Slack Implementation and Lack of Oversight Causes Suffering and Death
(Buenos Aires) - Thousands of women and girls in Argentina suffer needlessly every year because of negligent or abusive reproductive health care, Human Rights Watch said in a report released today.
The 53-page report, "Illusions of Care: Lack of Accountability for Reproductive Rights in Argentina," documents the many obstacles women and girls face in getting the reproductive health care services to which they are entitled, such as contraception, voluntary sterilization procedures, and abortion after rape. The most common barriers to care include long delays in providing services, unnecessary referrals to other clinics, demands for spousal permission contrary to law, financial barriers, and in some cases outright denial of care.
"Women need dependable care throughout their reproductive lives," said Jose Miguel Vivanco, Americas director at Human Rights Watch. "But in Argentina, it's more like a lottery: you might be lucky enough to get decent care but you are more likely to be stuck with deficient - or even abusive - services."
As a direct result of these barriers, women and girls in Argentina often cannot make independent decisions about their health, and many face unwanted or unhealthy pregnancies as a result. Forty percent of pregnancies in Argentina end in abortions, which are often unsafe. Unsafe abortion has been the leading cause of maternal mortality in the country for decades.
The report identifies a lack of oversight and accountability for carrying out existing laws and policies as the main problems in the persistent denial of proper care. Doctors and other medical personnel who deny women services to which they are entitled, or who apply arbitrary conditions for receiving the services, rarely - if ever - are investigated or penalized.
"Argentina's reproductive health policies are certainly not perfect, but if they were implemented they would prevent quite a lot of the suffering I saw in researching for this report," Vivanco said. "The government needs to put a lot more effort into monitoring how these policies are carried out and punishing abuse."
Human Rights Watch's report also criticizes Argentina's reproductive health policies for ignoring key constituencies such as women and girls with disabilities. With its recent ratification of the Convention on the Rights of Persons with Disabilities, Argentina has taken on specific international obligations in this area that are not being met, Human Rights Watch said.
"Women and girls with disabilities face all the same barriers as women without disabilities, and then some," Vivanco said. "Apart from straight-up access issues - are there ramps at clinics, or is information translated into Braille or sign language, for example - there is a larger question of prejudice. Some doctors just don't think women with visual or hearing disabilities, have sexual relationships or can remember to take their contraception."
The Argentine government has recently taken steps to remedy some of the issues highlighted in "Illusions of Care," though some of the policy changes were later retracted. In May, the National Health Ministry created a free call-in number to answer questions about where to find reproductive health care services and register complaints. In July, the ministry announced its intention to make sure that abortions are carried out for women and girls whose lives or health are threatened by their pregnancies, or who have been raped. The day after the announcement, however, the government retracted its statements, noting that it did not intend to guarantee access after all.
"The Argentine government seems to be slowly waking up to the notion that laws on reproductive health mean nothing unless they are enforced," Vivanco said. "But unless changes are constant and clear, women and girls will continue to suffer and, in some cases, die."