations and discrimination by government officials.

Amnesty’s report shows that violence in Uganda against women and girls remains widespread. It is estimated that two out of every three Ugandan households have experienced domestic violence, with women being four times more likely than men to be targeted for both physical and sexual violence.

The report also highlights that almost one in four women aged 15-49 (24 per cent) reported that their first sexual intercourse was forced against their will, according to the Uganda Demographic and Health Survey – and more than half of these (54 per cent) first suffered sexual violence below the age of 18 with much of this violence and exploitation happening in schools.

Violence is compounded by discrimination on the grounds of ethnicity, sexual orientation, social status, class and age. These multiple forms of discrimination further restrict women’s choices putting them at greater risk of violence making it still harder for them to access justice.

Survivors of violence are often left facing inadequate responses by police; Amnesty explained having to pay for the cost of police transportation to arrest the accused, forensic examination fees and other expenses related to the investigation.

Amnesty’s Senior Director Widney Brown said:

“Women in Uganda have been left with no faith in the justice system.

“The failure of the government to protect and support victims of sexual violence undermines the quest for justice. Lack of government resources and political will mean that perpetrators rarely face justice.”

The report includes several personal accounts highlighting how the police, prosecution service and the courts are under-funded and understaffed. These in turn become obstacles to women accessing justice as the criminal justice system lacks the resources to provide these services to victims.

One woman told Amnesty International:
“When I went to the police station they asked me for money for fuel which I did not have. My husband beat me again but I gave up going to the police because they always ask for money which I don’t have.”

In Uganda, there is no state-run shelter for victims of gender based violence. Women are also turned away from charity-run shelters for lack of space, and legal aid institutions are overwhelmed with cases of gender-based violence.

Meanwhile, attitudes among many government officials in Uganda are pressuring many women to accept mediation and stay in a violent relationship in spite of the danger. As a result, many women are stripped of their rights to be free from violence and to equal protection of the law.

The report also reveals how few systems are in place to protect survivors. Counsellors at a women’s shelter told Amnesty International how a 13-year-old girl who reported years of sexual violence by her father is now facing intimidation from her relatives and fears for her safety. Her case worker believes she is not safe where she is now living.

While the report stresses the need for the Ugandan government to adequately resource the criminal justice system to ensure that perpetrators of violence against women can be brought to justice, it also reveals that the government has not taken some basic measures to make the system work for women.

Many women Amnesty delegates spoke to said they were subjected to humiliating lines of questioning about their private lives and prior sexual conduct by inadequately-trained police and defence lawyers.

The government of Uganda is also falling short of its international obligation to ensure women’s access to justice. As a result, perpetrators escape prosecution and punishment for their crimes.

Widney Brown said:

“The Ugandan government needs to take a hard look at its laws, policies and practices and close the vast chasm between its rhetoric of respect for women’s rights and its abject failure to protect and fulfil those same rights.”

Amnesty is urging the Uganda government to take immediate action to provide survivors of violence against women with legal support and related health, safety and shelter needs.

It should also take steps to prevent violence against women by addressing its root causes by transforming discriminatory attitudes and remove the obstacles impeding women’s access to justice.


Women bear the disproportionate burden of climate change, but have so far been largely overlooked in the debate about how to address problems of rising seas, droughts, melting glaciers and extreme weather, concludes The State of World Population 2009, released today by UNFPA, the United Nations Population Fund.

“Poor women in poor countries are among the hardest hit by climate change, even though they contributed the least to it,” says UNFPA Executive Director Thoraya Ahmed Obaid.

The poor are especially vulnerable to the effects of climate change, and the majority of the 1.5 billion people living on $1 a day or less are women. The poor are more likely to depend on agriculture for a living and therefore risk going hungry or losing their livelihoods when droughts strike, rains become unpredictable and hurricanes move with unprecedented force. The poor tend to live in marginal areas, vulnerable to floods, rising seas and storms.

The report draws attention to populations in low-lying coastal areas that are vulnerable to climate change and calls on governments to plan ahead to strengthen risk reduction, preparedness and management of disasters and address the potential displacement of people.

Research cited in the report shows that women are more likely than men to die in natural disasters — including those related to extreme weather — with this gap most pronounced where incomes are low and status differences between men and women are high.

The State of World Population 2009 argues that the international community’s fight against climate change is more likely to be successful if policies, programmes and treaties take into account the needs, rights and potential of women.

The report shows that investments that empower women and girls — particularly education and health — bolster economic development and reduce poverty and have a beneficial impact on climate. Girls with more education, for example, tend to have smaller and healthier families as adults. Women with access to reproductive health services, including family planning, have lower fertility rates that contribute to slower growth in greenhouse-gas emissions in the long run.

“With the possibility of a climate catastrophe on the horizon, we cannot afford to relegate the world’s 3.4 billion women and girls to the role of victim,” Ms. Obaid says. “Wouldn’t it make more sense to have 3.4 billion agents for change?”

UNFPA, the United Nations Population Fund, is an international development agency that promotes the right of every woman, man and child to enjoy a life of health and equal opportunity. UNFPA supports countries in using population data for policies and programmes to reduce poverty and to ensure that every pregnancy is wanted, every birth is safe, every young person is free of HIV/AIDS, and every girl and woman is treated with dignity and respect.

Also Causes Delays for Many Who Do Obtain the Procedure

Approximately one-fourth of women who would obtain a Medicaid-funded abortion if given the option are instead forced to carry their pregnancy to term when state laws restrict Medicaid funding for abortion, because they lack the money to pay for the procedure themselves. According to a new report, “Restrictions on Medicaid Funding for Abortions: A Literature Review,” by the Guttmacher Institute and Ibis Reproductive Health, Medicaid funding restrictions also delay some women’s abortion by 2–3 weeks, primarily because of difficulties women encounter in raising funds to pay for the procedure.

Currently, 32 states and the District of Columbia allow Medicaid funds to be used for an abortion only in cases of rape and incest, or if the woman’s life is endangered, in accordance with the federal Hyde Amendment; only 17 states have policies to use their own funds to pay for all or most medically necessary abortions. Lacking insurance coverage, some poor women need a considerable amount of time to come up with the money to pay for an abortion, and may have to pull resources from other family necessities, like food or rent, if they are able to find the funds at all. As the cost of the procedure increases with gestation, many poor women become trapped in a vicious cycle of scrambling to raise enough money before the cost—and risk—increase further, while others are left with no recourse but to carry an unwanted pregnancy to term.

“The research literature clearly shows that restricting Medicaid funding for abortion forces many poor women—already at greatest risk of unintended pregnancy—to carry an unwanted pregnancy to term,” says Stanley Henshaw, Guttmacher Institute senior fellow and the study’s lead author. “Antiabortion advocates are using these restrictions in a misguided attempt to reduce the nation’s abortion rate. Instead, we should be focusing on reducing the underlying cause of abortion—unintended pregnancy—by ensuring better access to and use of contraceptives.”

The Hyde Amendment allows federal funding for abortion only in cases of rape, incest or life endangerment. In addition, Congress has enacted legislation essentially banning coverage of abortion for women whose medical insurance is provided by the federal government, including federal employees, military personnel, women in federal prisons and low-income residents of the District of Columbia, which does not have a state funding option. The issue of federal funding goes to the heart of who has access to abortion in the United States and under what circumstances.

“In his recent budget proposal, President Obama had the option of calling on Congress to end the funding restrictions imposed by the federal Hyde Amendment. We are disappointed that he did not do so,” says Heather Boonstra, a Guttmacher senior public policy associate. “It is time for Congress to repeal the Hyde Amendment and restore Medicaid coverage for abortion so that every woman, regardless of her economic circumstances, has the right to decide when and whether to have a child.”

Click here for the full report “Restrictions on Medicaid Funding for Abortions: A Literature Review,” by Stanley K. Henshaw, Theodore J. Joyce, Amanda Dennis, Lawrence B. Finer and Kelly Blanchard.

The Guttmacher Institute – – advances sexual and reproductive health worldwide through research, policy analysis and public education.

A dramatic plunge in international donor funding for family planning is threatening to undermine other humanitarian goals such as fighting poverty and hunger, as well as efforts to counter global warming, according to the UN and other specialists.

An estimated 200 million women lack contraception; the potential surge in the world’s population could well reverse humanitarian gains, experts say.

The largest amount earmarked for family planning since the 1994 International Conference on Population and Development in Cairo was in 1995, with US$723 million committed, remaining above $600 million for all but one year to 1999. The latest estimate, for 2007, is about $338 million.

“That’s a hell of a decline,” UN Population Fund (UNFPA) senior demographer Stan Bernstein told IRIN. Nor does it take account of inflation, making the drop even sharper in 1994 dollars. The word disaster is “entirely appropriate”, he said, noting that the issue seemed to have been pushed to the backburner by donors and media alike.

Akinrinola Bankole, director of international research at the US-based Guttmacher Institute, an NGO focused on reproductive health research and policy analysis, said: “Unless there is a renewed attention on population and funding for family planning, high fertility, especially in sub-Saharan Africa, in spite of desires for smaller families and high unmet need for contraception will aggravate the negative consequences, some of which are already horrendous.”

UNFPA executive director Thoraya A Obaid is calling for an increase in funding regardless of the financial crisis. “We have to protect the gains made and ensure that these gains do not slip back as more and more people are slipping back to poverty.”

In an effort to push the issue up the development agenda ahead of World Population Day on 11 July, UNFPA convened 30 leading family planning experts in New York at the end of June, including representatives from Bangladesh, Colombia, Guatemala, Kenya, India, Senegal, Tanzania, Uganda, the UK and USA.

“In one sense the issue is a victim of its own success,” Carmen Barroso, western hemisphere director at the International Planned Parenthood Federation, told IRIN, adding that “enormous progress in certain countries, regions, and segments of the population” had blinded people to the problems in other regions where the poor continue to be neglected.

“This is like declaring the marathon is over when the fastest runners have crossed the finishing line; people don’t appreciate the level of unmet demand in poorer countries,” Bernstein said, citing Kenya and Pakistan as examples of countries where fertility rates that had been falling are now stalled.

“There are a growing number of countries where there has not been the progress that there was in the past and some of that was because the expectation was that things were on the right track and so you could start putting money elsewhere,” he said.

“The difficulty of course is that every year more young women are ageing into their reproductive years and they would not have heard information campaigns that were done 10 years ago… It used to be that when you arrived in a developing country you would see billboards or hear radio spots advocating family planning; now all you see are HIV/AIDS billboards. That’s where all the money went.”

Bankole also said a decline in fertility in regions other than sub-Saharan Africa had nurtured the belief that a decline in all regions was inevitable.

“The issue of family planning has been demonized by the extreme conservatives who have [made] it … a taboo issue,” Barroso said.

Bernstein cited the link some people made between family planning and abortion. “And they are linked,” he added. “The link is family planning services reduce recourse to abortion, it’s as simple as that, but some people put family planning and abortion in the same category of wrong choices.”

He also noted that reproductive health in general and family planning in particular were not originally in the Millennium Development Goals because reproductive health and issues about women’s rights were felt to be too controversial. Universal access to family planning by 2015 is now included under the MDG of improved maternal health, but its absence at the start slowed things down, he added.

Finally there is the fatigue resulting from the very long-standing persistence of the issue. “There’s a little bit of ‘this is an old story, didn’t we talk about population growth and its impact in the 70s and the 80s,’ and it sort of doesn’t have the grab of the new,” Bernstein said. “It’s not that there have been that many new contraceptive technologies invented since; it’s always the new thing, the new invention that gets attention.”

A recent meeting in London on climate change and population noted that while the links were complex, population growth was clearly one of the drivers, particularly on a local scale, with regard to such issues as deforestation and water sustainability.

“It’s not a very simple relationship but it’s certainly one of the important factors in climate change,” Barroso said.

As with most such issues, it is the poor, especially in Africa, who bear the brunt of the funding shortfall.

“Many African countries are going to double or even triple in size between now and mid-century. And that I think poses huge problems for development. We need to debate population issues openly and honestly in a way that we haven’t been prepared to do in the last 10 to 15 years,” John Cleland, professor of demography at the London School of Hygiene & Tropical Medicine, told a news conference in June.

Obaid agreed: “I would like to stress that investments in women and reproductive health are not only decisive for overcoming poverty, managing the speed of population growth and achieving the MDGs; they are also cost-effective,” she told IRIN.

“An investment in contraceptive services can be recouped four times over – and sometimes dramatically more over the long term – by reducing the need for public spending on health, education, housing, sanitation and other social services.”

She called on decision-makers, now more than ever, to increase resources for family planning. “I do not think that any of the crises we are facing today – whether it is the food crisis, the water crisis, the financial crisis or the crisis of climate change – can be managed unless greater attention is paid to population issues,” she said.

Growing numbers of children in Zimbabwe are turning to prostitution to survive, the charity Save the Children says.

The aid agency says increasing poverty is leading girls as young as 12 to sell their bodies for as little as a packet of biscuits.

It also claims that the coming football World Cup in neighbouring South Africa could soon make things worse.

Unemployment in Zimbabwe is thought to top 90% and many cannot afford to pay for food, medical care or school fees.

The deputy head teacher of a large school with 1,500 pupils east of Victoria Falls told the BBC that hundreds of her female students are now selling their bodies for whatever they can get.

“It could be books, it could be biscuits, chips, some even just to be given a hug.”

Many Zimbabwean children face terrible risks as part of their everyday lives

Throughout my conversation with the deputy head, two small teenage girls in threadbare school uniforms sat watching from a brick wall by the playground. Both are orphans.

The older one, who is 14, said she knows many girls here who have become prostitutes.

“I don’t want to do that but life is so difficult, so very difficult. Both my parents are dead and I rarely see my two sisters. Recently I stood by the river and I thought about throwing myself in but I didn’t. I don’t know why.”

There is also evidence that many girls are being targeted by child traffickers, Save the Children’s country director Rachel Pounds says.

They are thought to have plans to send young Zimbabwean girls to South Africa to work as prostitutes during next year’s football World Cup finals.

See also: Children exchange sex for money in Côte d’Ivoire

Shabnam had dreamed of owning a home for years, but with few prospects for her husband, she followed the lead of many poor women in her town in western India: she signed up to carry a baby for another couple.

At the clinic of Nayna Patel, perhaps India’s best-known “surrogate doctor” who delivered Anand town’s first surrogate baby, more women are signing up to be surrogates, with even nurses and teachers lining up, as their husbands lose their jobs.

“The women who come here usually want the money to buy a home, pay off loans, or for their childrens’ college education,” said Patel in her small clinic, the walls of which are covered With clippings and pictures of Patel with babies and parents.

A surrogate is generally paid about 250,000-400,000 rupees ($4,000-$8,000), a huge sum of money in a country where many live on less than $2 a day.

Doctors with a western education, top-notch facilities and lower prices have already made India an attractive destination for procedures ranging from bypass surgery to liposuction.

Lax legislation and an entrepreneurial streak in Gujarat state have helped make Anand a last stop for many childless couples at home and abroad, after its first surrogate baby five years ago.

In this bustling town known for India’s best-known brand of butter, Patel has delivered more than 100 surrogate babies, 40 percent for Indians living abroad and 20 percent for foreigners.

It all began with a grandmother surrogate for a UK couple five years ago that pitched Anand and Patel into the spotlight.

Following their lead, locals and foreigners began to flock to Patel’s clinic, drawn by the lower costs, relaxed attitude toward surrogates and lack of legislation.

A draft bill on surrogacy is pending before parliament, and meanwhile, hundreds of clinics have mushroomed across the country, with critics saying touts promoting this “reproductive tourism” care little for the health or rights of the surrogates.

Patel, who was featured on a special show on Oprah Winfrey two years ago, raises her voice in defence.

“My argument is: the surrogate is not killing anyone, not committing an illegal or immoral act. And if a surrogate’s child is able to get an education, if one family is able to buy a home — and help a needy couple in the process, where is the harm?”

Not everyone sees it that way.

Patel and the couples, more than half of whom are either non-resident Indians or foreigners, have come under a barrage of criticism for “exploiting” surrogates and for glossing over the ethical debate.

Many surrogates themselves do not tell their parents or in-laws for fear of being ostracised, and several of Patel’s surrogates live in a Surrogate House to ensure they have a proper diet, and are safe from drunken husbands and nosey neighbours.

Shabnam, 26, has not told her two older daughters or her in-laws that she is a surrogate; she lives with a few other surrogates at the hospital with her youngest child, while her husband, who is out of work, cares for the two others at home.

“I don’t think I can ever tell them; I don’t think they’ll understand,” she said, insisting on using just one name. Her husband used to earn less than $1 a day washing dishes.

Some experts say surrogates, who are often barely literate, do not understand all that the process entails, and are putting themselves at physical and emotional risk but have few rights.

“The primary concern is the physical and mental health of the surrogate: there are several risks, including maternal mortality, associated with assisted reproductive technologies,” said Preeti Nayak at Sama Resource Group for Women and Health.

India’s maternal mortality ratio is 301 in 100,000 births, the highest in south Asia after Bangladesh, the World Bank says.

For Chris McDaniel and his wife Shannon, who came to Anand last April from San Diego after having tried every option in the United States, where hiring a surrogate can take months and cost up to $100,000, the decision to go to Patel was clear.

“It wasn’t in our life plan to fly half-way around the world to a country we barely knew about to have our child,” said Chris, who is writing a book on their experience.

It is hard to come by numbers of surrogates in the country, but Patel has a list of nearly 200 and is seeing more women walk in everyday because they are feeling the pinch of the slowdown.

In the absence of legislation, Patel sticks to guidelines of apex body Indian Council of Medical Research, which say a surrogate may only be implanted with the egg and sperm of the couple or anonymous donors, and that she must be below 45 years.

Patel also insists couples seeking surrogates must have a medical condition that makes child bearing impossible or risky, and draws the line at gay couples and single parents.

The surrogate, who must have her husband’s consent, has no rights over the baby, but feels empowered nevertheless, she said. “Until then, they have felt powerless, helpless; now, they feel like they can be of some use to their family,” she said.

Shabnam’s ambition is far more modest.

“I was very scared thinking of our situation, thinking how will we manage?” said Shabnam, who is eight months pregnant with the baby of an Indian couple living in the United States. Now I feel a bit more confident. At least if we can buy a house, then things will get better.” ($1 = 50 rupees)

UNICEF’s 2009 Humanitarian Action Report (HAR) highlights the plight of children and women around the globe in humanitarian emergencies.

The Humanitarian Action Report is UNICEF’s annual funding appeal for protracted emergencies and is seeking just over $1 billion to assist children and women in 36 countries. The amount sought is some 17 per cent higher than UNICEF’s 2008 appeal, largely because of increased needs in eastern and southern Africa.

“Many countries featured in the report are silent or forgotten emergencies,” said UNICEF Executive Director, Ann M. Veneman. “Women and children are dying every day due to disease, poverty and hunger, but sadly their deaths go largely unnoticed.”

The report notes that over half the funds are to continue UNICEF support to victims of the five largest global humanitarian operations: in the Democratic Republic of Congo, Somalia, Sudan, Uganda and Zimbabwe.

“I have recently returned from Zimbabwe where the economy is crumbling and the cholera outbreak is not yet controlled,” said Veneman, the first head of a UN agency to visit the country in over two years. “Over half the population is receiving food aid and basic social services are collapsing.”

In recent decades, the number and severity of natural disasters has increased significantly. The emergencies included in the Humanitarian Action Report represent only a small fraction of UNICEF’s emergency response activities. Between 2005 and 2007, UNICEF responded to an annual average of 276 emergencies in 92 countries. Over 50 per cent were caused by disasters, 30 per cent were a result of conflict, and health-related emergencies, like epidemics, accounted for 19 per cent of UNICEF’s emergency response.

The report also notes that higher food prices and climate change have negatively affected most of the countries for which emergency aid is sought. UNICEF has initiatives in place to address nutrition insecurity, but more resources are required to ensure the response meets urgent 2009 needs.

The UNICEF report cites recent studies which find the risk of hunger could increase for some 50 million people worldwide by 2010 as a result of climate change.

Some experts have estimated that in the next decade children and women will represent 65 per cent of all those affected by climate-related disasters. If these predictions prove correct, some 175 million victims of climate change will be children.

UNICEF is present in more than 150 countries and is often among the first responders to crises.

“These funds will help UNICEF respond effectively and efficiently to the needs of children affected by emergencies,” said Veneman. “As a result the lives of many will be saved.”


UNICEF is on the ground in over 150 countries and territories to help children survive and thrive, from early childhood through adolescence. The world’s largest provider of vaccines for developing countries, UNICEF supports child health and nutrition, good water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is funded entirely by the voluntary contributions of individuals, businesses, foundations and governments.

Child marriage and a lack of access to school are the norm for millions of girls around the world. In northwest Afghanistan, where the strains of a record drought and food crisis mix with traditions that harm girls and women, the challenges are particularly harsh.

A new multimedia presentations from the Christian humanitarian agency World Vision focus on the impact of the crises in Afghanistan, commemorating the International Day for the Elimination of Violence Against Women on Nov. 25. The audio-visual presentations on “Being an Afghan Girl” include the following:

* “Child Brides” features a family that has recently sold an 11-year-old daughter into marriage. She is their third young daughter to be given as a bride so they can pay off debts and buy food as they have slid from being subsistence farmers to homeless refugees, to near-destitute. See:

* “Where Education Can Kill You” profiles a brave father and daughter who risk death by secretly schooling girls in a region where education is off limits to females. Shackled by illiteracy, many girls are subject to traditions that often have them married and mothers before their mid-teens. See:

* “Before She’s Ready: 15 Places Girls Marry by Age 15” is a briefing paper that gives an overview of the causes and devastating consequences of early marriage, and examples of intervention approaches from various countries and regions. See:

Last year, 57 percent of Afghan girls were married before the legal age of 16, a trend exacerbated by a lack of food and resources. Afghanistan’s fiercest winter in 40 years killed 100,000 head of livestock last season, and skyrocketing grain prices have left farmers unable to feed their livestock and families. In a region hammered by these events, pre-teen daughters have become the means for subsistence farmers to buy themselves out of complete financial ruin.

Similar situations also exist in other countries, with 51 million girls in the developing world already married before the age of 18, and where another 21,000 underage girls marry each day.

World Vision’s related work in Afghanistan includes food-for-education programmes that help feed families and provide an incentive to keep girls in school; agricultural training and resources; and support of Herat Regional Hospital and health programmes for women including a project that trains midwives for village practice, emphasizing the importance of regular check-ups during pregnancy and the benefits of later marriage.

At the gates of one of Kenya’s export processing zones (EPZs) men and women push and shove each other, trying to get their national identity cards taken by the guards.

Having one’s card taken increases the chances of being employed that day as a casual labourer at one of the factories set up to boost the country’s export capacity. Men often bribe guards and managers to get jobs, but sex is the preferred inducement for women.

“Let me be honest with you, for us women, and especially young ones like us, it is difficult to get a job here without having sex with the bosses,” said Rosaline Muendo*, who has worked as a seamstress in an EPZ for the past three years.

Jacqueline Adhiambo*, another casual labourer at the EPZ, says her manager is also her boyfriend. “The person who is recruiting you is not the same person who will be supervising you or renewing your contract,” she said. “You have to please all these people and they just want to sleep with you.”

According to a 2007 Kenya human rights and business country risk assessment (, more than 90 percent of female export processing zone workers have experienced or observed sexual abuse at their workplace. More than 40,000 people are employed in over 40 EPZs, which produce around 10 percent of the nation’s exports.

Concerns about possible HIV infection are less important than the desperate need for money to feed families. “The power to use a condom or not lies with the man,” said Doris Mwende*, 23, who has worked at an EPZ company for two years. “You ask a man to use a condom and he tells you that you are too young to infect him.”

David Kisilu*, a recruitment supervisor at an EPZ company for over five years, admitted that sex for work was common but difficult to regulate because of its “willing seller, willing buyer” nature.

“These things happen, but management does not know where the deals are hatched,” he said. “People meet outside, maybe after work, and get into these deals, and the next morning they just come and get in to start working.”

According to Collins Ajuoga, a human resources manager working in the EPZ, most companies are aware of the rampant sexual harassment but are powerless to intervene unless the victims complain, which rarely happens.

“We have a very clear policy on sexual harassment, but nobody is willing to come forward,” he said. “They feel they will be victimised when that is really not the case; we even have suggestion box where people can report such cases [anonymously], but it has not been successful.”

Elsa Anyango, a single mother of two, does not believe Ajuoga’s claim that there would be no repercussions for workers. “Fine, so somebody comes and tells you that you should report sexual harassment; you weigh [the choice] between reporting and giving in [to sex] to get a job,” she told IRIN/PlusNews. “Most of us will go for the sex option.”

According to officials at the Central Organisation of Trade Unions (COTU), the EPZ workers are in a poor position to raise issues such as sexual harassment and better working conditions because they are not unionised.

“Getting these workers to join a union is difficult because the managers at EPZ companies use non-registered organisations to recruit casuals on their behalf,” said Erick Omino, a representative of the Kenya Textile Workers Federation at COTU. “When you approach them on the fate of these workers, they say you should talk to those who bring them in.”

EPZ employees say they work in harsh conditions, and are often subjected to physical and verbal abuse from managers. The 2007 assessment found that women in the EPZs often lost jobs for falling pregnant;

“The export processing zones are notorious for repressing trade union communications and events,” the assessment report stated. “Workers in such zones are routinely and systematically exploited in the areas of work hours, rest periods, production quotas, employment contracts, union representation and health and safety.”

*Not their real names

Poverty has led indigenous women, particularly B’laan women from various towns in Sarangani, to turn to prostitution.

The tribeswomen, aged 15 to 18, work in different beer gardens, fun houses, nightclubs and big hotels in General Santos City.

The women, social workers said, believe that with just 10 to 15 minutes with a “client,” they can immediately earn enough to sustain their family’s needs for a day or even a week depending on the “price.”

B’laan women told the BusinessMirror that years of government neglect has forced them into the oldest profession.

However, not all B’laan women have turned to prostitution.

Many have learned how to use the Internet and have made contact with foreigners who offered marriage to them.

Not all who married foreigners, however, led happy lives because in some instances, the foreigner husbands are the ones who forced the tribeswomen into prostitution.

In some instances, some women who fail to bag a foreigner also join the oldest profession in order to survive.

Sarangani board member Danny Martinez confirmed that many B’laan women have really turned to prostitution to survive.

Most of these women come from Maasim, Kiamba, Malungon, Maitum, Glan, Malapatan and Alabel.

Many of the women go to General Santos City, to ply their trade.

While in the city, the tribeswomen also learn how to use the Internet to make it easy for them to make contact with foreigners, with the hope of getting married.

After her aunt turned her out onto the chaotic streets of Port-au-Prince, capital of Haiti, eight months ago, Marie Jessy*, 16, survived by befriending men who gave her a place to stay for the night and some money the next morning.

“I don’t want to do this kind of work, I want to finish school,” she told IRIN/PlusNews. “But I feel I don’t have anyone; my family can’t help me.” Even if she had finished school, things may not have turned out differently for Marie Jessy, who lives in the poorest country in the Western Hemisphere.

More than 60 percent of Haitians live in poverty on less than US$2 a day, and the unemployment rate is over 30 percent. In the past year they have been struggling to cope with crippling increases in the prices of food and transport, while remittances from family members living overseas have been shrinking; both consequences of global economic trends.

The four consecutive tropical storms that hit the Caribbean island nation in August and September wiped out much of the country’s agricultural sector and cut roads to many cities, pushing living costs even higher.

The resulting food crisis already threatens many HIV-positive people who can no longer afford adequate nutrition, but it may also increase the number of new infections as more desperate young women resort to sex work to survive.

According to the 2008 UNAIDS Epidemic Update, overall HIV prevalence in Haiti has halved in recent years to the current rate of 2.2 percent, but the number of young Haitians having sex before the age of 15 has increased, while condom use among women who had more than one sexual partner in the last 12 months has decreased.

“Women are particularly vulnerable,” noted Steeve Laguerre of Catholic Relief Services, an international non-governmental organisation (NGO) that provides food and other support to people infected and affected by HIV. “We have a lot of cross-generational sex between young girls and older men who can provide for them.”

Marie Jessy is off the streets now and living with her 32-year-old boyfriend. “People ask me if he’s not my father or older brother, but that doesn’t bother me because I need his help,” she said.

The reasons women enter into such relationships were nearly always the same, said Fritz Moise, executive director of the Foundation for Reproductive Health and Family Education (FOSREF), a local NGO that runs drop-in centres for young people and sex workers: “Poverty, misery, and many of them have a child to support.”

FOSREF runs 29 centres around the country: 16 assist youth, while 11 assist sex workers, but according to Moise, there is an increasing overlap between the two.

“The sex business starts at [the age of] 15 or 16. They go to the youth centres, but they won’t admit they’re sex workers,” he said. “They’re the most at risk because the clients are mostly older, married men who think it’s safer to have unprotected sex with a young girl.”

The FOSREF centres, called “Lakay” (Creole for our home), offer counselling and testing for HIV, treatment of other sexually transmitted infections (STIs), and vocational training that aims to give the women an alternative to sex work.

“Our job is easy, because in most places any job will pay more than what they make,” said Moise, who estimated that most sex workers in Port-au-Prince’s downtown area earned less than US$1 per client, and slightly more in Petionville, an affluent suburb in the hills above the city.

Seven years ago, the rate of HIV infection among sex workers in some parts of the capital was as high as 30 percent, but testing figures from FOSREF’s centres now indicate a prevalence of about 6 percent.

Many have died and some have moved out of prostitution, but Moise also attributed the decline to FOSREF’s aggressive promotion of condoms. To participate in the vocational training programmes and benefit from other services the centres offer, the sex workers must commit to a “100 percent condom policy”, which is strictly enforced.

“We use mystery clients who offer extra money to have sex without condoms,” he explained. “If she agrees, she loses access to all opportunities through the programme.”

The policy may seem harsh, but Moise insisted it was effective, although there was no way of ensuring that the women used condoms with their regular boyfriends.

Adele*, 23, got into sex work after she finished school and could find no other way to support herself. Before coming to the FOSREF centre in Carrefour, an impoverished neighbourhood in Port-au-Prince, she knew about condoms but had used them infrequently. Now she always uses them, even with her boyfriend. “I have to protect myself because I don’t know if he protects himself,” she said.

Most people living in Carrefour are unemployed and “living in very precarious conditions”, according to Rose Anne Auguste, who runs a community-based organisation that supports HIV-positive women in the area.

Many of the women depend on male sexual partners for financial support and protection from the sexual violence that is rife in the city’s slums. “If there was socio-economic security for the woman, it wouldn’t be necessary for her to find a boyfriend,” said Auguste. “They have one boyfriend, but the men have several girlfriends at a time.”

Marie Jessy talks wistfully of returning to school, but her hopes for a future that doesn’t involve sex work seem to be more strongly tied to finding “someone special”.

“Most guys outside aren’t good,” she said, picking at some scabs on her arm, the legacy of a recent fight with another girl who attacked her with a broken bottle. “I want someone who will help me.”

*Not their real names