UN: Human Rights Council discusses women's human rights & maternal mortality

The General Assembly had tasked the Council with setting priorities in addressing violence against women as a follow-up to its consideration of the Secretary-General's study on the subject. Millions of women and girls were subjected to desperate and dehumanising conditions on a daily basis, and in many cases with no relief or recourse to justice. In particularly egregious forms, violence, including sexual violence, had been committed and continued to be perpetrated in the midst of conflict and post-conflict societies on a magnitude and level of brutality that defied belief. Whether perpetrated in conflict or in peace, the root causes of violence against women were deep-seated inequalities and discrimination. A concomitant denial of basic rights, such as access to health services, education and water, overwhelmingly affected women.

Peteris Larlis Elferts, Ambassador of Latvia to the Council of Europe and Moderator of the Panel, said violence against women should remain a priority and be at the top of the agenda in order to see how this work could be brought forward. Violence against women encompassed a broad challenge at the national level, crossing all types of legislative and judicial challenges. The task of integrating work on violence against women into the agenda of the Human Rights Council was a high priority, including specifically integrating it in the Universal Periodic Review mechanism.

Pauline Velso, Minister of the General Secretariat of Chile, said violence against women was a major violation of human rights. It was an age old reality, yet it was only a very recent concern for the international community. Violence against women was a scourge. Combating the scourge was complex. In order to address it, the root causes must be examined. It was not sufficient to criminalize the behaviour. It was not enough to provide aid to victims. The State had to have a policy to change norms.

Kathleen Cravero, Assistant Administrator and Director at the United Nations Development Programme, said that in today's wars, modern armies and militia used sexual violence against women as a strategy of war, scarring not only victims, but all who witnessed that brutality; that "scorched-women policy" would destabilize generations to come. Others succumbed to the slow murder of HIV/AIDS. The challenge was threefold. They had to work towards prevention, address impunity and bring redress for victims.

Isabel Martinez Lazaro, Secretary-General of Gender Equality Policies of Spain, said violence affected all women all over the world. Fighting violence against women required a firm and coordinated hand from all States to ensure this work would be continued. The new Government of Spain was committed to combat all forms of discrimination against women. Almost 50 million euros had been committed to fight gender violence in Spain.

Alejandra Sarda, Member of the Network of the Latin American and Caribbean Countries Committees for the Protection of the Rights of Women, said cultural norms formed many of the causes for violence against women. There was a solid set of international systems to define and penalize such behaviour. The Human Rights Council must now move on with further work. She recommended that the Human Rights Council appoint a focal point for violence against women.

Delegations also said that violence against women was one of the most pervasive human rights abuses that persisted in all countries of the world. A lack of leadership, political will and resources to take effective action was noted. The need for a coordinated database was underlined. Also discussed were the need to protect women from rape and sexual abuse in peacetime, wartime and conflict and post conflict situations; harmful traditional practices such as female genital mutilation; enhancing women's participation in decision making issues; and promoting their access to education. It was noted that a comprehensive approach towards empowerment of women remained the most effective instrument to counter violence against women.

In summing up, the Moderator, Mr. Elferts, said that among issues highlighted in the discussion had been the need for legislation, awareness-raising, and attention to victims. Also, the role of men should not be forgotten, and the need to target actions in that regard. The Secretary-General's report had been raised as an essential tool, and the fact that violence against women was part of the Universal Periodic Review process had also been seen as useful. Further, it had been underscored that to establish best practices and formulate the comprehensive approach that was necessary to address violence against women, they needed to gather data. Also essential was the need for the political will and commitment to allocate the necessary financial and human resources.

Speaking in the interactive discussion on violence against women were the delegations of the Maldives, Slovenia on behalf of the European Union, Qatar, Argentina, France, the Netherlands, Mexico, New Zealand and Canada in a joint statement, Norway, Switzerland, India, Pakistan, Brazil, Australia, Algeria, Romania, Sweden and Indonesia in a joint statement, Finland on behalf of the European Union, Egypt, Turkey, South Africa, Republic of Korea, Malaysia, China, the United Nations Population Fund, the Russian Federation, Italy, Sri Lanka, Morocco, the International Organization of the Francophonie, Colombia, Ireland and Tunisia.

Also speaking were representatives of the International Federation of University Women in a joint statement, the Inter-African Committee on Traditional Practices Affecting the Health of women and children in a joint statement, World Young Women's Christian Association in a joint statement, Coalition Against Trafficking in Women, World Organisation Against Torture, the International Indian Treaty Council in a joint statement and Human Rights Watch in a joint statement, the International Women's Rights Action Watch Asia Pacific, the International Network for the Prevention of Elder Abuse, Union de l'Action Feminine, Comite International pour le Respect et l'Application de la Charte Africaine des Droits de l'Homme et des Peuples, Action Internationale pour la Paix et le Developement dans la Region des Grands Lacs and the Canadian HIV/AIDS Legal Network.

In the second panel discussion on maternal mortality and the human rights of women, the Moderator, Francis Songane, Secretariat for the Partnership for Maternal, Newborn, and Child Health, and Former Minister of Health of Mozambique, said giving birth should be a time of joy. For too many women it was a time of death and disability. Many babies died due to poor care at birth, often related to the death of the mother. The life-time risk of death during childbirth or pregnancy was highest in sub-Saharan Africa.

Monir Islam, Director of Making Pregnancy Safer at the World Health Organisation, said that every minute somewhere in this world, a woman was giving her life during pregnancy, childbirth or the post partum period. From country after country analysis it had become clear that rural and poor women were excluded, marginalized and had very little or no access to health services during pregnancy and mostly died or suffered from long term disabilities.

Vincent Fauvau, Senior Maternal Mortality Advisor at the United Nations Population Fund, said that the fifth goal in the Millennium Development Goals set to reduce infant mortality ratio by 75 per cent, which would unlikely be met. Half a million women died each year, and it was unacceptable that a high number of women still died from complications of pregnancy and childbirth when proven interventions existed.

Jashodhara Dasgupta, Coordinator of SAHAYOG, said that despite all the technology, despite the advances in communication and medicine, women still died during child birth. A group of 4,000 rural woman in India had come together to declare that the issue was a violation of their human rights. She outlined a number of actions these Indian women had taken, including learning about the entitlements available to them and getting valuable information. Tackling the problem of maternal mortality meant empowering and educating women.

Paul Hunt, Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, said the right to the highest attainable standard of life demanded that a health system had certain key features. Of course, this right was subjected to resource availability; this was a complication but it was manageable. Millennium Development Goal 5 had not generated as much attention as other Millennium Development Goals, but there was now a proliferation of initiatives and programmes for maternal health. Further, human rights demanded accountability. It seemed that currently, independent accountability was weak.

In the following debate, delegations made comments and raised questions on the promotion of gender equality and that the enjoyment of human rights by women and girls were goals in their own right. How could it be guaranteed that women and men had access to the information, education and services needed to achieve good sexual health and exercise their reproductive rights and responsibilities? The issue of violence against women had many dimensions. A comprehensive approach was important to deal with the issue in all its complexity. Fostering coordination between international actors was vital to ensuring consistent and coordinated approaches to prevention measures at the national level.

Mr. Songane, the Moderator, in summarizing some of the key points made during the panel discussion, said some of the points made were on recognizing that maternal mortality and infant mortality were recognized as human rights issues, there was a call to address the issues, that accountability was at both the national and international level, availability of data was vital and not just global data, but local data that could help these groups of people, community support was strongly encouraged as they could reach the most marginalized members, and a comprehensive plan at the national level should be devised, including a budgetary plan. The relevant Special Rapporteurs were also encouraged to give this issue special attention. The creation of a simple mechanism for accountability to meet the Millennium Development Goals was stressed.

Speaking in the interactive discussion were the delegations of Slovenia on behalf of the European Union, Chile, Pakistan, Norway, New Zealand, Canada, Switzerland, Romania, Ireland, Singapore, Luxembourg, Holy See, Cuba and Australia.

Also speaking were the following non-governmental organizations: Latin American Committee for the Defence of Women's Rights, Amnesty International, Human Rights Watch and Society for the Protection of Unborn Children.

The panels on the human rights of women were held in two back-to-back meetings from noon to 6 p.m.

When the Council meets at 9 a.m. on Friday, 6 June, it will discuss follow-up to the Special Session on the world food crisis, and hear a briefing from the Special Rapporteur on the right to food who had attended the 3-5 June meeting by the Food and Agricultural Organization on the world food crisis in Rome. Then it will hold review, rationalization and improvement processes for the Special Rapporteur on trafficking in persons, especially in women and children, and the Special Rapporteur on the right to education.

Statement by the High Commissioner for Human Rights

LOUISE ARBOUR, United Nations High Commissioner for Human Rights, welcomed the debate today, focusing on the two pressing issues of violence against women and maternal mortality. The General Assembly had tasked the Council with setting priorities in addressing violence against women as a follow-up to its consideration of the Secretary-General's study on the subject. Released in 2006, the study unequivocally demonstrated that multiple forms of violence against women remained pervasive in the world. The report described that violence as a "pandemic" and as "one of the most serious challenges of our time". But those alarming words just barely afforded a glimpse into the desperate and dehumanising conditions that millions of women and girls were subjected to on a daily basis, and in many cases with no relief or recourse to justice. In particularly egregious forms, violence, including sexual violence, had been committed and continued to be perpetrated in the midst of conflict and post-conflict societies on a magnitude and level of brutality that defied belief. However, although violence against women had been an ugly feature of wars since time immemorial, only recently had there been a recognition that such violence was punishable by law as a war crime, a crime against humanity and, indeed, at times, an act of genocide. International enforcement of that law represented a vital step forward.

Ms. Arbour highlighted that, whether perpetrated in conflict or in peace, the root causes of violence against women were deep-seated inequalities and discrimination. They certainly recognized that, since the adoption of the Universal Declaration of Human Rights, much progress had been made to eliminate discrimination against women. Obligations had been set forth in the Convention on the Elimination of All Forms of Discrimination against Women, the International Covenant on Civil and Political Rights and other treaties. Still, a recent study underscored the persistence of laws and customs that made women second-class citizens and that, consequently, exposed them to undeterred and unpunished violence and equality. A concomitant denial of basic rights, such as access to health services, education and water, overwhelmingly affected women. That inequality might condemn women to poverty which, in turn, exposed hundreds of millions of girls and women to continuous abuse.

Discriminatory laws and practices were also at the root of many cases of maternal mortality. Early marriage, female genital mutilation and disrespect of women's safe reproductive rights – which were incompatible with the obligations set forth in the Convention on the Elimination of All Forms of Discrimination against Women – were key contributors to the millions of deaths and disabilities resulting from pregnancy and childbirth annually. The Human Rights Council, alerted by today's discussion, could play a groundbreaking role in clearly defining maternal mortality as a human rights issue and articulating the indivisibility and interrelatedness of rights in that respect. To conclude on a positive note, Ms. Arbour noted that it was very encouraging that several States had made commitments with respect to women's rights in the context of the Universal Periodic Review, including pledges to remove far-reaching and longstanding reservations made to the Convention on the Elimination of All Forms of Discrimination against Women.

Statements by Panellists in Panel on Violence against Women – Identification of Priorities

PETERIS LARLIS ELFERTS, Ambassador of Latvia to the Council of Europe and Moderator of the Panel, said violence against women was a challenge for the regional organizations and for the United Nations. It should remain a priority and be at the top of the agenda in order to see how this work can be brought forward. It was not just a women's human right issue but also a girls' human right issue, because of practices like female genital mutilation and forced marriages. Violence against women encompassed a broad challenge at the national level, crossing all types of legislative and judicial challenges. It was important to assure the protection of the female victims who suffered both physical and psychological wounds. These wounds were also passed down to the children that were witnesses of the violence, extending throughout generations.

The task of integrating work on violence against women into the agenda of the Human Rights Council was a high priority, including specifically integrating it in the Universal Periodic Review mechanism. Violence against women and girls was a violation of human rights. It infringed on all their rights. The Council should continue the campaign to promote awareness of the violence against women without duplicating efforts. The integration of this cause would be integral to achieving the Millennium Development Goals.

PAULINE VELOSO, Minister of the General Secretariat of Chile, congratulated the Human Rights Council for organizing the panel since violence against women was a major violation of human rights. It was an age old reality, yet it was only a very recent concern for the international community. As a consequence, it had shown real progress to bring the issue to the forefront. Violence against women had many causes and was linked to culture; in all societies there was a great deal of permissibility on this subject. The legal order tended to define hierarchy in families. The use of the word boss in Spanish as head of the household was an example of this hierarchy. Violence against women was a scourge. Combating the scourge was complex. In order to address it, the root causes must be examined. It was not sufficient to criminalize the behaviour. It was not enough to provide aid to victims. The State had to have a policy to change norms.

Most countries had not fully quantified the problem of violence against women, which was essential to over come it. Despite efforts, all must work harder to fight this issue. A University of New York study showed that violence in culture was still a problem. There remained indifference from States. Violence was still extremely pertinent. There was a need to understand the phenomenon. More help was needed with investigations. The holistic gender policy structure needed to be improved. Activities of States needed to be coordinated with civil society. At the international level, more work was needed. A universal treaty on violence against women needed to be established. The Human Rights Council had a leading role. If it did not accept that role, the Human Rights Council would lose credibility.

KATHLEEN CRAVERO, Assistant Administrator and Director of the United Nations Development Programme (UNDP), said that in today's wars, modern armies and militia used sexual violence against women as a strategy of war, scarring not only victims, but all who witnessed that brutality; that "scorched-women policy" would destabilize generations to come. Many were forced to bear children of the enemy who would find no place in the post-conflict communities. Others succumbed to the slow murder of HIV/AIDS. Perhaps the worst atrocities today were being perpetrated in the Democratic Republic of the Congo, where the scale of the violence affirmed that women's bodies were part of the battlefield. Victims had little hope to see their rapists brought to justice. As one seasoned peacekeeper had said, it was now more dangerous to be a woman than to be a soldier in the Eastern Democratic Republic of the Congo.

Ms. Cravero noted that, according to the Rome Statute of the International Criminal Court, sexual violence was among the gravest breaches of international law: constituting a war crime, a crime against humanity, torture, even genocide – depending on the elements of the offence. However, often these crimes kept below the radar. The victims often did not report sexual violence fearing stigmatisation or, worse, being accused of adultery. As women's social standing was reduced in that atmosphere of impunity, sexual violence could then be seen as both a cause and effect of women's diminished status.

The challenge was threefold, Ms. Cravero said. They had to work towards prevention, address impunity and bring redress for victims. In terms of prevention, they desperately needed to promote the empowerment of women, by taking the principle of non-discrimination and applying it to the entire range of economic and social rights. That meant such things as ensuring equality of access to education, as well as prioritising antenatal and women's health care services, and ensuring women had to be able to own land and property. In terms of impunity, few perpetrators had been brought to justice. The International Criminal Court had an important role to play in that regard. Finally, on redress, women had to have access to health and other essential services. They had to be better at empowering women. Their failure to do so was in large measure what had blocked effective implementation of Security Council resolution 1325.

ISABEL MARTINEZ LAZARO, Secretary-General of Gender Equality Policies of Spain, said collaboration on the work on violence against women with the different bodies of the United Nations was essential. She was convinced that the Human Rights Council was a strong instrument that was capable of applying this work and where change could happen. Violence affected all women all over the world.

Fighting violence against women required a firm and coordinated hand from all States to ensure this work would be continued. The new Government of Spain was committed to combat all forms of discrimination against women. Spain had adhered to the recommendations of the Secretary-General on this issue. Cases of unusual violence against women in conjugal relationships had come up and new legislation to combat this had been adopted. Social measures had also been adopted to help women emerge from such violence by promoting structural changes. Since the application of the legislation, more women were emerging from these situations, courts had been created that dealt with it specifically, and more than 73 per cent of men tried had been convicted of such crimes.

Almost 50 million euros had been committed to combat gender violence in Spain. Spain was a major contributor to UNIFEM. Three million euros had been spent by Spain as it played a leading role in the fund established by the United Nations to address gender violence. Some ways for the Council to address these needs would be to have greater information available to address these problems.

Another example of efforts currently underway was the United Nations creation of databases to help in the establishment of policy on clear indicators. Violence against women and girls remained one of the worst violations of human rights. Addressing this issue with effective legal instruments would be able to help end these human rights abuses.

ALEJANDRA SARDA, Member of the Network of the Latin American and Caribbean Countries Committees for the Protection of the Rights of Women, said 20 years of work had shown that violence against women was now on the map. Cultural norms formed many of the causes for this violence. There was a solid set of international systems to define and penalize such behaviour. The Human Rights Council must now move on with further work. Women were subjects of rights. A holistic fashion was needed. The organization had recommendations for the Human Rights Council, which included the need for a focal point for violence against women.

The Universal Periodic Review should integrate a gender perspective fully. The review should centre itself on whether a legal framework existed to fight the violence. There should be specified budgetary resources. The sharing of best practices was required. Those practices needed to be specific and action oriented. States could prepare lists with several recommendations in order to gain as wide a collection of ideas as possible. After the review, technical assistance could be provided to States that required help. It was important to guarantee participation by civil society and women groups for follow up. She had further suggestions for the work of the Human Rights Council, such as appointing a Special Procedure on violence against women.

Discussion on Violence against Women

In the following interactive discussion, delegations made various comments and asked questions on gender based violence, the impact of the interpretation of religion on women, the structural relationships of inequality between women and men, the empowerment of women, international standards and norms to eliminate all forms of violence against women, and the situation of women in post-conflict areas. How could the Human Rights Council support the implementation of the Secretary-General's recommendations to eliminate all forms of violence against women?

Delegations also said that violence against women was one of the most pervasive human rights abuses that persisted in all countries of the world. A lack of leadership, political will and resources to take effective action was noted. The need for a coordinated database was underlined. Also discussed were the need to protect women from rape and sexual abuse in peacetime, wartime and conflict and post conflict situations; harmful traditional practices such as female genital mutilation; enhancing women's participation in decision making issues; and promoting women's access to education. It was noted that a comprehensive approach towards empowerment of women remained the most effective instrument to counter violence against women.

Another important area underlined by delegations was the sex industry and the commercial sexual exploitation of women; these were among the most humiliating and degrading forms of violence against women. How could the Council address gender stereotypes? Maternal mortality was also addressed. It was important to enable women to attain appropriate standards of health. It was also noted that developing countries found more difficulties to implement policies. Could the panellists comment on the relationship between the rights of women and the right to development?

Non-governmental organizations also addressed the practice of collective rape in armed conflicts; it was felt that it should be condemned as a crime against humanity. How could the Council more effectively address human rights violations taking place in the private sphere? The Council's attention was called to the over 500 mainly unresolved murders and disappearances of indigenous women in Canada. A study had indicated that indigenous women were 2.5 times more likely to be raped than other women in the United States.

In the first round of answers, panelists said that the Council should urge countries to bring legislative changes in order to protect women more effectively against violence and to reform cultural norms that were the basis of human rights violations. The problem of violence against women in all its different aspects should be included in the Universal Periodic Review process. Prevention was seen as the foremost step. It was noted that rape was now a systematic strategy of war and thus, it should be pursued as a war crime. A generally agreed issue was that violence against women had cultural roots and that this was a grave human rights violation. Investing into policies providing greater equality was seen as one of the step to take in order to improve the situation. The problem of sexual exploitation and human trafficking was believed to be one of the most outstanding problems; it was similar to slavery. The Council was urged to readdress this situation.

In a second round of questions, delegations talked about the importance of data collection in fighting against violence against women. What were the ways and means to strengthen the possibilities to acquire objective data about violence occurring within families? It was also underlined that women empowerment remained central for achieving the Millennium Development Goals. What role did the panel see for the Council in order to re-launch a specific reflection on how to eradicate female genital mutilation? How could discussions in forums, such as this, lead to practical work on the ground?

Non-governmental organizations also noted that gender-specific human rights violations against women were too often invisible and seen as trivial or private matters, despite efforts by women human rights activists for decades. The rights of elder women were also addressed; they should be recognized as a distinct vulnerable group and issues relating to them should be mainstreamed within all Special Mandates. With regard to the Millennium Development Goals, States were urged to allocate adequate resources to address gender equality and provide financial support to women's movements. The issue of women and young girls affected by the conflict in the Democratic Republic of the Congo was also brought up.

Concluding Remarks by Panellists on Violence against Women

KATHLEEN CRAVERO, Assistant Administrator and Director at the United Nations Development Programme, in concluding remarks, thanked the delegations for their remarks. On the need to address sexual violence, she said that addressing its root causes was of outmost importance. On the use of rape in conflicts, she would not make an intensive analysis but suggested that, with wars and conflicts norms and standards did somewhat disappear. There was often a break down in consensus and respect of rules of engagement. Women were left behind alone in villages. In view of inflicting long term damage to enemies, rape was becoming more and more used. Rape was a strategy of war and the military often enjoyed a form of impunity.

PAULINE VELOSO, Minister of the General Secretariat of Chile, in her closing remarks said that she shared many of the concerns the delegates attached to the issue of violence against women. She agreed with the point made by the delegate of Egypt that the causes needed to be focused on, along with continued attention to the effects. The laws which allowed discrimination against women were a central aspect of addressing and ending violence against women, and as such needed to be changed. The Council should use all mechanisms to address this matter visibly and ensure ongoing coverage so that an end could be put to this scourge. Violence against women should be an agenda item in all the regular sessions and special events to increase the focus on addressing this issue. The coordination of civil society had made a historical effort in this regard. The international community was not just in the stage of studying violence against women, but was moving to put practical steps towards ending it.

ISABEL MARTINEZ LAZARO, Secretary-General of Gender Equality Policies of Spain, said that some interesting comments had been made. Egypt stated that it was more important to look at causes of violence against women. Many of the causes were already known. It was known that violence could only be reduced if it was given priority by States and received a political dimension. It was also important to look at consumption of prostitution in Europe. Prostitution in Europe was linked to the trafficking of women and girls. There must be a cross cutting effort. Social measures had to provide alternatives for women who had been victims of violence. She called the panel illuminating and said she was taking away lessons that were very helpful.

ALEJANDRA SARDA, Member of the Network of the Latin American and Caribbean Countries Committees for the Protection of the Rights of Women, expressed her thanks for the questions on the focal point on violence against women. Violence against women was a crossing cutting issue that impacted other human rights as well. The Millennia Development Goals 3, 5, 6, could be achieved by addressing violence against women. She also recommended that civil society continue to play a constructive role in addressing violence against women.

PETERIS LARLIS ELFERTS, Ambassador of Latvia to the Council of Europe and Moderator of the Panel, in summing up the panel discussion, said that among issues highlighted in the discussion had been the need for legislation, awareness-raising, and attention to victims. Also, the role of men should not be forgotten, and the need to target actions in that regard. The Secretary-General's report had been raised as an essential tool, and the fact that violence against women could be part of the Universal Periodic Review process was also seen as useful. Further, it had been underscored that to establish best practices and formulate the comprehensive approach that was necessary to address violence against women, they needed to gather data. Also essential was the need for the political will and commitment to allocate the necessary financial and human resources. The highly valued and important work of the Special Rapporteur on violence against women, its causes and consequences, Yakin Ertürk, was also stressed.

Mr. Elferts also said that violence against women and the violation of their rights was not a private matter. The role of civil society was also very important to help address the situation. In order to set common legal binding rules several international treaties could be drawn upon. The African Union already had such a tool in place. It was also noted that next week, in Strasburg, a European conference on violence against women would take place; this could be seen as a regional continuation of today's discussion.

Statements by Panellists in Panel on Maternal Mortality and the Human Rights of Women

FRANCIS SONGANE, Secretariat for the Partnership for Maternal, Newborn, and Child Health, and Former Minister of Health of Mozambique, Moderator of the Panel, in his opening remarks said the decision taken by the Human Rights Council to hold this discussion was welcomed. There was growing momentum behind the Millennium Development Goals and specifically goal number five on maternal deaths. Giving birth should be a time of joy. For too many women it was a time of death and disability. Many babies died due to poor care at birth, often related to the death of the mother. The life-time risk of death was highest in sub-Saharan Africa. The inequity between there and the rest of the world had not changed in the last 20 years. That being said, it was also a problem in developed countries. In the United States more black mothers died compared to white or Hispanic mothers. In Australia, Aboriginal women suffered at a higher rate than non-Aboriginal citizens. There were many problems, one being the near total silence of the media about maternal mortality. Women rights were being violated at a grand scale. United Nations agencies, donor countries and civil society had a unique opportunity to work on this issue.

MONIR ISLAM, Director of Making Pregnancy Safer at the World Health Organisation, said that women giving their lives while bringing new lives to this world was the most shameful and gross injustice. It was one of the most striking examples of inequities in health. The implementation of the Convention on the Elimination of Discrimination Against Women ensured all women's access to information and health care services. Every minute somewhere in this world, a woman was giving her life during pregnancy, childbirth or the post partum period. From country after country analysis it had become clear that rural and poor women were excluded, marginalized and had very little or no access to health services during pregnancy and mostly died or suffered from long term disabilities. In developing countries, rich people would reach Millennium Development Goal 5, the goal of reduction of maternal mortality, but not the poor countries. This was a gross injustice.

Whose decision was it to get married before the age of marriage, asked Mr. Islam. Whose decision was it to get pregnant or not? Whose decision was it to seek routine care when life was in danger? Could women decide? Or was it rather the decision of a father, mother, mothers-in-law, relatives or husbands? Even when a woman got permission or decided to seek care, did she have access to resources to reach the facilities? Often, women did not get the needed care in time. Such delays were gross injustices. These deaths were mostly preventable and mostly unnecessary. The fact that women were dying silently and alone after giving birth, while family members were bursting into joy with the newborn, was a violation of their right to life. Politicians and policy makers had to be made accountable.

VINCENT FAUVAU, Senior Maternal Mortality Advisor at the United Nations Population Fund, said that in Ecuador one of the best achievements made was the reproductive health committees established to monitor the services and educate the community and providers on what the law in the country provided them. This was an example of how accountability and participation of human rights approaches could shed light and make changes. The fifth goal in the Millennium Development Goals set to reduce infant mortality rates by 75 per cent, which would unlikely be met. Half a million women died each year, and it was unacceptable that a high number of women still died from complications of pregnancy and childbirth when proven interventions existed. Many health services remained out of reach to many, especially women living in countries where natural disasters had occurred and war torn countries. 200 million women in the world would like to plan their families, however, were unable to due to the lack of services available to them, such as the lack of contraception. If such services were made available, a 30 per cent reduction in enfant mortality could be attained.

Experience and studies showed that maternal deaths and disabilities could be reduced significantly if every woman had access to reproductive health services. These services for family planning, skilled attendance at birth and emergency obstetric care saved women's lives, and yet today these services remained out of reach for millions of women. Among all human development indicators, those for reproductive health showed the starkest inequities between the rich and poor. In any country, a poor woman was more likely than a rich woman to die in childbirth, and the disparities between developing and developed countries were profound. Further, gender discrimination and violence were a direct threat to the health of women and mothers. Because of women's low status, they were often denied the right to make their own decisions about pregnancy and childbearing. Each year an estimated 14 million adolescents between the ages of 15 and 19 gave birth. Adolescents were shown to be at higher risks of dying during pregnancy or childbirth. Great importance must be attached and kept in mind in particular situations of adolescent girls when discussing human rights and maternal mortality. Investment in reproductive heath would improve countries productivity and health. Further, there could be no safe future without safe motherhood.

JASHODHARA DASGUPTA, Coordinator of SAHAYOG, congratulated the Human Rights Council for organizing the discussion. She said that despite all the technology, despite the advances in communication and medicine, women still died during child birth. The means to save their lives did exist. She asked why there a lack of political will to stop the problem. A group of 4,000 rural woman in India had come together to declare that the issue was a violation of their human rights. She outlined a number of actions these Indian women had taken, including learning about the entitlements available to them and getting valuable information. Tackling the problem of maternal mortality meant empowering and educating women. She was seeking institutional commitment from the Human Rights Council. It meant the Council should recognize that the deaths were preventable. It had to look forward to the formulations of laws and policies to protect women and grievances mechanisms that would allow redress. She called for transparent audits of all female deaths. Maternal mortality was a result of poverty, the lack of information, and marginalisation. It required analysis and research to determine where the maternal mortality deaths were clustered. She urged the Council to create greater political will. She called on the Human Rights Council to see this critical right of women not only as an issue of State accountability but also one of international accountability.

PAUL HUNT, Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, said that the landscape of human rights was changing dramatically and this panel symbolised this change. Human rights were also about prisoners of poverty and about avoidable deaths from preventable health conditions. Poverty and preventable maternal health had not been part of the human rights landscape ten years ago. These changes demanded other changes, like cooperation across different governmental departments, United Nations Agencies and professions. Today's panel typified the sort of cooperation that the new human rights landscape demanded. In recent years, the Human Rights Council had played a decisive role in shaping this new human rights landscape.

The health system required basic data which were disaggregated so that they could know which disadvantaged groups to target. It required outreach programmes to reach disadvantaged groups. It required monitoring and accountability mechanisms to know what was working and what not. The right to the highest attainable standard of life demanded that a health system had certain key features. Of course, this right was subjected to resource availability; this was a complication but it was manageable. Millennium Development Goal 5 had not generated as much attention as other Millennium Development Goals, but there was now a proliferation of initiatives and programmes for maternal health. Further, human rights demanded accountability: an accessible, transparent, effective and independent mechanism, with a view of finding out what worked. It seemed that currently, independent accountability was weak. Women's commissions were needed at the national level. At the international level, the Universal Periodic Review had to routinely encompass maternal mortality and relevant Special Procedures should be encouraged to give careful attention to the topic. Could one expect the United Nations agencies to hold States and others to account in relation to maternal mortality? It was not what they were designed to do. There was no alternative to a simple mechanism at the international level to hold States to account in this regard.

Discussion on Maternal Mortality and the Human Rights of Women

In the following debate, delegations made comments and raised questions on the promotion of gender equality and that the enjoyment of human rights by women and girls were goals in their own right. How could it be guaranteed that women and men had access to the information, education and services needed to achieve good sexual health and exercise their reproductive rights and responsibilities? The issue of violence against women had many dimensions. A comprehensive approach was important to deal with the issue in all its complexity. While it was the responsibility of States to promote the rights of women, efforts needed to be made at the international level to help develop remedies to deal with such issues. Solutions should go beyond advocacy. Counselling and directives should be aimed at underdevelopment and poverty, which constituted two main causes hindering women's enjoyment of all their rights.

Fostering coordination between international actors was vital to ensuring consistent and coordinated approaches to prevention measures at the national level. If a human rights consideration was integrated into policies and programmes to address maternal mortality, such initiatives were likely to be more effective, equitable, non-discriminatory and participatory. What role could national human rights mechanisms play in assisting existing efforts to reduce maternal mortality rates? It was clear that preventing maternal mortality was more than just a critical health issue, as well as one of the Millennium Development Goals, but also a human rights issue that demanded the attention of the Council. How would such information as treaty body reports, facilitated visits by Special Rapporteurs and submissions for the Universal Periodic Review help reduce the incidence of maternal mortality and how would it relate to existing policies and programmes at the international and national levels? Women should be able to participate in the design and implementation of policy aimed at reducing maternal mortality rates. Would the Universal Periodic Review mechanism be an effective mechanism used to affect maternal mortality rates? If so how could it be used?

The Secretary-General's study identified a number of actions States should undertake in order to prevent and combat violence against women, speakers said. Infant mortality rates had reduced and efforts had been made to continue to generate greater resources to continue cutting these rates. Could the panel point to practical and feasible ways that health service providers and non-governmental organizations could aim to reduce maternal mortality?

Maternal health was accorded a top priority in the belief that healthy mothers brought up healthy children. There had been collaboration with the World Health Organization to develop training in family planning and safe motherhood strategies. What role could the Council play in addressing this issue without duplicating already established efforts? If the Millennium Development Goals were not met it would be an injustice to women worldwide. Meetings such as the Human Rights Council should take place regularly to address maternal health. Could accessibility, availability, appropriateness, and quality be good indicators for establishing policies for high standard heath care services?

Concluding Remarks by Panellists on Maternal Mortality and the Human Rights of Women

MONIR ISLAM, Director of Making Pregnancy Safer at the World Health Organisation, addressing questions on how the State should investigate the extent of maternal mortality and what it should do, and how women could access information, stated the importance of maternal death audits. There purpose was not to blame, but to simply determine why a woman died. He advocated for segregated data, which showed how rural and poor women had a lack of access to health services. He said every woman should have access to information, but it was not the responsibility of States alone. Every community had to ensure information was available.

In concluding remarks, Mr. Islam said that as Cuba pointed out, the international community knew exactly what needed to be done. But political will was lacking and investment was needed. Non-governmental organizations could help to make States accountable and to monitor the situation. Japan had recently looked at whether maternal health should become an item on the G8 agenda. What was most important was to win the political battle.

VINCENT FAUVAU, Senior Maternal Mortality Advisor at the United Nations Population Fund, answering questions concerning measurement and how to compile information and also the quality of services, said that the role of the Human Rights Council at global and country level was for accountability and that the primary pillar of accountability was measurement. He said it was a collective responsibility to collect information and to arrange it in a manner that showed inequalities and gaps. Then this information could be used to establish policies to fill the gaps. He also spoke of the importance of audits in improving the quality of care. The Human Rights Council should also focus on human resources for health. Midwives were needed. Maternal deaths were preventable, but not predictable, which meant people need to be present at births.

Mr. Fauvau, in concluding remarks, said that maternal mortality had been gaining more visibility, especially as it started to be seen in coordination with maternal health initiatives. This was an example of how important it was seen for the Council to join in this international arena. New partnerships, health partnerships such as the H8, had been formed recently with the goal of addressing health care issues worldwide. The Human Rights Council's work should coincide with that of such partnerships of the H8 to ensure that human rights aspects were integrated into this challenge.

JASHODHARA DASGUPTA, Coordinator of SAHAYOG, answering questions related to how to bring maternal mortality to the Human Rights Council, said that the role the Council could play was ensuring the implementation of the decisions of various world conferences. When talking about rights, the discussion needed to focus on the human rights principles. She also said that discussions could not focus on the supply side of services alone, but also on the demand side. Unless there was an increase in the demand side by well informed women, the services would not matter. All investigations could not examine bio-medical reasons, but had to take a holistic approach.

Ms. Dasgupta, in concluding remarks, said the Human Rights Council needed to incorporate maternal mortality within the Universal Periodic Review. There was very little reference to the issue despite it being a violation of women's human rights. The Human Rights Council could create standards and monitor their application, especially for services that were available for women, with special attention paid to inequality. The Human Rights Council could indicate to its members that there was a need for a cohesive response to maternal mortality, which was a function of many factors, including nutrition, financial resources and location and physical access to care. The Human Rights Council must adhere to the resolution of the United Nations General Assembly, specifically the resolutions concerning abortions.

PAUL HUNT, Special Rapporteur on the right to health, answering questions that pertained to how to keep institutions from overlapping work and also how to bring a human rights perspective to maternal mortality, said that there were many technical experts available who knew what had to be done to reduce maternal mortality. They were not well positioned to make independent judgements about what States and others were doing. It was the United Nations rights system that was best positioned to do that. A mechanism of robust, transparent and effective international accountability was needed. And here was a role the Human Rights Council could play. It would have to develop the capacity, however, employing medical experts and workers along with human rights experts.

Mr. Hunt, in concluding remarks, said that, as was known, in 1978, the World Health Assembly had adopted the goal of "Health for All" by 2000. It was an inspiring document. But the goal had not been realised, nor had there been an independent monitoring process of the implementation of this decision. It was now known that national policies had been put in place during this time that had been running counter this goal.

On the role of donors, Mr. Hunt said that maternal mortality was a great challenge for developed countries. In recent studies, it had been revealed that the great bulk of donors were still going through projects, not through budget support. Additional investments were needed to realise Millennium Development Goal 5. But the recipients States also had their roles to play. Further, settling the issue of maternal mortality required a number of different interventions and most of all an effective health system was needed. What had to be done was known, but it was strange that some States were doing what was needed and others were not doing what was needed.

Also, there was no point accelerating women's access to clinic, if when they got there services were inadequate or inexistent, noted Mr. Hunt. A package of intervention was needed: education about reproduction was needed, talk about contraception was important. These were sensitive issues that had to be approached with the right mix.

On indicators and benchmarks, Mr. Hunt said that they were much needed. They could help policy makers. United Nations treaty bodies had been encouraging States to work with such tools. The scale of maternal mortality was absolutely shocking, it was nothing compared to the number of executions and disappearances throughout the world. Maternal mortality was, for its most part preventable. It was not just a humanitarian and health problem, it was a human rights problem. The good news was that experts knew what needed to be done. One of the key issues was international accountability. Other international initiatives were urged to take that role if the Human Rights Council was presently not able to do so.

FRANCIS SONGANE, Secretariat for the Partnership for Maternal, Newborn and Child Health, Former Health Minister of Mozambique, Moderator, said that it was important to share information and it would be useful if the Human Rights Council had the issue of maternal mortality as a regular agenda item.

In summarizing some of the key points made during the meeting, Mr. Songane said some of the points made were on recognizing that maternal mortality and infant mortality were recognized as human rights issues, there was a call to address the issues, that accountability was at both the national and international level, availability of data was vital and not just global data, but local data that could help these groups of people, community support was strongly encouraged as they could reach the most marginalized members, and a comprehensive plan at the national level should be devised, including a budgetary plan. The relevant Special Rapporteurs were also encouraged to give this issue special attention. The creation of a simple mechanism for accountability to meet the Millennium Development Goals was stressed.

Mr. Songane said that in order to ensure that information was shared it was important to liaise with the Secretariat. Further to build on that knowledge base, published information could be used and built on. Having maternal health on the Council's agenda would be extraordinary. The strengthening of the health care systems was the best way to track the rates. For example caesarean procedures dealt with real emergencies, a time when complications could not arise and if a facility could deal with this type of procedure in a timely manner; providing the quality of care necessary to successfully and safely deliver a healthy baby, this would be a good indicator that there had been progress in improvement of that health care system.

This was the first time this topic had been debated for three hours at the Council. It was remarkable and he was very thankful and looked forward to working with the interface of the Council and other institutions. At the meeting in Cape Town, at the inter-parliamentary meeting where over 300 parliamentarians discussed these issues, they were surprised with the scale and magnitude. Information was crucial to improving maternal and child health care and was necessary to reach the Millennium Development Goals.

UNITED NATIONS Press release
Human Rights Council
AFTERNOON
5 June 2008