PHA-Exchange> Former health minister of Peru

[WGNRR]

Please have a look at the letter below by the Center for Health and Gender
Equity. Quite shocking.
regards,
Nadia

WGNRR Women's Global Network for Reproductive Rights
website www.wgnrr.org


U.S.-Funded Speakers at UN Oppose Family Planning
Today the US Government's Permanent Mission to the United Nations sponsored
a discussion on maternal mortality at the UN's New York headquarters. Titled
"Maternal Mortality: Effective Strategies for Increasing Maternal and
Newborn Survival," admission to this US taxpayer-funded event was controlled
by Austin Ruse, president of the ultra-conservative Catholic Family and
Human Rights Institute (C-Fam). Discussion panelists included the former
Peruvian Minister of Health, Dr. Fernando Carbone, who attempted to prohibit
the use of emergency contraception in Peru's family planning program and to
require women to register all pregnancies with Peruvian public health
services from the moment of conception.
Dr. Carbone's US-supported participation in an UN event is of great concern
to the Center for Health and Gender Equity (CHANGE). In the following
letter, sent to John Danforth, U.S. Ambassador to the UN, and Colin Powell,
US Secretary of State, CHANGE demands that the Ambassador Danforth offer an
explanation for the composition of the maternal mortality panel.
------
October 19, 2004
Dear Ambassador Danforth,
We understand that the US Permanent Mission to the UN is sponsoring a panel
discussion tomorrow at UN headquarters: Maternal Mortality: Effective
Strategies for Increasing Maternal and Newborn Survival. As on-the-ground
witnesses of maternal and reproductive health policies in Peru for over six
years, we are outraged by the inclusion of Dr. Fernando Carbone, former
Health Minister of Peru, as a participant on this panel.
The Center for Health and Gender Equity has been monitoring maternal and
child health and family planning programs funded by the U.S. government in
Peru since 1998 with the purpose of ensuring that U.S. policies and funding
support human rights and promote best practices in public health according
to internationally recognized standards. Over the past six years, and
through our in-country staff, we have documented a series of critical
improvements to womens reproductive health, including efforts to expand
access to emergency obstetric and post-abortion care, broaden the range of
contraceptive options available to women, and ensure provider compliance
with standards of quality of care and informed consent, among other
important changes. While Peru, like virtually every other country in the
world, has a way to go to reach the ideal in terms of ensuring universal
access to essential health care, USAIDs support has contributed to
sustained progress in each of these areas and by extension improved the
prospects for women and their families.
However, progress in reproductive health in Peru was overshadowed between
January 2002 and July 2003, when Dr. Fernando Carbone was Health Minister.
Dr. Carbone worked to impede access to services and information on modern
contraceptives as well as post-abortion care, two essential strategies for
preventing maternal deaths. Specific steps included directives discrediting
critical reproductive technologies, spreading dis-information in the mass
media, and blocking the distribution of needed supplies. For example, in
early 2002, Carbone attempted to remove the IUD from the MoH protocol for
contraceptive services on the basis that it is an abortifacient, while at
the same time touting the effectiveness of the Billings method. He also
deterred the use of manual vacuum aspiration for post-abortion care, despite
it being the safest available technology for treating incomplete abortion
and miscarriage. In late 2002, his office launched a dis-information
campaign against condom use. He systematically refused to make emergency
contraceptive pills available in public health services.
In late 2002, the Public Ombudsmans office released a report on its
monitoring of government family planning and maternal health services,
funded by USAID. The evidence demonstrated measures imposed by health
services to deter women from obtaining contraceptive methods as well as
coerce women into complying with maternal health services. For example, MoH
clinics levied fees from women seeking contraceptive services, which are
supposed to be free of charge. MoH providers illegally charged women with a
fine who choose to give birth at home, instead of at a health facilities,
and women who missed some or all of their prenatal visits. Women who did not
comply with the exigencies of MoH maternal health services were also denied
birth certificates for their newborns. In addition to contraceptive
stock-outs, the Public Ombudsman found a long waiting list of women who had
requested sterilization, but had yet to receive the procedure from the MoH.
Other studies have since demonstrated the devastating effects of Carbone4s
policies on maternal and reproductive health. The Policy Project has
repeatedly found stock-outs of modern contraceptives in government health
services, methods purchased in large part by Perus public treasury.
Pathfinder International and the Peruvian Womens Center Flora Tristan found
decreases in womens access to and use of modern contraceptives and
increased reliance on natural methods and unsafe abortion.
While Minister of Health, Dr. Carbone also reversed important gains made to
the administration and management of public health programs. He replaced
skilled technical personal with persons who shared his religious conviction
but had no experience or competence in administering public health programs.
This led to the dismantling of Perus internationally recognizes public
health programs, such as TBC, HIV/AIDS and immunizations. Meanwhile, under
Carbone, policies were developed to advance an anti-women ideology rather
than practically improve their lives. For example, in May 2003, Carbone
approved new Regulations of the Structure and Roles of Health Departments,
which included a provision that requires all Health Departments, directly
or through competent entities, to protect the life and health of all unborn
children from their conception, and to register them officially as conceived
and [as] the subjects of constitutional rights." If the MoH had attempted to
implement the measure, the practical implications would have been enormous.
To date, the public health system in Peru remains unable even to carry out
accurate registration of actual births and deaths. In addition to being a
blatant attack against womens rights to privacy, the implementation of this
provision would have represented a highly irrational use of scare resources
that could be put to better use addressing the urgent health and survival
needs of millions of living Peruvians.
Dr. Carbone was removed from his post as Health Minister in response to
widespread protest, not only from Peru4s civil society but also from members
of congress, major medical associations, womens community-based
organization, and the press. Today, these same institutions continue to be
appalled by the emerging evidence of damage done to Perus public health
system between 2001 and 2003, putting it back at least ten years. Given Dr.
Carbone4s trajectory as Minister of Health of Peru, we are completely
outraged that our government would even consider his participation on a
panel and thereby support the dissemination of his misguided policies
regarding maternal mortality and reproductive health.
Sincerely,
Jodi L. Jacobson Anna-Britt Coe
Executive Director Program Director, Latin America
The Center for Health and Gender Equity is a U.S.-based non-governmental
organization focused on the effects of U.S. international policies on the
health and rights of women, girls, and other vulnerable populations in
Africa, Asia, and Latin America. For more information on this issue or about
our database, please e-mail Ebony Baltimore at ebaltimore at genderhealth.org
<mailto:ebaltimore at genderhealth.org>