health of women and girls – UAB Institute for Human Rights Blog

Pakistan’s Floods : A Humanitarian and Climate Crisis

One third of Pakistan is underwater following disaster-level floods that have ravaged the country since mid June of 2022. The flooding is a humanitarian crisis of epic proportions, bringing climate change and environmental justice into the focus of conversations about why the floods are so devastating. The record-breaking monsoon rains have affected 33 million citizens, leaving millions displaced and threatening the economy by washing away the fall harvest and essential farmland. Pakistan’s most vulnerable are struggling to access the scarce aid that is available, including the 19 million children affected by the floods. It is an unprecedented, once in a century crisis event exacerbated by climate change, poor infrastructure, and the damages of the recent economic crisis prior to the flooding.

Direct Impact of the Floods: Hunger, Disease and Displacement.

The monsoon rains have killed over a thousand people, roughly 400 of which are children. However, hunger, thirst, disease, and shortages of essential supplies threaten the lives of even more; millions of Pakistani people have been displaced over the course of the floods since June. The United Nations Refugee Agency has estimated that 6.4 million people are in need of immediate support.

Any discussion of rebuilding has been shelved in submerged regions as the flood waters may not recede for months, leaving the thousands of kilometers of roads, tens of thousands of schools, hundreds of thousands of homes, thousands of essential healthcare facilities destroyed by floodwater, and prior residents stranded or displaced. In addition to the initial death toll from the floods, the Pakistani people are facing immediate dangers of water borne disease, lack of access to food, water and shelter, and risks of violence; especially for women, children, and minority groups.

The country’s health system has faced substantial blows, both from loss of structures and supplies caused by the flood and the overwhelming need of those affected. Dehydration, dysentery, cholera, malaria, and dengue fever are ravaging make-shift camps as the flood waters become stagnant and clean water and sanitary supplies become harder to come by. Sindh Province, the second-most populated province in Pakistan, and one of the hardest-hit by the floods, has seen over 300 deaths from water borne-diseases since July. Early disease surveillance by the WHO has revealed that tens of thousands of cases of flood water-caused diseases are already present amongst those within reach of relief efforts. Countless villages remain stranded as roads and highways are underwater, so the true number of deaths, displaced persons, diseased, and persons otherwise impacted by these crises are expected to climb as more recovery efforts continue to search the flooded regions.

Without international aid and intervention, an epidemic of disease caused by the floods will cause a second wave of deaths in Pakistan, of which the elderly, children, and pregnant women will be the largest groups facing losses. International aid, medical and humanitarian organizations have joined the Pakistani government and are regularly dropping medical supplies, malaria nets, food and provisional shelters, but the need continues to grow as more people find their way to temporary camps and the rate of disease climbs.

Human Rights & The Most Vulnerable

A nation’s most vulnerable populations are often the ones who suffer the worst effects for the longest time after a natural disaster like these floods. For Pakistan, those vulnerable groups are women, children, the Khwaja Sira (transgender) community, those living in extreme poverty, religious minorities, and other marginalized groups. Typically, socially disadvantaged groups are living in regions with lesser infrastructure, facing the initial worst impacts of natural disasters, but marginalized status often leads to upwards battles to access humanitarian aid after the disaster as well. There are estimated to be 650,000 pregnant women displaced in Pakistan right now, in urgent need of maternal health care and safe, sterile facilities to give birth in, with many taking perilous journeys in hopes of reaching a hospital or safe places to give birth.

CARE, an international human rights and social justice organization, spoke on this concern. Pakistan Country Director for CARE, Adil Sheraz said, “With entire villages washed away, families broken up and many people sleeping under the sky, the usual social structures that keep people safe have fallen away, and this can be very dangerous for women and girls.” 

Following the 2010 floods in Pakistan, denial of aid and violence against minorities became a prevalent issue and large protests against law enforcement arose due to their failure to protect vulnerable groups. Preventative measures against recurrence of these issues have been few and far between since 2010, and international human rights communities are on high alert for rising reports of discrimination in relief distribution and crimes against minorities. Reports of sexual violence have already increased following the floods.

In addition to some of the most vulnerable Pakistanis are roughly 800,000 Afghani refugees who have been hosted by Pakistan in Sindh and Balochistan; two provinces faced with the worst of the flooding and submersion. Pakistan has a deep history of offering asylum and refuge for those fleeing across the border from conflict in Afghanistan, and is home to 1.4 million Afghani refugees currently in 2022. Following the August 2021 withdrawal of US troops from Afghanistan, the Islamic Emirate government (also known as the Taliban), Pakistan became an even more essential haven for the influx of refugees fleeing a violent authoritarian regime. In the wake of this natural disaster, the loss of $30 billion dollars worth of infrastructure, homes and supplies, and facing an economic crisis, Afghani people with hopes of finding refuge in Pakistan must now find new routes to safety.

Environmental Justice & Climate Change

Though Pakistan faces annual flooding of the Indus river from heavy rains in monsoon season, record breaking rains preceded by an extended heatwave contributed to an unrivaled degree of flooding this summer. Heatwaves brought temperatures around 50° Celsius (122° Fahrenheit) to India and Pakistan between March and May of this year. Monsoon rains followed the spring heatwaves, and in the regions of Sindh and Balochistan rainfall reached 500% above average. The 2022 floods will leave a significant economic, infrastructural, and humanitarian impact on the country of roughly 220 million people. The reason for the dramatic influx in severity is complex, but simple at its core: climate change.

Pakistan is facing an unfair share of the consequences of climate change; while it was responsible for only .3% of global CO2 emissions in 2020, it is likely that this year’s heatwaves and floods will be on the less severe end of what is to come. The United Nations has deemed Pakistan a “climate change hotspot”, stating that people in South Asia are 15 times more likely to die from climate impacts. As the global temperature rises and geohazards become more extreme, disaster-prone regions like Pakistan will face more and more devastation. The best prognosis for the region comes with prevention efforts like strengthening anti-disaster infrastructures. As the global north is responsible for 92% of excess emissions contributing to global warming and climate change, Pakistan, the United Nations, and other international agencies are calling for countries like the United States to make increased contributions to relief funds and infrastructure development overseas.

United Nations Secretary-General Antonio Guterres, while visiting Pakistan in September 2022, said, “…the fact is that we are already living in a world where climate change is acting in such a devastating way. So, there must be massive support to what usually is called adaptation, which means to build resilient infrastructure and to support resilient communities and to create conditions for those that are in the hotspots of climate change. Pakistan is one of the hotspots of climate change. For those countries to be able to prepare for the next disaster and to be able to resist the next disaster, this needs a huge investment and this investment needs to be provided.”

Relief & Aid

Pakistan has faced an overwhelming series of calamities since the start of this year, and the impacts from these disasters are greatly exacerbated by food shortages and an economic crisis prior to the start of the disasters in March. There are millions of people in need of aid, and every bit of support helps. If you are unable to financially contribute, please consider sharing this or other articles about this crisis to increase international attention on those who need our help.

For donations of money, time, or other resources, we have compiled some reputable aid agencies below:

Pakistan’s Red Crescent Society is providing clean drinking water, medical treatments, temporary housing, and other essential aid across flood-hit regions. Donate or get involved with their flood response efforts here.
The United Nations Refugee Agency has provided millions of dollars in aid to Pakistan, and you can contribute here to support their continued relief efforts.
The International Medical Corps are on the ground in Pakistan, providing medical care and responses to both the floods and gender-based violence across the country. Find out more & how you can donate here.
Muslim Aid has reached over 29,000 people in three affected districts of Pakistan, providing hygiene kits, shelter, and essentials to those in need. Contribute to their fund here.

An Argument for Decriminalizing Sex Work

Abstract of a red light — Abstract at a Red Light. James Loesch. Creative Commons for Flickr.

Different human rights groups support or have called for the decriminalization of sex work. Some of which include Amnesty International, World Health Organization, UNAIDS, International Labour Organization, the Global Alliance Against Trafficking in Women, the Global Network of Sex Work Projects, the Global Commission on HIV and the Law, Human Rights Watch, the Open Society Foundations, and Anti-Slavery International.

Picking on one, the Human Rights Watch supports the full decriminalization of consensual adult sex work in support and defense of human rights relating to personal autonomy and privacy as, “A government should not be telling consenting adults whom they can have sexual relations with and on what terms.” Joining 61 other organizations, they recently advocated for a bill that would decriminalize sex work in Washington, DC. This Community Safety and Health Amendment Act intends to repeal statutes that criminalize adults who voluntarily and consensually engage in sexual exchange, while it upholds and defends the legislature which prohibits sex trafficking. The HRW affirms that adult consensual sexual activity may be covered by the concept of privacy, rejecting the idea that criminalization was a protective measure against HIV and STIs, and conveying that it was more likely to drive a vulnerable population underground.

However, the demands of these organizations and supporters of sex workers have surfaced controversy around sexuality, health, economics, and morality. Often the idea of sex work may be tied to or conflated with sex trafficking, child sex abuse, and rape. Open Society Foundation simply defines sex workers as “adults who receive money or goods in exchange for consensual sexual services or erotic performances, either regularly or occasionally.” Sex work encompasses a wide range of professions and activities which include the trade of some form of sexual activity, performance, or service for a client to a number of fans for some kind of payment (including prostitution, pornography, stripping, and other forms of commercial sex). It is clearly separated from those services that utilize “the threat or use of force, abduction, deception, or other forms of coercion for the purpose of exploitation”. Decriminalizing sex work would call for the “removal of criminal and administrative penalties that apply specifically to sex work, creating an enabling environment for sex workers’ health and safety.” Amnesty International expands on these definitions in this report.

Many members of society view sex work as immoral or degrading to women, arguing that sex work is inherently exploitative of women, even if these workers find it profitable or empowering- even simply as the power to creatively express one’s sexuality. When we think of sex workers, we tend to assume they were forced into it or assume a desperate narrative with no other options. Then, maybe, we judge their appearance while tying it to their worth or a fantasized idea of sex workers opposed to the ordinariness we associate with other professions and community members. A simple argument says that, like any profession, there are extremely different motivations to pursue these professions and, in the end, it’s a job or choice of work with its own pros and cons for each lifestyle (affording many lifestyles). Also, anyone and any personality can be a sex worker.

People enter and remain in this work for a multitude of reasons creating each individual experience of sex work; however, many face the same response and abuse in the workplace or trade. Owning to the stigma associated with the profession, not many can come out and say they are a sex worker. They must fight to be recognized beyond the stigma or continue to repress or hide their daily lives from their community or society. Sex workers report extreme violence and harassment from clients, managers, police and society and even more cannot report these violences, facing incrimination or even incarceration. Ironically, laws on sex work undermine governments’ own efforts to reduce high rates of violence against women and reduce rates of HIV infection in sex worker populations.

Repressive policing not only further marginalizes sex workers as a whole, but it also reinforces what it promises to remove as it exposes sex workers to different abuses and exploitation by police or law enforcement officials who may arrest, harass, physically or verbally abuse, extort bribes and sexual services, or deny protection to sex workers avoiding the eyes of the law. Some sex work may be illegal because it is viewed as immoral and degrading, but people governed by these laws do not share the same moral beliefs. As police fail to act on sex workers’ reports of crimes, or blame and arrest sex workers themselves, offenders may operate with impunity while sex workers are discouraged from reporting to the police in the future. Then there is the financial toll of criminalization as repeating fines or arrests push some further into poverty. People may be forced to keep selling sex as potential employers will not hire those with a criminal record. Also, if the need for money found some sex workers in the streets, how will fines deter the work?

The work entails forming relationships with a wide range of clients at different levels of intimacy. Unfortunately, sex work offers comfort to predators, or those who mean harm, who also understand and exploit the workers paralleling relationship with police. Working in isolation, workers’ lives are threatened as they avoid the police and are denied these protections in their workplace and, off the hook, predators continue to harm more even those outside of the sex trade. Facing arrest or prosecution themselves, any client may protect themselves from blocked numbers leaving workers in the dark with no evidence of whom they are dealing with, surrendering that safety. Some laws advocate helping sex workers by removing the option of work as it criminalizes only those who buy sex. Now, to incentivize clients and income, workers may be forced to drop prices, offer more risky services, or reach out to potentially abusive third-party management.

Woman holding poster reaing "Sex Workers Demand Safe Spaces" — Sex Workers Demand Safe Spaces. Fibonacci Blue. Creative Commons for Flckr.

Decriminalizing and regulating the work of sex workers would allow them the right to choose their clients and negotiating power or power to cease the service when they feel uncomfortable or unsafe. Criminalization, or the threat of it, complicates and weakens workers’ power to negotiate terms with their clients or collaborate with others for safety. So, for example, it may increase the chance for workers to engage in sex with clients without a condom (which may be used as evidence of the crime). Although variable in different contexts, in low and middle-income countries on average, sex workers are 13 times more at risk of HIV, compared to women of reproductive age (age 15 to 49), so their ability to negotiate condom use is important.

According to a study led by the London School of Hygiene & Tropical Medicine and published by the American Association for the Advancement of Science, sex workers who had been exposed to repressive policing had a three times higher chance of experiencing sexual or physical violence by anyone, including clients and partners. They were also twice as likely to have Sexual Transmitted Infections than those who avoided repressive policing.

In order to be protected from exploitation by third party managers and dangerous clients, to be informed on sexual transmitted infection and other health concerns or vulnerabilities, to be able to unionize and self-manage, and to be able to reach out to law enforcement, sex work should be regulated by the same occupational safety and health regulations that benefit workers in other labor industries. Dedicated efforts must consider the elevated or unique risks, vulnerabilities, and intersectional stigmas surrounding different sex workers, including men, transgender, and other gender identities and portions to improve health outcomes and human rights. Wider political actions are needed to address inequalities, stigma, and exclusion or marginalization that sex workers face even past the criminal justice system to health, housing, employment, education, domestic abuses, etc.

We are faced with opposing or contradictory narratives of the sex work experience, but we have chosen some to represent the entire concept especially those tailored to our own feelings of sex and commerce without concern or consideration of those even more immediately affected. The conversation of sex work needs to open up to understand and share the message to all that the labor itself is the commodity, not the laborer and it requires workers more considerate rights and regulations. If sex work is legally accepted with due rights and respect, it can become something that benefits- even especially vulnerable or marginalized- women and humanity.

“What sex workers need is not condescension and invasion into their private lives, but support in achieving decent working conditions.”

Additional Sources:

Open Society Foundations

Vox

Gender Based Violence

by Grace Ndanu (student guest blogger)

It is believed that Gender Based Violence existed from long time ago as a result of male dominance and power, meaning women were left inferior. Generally GBV stops girls from reaching their potential, where by there is a lot of working to transform attitudes towards girls and women that perpetuate violence against them. That is why women are trying to negotiate with the men that they can be equal, but men want to maintain their dominance, which causes an increase in GBV cases.

GBV occurs almost everywhere now, and the girls and women are the victims. Stating at home, children’s vulnerabilities to violence stem from the fact that they depend on their parents or caregivers for their development health and wellbeing. Girls and young women often experience violence at home, from physical punishment to sexual, emotional or psychological violence. Acceptance of violence as a private affair often prevents others from intervening and prohibits girls and young women from reporting in the name of keeping the family name clean.

In primary and high school the violence rate is low unlike in the college and universities. This is because there are strict rules and supervision, which is not the case in colleges and universities around the world. While in college a girl is considered to be an adult. Also, her parents are far away, so anyone she has the freedom to do whatever she wants, including engage in sexual relationships. In these relationships the boys often want to take charge of girl’s life. At this point most of the girls already know their rights and hence they will never accept to be dominated. Unfortunately, this makes them vulnerable to gender based violence because the boys will still fight to maintain the “man’s “position in a girl’s life.

In the work place the top positions are designed for men, including the managers, directors and supervisors, while women are secretaries and cleaners. Gender based violence is likely in situations where a qualified female is expected to perform sexual favors to management in order to get a promotion.

Gender based virulence is also a rising issue in online spaces with girls and young women reporting harassment and abuse. For many girls, there is a pressure to leave online platforms. I am opposed to this because these are the places where most girls and young women get to know their capabilities and strengths through interaction with different types of people. But girls need to be careful in these spaces.

Gender based violence occurs in all parts of the world, but the risk is higher where violence is normalized and where rigid concepts of gender exist. In many cultures, especially the developing countries, violence towards girls and young women is accepted as a social norm. Here comes a saying of an African woman who is strongly tied to culture “a husband who does not beat his wife does not love her”. And the woman herself will ask her husband to beat her. This must be challenged as a matter of urgency, the blame, shame and stigma faced by victims must be eliminated.

Violence should never be a private matter and everyone should be aware of this starting from the youngest to the oldest. So that it can be challenged. Ending GBV will involve action at all levels; strengthening legislation and criminalizing the violence, challenging social norms that condone violence and prosecuting the perpetrators.

Children should learn about gender equality at school, just as it is important to promote integrational dialogue on violence against children. Community dialogue can challenge dominance that brings about gender based violence.

Everybody has a responsibility to promote and strengthen values that support nonviolent, respectful, positive gender equitable relationships for all children and adolescents, including the most vulnerable and excluded.

Young girls and women are encouraged to speak up about the issues they face which embolden them to speak up for change. On the other side young men are encouraged to identity and challenge harmful and negative masculinities that perpetuate discrimination and violence.

WILL MY STORY AND HOW AM PLANNING TO HELP THOSE WITH THE SAME PROBLEM EVER RULE THE WORLD?

by Grace Ndanu

Over spring break 2019, UAB students traveled to Kenya with Dr. Stacy Moak, Professor of Social Work, and Dr. Tina Kempin Reuter, Director of the UAB Institute for Human Rights. They visited CARA Girls Rescue Center where they met Grace, a student and former resident at CARA [she is behind the lady in the orange dress]. Below is Grace’s narrative which includes sexual violence.

As humans, we are born to expect much than to face reality. We come to learn that everything has a purpose.

I was born in 1998 and raised by a single mother till 28th November 2004, where I got a daddy who I thought was loving and caring. Instead, he became a monster. Before my sister who was born in 22nd November 2005, the man started beating me for no reason and not just a child beat, it was a criminal beat whereby he used an electric wire to beat me up. As a child, I expected my mom to get in between and talk to her husband about the matter. My expectations became a fantasy and the beating became a habit. In 2006 in grade 4, I was supposed to go for tuition on weekends, but instead, I was forced to stay with my little sister at home so that my mom can go for work or church meeting. When I refused I was given a thorough beat and asked why I didn’t love my baby sister.

Sometimes the man volunteered to stay with the baby but insisted I remain so that I will help him with the baby. His agenda was opposite and he started molesting me. He started touching my private parts and when he knew it was time for mom to come back, he beat me up so that I should not say. As this was going on, we had a male neighbor who was doing the same as what my dad was doing but didn’t beat me. Until one Sunday, I refused to go to church and now I was left with the neighbor in the compound where he got a chance to rape me and asked me to keep quiet. Later in the evening, I decided to open up to my mom and she said that I was lying. She talked with my dad about the issue and they decided to ask the neighbor. Definitely, he denied. From this point, my parents started calling me a liar. This made my dad more comfortable in continuing what he was doing to me that is threatening me and sexually harassing me. This was still going on and my little sister grew up knowing I was a bad girl. It came to a point where anything happened to her she would say it is me.

a group photo of Grace and two of her friends — Photo by Grace Ndanu

On 22 April 2008, I got a baby brother and now I felt my life was at the peak. I didn’t want to live anymore and attempted three suicides. God remained faithful and kept me alive. It was on the second term of my grade 6 and I was transferred from a private to a public school which was 8km away from home. I was forced to walk all the way and come back home remember no lunch for me. In 2009, it was time for my sister to join [to go to] school. She was brought to the school I was which made my life more and more difficult because I carried the girl at my back every morning to school. My going to school late and tired became a habit and whenever I raised the issue, I was beaten and threatened that I will not join high school. I faced rejection, hatred, insult, and isolation. My brother and sister were growing knowing am the baddest person on earth. I went to a different church from the family so that I can come back home and do the house chores at this time. I was not allowed to stay with my siblings become it was believed I had no good intentions towards them.

In 2010, a church friend of my mom noticed she hasn’t seen me for a while and decided to visit us at home. She asked me if am fine and my response was positive but she was not convinced. She decided to pay my school fees and she ordered that I go back to my previous school. My dad was not happy and started accusing me of witchcraft, asking ‘why it is only me and not any other person.’ At this point, I decided to run from home – hoping after five years of tears and pain, I will come to my rescue. I didn’t know where to go but I started my journey in February on a Tuesday. I boarded a bus to a place called Kiserian and another one to Nairobi. I had no money but I reached Nairobi. I stayed in Nairobi for three days without food, just loitering and later I decided to call my mom with a stranger’s phone and she came to my rescue. The following Monday I was taken to school. I tried being strong by working hard but my life was miserable until I was through with my primary school. I promised myself that I will not live any longer and attempted another two suicides; I found myself alive.

I was enrolled in high school in 2011 which made me happy but inside I was dying. I knew the battle isn’t over yet because, during the holidays, I would go home. [In Kenya, most high schools are boarding schools.] My first holiday that was in April, I went home and this gave my dad a chance to rape me. He threatened me with a knife that if I said he will kill me. After four weeks, I went back to school. While in school, I started developing ulcers and depression. I started falling sick each day and this forced me to go home. While my mother was nursing me, I opened up to her about what dad was doing. [I thought she would defend me but] It came out the opposite and she defended her husband. She told me that I was lying. Later that evening she told the man what I told her during the day. The man denied and told my mom that I am cursed and that she should let me get married because I was a grown up at 13 years. I got well and went back to school. I got more depressed and started fainting. One of the teachers realized that nothing was going well with me. She decided to call me and ask me [about] the problem. I opened up to her. She went ahead and explained the matter to the principal. The principal made an arrangement of visiting a counselor and a doctor at the Nairobi Women’s Hospital. I started the medication together with the counseling sessions which was of great help.

a photo of Grace — CARA. Photo by Grace Ndanu

The principal did not only helped me get well. She also [helped me] find a good home for me at the Cara Girls Rescue Center. The center took good care of me and they also counselled me. After some weeks, I had no one to pay my school fees there. I was transferred to AIC girls where I would get a sponsor and continue with my studies. After I got someone to support me, I went back to Cara Girls Rescue Center where I am till date. Being suffered for eight good years–my all childhood life has been a hell. There was no love, no care, and no mercy even from my own mother. I promised myself that I will never allow any child or anyone go through what I went through. Through this, I have always admired to be a Gender and Development CEO. I am working towards the goal. I am in my second year of studying in Gender, Women, and Development Studies. I have joined Egerton University Human Rights Club and an organization, Family Health Options Kenya, which deals with sexual health. It involves educating peers about sex and what they should do when their rights are violated. In the future, I am planning to do a Masters in Gender, Peace, and Security. I must ensure children especially the ones living with their stepparents to have full access of their mental peace, and the young girls and women who can’t raise their voices. I aspire to give people light and hope and reasons to enjoy their lives. I have realised I never enjoyed life. I just lived because it was a must but now it is time to live in reality. This is what am supposed to do: make people live the reality life, the life they deserve and deal with the ones that come in between their peace, joy, happiness and their rights.

I believe I am an agent for change. I must bring a change AND WE WILL RULE THE WORLD.

If you would like for girls like Grace to stay in school, please consider donating to our LadyPad project, during the UAB Giving Day Campaign, by using this link https://www.uab.edu/givingday/?cfpage=project&project_id=27174