Zika Virus. Public Domain.
As the Zika virus ravaging Latin America moves northward, renewed attention
has focused on the struggle for reproductive justice in El Salvador. In the
face of alarming suggested (if contested) links between the
mosquito-borne virus and microcephaly in infants, El Salvador’s Ministry of
Health recommended that women delay pregnancy for two years; officials in
Brazil, Colombia, Jamaica and elsewhere have since issued similar warnings. And
on February 1, the World Health Organization declared that the virus poses
a global public health emergency.
Reproductive rights’ advocates both locally and abroad have objected to El Salvador’s calls
for family planning: In El Salvador, abortion is defined by law as a criminal
act, without exception.
Some important context: In 2009, the leftist Farabundo Martí National
Liberation Front (FMLN) party was elected to the presidency in Salvador,
unseating the U.S.-backed, right-wing Nationalist Republican Alliance (ARENA)
party after 20 years of consecutive rule. The FMLN’s election marked the first
time in El Salvador’s history that a progressive administration governed the
country. In 2014, the party won another five-year term.
Since taking office in 2009, the FMLN has overseen unprecedented gains for
women’s healthcare— rarely reported on both domestically and abroad. The
National Healthcare Reform of 2010 established over 600 community health clinics in
rural and underserved areas, with healthcare promoters bringing pre- and
post-natal care to women’s homes. In addition, the number of women seeking
gynecological services in local public clinics rose from 30,154 in 2009 to 313,521 in 2014. These
programs, along with the creation of maternal pre-birth centers for women
living in areas with difficult hospital access, have reduced maternal mortality
by an astounding 68% since 2009.
What’s more, the FMLN government inaugurated a new state-of-the-art National Women’s Hospital to
replace the old Maternity Hospital, which languished in disrepair for years
following a 2001 earthquake. The FMLN has also pioneered a groundbreaking model
of “Women’s City” service centers, which
provide mental and reproductive healthcare, legal support, childcare, credit
and job training in six sites across the country, with three more planned for
2016. And FMLN-sponsored legislation, such as the Gender Equity,
Equality and Nondiscrimination Law and the Life Free of Violence against Women
Law, has provided an important legal framework for women’s advocates.
But these impressive advances stand in stark contrast to the persistent
criminalization of abortion in El Salvador. In 1997, the right-wing controlled
legislature voted to criminalize abortion without exception, joining
neighboring Honduras and Nicaragua along with Chile and the Dominican Republic
in a disgraceful regional club of nations with absolute abortion bans. At the
time, the FMLN divided its votes, with some legislators joining the right-wing
parties in favor of criminalization and others voting against. Since the law
went into effect in 1998, countless women have been forced to attempt to
terminate pregnancies in unsafe clandestine conditions. Over two dozen women
have been imprisoned for the crimes of murder
or abortion— many apprehended while seeking healthcare in the wake of a
miscarriage. With so much progress for women in other areas, how has this
inhumane abortion ban remained intact?
On February 3, I sat down with Sara García of the Citizen Group for the Decriminalization of Abortion in the
capital city of San Salvador, El Salvador, to discuss the movement for
reproductive justice and the political power dynamics behind one of the world’s
most restrictive anti-choice laws. The following are excerpts from our
conversation.
Can you start by explaining
the Citizen Group for the Decriminalization of Abortion?
The Citizen Group for the Decriminalization of Abortion arose in the
framework of a binational summit in Nicaragua. Both El Salvador and Nicaragua
have very similar legislation; in both countries no alternatives exist even
when the life or the health of a woman is at risk. So in 2009 there was this
summit of social organizations to see what could be done.
She didn’t know she was pregnant, then she lost the pregnancy, and when she
got to the hospital, basically what they said to her was, “You have committed
murder.” Also in 2009, after a broad social movement mobilization, we
achieved freedom for Karina, a woman who was incarcerated for seven and a half
years.
Many feminist compañeras knew this case well before 2009.
They got involved, documented and reconstructed the entire path and history of
her case. This was a young woman who turned to the public healthcare system—the
same system under which she had been sterilized. And later she gets
pregnant. She didn’t know she was pregnant, then she lost the pregnancy,
and when she got to the hospital, basically what they said to her was, “You
have committed murder.” They attribute guilt to women for the
mere fact of being women, and thus they violate the presumption of
innocence. After reviewing the sentences they were able to prove that Karina
was innocent, that there had been errors throughout the judicial process, and
that there was a clear gender stereotype that had ultimately ended with her
unjust imprisonment.
El Salvador didn’t always have these laws. Before 1998, alternatives did
exist. Therapeutic abortion, when the life or the health of the mother was at
risk, was recognized, as was ethical abortion— when the pregnancy was the
product of sexual violence – and eugenic abortion, when the fetus was
incompatible with extra-uterine life. So these three grounds existed before
1998, the year that the prohibition entered effect. In 1999, another important
change occurred at the constitutional level when it became recognized that
human life begins at the moment of conception. Those two changes were intended
to be ending any discussion about reproductive rights in this country.
In the midst of all this a group of citizens and compañeras from
different backgrounds— lawyers, theologians, psychologists, philosophers—
decided to say, “Okay, let’s unite, and let’s see how we can work on this
issue.” We started with this need to fight for the women who are in prison, to
bring them back, but also to recuperate what we used to have. As the Citizen
Group, we have to regain what we used to have in our country. We’re not
inventing anything new, since we used to have legislation that at least gave us
alternatives in extreme cases.
We needed to be able to build a voice that no longer spoke of abortion as a
sin but that spoke of abortion as a right. I think we’re also trying to build
dialogue, since these laws are so biased. […] In the end, without dialogue, we
will never build that democracy, or that justice and peace that we want to talk
about, if all voices are not heard.
Sara Garcia and members of the Citizen Group protest against unjust abortion laws in Central America (Photo by Agrupación Ciudadana por la Despenalización del Aborto)
Who are the actors and
political forces that are obstructing reproductive justice in El Salvador
today?
The case of Beatriz [in 2013] allows you to see
precisely how women have trouble accessing reproductive justice. She was a
22-year-old woman, pregnant with an anencephalic fetus, which is to say that it
had no brain. She also had lupus. Beatriz requested an injunction because she
couldn’t interrupt her pregnancy. Several different human rights organizations
supported this injunction. However, the process went before the Constitutional
Chamber of the Supreme Court, and the Chamber delayed this process for 81 days
while her life was in danger. They made her wait 81 days for a response, and in
those 81 days several different actors intervened.
The Chamber requested an opinion from the National Forensics Institute,
which said that Beatriz should continue her pregnancy because her life wasn’t
at risk. This opinion was written by the director of the Institute at the time,
[Miguel] Fortin Magaña, a person who has been very open about his Opus Dei
views. He went to the press saying, “No, Beatriz can live, she’s fine.” And
that was quite contradictory, because in the hospital where Beatriz was—a
public hospital—a team of 15 doctors signed a statement saying that it was
necessary to interrupt the pregnancy. The Minister of Health at the time was in
favor as well. Even the director of the hospital came out telling Fortin
Magaña: “You attend to dead people, we attend to the living. How can someone
who attends to the dead say that she can continue living?”
In addition to this, there were the fundamentalist groups, who went to the
extreme of holding press conferences in which they said they’d donate hats to
Beatriz for her to put on the infant in order to hide the fact that it had no
brain. It’s a level of cynicism that’s hard to imagine.
So this was a woman who was even supported by the Ministry of Health,
because they understood her case. This case demonstrates how difficult it is
for women to have access to justice, because these fundamentalists have
permeated certain institutions and they have power. They’re part of the mass
media, and they even collude with institutions like the Constitutional Chamber,
which may well be respectable on other issues, but on the matter of
reproductive rights they have enormous debts to women, to their citizens, to
human rights, in general.
In the end, Beatriz was able to interrupt the pregnancy, but only after
waiting all that time. But I think it’s important to reflect on this case,
because these institutional obstacles come from a fundamentalist ideology that
has materialized in legislation and in policies that are absolutist and
absolutely prohibitive.
Often in the international
community the Salvadoran government is talked about as though it were
monolithic, but what about the role of the judicial system versus the
legislature versus the executive?
Yes, I think it’s very important to parse that. We’re talking about a
justice system that has clear and enormous debts, but certainly I think that
this leftist government, which is now in its second term, has had women’s
struggle or women’s rights at the center of its policy and vision. This has
been clearly demonstrated through a wide range of programs. And I think it is
important to show these contradictions. There’s the judicial system and the
Court’s behavior, which I think is fairly reproachable, and the legislature,
which is diverse and can’t be generalized. There have been important actions
[in the legislature]. For example last year a legislator from the leftist party
sponsored an initiative to modify the Penal Code to enhance penalties for hate crimes [based
on sexual orientation or gender identity]. And this allows us to see that there
are changes happening in this country that are very important, and these are
changes that were never before seen—the whole issue of sexual diversity and
LGBTQ people is another debt pending to the population and is very important to
mention. There is indeed a progressive effort to promote these rights that have
historically been denied.
Nevertheless, I think that the international community – and national
organizations as well – must continue to advocate for these rights. Like I said
before, the issue of abortion has been become a politically dangerous one to
support, and that must be upended: the political danger should be for those
legislators who are not in favor of women’s lives, for those who are not in
favor of saving a life that is at risk. We need to make that a
political cost.
I think the fact that the legislators from the FMLN have an historic
commitment to human rights could allow for discussion, debate, and changes in
the law in 2016 – as a matter of social justice and public health. The current
political panorama in the Assembly offers opportunities; the President of the
Assembly [Lorena Peña of the FMLN] is committed to the struggle for women’s rights.
I think the fact that the legislators from the FMLN have an historic commitment
to human rights could allow for discussion, debate, and changes in the law in
2016 – as a matter of social justice and public health. Even within the
right-wing parties we know that there are dissident positions, and some of the
legislators have spoken out on this issue and on issues of sexual diversity.
Photo by Agrupación Ciudadana por la Despenalización del Aborto
So what about Zika? How has
the issue of Zika impacted the abortion debate, and how do you evaluate the
Ministry of Health’s actions?
In the face of the so-called Zika emergency, the Ministry of Health in our
country has responded with various actions: It has informed the population of
the risks of pregnancy while high rates of Zika infection exist, calling on
women not to get pregnant over the next two years. In order to facilitate
people’s access to family planning, it has supported the distribution of
contraceptives, and it is also providing monitoring and care for pregnant women
who have had Zika. To date no [pregnancy] has been determined to be affected by
microcephaly; it wouldn’t be until August 2016 that the impact of this epidemic
could be seen. At the same time, campaigns to eradicate the Aedes
aegypti mosquito, which transmits Zika, have intensified. The Ministry
of Health has stated that current legislation prevents women infected with Zika
from carrying out a legal and safe interruption of their pregnancy in the
public healthcare system.
We think that it is correct for the ministry to inform the public about the
effects of Zika on the fetus when a pregnant women contracts the disease.
However, we think that advising women not to become pregnant is an insufficient
and difficult measure to apply for several reasons. First and foremost, the
state should guarantee the health of the population, eradicating the disease
and risks of contagion, although citizen participation is also important in
achieving that. The responsibility of not getting pregnant shouldn’t fall on
women, because all pregnancies involve a man who should also assume
responsibility. We also need to consider that in this country 39% of
pregnancies are unplanned, due to a lack of sexual and reproductive
information, difficult access to contraception, and in many cases sexual
violence, abuse, rape, incest, or non-consensual relations that go unpunished.
This situation could create a serious public health problem in El Salvador,
given that the birth of a high number of infants with microcephaly would require
specialized education and healthcare that the state should guarantee. In
addition, like in other Latin American countries, we could expect an increase
in unsafe abortions carried out by women who are unable to carry on the
pregnancy with fetal deformations but can’t find a way to end it safely and
legally – thus increasing maternal mortality.
You can read the complete interview here.
