Improving Access, Improving Care for Women in Delhi

Joie Lemaitre Guest Blogs for Americans for UNFPA

It's early AM, we leave for Udaipur today in the state of Rajasthan. I hear it's a very colorful area, we'll see what that means exactly. I do know that Madonna has been there with her family and entourage absorbing the music and culture in that area. That story and the cricket news is big here. I'm sure you all have been following the big cricket controversy as well, :).

Yesterday we began the official part of the delegation which was eye opening and really interesting. Our day started with an overview of UNFPA's programs here in India....all programs under their auspices relate to maternal and child health, family planning education, HIV/AIDS education as well as working with the govt. of India in helping to promote laws that will better the lives of women and give them more autonomy and control over their bodies and their lives. I am again so impressed, as I was in Cambodia, with the passion and the love the staff here give to their jobs. The issues they face here are daunting, but they are realistic and know improving access, improving care all takes time....and money.

The single biggest issue right now in India as far as maternal health and family planning are concerned is the skewed male/female sex ratio...the gap between boy and girl live births has increased drastically over the last 20 years. What is counter intuitive is that the drop in female births is due not to lack of education but due primarily to a financially secure and well educated middle class. It's not the rural woman who throttles and kills her girl child that is the primary issue, though that's certainly a concern. It's the middle class couple who through modern technology decide to abort female fetus's...obviously to the detriment of the woman, her child and Indian society.

Despite education and despite financial security, if a couple now has only one or two children they make sex-selection decisions based on deep rooted cultural beliefs. The boy child is still valued for these reasons 1) passing on the family name 2) land and property rights 3) care of parents in old age, though girls do this more and more 4) they are the only ones with the ability to perform last rites.

Now, this is primarily limited to Hindus and northern Indian, but Hindus make up over 90% of the population. The one exception are the Sikhs, which are a branch of Hinduism which broke away from the main religion several hundred years ago. The did not believe in the caste system and they also believe more fully in the equal rights of the sexes and value both boy and girl children. Sikhs making up a number of immigrants to the U.S have a strong and very progressive belief system.

Anyway it is now illegal in India to use ultrasound or sonograms for the purpose of sex selection. The Govt. run hospital we visited yesterday has a huge sign making it very clear that they do not perform sex selection abortions. The hospital offers free contraceptives, surgery such as tubal ligation and vasectomy's, free delivery and maternal care and post natal care, as well as early stage abortions which are legal in India. The facility is old, unclean, and outdated in technology and equipment (unlike the private hospitals which are state of the art). However, the staff are dedicated and caring and very hard working.

In the afternoon we visited Shakti Shaleni, which is a woman's shelter. Most of the women were young, between the ages of 17 and 26. There were a couple of girls who had been rescued from the sex slave trade, but most were victims of "dowry" violence. This, too, is a big problem in India. A groom's family can demand more property or money indefinitely, even after the marriage. If a bride's parents can't pay up, the new bride is often rejected by the family and her new husband. It's too shameful for the bride's family to take her back, so she either puts up with abuse from her husband and his family or through the help of NGOs and UNFPA sponsored programs can find the help she needs to leave the situation. These young women are very courageous and their stories are so amazing. I am again in awe of the strength of people. These young women...oh they touch your heart. Our daughters are so lucky to have the opportunities they have, and they choices they have.

Last year a law was passed outlawing "dowry" law, but very few people will take these things to court, at least yet.

Gosh, that's probably way more information than you want, but it's good for me to get this down on paper. And, this just scratches the surface.

I am excited about seeing Udaipur and continue to see the programs offered by UNFPA in this region.