UN Population Division, Department of Economic and Social Affairs,
with support from the UN Population Fund (UNFPA)
DISPATCHES -- NEWS FROM UNFPA, THE UNITED NATIONS POPULATION FUND NUMBER 6, MARCH 1996 DISPATCHES is a monthly bulletin dedicated to the activities of the United Nations Population Fund (UNFPA). It is published in English, French, and Spanish by the Information and External Relations Division and is available free of charge from UNFPA offices worldwide. The designations employed and presentation of material in DISPATCHES do not imply the expression of any opinion whatsoever on the part of UNFPA concerning the legal status or authority of any country, territory, city, or area or the determination of its frontiers or boundaries. Views expressed are the authors' and sources' own and do not necessarily reflect the opinions or policy of the Fund. All material is checked for accuracy as received from source; all enquiries should be addressed to the source/further information address provided at the end of each item. Material may be freely reproduced; credit and copies of reproduced material would be appreciated. We invite colleagues from UNFPA and cooperating organizations to submit articles about UNFPA-assisted programmes and projects, accounts of lessons learned from past and ongoing work, and anecdotes from their country or area of work. These should be sent to: DISPATCHES, c/o IERD, UNFPA, 220 East 42nd Street, 23rd floor, New York, NY 10017, USA. Telephone: (212) 297-5022. Fax: (212) 557-6416. Internet: <firstname.lastname@example.org>, <email@example.com>, <firstname.lastname@example.org>. ========== In this issue: ICPD implementation: Difficult times ahead Executive Board decisions Doctors' responsibilities ========== Uganda: FGM breakthrough Kapchorwa District - UNFPA is spearheading a local initiative to eliminate female genital excision among the Sabiny people, whose remote villages cling to mountain slopes on the border with Kenya. The community has made national and regional headlines over the years for its strict adherence to the tradition of excision as a rite of passage into womanhood. In the early 1990s, attempts to enforce compliance with international health and human rights norms created a backlash: Local women who had evaded the custom embraced the blade as an act of resistance to cultural interference. Where outsiders have failed, the community is now succeeding. In January, the Chairman of the local Elders' Association proposed replacing the practice with a symbolic gift-giving while preserving the singing, dancing, and other traditional festivities which mark a girl's initiation as a full-fledged member of the community. Coming as it does from a custodian of community culture, his proposal has nurtured discussion of how best to honour cultural values while altering the rituals they express. The discussion is far from academic: Community members are tackling the practical details of replacing excision with some form of gift-giving as well as the essential details of making sure that the new cultural norm is observed. Local authorities and media attribute the breakthrough to REACH, the UNFPA-sponsored Reproductive, Educative, And Community Health programme, which provides a forum for information and discussion among local community and political leaders, health professionals, parents, and adolescents themselves. REACH seeks to avoid fuelling unnecessary sensitivity about the issue. Thus, for example, participants coined a new phrase for FGM: "female genital cutting." The term "female circumcision" was rejected as a misleading euphemism, but "female genital mutilation" was thought to imply excessive judgement by outsiders as well as insensitivity toward individuals who have undergone excision. The programme also offers a reproductive health package including training for traditional birth attendants and reproductive health and family planning services and peer education for parents and adolescents. Sabiny boys undergo circumcision and girls, excision in December of every even-numbered year. William Cheborion, Chairman of the Kapchorwa Elders' Association, closed the first REACH community workshop in January by encouraging community members to gather this coming December to recognize the season of initiation. "The occasion of the Sabiny girl becoming a woman needs celebration," he said, "but when it's time for the cutting, you just go home." When others suggested a symbolic, more benign blood-letting ritual, Cheborion remarked: "There has already been too much cutting." As Elaine Eliah, a correspondent for [The East African], a newspaper circulated in Kenya, Tanzania, and Uganda noted, Cheborion's "pleas were perhaps the most significant words uttered throughout the entire workshop. Never before had a recommendation for change come from within the Sabiny community itself, especially from such an esteemed source. With Cheborion's sanction, and his heartfelt endorsement of a pain-free initiation for Kapchorwa's girls, the possibility of change feels closer than ever. As if to second Cheborion's recommendation, Parliamentarian Peter Kamuron committed to hosting an initiation party for his two daughters this December. He plans to gift them each a cow." -Source/further information from: Francois Farah, Country Director, UNFPA, 15B Clement Hill Road, P.O. Box 7184, Kampala, Uganda. Fax: (041) 236645. ========== ICPD: Difficult times ahead Washington - Population institutions fear that "devastating" funding cuts announced by the United States will jeopardize implementation of the ICPD Programme of Action, and that increases made by other countries will be insufficient to offset the loss. They warn that, contrary to the stated intentions of those wielding the budget axe, the cuts will result in a dramatic increase in unplanned pregnancies and unsafe abortions. Stop-gap legislation passed by the US Congress to keep the US government running during a budget impasse effectively reduces US funding for family planning and reproductive health programmes overseas from US$547 million in 1995 to around US$72 million for this fiscal year. In addition to limiting spending, the legislation imposes unprecedented restrictions on USAID. The agency is now barred from committing any money before 1 July and will only be allowed to make commitments a month at a time over the following 15 months. USAID officials say the restrictions will complicate attempts at long-term planning. They add that while they grapple with as much as a 35 per cent reduction in overall funding, the resources available to them for population assistance this fiscal year have effectively been reduced to 14 per cent of the amount appropriated last year. "Even allowing for some funds still in the 'pipeline'...the cut is devastating," said Jeannie Rosoff, president of the Alan Guttmacher Institute. Population programmers say the cuts will have a particularly dramatic effect in developing countries because of the key role played by USAID and the NGOs it supports worldwide. They say they fear UNFPA and other major collaborators will not be able to make up for the loss. They note that many developing countries themselves and several key donors -- including Denmark, Germany, Japan, the Netherlands, and the United Kingdom -- have made significant funding increases this year to fulfil their commitment to ICPD implementation. Nevertheless, "we don't expect overall funding in the field to recover from this setback," said Stirling Scruggs, director of UNFPA's Information & External Relations Division. The anti-family planning riders attached to the legislation were "encouraged by the Christian Coalition and anti-abortion groups," according to George Moffett of the [Christian Science Monitor]. "What we did is bar access to family planning services to approximately 17 million couples, most of them living in unimaginable poverty," said Republican Senator Mark Hatfield, an opponent of the legislation. "I intend to do what I can to rectify this situation as soon as possible." "More than 10 million unintended pregnancies could result annually," said Population Action International's Sally Ethelston of the cuts. "That could mean at least 3 million abortions, at least half a million infant and child deaths, and tens of thousands of maternal deaths." The cuts come amid deficit-reduction measures which include a 30 per cent reduction in overall bilateral US development aid to countries in Africa, Asia, and Latin America and the Caribbean. Sadik's appeal Speaking on these issues last month in Washington, DC, at the Conference of religious leaders on Women, Poverty, and Population, UNFPA Executive Director Nafis Sadik said: "Voices are heard today advising America to go into isolation, to interpret national interest in the narrowest possible way. If these forces can successfully be opposed, America will reaffirm its own beginnings and enhance its destiny. America will grow in stature, in moral leadership, and in practical influence in the world." In what Yvette Collymore of Inter Press Service termed "one of her most direct appeals yet to politicians and legislators here," Dr. Sadik said: "For thirty years, you have led the way to action in the area of population and development. American leaders were among the first to state that there is a link between population and poverty; American women have led the fight for autonomy and equality. America was the driving force behind setting up UNFPA; America has historically been the biggest supporter of population and development programmes, and it was American leadership above all which drove the Cairo process along and brought it to a successful conclusion. Now the world looks again to America for leadership. We look to you to confirm your support for the United Nations process, to make good the pledges made in Cairo and Beijing, to maintain your programme of foreign assistance, and in the area of population and development...not to turn your backs on the less fortunate people of the world, among the poorest of whom are women." - Sources: Executive Director's Statement to the Conference on Women, Poverty, and Population, Washington, DC, 9 February 1996; press clippings. Further information from: Information & External Relations Division, UNFPA, 220 East 42nd Street, New York, NY 10017, USA. Fax: (212) 557-6416. ========== Reproductive health: Doctors reminded of their responsibilities Geneva - Obstetricians and gynaecologists are being reminded that they have a responsibility to protect women's right to reproductive health. The reminder comes from the WHO/FIGO (International Federation of Gynaecology and Obstetrics) Task Force on Maternal Health and Safe Motherhood, of which UNFPA is a member. Inspired by ICPD, the Task Force in September 1994 held a workshop in Montreal, Canada on "Population and Human Rights: Responsibilities of OB/GYNs." Since the Beijing women's conference reaffirmed the reproductive health aspects of the ICPD Programme of Action, the Task Force last November decided to reiterate the recommendations of the Montreal workshop and to lay plans for follow-up regional workshops. These are reportedly being organized by FIGO. The Montreal workshop focussed on three main areas: > women's right to information and education about, and the means to practise, family planning; > women's right to make decisions that affect their health voluntarily and with a choice of options; and > the link between women's rights and their health. In their recommendations, summarized by the Task Force, workshop participants emphasized the following: > Women have a right to information and education on the procedures and treatments they might have to undergo and FIGO should discourage practices that abuse women's rights. > It is important that adolescents should receive information, counselling, and services regarding their reproductive health. > There is a need for obstetricians and gynaecologists to be trained in communication and counselling skills, whether through workshops run by national societies or by the inclusion of these skills in the curricula of medical schools. > National societies should further the provision of comprehensive reproductive health services. The interventions of WHO's Mother-Baby Package were considered to be relevant to this, with particular focus on emergency obstetric care. Other important elements included the discouraging of female genital mutilation, and counselling both on sexuality and for women who are victims of violence. Earlier WHO/FIGO workshops included one in Rio de Janeiro in 1988, on "Women's Health and Safe Motherhood" and in Singapore in 1991, on "Women's Perspectives and Participation in Reproductive Health." - Sources: WHO/FIGO Task Force; Reproductive Health Branch. Further information from: Reproductive Health Branch, Technical & Evaluation Division, UNFPA, 220 East 42nd Street, New York, NY 10017, USA. Fax: (212) 297-4915. A full report of the Montreal workshop (Document WHO/FHE/FPP/95.112) is available from the Division of Family Health, WHO, Avenue Appia, CH-1211 Geneva 27, Switzerland. Reports of the Rio and Singapore workshops are also available from the same address. ========== Executive Board: Contraceptive commodity programme passed New York - UNFPA's Executive Board has approved a global contraceptive commodity programme to be managed by the Fund. With an initial capitalization of US$5 million, the programme is to be an integral component of the Fund's overall work in "strengthening reproductive health programmes, including family planning and sexual health," according to Board documents. In decision 96/03, made on 19 January, the Board emphasized that activities undertaken as part of the programme "should be monitored carefully to ensure that they adhere to technical standards of safety and quality." Under the terms of the decision, the Fund will have to report on the programme's implementation annually, "paying particular attention to the progress in strengthening national capacities to deal with the logistical aspects of contraceptive procurement." The Fund must also "engage in further appropriate collaboration and coordination with other relevant United Nations entities, in particular, the Inter-Agency Procurement Services Office and the World Health Organization, active in the fields of procurement and reproductive health." The programme grew out of UNFPA's Contraceptive Requirements and Logistics Management Needs in Developing Countries initiative. It aims to anticipate demand and facilitate prompt action to avert disruptions in contraceptive supplies; achieve economies of scale and lower costs to recipient countries; ensure the quality of contraceptives provided by the Fund; and build national capacity in contraceptive procurement and logistics, with a view to self-reliance. South-South cooperation The Board also approved the arrangements outlined in document DP/FPA/1996/11 to recruit and assign project personnel to the Secretariat of Partners in Population and Development, an intergovernmental organization of 10 developing countries. In decision 96/09, the Board invited the organization to consider broadening its scope "by actively involving other developing countries as well as countries with economies in transition" in its programmes. UNFPA is to report to the Board in 1998 on the activities and achievements of the initiative, including the Fund's role in them. At that time, the Board will consider UNFPA's continued involvement beyond 1998. Other decisions of note to UNFPA include 96/05, on reporting to ECOSOC, 96/06, on documentation, and 96/07, on UNDP successor programming. The UNFPA Strategy for Resource Allocation is due for further consideration at this month's session of the Executive Board. - Source: "Decisions Adopted by the Executive Board of UNDP/UNFPA, First Regular Session 1996, (15-19 January 1995, New York)," Unedited Version, 19 January 1996. Further information from: Executive Board, UN Liaison, & External Relations Branch, Information & External Relations Division, UNFPA, 220 East 42nd Street, New York, NY 10017, USA. Fax: (212) 557-6416. ========== DISPATCHES -- NEWS FROM UNFPA, THE UNITED NATIONS POPULATION FUND NUMBER 6, MARCH 1996 ENDS.