CENTRAL ASIA: Disabled Citizens Find Avenues to Advancement Blocked

By Alisher Khamidov

BISHKEK, Kyrgyzstan, Oct 24 2012 (EurasiaNet) – As a child, Feruza Alimova dreamed of becoming a lawyer so she could help disabled people.

But the 22-year-old cannot pursue a law degree because a bone deformity keeps her homebound. Her parents, who make a living growing cotton and tobacco in the Kyrgyzstani hamlet of Chekabad, in the Ferghana Valley, spend a large chunk of their income on expensive medications for Feruza and two other children suffering a similar bone condition.

Mukhabat, Feruza’s mother, says neighbours blamed her and her husband for their children’s disabilities. “We were also ashamed at the beginning, but gradually we decided that what mattered is not the opinions of others, but the happiness of our children,” Mukhabat told EurasiaNet.org.

Because public minibuses do not accommodate her wheelchair, Feruza could not attend law school. Instead, last year she completed a knitting course offered by a local vocational school.

Across Central Asia, hundreds of thousands of disabled people are unable to attend school because they live in a world with few handicap-accessible amenities, according to the State Department’s 2011 Human Rights reports for Uzbekistan, Kyrgyzstan, and Tajikistan.

In Tajikistan, the law “requires government buildings, schools, hospitals, and transportation to be accessible to persons with disabilities, but the government did not enforce these provisions,” the report states.

In Uzbekistan, the State Department maintains that disabled Uzbeks are stigmatised and educational opportunities are limited for those unable to walk on their own. “Many of the high schools constructed in recent years have exterior ramps, but no interior modifications that would allow wheelchair accessibility,” the report stated.

Civil society groups say Central Asian governments are resistant to addressing the issue.

“Authorities (across the region) view a disability as a medical ailment that can be treated, and not as a social condition that needs to be accepted by society,” said Azat Israilov of Kelechek, a Bishkek-based non-governmental organisation that works with disabled children. As a result, state assistance is often limited to monthly payments to help cover medicine, he said.

In a continuation of Soviet-era practices, all of the Central Asian republics divide disabilities into three groups. People with “category one” disabilities are completely dependent on others for care; people in “category two” can take care of themselves with assistance (blindness, some intellectual disabilities, and bone deformities fall into this category); “category three” can include impaired vision and rheumatism. State-run medical commissions assign the categories.

According to official data, in Kyrgyzstan, Tajikistan, and Uzbekistan, individuals in category one receive up to 70 dollars per month; no precise figure is available for Kazakhstan, though the number is sometimes reported as 100 dollars.

The cash is welcome, but nothing like the benefits that disabled people received a generation ago, before the Soviet Union collapsed.

“During the Soviet period, we (disabled people) enjoyed many privileges such as free healthcare, state subsidies, and allowances. Now most of these perks are gone,” said Ilkhom Madumarov, a Tashkent resident in his late fifties who, missing a leg, is in category two.

Mukhabat, Feruza’s mother, says the cash benefits for her children, whose disabilities all fall into category one, is not enough to cover their monthly treatment. But it’s not the size of the payments that makes her angry.

“What my children need is not just small monetary compensation; they want to be treated like everyone else. The government needs to create conditions in which children like mine can function like normal people despite their disabilities,” she said, such as access to schools.

For years, international aid agencies have promoted reform. But in recent years, their support has dwindled. Following the May 2005 massacre in Andijan, a suspicious central government in Tashkent forced many foreign non-governmental organisations out of Uzbekistan. And since the 2010 political turmoil in Kyrgyzstan, Israilov of Kelechek complains, much of the donor community’s attention has focused on post-conflict reconstruction efforts.

In some cases, too, aid agencies appear to be suffering from donor fatigue. Despite pressure from international development outfits, endemic corruption and bureaucracy have hampered reform efforts, aid workers say privately.

For example, given the monetary compensations and other perks associated with disability status (people with disabilities pay lower taxes, obtain subsidised medical treatment at state-funded clinics, and receive discounts when using public transportation), government disability commissions throughout Central Asia often try to extort bribes from applicants, some of whom do not have disabilities.

A December 2010 law adopted by Uzbekistan’s parliament abolished financial payments for category three disabilities, a move that impacted 200,000 individuals, who lost monthly benefits of 60,000 sums (37 dollars) a month. Legislators said they were trying to make the system more efficient. Observers in Tashkent believe the law is also intended to crack down on corrupt government employees selling disability permits.

More generally, benefits seem to be on the chopping block in budgeted-squeezed Central Asian states. On Oct. 18, Kyrgyzstan’s government announced budget cuts that will affect social spending.

Some disabled people have taken radical measures to improve their plight. Since the April 2010 uprising in Kyrgyzstan, a group of disabled people have illegally occupied a mansion belonging to the ousted president’s hated son.

In Uzbekistan, meanwhile, a group of people with disabilities petitioned several independent news outlets in March, blowing the whistle on alleged infighting within the Society for Disabled People of Uzbekistan, a quasi-government agency that administers some of the state’s assistance programmes. The petition claimed the Society is rife with corruption and nepotism.

Such outspoken criticism of the government is rare in Uzbekistan and often punished severely. “These protest letters indicate the extent of despair,” said a local teacher familiar with the campaign.

*Editor’s note: Alisher Khamidov is a researcher specialising in Central Asian affairs.

This story was originally published by EurasiaNet.org.

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The Word on Women – Forced sterilization and the Millennium Development Goals

 

By Widney Brown

Two reports by the BCC this month raise the spectre that the United Nations Millennium Development Goals which include reducing maternal mortality and ensuring environmental sustainability may actually be undermining women’s sexual and reproductive rights.

The BBC has reported on the UK government’s Department for International Development is funding a program of forced sterilization of both men and women in India.

As happens all too often, poor tribal women seem to be particularly targeted for the forced sterilization.

And if being sterilized against your will is not bad enough, there are also reports of long term suffering because the procedures were botched.

The BBC also ran a shocking exposé on allegations of forced sterilization of women in Uzbekistan. In the report, an unnamed government official made the link between reducing fertility rates and the MDGs.

Since the world’s population topped 7 billion people toward the end of 2011, the language of “population control” has increasing crept back into the discourse. Implicit in the concept is a focus on preventing poor people from having a lot of children, echoing the ideas promoted by Thomas Malthus, a British clergy and economist in the late 1700s.

There is no question that an increase in the number of people in the world has a negative impact on the environment and biodiversity. However, returning to the draconian measures of forced sterilization undermines fundamental principles of human rights and ignores what we have learned about how to lower fertility rates without resorting to force.

Amnesty International has long warned the international community of the dangers of defining quantitative development goals without a strong normative human rights framework.

Public health logic may hold that reducing fertility rates leads to slower population growth and lowers maternal mortality rates. But forced sterilization violates the principle that men and women have a right to make independent choices regarding the number and spacing of their children without discrimination, coercion and violence.

Study after study demonstrates that empowering women through ensuring access to education, promoting women’s economic independence, and providing women access to comprehensive contraceptive and other health services reduces fertility rates and leads to better public health results. Where women are able to decide independently when, how often, with whom, and with what frequency to have children, the consequence is more often than not only do maternal and infant mortality rates go down, so too do fertility rates.

To be clear, forced sterilization is in and of itself a violation of human rights. It is the type of violation that has long term consequences for individuals and society. Perhaps most immediate is its destruction of the bond of trust between patient and medical service provider. When that bond is broken, women are less apt to see critical pre and post-natal care when they are pregnant.

There is speculation that the report by the BBC on Uzbekistan may mask another issue: women seeking sterilization but not informing their families because they will be ostracized for not wanting to have more children. But this alternative narrative underscores the importance of promoting women’s rights and gender equality to ensure that women and their partners can freely exercise their reproductive rights. Women who feel their only control over their fertility is to be secretly sterilized are clearly not able to make their own decisions.

Regardless of which explanation is correct in Uzbekistan, it highlights the integral connection between promoting women’s rights and gender equality and reduced fertility rates. Like Uzbekistan, India has a long way to go toward demonstrating its commitment to women’s rights and gender equality.

Rejecting forced sterilization policies does not leave governments’ with no alternatives. They can ensure that young people have access to comprehensive sex education and contraceptive services. They can discourage early marriage and promote education at the secondary and tertiary level paying particular attention to why women and girls often drop out of school.

Anti-natalist policies adopted by governments should not be discriminatory or undermine people’s fundamental rights.

The international community needs to pay heed to stories like these on India and Uzbekistan which so clearly illustrate how agreeing the Millennium Development Goals without ensuring a human rights framework for the goals, contribute to undermining women’s rights.

People living in poverty can be empowered through direct engagement in identifying the problems, defining and implementing solutions, and in evaluating the effectiveness of those solutions, thus promoting the sustainability of progress.

When the international community convenes in the next couple of years to decide a post 2015 development strategy, it is important that it take on board the dangers of promoting quantitative goals while ignoring the importance of human rights in empowering people living in poverty.

Without a human rights framework, people become the objects of government policies and practices, rather than empowered, unique, and autonomous rights holders. Development practices designed with normative human rights standards in mind enable people living in poverty to be the subjects actively working their way out of poverty.

Read Article here

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BBC Provides Horrific Testimonies on Forced Sterilization in Uzbekistan

April 12, 2012 –

The BBC has a horrifying new report on the forced sterilization of women in Uzbekistan.

Stories have been leaking out for years about doctors secretly performing hysterectomies on women who have given birth in hospitals. The surgeries are described as “voluntary,” but EurasiaNet.org has reported how increasing numbers of women are choosing to give birth at home, fearing doctors will tie up their fallopian tubes or cut out their uteri without their consent.

The UN Committee Against Torture and the US State Department have both expressed concern. Nevertheless, it appears Tashkent is issuing doctors quotas for the procedures.

“Every year we are presented with a plan. Every doctor is told how many women we are expected to give contraception to; how many women are to be sterilized,” a gynecologist from Tashkent told the BBC’s Natalia Antelava.

Several doctors I spoke to say that in the last two years there has been a dramatic increase in Caesarean sections, which provide surgeons with an easy opportunity to sterilize the mother. These doctors dispute official statements that only 6.8% of women give birth through C-sections.

“Rules on Caesareans used to be very strict, but now I believe 80% of women give birth through C-sections. This makes it very easy to perform a sterilization and tie the fallopian tubes,” says a chief surgeon at a hospital near the capital, Tashkent.

One local expert estimated tens of thousands of forced sterilizations have happened in the past few years across Central Asia’s most populous nation, a vast country of, officially, 28 million.

Adolat comes from Uzbekistan, where life centers around children and a big family is the definition of personal success. Adolat thinks of herself as a failure.

“What am I after what happened to me?” she says as her hand strokes her daughter’s hair – the girl whose birth changed Adolat’s life.

“I always dreamed of having four – two daughters and two sons – but after my second daughter I couldn’t get pregnant,” she says.

She went to see a doctor and found out that she had been sterilized after giving birth to her daughter by Caesarean section.

“I was shocked. I cried and asked: ‘But why? How could they do this?’ The doctor said, ‘That’s the law in Uzbekistan.'”

One mother of three describes regular visits from a nurse warning her to get a free hysterectomy before the state starts charging. “Another mother says she experienced months of mysterious pain and heavy bleeding following the birth of her son. Then she had an ultrasound check and discovered that her uterus had been removed,” the report said.

Why? Some observers believe Tashkent is obsessed with statistics. Unhappy that maternal mortality rates place the country between Palestine and Botswana (Central Asians dread being compared to Africans), officials seem to see sterilizations as a way to improve their rankings.

“It’s a simple formula – less women give birth, less of them die,” said one surgeon.

The result is that this helps the country to improve its ranking in international league tables for maternal and infant mortality.

“Uzbekistan seems to be obsessed with numbers and international rankings,” says Steve Swerdlow, Central Asia director at Human Rights Watch.

“I think it’s typical of dictatorships that need to construct a narrative built on something other than the truth.”

The government denies women are being sterilized by force and says Uzbekistan should be considered a role model for maternal health.

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