Women march in El Salvador for International Women’s Day. Photograph:ACDATEE
The mosquito borne Zika virus has become a primary concern for Latin America, reigniting debates around birth control and abortion in the region, and raising questions about how far government recommendations for prevention, mainly addressed to women, meet the reality of women’s control.
Following the first local transmission of Zika in Brazil in May 2015, the virus has spread to more than 20 countries in the Americas, causing the World Health Organisation to declare a global public health emergency. In Central America the following countries are subject to a ‘Level 2’ alert, suggesting they practise enhanced precautions: Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua and Panama.
The Zika virus has been linked to a steep increase in reports of microcephaly, a brain defect in babies and as a result, Latin America has been considering actions to reduce the incidence of Zika in pregnant women.
Initial responses to the outbreak led some governments to advise against women becoming pregnant. Brazil, Colombia, Ecuador and El Salvador all took this approach. Colombia advised women to avoid becoming pregnant for six to eight months, while El Salvador called for women to avoid pregnancy for two years. Not only does this squarely place the burden of public health responsibility onto women, but it also assumes that women have the choice in the first place.Ironically, El Salvador, a country asking its female population to take responsibility for family planning for the next two years, denies those very same women the ability to access that right.
According to Amnesty International, over 50 per cent of pregnancies in Latin America are unplanned. Rates of teenage pregnancy in the region, and particularly in Central America, are also high. Access to sex education and contraception is inconsistent and often insufficient. Despite efforts to increase access to contraception over the past decade, a significant unmet need exists, especially for those from poor and rural backgrounds. Many Latin American countries are short of basic contraceptive supplies for women. According to the Kaiser Family Foundation, the Dominican Republic, El Salvador, Guatemala, Haiti and Honduras all saw clinics run out of basic contraceptive supplies in 2015.
Advising women to avoid becoming pregnant also ignores the deep-rooted culture of machismo and violence in the region, which has fostered exceptionally high rates of rape and sexual violence. Guatemala, Honduras and El Salvador have seen some of the highest rates of femicide and sexual violence in the world. These countries, along with others in Central America, have suffered high rates of gang-related violence, human trafficking, domestic violence and femicide.
Indeed, high rates of violence and poverty have driven large numbers of women to flee the region, many to the United States. Numerous reports suggest that women are at great risk of sexual violence when they migrate, with Amnesty International suggesting that 80 per cent of Central American women have been raped during their journey. It goes without saying that victims of rape have no choice in the matter of whether or not they become pregnant.
Yet highly restrictive abortion laws in the region often see victims of rape denied the right to a safe, legal abortion. Latin America has some of the most draconian abortion laws in the world. In Brazil, where Zika is most prevalent, abortion is only permissible in cases of rape, where the mother’s life is at risk or in the case of an anencephalic foetus. The recent Zika outbreak and the potential connection to microcephaly has sparked a wider debate around abortion laws in Latin America.
In Chile, Nicaragua and El Salvador, abortion is illegal in all circumstances. Victims of rape are denied access to an abortion. Pregnant women whose lives are in danger are denied access to an abortion. Women carrying deformed foetuses are denied access to abortion. Ironically, El Salvador, a country asking its female population to take responsibility for family planning for the next two years, denies those very same women the ability to access that right.
A number of recent cases in El Salvador, in which women suffering miscarriages or birth complications have faced lengthy prison sentences for murder, demonstrate the inhumanity of the country’s abortion laws. Many women in Central America are denied control over their own bodies, highlighting the very basic problem with asking them to be responsible for controlling the Zika outbreak through family planning.
Restrictive abortion laws may also see women who become pregnant in Zika-affected areas more likely to access illegal abortions or suffer miscarriages which, in countries like El Salvador, can result in long prison sentences.
While sexual violence and restrictive abortion laws affect all women, there is no doubt that those from economically disadvantaged backgrounds are likely to be more exposed to the Zika virus and face fewer options once infected. Poorer women are less able to access contraception. They are likely to face higher exposure to the mosquito borne virus by living in less developed regions or substandard housing. They are less able to afford mosquito nets or repellent. They have less access to healthcare and cannot afford to travel to private clinics, which may be internationally located, for emergency contraception or abortions.
The Zika virus, and responses to it, have so far shone a light on the inadequacies of abortion and family planning laws in Latin America.
Nevertheless, the Zika outbreak represents an opportunity for Latin America to review its own sexual health policies and address some long overdue issues, from access to contraception and abortion to a machismo culture that fosters sexual violence and discrimination. While worldwide attention is turned to the region, it is essential that the international community puts pressure on Latin America to address these issues.
Visit the Central America Women’s Network website to take action: scroll to the end of this article to download a model letter to MPs.