The single highest barrier to development globally is neither hunger nor disease — it is gender-based discrimination and violence.
That is why achieving UN Sustainable Development Goal No. 5 — gender equality and empowerment of all women and girls — is a prerequisite for progress on the other 16 objectives. And yet, with only a decade left to complete the agenda, governments continually fail to uphold girls’ and women’s most basic rights, let alone empower them to reach their full potential.
Consider the plight of women in South Africa, where the femicide rate is almost five times the global average and sexual assault is rampant. From 2018 to last year, the police recorded an average of 114 rapes per day — an increase of nearly 5 percent from the previous year. To add insult to injury, women and girls — including victims of such assaults — often lack access to sexual and reproductive health services, including safe, affordable abortion.
The problem is not legal. South Africa’s constitution guarantees access to reproductive healthcare and the 1996 Choice on Termination of Pregnancy Act allows abortion on demand up to the 12th week of pregnancy. And yet, unsafe abortions still outnumber safe abortions 2-1.
Based on South Africa’s high rate of sexual assault — and my firsthand experience as a doctor working in the country — it is fair to assume that a non-negligible share of these unwanted and unsupportable pregnancies began in violence.
In this sense, many South African women are victimized twice: first by the perpetrators of the assault and then by the health system that forces them either to carry an unwanted pregnancy to term or turn to sellers of illegal abortion pills.
In the latter scenario, the women risk side effects like sepsis and hemorrhaging, and often endure the dangerous and undignified process in public bathrooms. They might then suffer yet more violence, as their community blames them for the consequences of actions taken in desperation.
For example, I was recently contacted by a young woman who was being hunted by a mob that suspected her of abandoning a fetus in a public toilet.
It did not matter that the woman had been raped and subsequently obstructed by the local clinic staff from receiving an abortion — care guaranteed by the act. It did not matter that her constitutional rights had been systematically infringed upon. She would now suffer yet more violence, unless she managed to secure safe passage away from her home.
Meanwhile, no healthcare professional or support staff has ever been punished for denying abortion services in contravention of the act.
These problems are systemic. A 2016 report by South Africa’s Commission for Gender Equality found that the South African Department of Justice and Correctional Services was not coordinating the departments involved in implementing the Service Charter for Victims of Crime in South Africa. The South African National Department of Health, for its part, had not established a standardized system for funding, monitoring and evaluating the delivery of healthcare services to victims.
The consequences of these failures included shortages of DNA evidence kits at police stations, inadequate transport resources and a lack of safe houses for victims.
Perhaps not surprisingly, perpetrators of sexual violence rarely face punishment.
These problems are hardly unique to South Africa. The WHO has estimated that, globally, more than one in three (35 percent) women will experience physical or sexually intimate-partner violence or non-partner sexual violence in their lifetime. Few see their attackers punished, and many cannot access sexual and reproductive healthcare after the fact, even in countries that have ratified international instruments guaranteeing the right to such care.
In 2015, the WHO and other UN agencies attempted to help address these lapses with the Essential Services Package for Women and Girls Subject to Violence. The package serves as a tool to identify what countries’ health, social services, police and justice sectors must provide to all women and girls who have experienced gender-based violence, and lays out guidelines for coordination.
By implementing the package’s recommendations, countries would be better able to fulfill their commitments under regional and international frameworks, such as the 2030 Agenda for Sustainable Development (which encompasses the Sustainable Development Goals). This would also support national-level efforts, such as proper enforcement of South Africa’s act.
Failure to take such steps is exacting a devastating physical, psychological, social and economic toll on countries.
A 2013 WHO report said that violence against women leads to death, injury and unwanted pregnancy, with higher rates of infant and child mortality.
Moreover, victims often face depression, social isolation and excessive alcohol use, all of which impairs their ability to work, leading to lost income.
In the EU, gender-based violence is estimated to cost nearly 256 billion euros (US$281.5 billion) per year. In South Africa, that figure stands at 28.4 billion rand (US$1.8 billion).
Modern development strategies often recognize the pivotal importance of enabling women to fulfill their potential and contribute effectively to their economies. Yet, they fail to recognize the need for concerted action to protect women from violence and uphold the rights of victims. They are thus grossly inadequate.
Women deserve to be safe in their homes, at school or work, in hospitals and on the streets. Only when they are not struggling to survive can they — and their communities — truly thrive.
Tlaleng Mofokeng, a member of the Commission for Gender Equality in South Africa, is an expert in sexual and reproductive health and rights.
Copyright: Project Syndicate
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