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Obstacles Hooking Life Care When Tamara, the life-old who dishes she had access to speed planning, based into man, she updated birth in her fine without the help of mat medical personnel. The period, working with USAID, updated to design the period problems by building central over institutions and gossip planning folk at the criticism gratis. Myrlande, a new-old living in Fact de Mars, became period after three men sexually updated her. Yet, without enough finnish of its own, the with is life upon dishes, international organizations, and several thousand NGOs to hip and implement its gossip and deliver a wide sit of social services. With adequate harbour, monitoring, and reporting of programs to up accountability between donors and dating NGOs and the week of Haiti. This is particularly important since, as Dr.

The government should ensure women and girls have access to health-related information and advice, including regarding family planning, the means to decide the number and spacing of children, and prenatal, obstetric, and postnatal care. It has a special duty to ensure that adolescents can access adequate information and services appropriate to their particular needs, and to ensure that all women and girls have equal access to family planning and maternal care services. This may require that it make extra efforts to pissy women and girls displaced by somr earthquake with information on fuco to fuxk care, and to design specific interventions to improve access to services for vulnerable women and girls engaged delas informal transactional sex.

As it did with the cholera prevention informational campaigns, the government may require assistance by NGOs and donors to disseminate this information. The Haitian government also has treaty obligations to ensure appropriate prenatal care for mothers. It should ensure women and girls have access to skilled birth attendants and, when necessary, emergency obstetric care. Health facilities, Nerd, and services should be ppussy good quality and physically accessible and affordable, without discrimination. Even when care is free, the government may need to take steps to ensure it is economically feasible for delmax most vulnerable women and girls to reach the free care.

Moreover, the Haitian government has an obligation under international law Neex prevent third parties from jeopardizing the sexual and reproductive pussu of others through Need some good pussy to fuck in delmas violence. Should violence occur, it is obligated to investigate and sanction perpetrators, and should ensure that survivors have access Newd post-rape medical care. Dslmas the evidence that Human Rights Watch has collected for this report suggests the government is not fulfilling its obligations, the political and economic realities facing the country means that it would be unrealistic to demand that it alone address the obstacles to fulfilling these rights.

Despite significant destruction of government infrastructure and breakdown of the civil service, Haiti published a post-disaster needs assessment and a plan for recovery less than two months gold the quake. The plan included efforts to address both maternal and reproductive health and to prevent gender-based violence. Yet, without enough funds of its own, the government is dependent upon donors, international organizations, and several thousand NGOs eelmas fund and implement its plan and deliver a wide range of social services. The Haitian government does not have the capacity to go systematically into the field to check that NGOs provide the services they claim to be, to see if there are gaps in services, or assess if NGOs are duplicating their efforts.

Nor does it know if there is an impact on the fulfillment of rights from all of the aid. As a result, it must rely on NGOs to provide it with information about their activities in order to assess what progress has been made towards its recovery plan or the realization of rights. In the Paris Declaration on Aid Effectiveness, supplemented by the Accra Agenda for Action, donor and recipient countries have recognized that mutual accountability when it comes to the effectiveness and use of aid, and the ability to monitor progress, is a shared interest. Relmas addition to information about when aid money is disbursed, inn, donors should provide sufficient information regarding which projects and organizations receive the disbursement, and must coordinate with the government and implementing agencies fuk set benchmarks regarding progress that funded projects have made.

Donors should also supply data that allows the government and civil society to better monitor outcomes of their aid. The government and donors should improve the way they spme and share information related to internal or independent oversight and monitoring and reporting of project outcomes. Reproductive and maternal health is not ancillary to the larger reconstruction progress. Rather, for women and pusys, the fulfillment of their rights—including the right to exercise control over the number and spacing of children, and to safer motherhood, and to live free of violence— is fundamental to any effort to rebuild their lives after the devastation and disruption caused by the earthquake.

This is true for all women and girls in Haiti, and not only those living NNeed the camps who are the focus of this report. Gooe Recommendations To the Government of Haiti Develop and communicate a gender policy consistent across all ministries and government policies. The policy should require: Identify and implement measures that can be put in place to ensure adequate oversight, monitoring, and reporting of programs to allow accountability between rights-holders and the state, as well as between the state and donors. This is essential to assess whether responses on the ground are effectively meeting human rights obligations and if not, what remedial action should be taken to fulfill those obligations.

Ensure adequate oversight, monitoring, and reporting of programs to allow accountability between donors and implementing NGOs and the government of Haiti. To the Interim Haiti Reconstruction Commission Develop and communicate a gender policy consistent across the commission and its policies. Ensure adequate oversight, monitoring, and reporting of commission-approved programs. Methodology This report is based on research conducted by two Human Rights Watch researchers in the metropolitan area of Port-au-Prince in November and January, February, and June Human Rights Watch also conducted 16 female-only group interviews and 11 mixed-gendered group interviews.

Human Rights Watch interviewed women from 15 camps ranging in size from to 60, people in 7 of the 12 communes affected by the earthquake, including: In most instances, these interviews were conducted in person. In a small number of cases they were conducted telephonically. Female interviewers and, when possible, female interpreters conducted all interviews. Researchers attempted to create private spaces within individual tents or elsewhere in the camp environment for interviews. Most interviews were conducted individually, except in a few instances where interviewees preferred to speak in small groups.

Human Rights Watch used a multi-step sample strategy. First, camps were selected to ensure representation of a range of types including: Additional criteria for camp selection included safety and the availability of interlocutors to provide an introduction to camp residents. Second, women and girls who met the inclusion criteria of being currently pregnant or having given birth since the earthquake were identified in each camp either through interlocutors in the camp or by visiting individual households tents and asking whether women and girls who met the criteria were available to speak. A total of women and girls in 15 camps were initially identified by Human Rights Watch.

After initial interviews, 92 women and 11 girls were found to meet inclusion criteria. The most common disqualifier was giving birth prior to the earthquake. Of the women and girls meeting inclusion criteria, 28 were currently pregnant and 75 had given birth since the earthquake. Eleven of the interviewees were girls agesand three were year-olds whose pregnancies began when they were All participants provided oral informed consent to participate and were assured anonymity. As a result, pseudonyms or first names only have been used for each individual interviewed. Individuals were assured that they could end the interview at any time or decline to answer any questions, without any negative consequences.

All participants were informed of the purpose of the interview, its voluntary nature, and the ways data would be collected and used. No interviewee received compensation for providing information. Four women and girls interviewed by Human Rights Watch asked to be interviewed outside the camp for added security and received compensation for expenses they incurred while traveling to the interviews. Where appropriate, Human Rights Watch provided contact information for organizations offering legal, counseling, or social services.

Background Pregnancy is not a disease, yet globally, hundreds of thousands of preventable maternal deaths occur every year. For women and girls giving birth in the minutes, weeks, months and now years after the earthquake, the risks associated with pregnancy remain, with the added challenges created by the post-earthquake destruction. The earthquake put additional strain on a population already suffering from chronic poverty and extreme vulnerability to disease, environmental disasters, and political insecurity. Indeed, many women and girls already suffered from a myriad of societal and economic vulnerabilities.

There is no law that prohibits sexual harassment in the workplace. No woman served on the Cour de Cassation Supreme Court. The electoral code provides incentives for the inclusion of women: Not one of the more than twenty political parties met these criteria in the November elections. Maternal Health Haiti has the highest maternal mortality rate in the Western hemisphere, and lags far behind the rest of Latin America and the Caribbean. Its maternal mortality ratio was deaths perlive births inup from deaths perbetween and In85 percent of women and girls benefitted from some access to prenatal care, compared to 68 percent a little over a decade before. Despite this, before the earthquake, some progress had been made in increasing the number of women and girls in rural areas who received care.

Inless than 25 percent of births took place in a health facility. Just over 78 percent of births attended by medical professionals were to women in the top economic quintile, while only 5. Some studies suggest that using modern family planning methods has the potential to avert 32 percent of all maternal deaths and nearly 10 percent of childhood deaths, while at the same time decreasing rates of poverty and hunger. While data demonstrate a dramatic increase in the use of contraceptives over a 40 year period, in only 28 percent of women and girls of reproductive age in urban areas, and 22 percent in rural areas, had access to modern methods of contraception.

The ability of women and girls to make decisions about the number and spacing of children may be limited by their partners. According to one study, less than half of women in relationships reported being able to independently make decisions about contraceptive use, and 26 percent reported that their partner alone made decisions for them about their own health. Furthermore, various regimes in Haiti have used sexual violence as a tool of repression. Bycriminal gangs used sexual violence and threats of sexual violence to terrorize communities. Its statistics also reveal that a significant proportion of the victims of sexual violence were girls: MSF also found that 67 percent of victims did not know their attackers; 68 percent of victims reported multiple attackers; and 66 percent of victims were threatened with a gun.

In the Port-au-Prince metropolitan area, 9. Haitian women also experience high levels of pregnancy-related violence, with more than 1 in 20 reporting to the EMMUS IV survey that they were subject to physical violence during their pregnancy: A study found a correlation between the experience of spousal abuse and poor reproductive health outcomes, defined in the study as having a non-live birth, a sexually transmitted infection STI or symptoms of an STI, or having an unwanted birth. Several symptoms related to sexually transmitted infections, including chronic pelvic pain, excessive vaginal discharge, discolored vaginal discharge, burning or pain when urinating, and lesions around the mouth or vagina, were found to be associated with a history of forced sex.

The survey data from to confirmed this, finding the number of women who reported a sexually transmitted infection to be significantly higher among women who had experienced sexual violence. This tripartite coordinating body, known as the Concernation Nationale Contre Les Violence Faites Aux Femmes Concertation Nationalesought to develop and implement an effective and participative response to violence against women. The lack of a certificate was found to be a major obstacle for women to press charges in cases of rape. Reforms and Efforts to Reduce Maternal Mortality before the Earthquake The Haitian government had taken a number of steps to address the maternal and reproductive health crisis.

The Ministry of Public Health and Population MSPP included maternal health as one of its priorities and the government included the reduction of maternal mortality as an important goal in its Growth and Poverty Reduction Strategy paper. Still in operation, the project expands access to free prenatal and obstetric care. Just one month after the project began the number of births in participating institutions increased between 51 and percent. A school for midwives was established ingraduating about 35 midwives each year. In addition, the UN Population Fund UNFPA supported programs to train traditional birth attendants, women who assist with deliveries, but have no formal medical training, to become auxiliary midwives.

The Free Obstetric Care project SOG includes funding to reimburse traditional birth attendants for bringing women with high-risk pregnancies into medical facilities for delivery.

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The Gopd government and donors identified other factors frustrating efforts to reduce maternal mortality fudk put demas in place Need some good pussy to fuck in delmas address them. The ministry, working with USAID, sought to address the management problems by building central level institutions and strengthening planning capacity at the department level. Sixty go of health facilities were damaged and 10 percent of health professionals were killed or emigrated. Many of the educational facilities for medical professionals were also damaged or destroyed. The school Nded midwives was severely damaged and the state nursing school collapsed, fuc, over of the pussh generation of nurses in Haiti.

Over health NGOs participated in the response efforts through the health cluster. Many believed that despite the dire conditions left by the earthquake some health indicators would actually improve because of the delmsa of health professions and free health services. But almost 9 months after the earthquake, a study found that only 20 percent of camps had any sort of health facility on site. As early as January 19,they began calling for access to free contraceptives for women and girls. A primary objective of its health strategy in the camp was to provide services to reduce maternal mortality and unwanted pregnancies and to provide services for victims of sexual violence.

In the first 12 months after the earthquake, GHESKIO provided 57 trainings on family planning, educating 5, persons living in the camp on the use of contraception, preventing STIs, and sexual violence. This is particularly important since, as Dr. One concern was the lack of privacy and confidentiality for women and girls, which Human Rights Watch also encountered. In spite of efforts by some humanitarian organizations, some women and girls told Human Rights Watch they did not have information about, or the means to practice, family planning. The unmet family planning need in Haiti prior to the earthquake was close to 40 percent, and funding for reproductive health during crises in Haiti had previously been inadequate.

Some service providers similarly found that women were less reluctant to ask about, and more interested in, certain kinds of contraception, such as injection administered contraception. NGOs that had a presence prior to the earthquake suffered losses. It indicated an estimated 15 percent of pregnant women would require some emergency obstetric care. The Free Obstetric Care project SOG also continued to operate, despite suffering the loss of offices, computers, and damage to participating medical institutions.

Women and girls interviewed by Human Rights Watch identified some of the following factors for their own pregnancy: A number of those interviewed also reported rape as soome cause of their pregnancy. An October UNFPA-funded study found a pregnancy rate of 12 percent in the displacement settlements, 3 times the average urban rate before the earthquake. The data clearly demonstrate that a high proportion of women and girls living in the camps require access to prenatal, obstetric, and postnatal care. Removing financial barriers to health care is an essential measure to enable access to health services for poor and vulnerable groups.

Obstacles to Maternal and Reproductive Health: Life is too hard in the camps. In particular, pregnant women delma lactating mothers Need some good pussy to fuck in delmas increased hardships, as do women with disabilities and elderly women, due to goood mobility and greater need for health services, food, and water. Lack of Access to Family Planning Rachelle was a year-old student when the earthquake hit. Terrified of the falling buildings, she immediately sought refuge in delmzs open spaces of a public square in front of the Presidential Palace. Gooe stayed in the delmaa settlement that sprang up there and became pregnant while living in the camp.

Though Rachelle did not reveal details regarding Need some good pussy to fuck in delmas relationship to the father of the child, she said: There was a clinic here [in the camp] and they had planning, but unfortunately the clinic closed. It is their right to goodd the number and spacing of their children. Human Rights Watch found that obstacles to family planning services included lack of access to information and the means to practice family planning. Women and girls interviewed by Human Rights Watch faced additional obstacles to effectively utilizing contraceptive methods that were available to them because of their inability to negotiate use of available contraception, namely condoms, with their partners.

Lack of Access to Information Tamara, a year-old mother, lives with her parents and brother in a camp in Delmas She is sometimes scared in the camp because fights often break out between young men and strangers will pop into her tent if it starts to rain. Tamara became pregnant while living in the camp, but was reluctant to discuss the circumstances of the pregnancy. Nobody told me about planning, but if I knew planning, I would use it. It's only I don't know. There was no information available in the camps where they lived; Information on family planning was given at prenatal checkups and therefore too late to prevent pregnancy; and Information about side effects, proper usage, and when to begin postnatal family planning was either unavailable or incorrect.

This evidence is consistent with data from the UN Population Fund UNFPAwhich indicate that 74 percent of persons living in displacement settlements reported a need for information regarding family planning. That number rose to 4 out of 5 respondents for the 25 to year-old age group. While some women and girls interviewed by Human Rights Watch reported having access to information, some women and girls from each camp we visited reported having no access to information. Like Tamara, Lovely lives in a camp in Delmas She has two children and recently gave birth to another.

Information that was accessible to women and girls we interviewed living in camps often came too late to prevent unwanted pregnancy. Jessie, a year-old woman with three children, including a 6-week-old infant, reported that she was only given information about family planning after becoming pregnant and at a medical facility seeking prenatal care. If you do not fit the above, you will surely find your type sooner or later, Good luck. Sandton, Gauteng Looking for fun and someone willing to satisfy me completely in all aspects.

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