Exploring New Frontiers in Sexual Health
New Delhi: The third National Family Health Survey (NFHS-III) shows that significant proportions of all married women have experienced physical and sexual violence perpetrated by their husbands. But as a recent study shows, many of the young men, who could be termed as `marital rapists’, are in need of basic information about sexuality.
But how can they go about it? Cultural taboos, religious fundamentalism, and a lack of access to information and services impede informed choices. These problems pose a challenge not just to India but to many countries in Asia and the Pacific.
Can some of the issues be addressed by expanding and empowering the sexual and reproductive health and rights movement? While experts agree that this is necessary, they say that equalizing sexual relationships in the context of gender and sexual diversity is equally important.
This is why the 4th Asia Pacific Conference on Reproductive and Sexual Health and Rights (APCRSH) has chosen ‘New Frontiers in Sexual and Reproductive Health and Rights’ as its theme.
The conference, being held in Hyderabad from October 29-31, 2007, will bring together more than 1200 participants including NGOs, government officials, donors, UN representatives, media persons and parliamentarians to discuss issues related to sexual and reproductive health (SRH) and rights.
Besides union health minister Anbumani Ramadoss, who will inaugurate the conference, other important speakers will be the chief minister of Andhra Pradesh, Y S Rajasekhara Reddy, Thoraya Ahmed Obaid, UNFPA Executive Director, who will deliver the keynote address and Gill Greer, IPPF Director General, who will speak on the journey from Cairo to Hyderabad.
Dr Baige Zhao, Vice Minister, National Population and Family Planning Commission, The Peoples Republic of China, and Renuka Chowdhury, Minister of State, Women and Child Development will address the first plenary session on ‘Implementing sexual and reproductive rights: an unfinished agenda’.
According to Poonam Muttreja, co-chair, international steering committee, 4th APCRSH, it is appropriate that the conference is being held in India because the greatest challenges in this area have emerged from Asia. Therefore, the conference aims to develop new strategies for future research and programming on the sex ratio imbalance in Asia, addressing unmet reproductive needs of young women, making pregnancy safe and wanted through more expanded, informed choices in services and the need for a renewed political and economic commitment.
A huge number (921) of research abstracts were received from 42 countries. Saroj Pachauri, chair, scientific committee, 4th APCRSH, says these were reviewed by 72 professionals from 15 countries. Finally, 343 abstracts were accepted; 182 for oral and 161 for poster presentations.
The rapid fertility decline and demographic transition experienced in most of Asia has been accompanied by heightened discrimination against girls. It is manifested through prevailing pre-natal sex selection and female feotecide resulting in increased sex ratio imbalance. Son-preference, the combination of traditional methods of neglect of girls and misuse of modern technology, urbanization, rising educational levels and standard of living has lead to an increasing deficit of young girls across the region, often so in the affluent sections of the populations.
The social well-being of any country can be assessed by its sex-ratio. Skewed sex ratios at birth have already resulted in a demographic gap in parts of China and in India, with the far reaching consequences, including growing violence against women and girls, bride trafficking and early marriages. Despite legislative responses, recent available data shows that the practice persists and its spill-over effects are impacting neighbouring countries too.
A recent study by Rajib Acharya and Shireen J Jejeebhoy of the Population Council shows that women who were forced into sex were significantly more likely than other women to have experienced SRH problems. The study, which is to be presented at the 4th APCRSH, finds that women who were beaten are almost twice as likely as those who were not beaten to report SRH problems.
Gender based violence is not limited to India alone. Presenters from countries like Indonesia, Afghanistan, Nepal and Thailand will talk about the situation in their countries.
There will be special focus on young people and adolescents keeping in mind that about 700 million adolescents (10-19 years) live in Asia. Not only are their numbers large but they are experiencing rapid changes in attitudes and expectations in a fast-changing world. Therefore, developing programmes to address their SRH needs poses a major challenge, says Sunil Mehra, co chair, India Organising Committee.
In India there has been considerable debate on the relevance and importance of sex education in schools. Sexuality does not operate in isolation says Radhika Chandiramani, director, Talking About Reproductive and Sexual Health Issues (TARSHI), a NGO working on the issues of sexuality. Chandiramani, who will chair a satellite session on ` More than Pleasure: New Issues in Affirming Sexuality in Asia, says sexuality intersects with gender, class, caste, religion, economics, the law, culture, and many other variables and is implicated in broader structures of power.
TARSHI, which has been running a telephone helpline on sexuality since 1996, has responded to more than 59,000 calls. Most callers say they want to know about basic facts like sexual anatomy and physiology, underlining the need for the introduction of comprehensive sexuality education in the school curriculum says Chandiramani.
The 4th APCRSH hopes to enable educationists and thinkers to get a wider regional and international perspective on the subject.
Sexual and Reproductive Health (SRH) is seen as central to achieving the Millennium Development Goals too. In this context, the integration of family planning, HIV/AIDS and SRH as envisioned at ICPD (International Conference on Population and Development held in Cairo in 1994) is fundamental. The conference will discuss how these goals can be achieved despite constraints of funding, organizational barriers, and limited training opportunities for health service providers.
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- dafaster » Blog Archive » Exploring New Frontiers in Sexual Health | October 22, 2007
The topic “Exploring New Frontiers in Sexual Health” is interesting and important. We need to focus on the issues, work on each issue related to the subject to takle from social and heath perspective.
Thanks.
Thoughts on Metro, from a well-traveled resident
Yasmin Chowdhury
The recent decision to build a Metro (underground rail) system in Dhaka has met with a range of responses. On one side is the “halleluyah” response—at last, government is taking public transit seriously, with plans to invest serious funds (at least $3.2 billion US dollars) into making life easier for the masses.
On the other side rises the practical question: how feasible is the plan, how much will eventually get built, will it actually function, and might not a different form of public transit—say, a tram or trolley, or Bus Rapid Transit—achieve similar benefits for about a hundred times less money per kilometer?
On the bright side, traveling in cities with a Metro is a far different experience from traveling in those without one. Where I grew up, there is no developed system for public transit, and it is virtually impossible to get around without a car. Since I let my driver’s license expire about a decade ago, I feel like a child when I visit, reliant on adults to take me places. Meanwhile, when I visit big modern cities, like Boston, Washington D.C., Chicago, New York City, or San Francisco, or any number of European cities, I can easily move around on my own.
But while the independent mobility is a blessing, with it comes a significant downside. When traveling underground, we fail to experience the city we are in. Living in Boston and frequently traveling by subway, I had many of the stops memorized, and could easily get around underground—but I had no idea what was over my head. When I finally got into the habit of walking through the city following the subway lines but above ground, I realized that only now was I gaining a perspective of where buildings, monuments, and important parts of the city are in relation to each other—not in terms of a subway map, but in terms of actual physical layout. In the process, I realized how little I had actually understood, all those years of living there, about the true layout of Boston—or of what is to be found in various neighborhoods that I had ever only passed under. The parts of the city I knew best were those I walked in, or where the subway emerged into a street-level trolley, and there was a sense of connection between the passengers and the street life out our windows.
When traveling underground, we are unaware—and thus often unconcerned—about the situation at ground level. Passing under a slum, we don’t pause to reflect on the lives of the people there, and whether something couldn’t be done to make it better, or on why trash is thrown here and there, or how desolate some of the streets look…but we do notice those things when traveling on the surface, and there is the possibility that from noticing, we will go on to change it.
This has a direct practical side as well for business owners; when traveling at ground level, we can see shops and other amenities. Oh, that’s where I can buy that—or oh, that looks like a pleasant restaurant! And knowing where it is and how to access it, there is the possibility of going back someday. This is both a far more amusing way to pass the time when traveling then in looking at tunnel walls, but also is good for the businesses we pass.
Then of course there are the practical matters. I remember seeing a map of the subway system in Washington, D.C. which showed various “planned” routes. I remember seeing the same map year after year, and being surprised that they were never built. Short on funds? Similarly, I read in the newspaper in Bangkok that the sky train was supposed to extend far beyond the existing network. That hasn’t happened, and the sky train itself took many years to build in part, I hear, due to corruption. Meanwhile, the new Metro in Bangkok doesn’t go much beyond the sky train. What then are the chances that Dhaka will succeed in building all it plans? If the existing plans prove unaffordable, as the price of materials continues to rise, how much will a very limited system do to reduce traffic congestion or make traveling easier?
Meanwhile, building a subway system requires building a lot of tunnels. The funny thing about tunnels is, they have to be accessed from the street. This involves a lot of big holes, and while those holes are in place, streets are closed down. So congestion will be significantly worse for the years during which the Metro system is built.
There is also the issue of crowding on the subway. I was in New York City recently, and given the intense street-level congestion, when going too far to walk, I tried the subway. It was certainly better than being stuck in traffic, but of course I had no idea where I was, and I couldn’t decipher the thick New Yorker accent of the conductor. On one trip, the train was so packed that I couldn’t see out the windows to read the names of the stops. This made arriving at my destination a bit of a challenge, and left me as clueless as ever about the geography of Manhattan.
The sky train is often packed in Bangkok, with barely room to stand. Thais are polite, and I have never had a man grab me. Unfortunately, I can’t say that for my experience of riding in crowded subways in Boston, and I have heard horror stories about the system in Mexico, which apparently had to provide separate carriages for women to prevent sexual harassment on the packed trains.
Then there are those lovely escalators down to the stations. Where there are hills, or where the system must go under high rise buildings, stations must be built far below ground. Some of those escalators seem to go on forever. Stepping onto those moving stairs with the ground so far below as to seem to belong almost to another planet always makes my head spin. I was relieved, on a recent trip to D.C., to discover that a Bangladeshi colleague had the same experience, only worse. He insisted on taking the lift. Of course the lifts are intended mostly for the disabled, those with small children, or those with luggage, so one sometimes must wait a long time for it. Between long lines for lifts and the crowded situations of the trains, it sometimes feels as if we have simply shifted a portion of our traffic congestion below ground.
Speaking of traffic congestion, it helps to remember that people need to be able to get to and from the public transit stops. Getting from one stop to another in little time is a great convenience, but the benefits of that convenience are rapidly diminished when it is difficult to get from public transit to one’s actual destination. I made a mistake in Bangkok once and got off at the wrong subway stop. As I came up to the street, I realized that where I needed to go was on the other side of a highway, with no provision for crossing. I could either go back underground, pay again, then wait for another train to come along to take me just one more stop, or I could risk my life running across the highway. Needless to say, I ran.
In cities with broken sidewalks, and sidewalks blocked by parked cars, and barbed wire and cement medians to prevent people from crossing the street, getting to and from public transit becomes a daunting challenge. Anyone in their right mind would choose to drive instead, if they had the option, thus defeating in large part the point of the public transit in the first place: to woo people away from their cars. That is, public transit doesn’t exist in a vacuum—it is part of the city, and it is meant to connect places not just along the tracks, but throughout the city. If people can’t easily get to the stops on foot, or on rickshaw, then there is little point in building the system in the first place.
Then there is that lovely dream of the uncongested streets of Dhaka, once our Metro system is built. How many large, crowded cities with crowded Metros have streets free of traffic jams? Let’s face it, moving through a city—even at a good pace—underground just isn’t that pleasant an experience. Subway stations are often hot and smelly. Homeless people tend to use them as urinals, and there are always those aggressive people who insist on smoking despite all the signs. If subways freed up the streets, then all the passengers who could afford a car or taxi would go back to riding in one.
I remember once being late for the airport in Boston and figuring that rather than go all that way below ground, and change trains twice, and move at the snail’s pace the Boston subway often goes at—it is the oldest subway system in the US and thus the least modern—I would take a taxi. Oops. Of course it took even longer, thanks to all the traffic, and I missed my plane. Yet Boston’s subway system is far more extensive than Dhaka’s is likely ever to be, and it is easy to walk in Boston, and there is a good bus system to complement the subway, and the population is a fraction of Dhaka’s. So why are there still traffic jams, when the Metro is supposed to eliminate them?
I’m sure the decision was made in good faith. Perhaps the planners involved have not spent much time in the major cities of the world, and experienced both their subways and the traffic situation above ground. Perhaps they feel that people enjoy being below ground, or that the city is best experienced as little as possible—that is, either underground, or safely insulated in a steel box. No doubt they consider the expenditure of a mere few billion dollars quite reasonable, pocket change really. Perhaps they are too busy to read the Strategic Transport Plan which was meant to map out the best transport plan for the future, and which found that a Metro would offer no significant improvements over surface public transit, and thus there is no justification to build it.
Even allowing that a few billion dollars is a minor sum which should involve little thought or planning before expending, I would still suggest that when Dhaka’s city planners make their final decision about an efficient, fast, affordable, high quality system of public transit, they should be careful not to miss the boat. It’s a lot more expensive and more technically difficult to build and operate an underground system than a surface one.
We would get a far more extensive system, with far lower fares or less government subsidy, if we built a surface rather than an underground system. The system could be built a lot faster than a Metro, and with a lot less disruption of traffic during its construction. That issue of fares is important—around the world, public transit tends to be expensive, and yet still highly subsidized by government. The more expensive the system is to build and maintain, the higher the fares and the subsidies, and the less that will eventually get built.
People could see their city out the windows while riding, gaining both a sense of perspective and of knowledge of what is happening around them. A less expensive system could be started quickly, and gradually expanded. Ensuring that people can walk around the city would not only make the public transit system viable, but would help reduce congestion by shifting some short distance trips to walking. The money to fix our footpaths, and the political will to ban car parking on them, should not be more difficult to find than the billions planned for the Metro.
Public transit is definitely the way to go—but not all public transit was created equal, and leaping onto the wrong train won’t help us reach our final destination.