This article discusses violence in relation to women's reproductive and sexual rights in Africa. Two types of violent behaviors are defined. One type is defined as a straightforward, aggressive act of brutality inflicted on one person by another, which may range from battery to rape, and which may occur domestically or be inflicted by a stranger. The other type of violent behavior is the violation of rights or denial of rights, which often operates not only on personal, but also on societal or cultural levels. These definitions allow us to address the record of violence against women in a broad social and political context in which not only men but women and society as a whole act to perpetuate systems resulting in various forms of abuse. In Africa, the strong patriarchal tradition with the economic mode of more formal and systematic, less centralized commerce makes it virtually impossible for a woman to move, act, or think freely. The most damaging type of sexual violence against women centers on the lack of control that women are allowed over their fertility. Denial of reproductive rights, services and information acts as pervasive form of violence, with significant consequences. Women face both the threats of direct bodily violence from strangers and within their own homes; and the exposure to the risk of HIV infection and other sexually transmitted diseases, of unwanted and unplanned pregnancy, and of unsafe abortion due to the violation of women's basic human rights.
Rosiska Darcy Oliviera, Executive Secretary of the Coalition of Brazilian Women from Non-governmental Organizations for Population and Environment, stresses the need to view population control as a political problem rather than just a technical problem of demographic organization. At present, science, technology, and capital separate the work in much the same way that the master slave relationship of colonialist times did. The vast majority of the excluded are from developing countries in the South and, from a market perspective, these outcasts serve no purpose to global processes. Relegated to the margins of society, outcasts are often forced to turn to illegal activities such as drug trafficking and prostitution to survive, and these behaviors are used to bolster racist ideology. Improving the quality of life for all men and women requires a global alliance to overcome this social apartheid. If women are to exercise their reproductive rights, women's health programs must extend their focus beyond contraception to include education that empowers women to make real choices and a material base that permits access to a spectrum of safe methods.
Third World women with complications from an illegally induced abortion tend to postpone seeking medical treatment, because of both a lack of knowledge about the signs of infection or hemorrhage and a fear of moral and legal sanctions. At admission, hospital policies require that women be questioned repeatedly until they acknowledge whether their symptoms are a result of induced or spontaneous abortion. In Bolivia, women hospitalized for abortion-related complications also face financial sanctions. They are charged 450 Bs (US$105) for dilatation and curettage); social security coverage is denied as is eligibility for sliding scale fees based on ability to pay. Interviews with 12 patients and 14 staff members at 4 Bolivian hospitals revealed substantial variation in the postabortion care women receive. Care seemed to be more dependent on the personal ethics of staff members than definite policies. In general, however, these women did not receive the moral support needed to help them overcome their feelings of ambivalence, guilt, and depression. Rather, a double standard prevails, where women alone bear responsibility for the pregnancy and then are blamed for seeking termination under illegal conditions.
The author, a representative of the Swedish National Preparatory Committee for the Cairo International Conference on Population and Development (ICPD), urges that each question and proposed action be considered within the framework of a gender and human rights perspective. The starting point for all discussions of population policies should be the individual rather than global population targets. Social and economic empowerment of women is essential to the success of development programs. If population growth is to match available resources, life-styles, production, and consumption strategies must be modified. In terms of sexual and reproductive health, the socioeconomic and cultural factors that impact on the decision to accept contraception must be considered. Safe methods of contraception and legal abortion must be available, and the sexual health issue should be broadened to include consideration of the sexual violence faced by many women and children. In addition, the fact the adolescents are sexually active must be accepted if unwanted pregnancies, deaths through unsafe abortion, and the transmission of sexually transmitted diseases are to be reduced. Support for contraceptive use is a necessary, but insufficient, precondition for women's health; essential is a more holistic approach.
In late October, 1993, 43 national scientific academies convened for 4 days in Delhi, India. This was the first time that so many academies had come together to discuss a topic of common interest: the controversial issue of population in conjunction with environment and development. The New Delhi gathering, known as the Population Summit, came up with a Conference Statement that earned the signatures of almost all participants. The statement proclaimed that ultimate success in dealing with global social, economic, and environmental problems cannot be achieved without stable world population. The goal should be zero population growth within the lifetime of our children. This goal will require prodigious planning efforts. If all couples were to decide right now that they would produce no more than 2 children, the world's population would still keep on growing through demographic momentum for another several decades. The source in shortest supply is probably not money but time. Said the Royal Society and the US National Academy of Sciences in 1993, "If current predictions of population growth prove accurate and patterns of human activity on the planet remain unchanged, science and technology may not be able to prevent irreversible degradation of the natural environment and continued poverty for much of the world ... Some of the environmental changes may produce irreversible damage to the Earth's capacity to sustain life. The future of our planet is in the balance." The Delhi statement was backed by 25 professional papers on subjects such as population history, energy, and water.
