Two Primary Reproductive Health Issues in Rwanda, Research Paper Example

The Human Rights Watch has criticised the Government of Rwanda for the inadequacy of provisions in the reproductive health bill.  In particular, this references the transmission of HIV/AIDS from one person to another. One primary reproductive health issue to consider is the concept of forced HIV screening and compulsory sterilization. This is seen as counterproductive to the reproductive cycle of women in Rwanda. It is known that current legal provisions stigmatized women, removed their dignity, and provided a platform of fear leading to coercion. The government has been observed in panic mode over an HIV/AIDS crisis without truly considering the potential positive impact of a dignified set of policy changes (Human Rights Watch).

The concept of forced sterilization has been condemned by Human Rights activists as noted in the following: “In our experience on this issue, every single time a sterilization campaign has a hard target and a timetable attached to it, it inevitably involves coercion and abusive expansion, just as night follows day” (Africa Great Lakes Democracy Watch).

In 2006, only 6 percent of the total health budget was spent on reproductive health, in spite of an HIV/AIDS crisis that has had serious impacts on medicine related to reproductive health.  In 2008, this issue was addressed by a Government Select Health Committee that demonstrated the urgent need for funding in the family planning sector (Government of Rwanda).   The Government stated that the primary cause was limited funding, coupled with the fact that it was fighting a number of other serious medical crises at the same time, including Malaria, Tuberculosis, and HIV/AIDS.  In general, the health sector is highly dependent upon a donor funding program for its very survival (Government of Rwanda). Despite the efforts made by the government, little progress has been made in improving these important health-related issues.

Forced HIV Screening

In many countries, there is a perception in place that it is necessary to provide mandatory forced HIV screenings for some population groups. It is known that “Compulsory blood testing is not a measure that respects and protects the right of people living with or vulnerable to HIV infection… Legislation authorizing the forced testing of people for HIV (i.e., without a person’s informed consent) does not represent an appropriately balanced policy response to the issue of occupational and non-occupational exposures to HIV” (Elliott, 2008). Under these conditions, it is difficult to imagine a scenario whereby there is a mandate for forced HIV screening against a person’s will, but this is exactly the case in many African nations, including Rwanda. Therefore, on the basis of basic human rights, this is an extremely difficult area of public policy to navigate, because forcing an individual to take an HIV test is against his or her basic human rights and right to privacy. There are many examples of this practice, such as an example whereby gay males were chained to hospital beds against their own will and were forced to take HIV tests in Egypt (Moszynski, 2008). This type of forced approach is clearly unethical, and it also creates new challenges for governments and healthcare workers when patients do not have any faith and trust in their care providers, which could make the problem of HIV even greater than it already is (Moszynski, 2008). It is important to recognize these concerns as they relate to the forceful action of some groups in mandating these tests in spite of their direct violation of human rights (Moszynski, 2008).

Compulsory Sterilization

In Rwanda, there are a number of significant political concerns which demonstrate that the government and many other groups do not support the best interests of the people of this country. It is instrumental to develop a greater understanding of these concerns as they influence this group of people. For example, the concept of forcing individuals to be sterilized is not only difficult to accept, but it is a clear violation of basic human rights and freedoms. There has been a growing belief that different social classes or other groups should be sterilized as a direct result of their status, which is an unacceptable practice, regardless of the circumstances (Weitsman, 2008). Under these conditions, it was perceived as “true genocide, as it sought to destroy the genus of particular racial and ethnic groups” (Weitsman, 2008). This is an extremely difficult concept to accept, and it reflects the problems that influence HIV/AIDS and their impact on the people of Rwanda.

The Human Rights Issues

Much of human rights criticism has surrounded the HIV/AIDS problem in Rwanda. In particular, the level of coercion placed upon women and the stigmatism and persecution of HIV/AIDS has been difficult to manage.  A survivor of the 1994 Genocide Godeliève Mukasarasi (Rwanda), Laureate has made a significant contribution in terms of emphasizing the human rights issues in Rwanda, specifically concerning brutal rapes and the sexual violence that resulted in the transmission of HIV/AIDS to unprotected women.  (Mukasarasi). Rwanda has been cited as breaching three aspects of International Law: Common Article 3 of the Geneva Conventions of 1949, the norms prohibiting crimes against humanity, The Genocide Convention (Woman Aid International).

In the war years, it was estimated that up to half a million women were systematically raped and that the soldiers used this as a weapon of fear and coercion.  The women were subsequently stigmatised and rejected by Rwanda society.  In the case of rape, society no longer deems her marriageable or socially viable. In these situations, women are outcast and often sent out to become martyrs for the cause. What is notable here is not only that women’s worth derives from their relationships to men, but also that the shame of victimization is far worse than the perpetration of the crime. This situation has important implications not only for identity but for gender politics as well” (Weitsman, 2008). Therefore, it is necessary to approach rape as a clear and direct violation of human rights, while also considering other factors which also influence how rape is viewed by Rwanda (Weitsman, 2008). In particular, during times of war and strife, these actions are particularly common and especially brutal, as they demonstrate a lack of respect for women and what they stand for in society (Weitsman, 2008). These problems serve as brutal reminders that there are significant patterns of genocide, rape, and different forms of coercion that are particularly difficult to accept, and that these actions must be addressed as basic human rights issues.

The majority of these women are destitute and cannot afford the retroviral treatment.  The United Nations (UN) has stated that the Rwandan Government has a responsibility to place effective health policies that protect the rights of women and provide remedial treatment plans (UN Women). Therefore, it is necessary to consider some of these concerns and how they impact the Rwandan population in different ways. Human rights violations are a common practice in many third world countries, and this presents a number of challenges which are very difficult to manage within the context of their actions. With the tremendous impact of HIV and AIDS on this population, it is particularly important to recognize how to improve some of the reproductive issues that continue to prevail in this country. These efforts will determine how the country might effectively respond to different practices that are considered to be not only unlawful, but a direct infringement upon human rights. There are many of these issues to consider in Rwanda as the country continues to move leaps backwards rather than forwards with the HIV and AIDS epidemic. Therefore, reproductive concerns must be managed in such a way that they will positively impact the population, rather than lead to further negative impacts, particularly for women and their children. For women who have already been diagnosed with HIV and AIDS, reproductive concerns are of critical importance, as it is necessary to educate women in regards to the spread of HIV/AIDS. However, when this is out of their control, additional problems ensue that are difficult to overcome. It is important to recognize these concerns and how they impact basic human rights, as these efforts will go a long way in improving the situation in Rwanda in regards to HIV and AIDS as they relate to reproductive concerns.

Works Cited

Africa Great Lakes Democracy Watch. Stand up Against Forced Sterilization in Rwanda . 14 2 2011. http://greatlakesdemocracy.blogspot.com/2011/02/stand-up-against-forced-sterilization.html. 6 11 2011.

Elliott, Richard. Legislation to Authorize Forced Testing for HIV in the Event of Occupational Exposure: an Unjustified and Unnecessary Human Rights Violation. April 2008. Website http://www.aidslaw.ca/publications/interfaces/downloadDocumentFile.php?ref=849

Government of Rwanda. National Health Accounts. Government Report. Kigali: Government of Rwanda, 2006. Report.

Human Rights Watch. Rwanda: Revise Reproductive Health Bill. 1 7 2009. Website. 2 11 2011.

Moszynski, Peter. Egyptian Doctors who took part in Forced HIV testing “Violated Medical Ethics.” BMJ 336(7649): 855.

Mukasarasi, Godeliève. Rights and Democracy. 2004. Web Report. 3 11 2011.

UN Women. Law and Policy Reform. 2009. Website. 3 11 2011.

Weitzman, Patricia A., The Politics of Identity and Sexual Violence: a review of Bosnia and Rwanda. Human Rights Quarterly, 30(3): 561-578.

Woman Aid International. Rwanda: Crimes Against Humanity. 2011. http://www.womenaid.org/press/info/humanrights/rwanda%20hr.html. 6 11 2011.