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To the IAC: a proposed domestic violence prevention program

March 3rd, 2011

To the Inter-African Committee on Traditional Practices Affecting the Health of Women and Children:

My name is Heidi Norton, and for the past ten weeks I have been studying the issue of domestic violence for a class on international women’s health and human rights at Stanford University. I have been exploring the cause of violence against women, as well as potential effective prevention strategies. I am writing to urge you to integrate a domestic violence prevention program into your youth education program, and to offer ideas as to what an effective program might look like. I will be focusing on the issue of domestic violence in Ethiopia, which has a shockingly high prevalence rate, but much of my research and suggestions could be applied to other nations as well.

As you know, a study conducted by WHO found that 71% of women interviewed in Ethiopia had been subjected to physical or sexual violence by an intimate male partner during their lifetime (1), which is significantly higher than the estimated global average of one in three. The prevalence rates of other acts of violence against women are also extremely high: 70% of 485 respondents randomly selected from different social groups reported being sexually abused as a child (2). A statistic that is perhaps even more telling of the larger problem is that 81% of Ethiopian women believe their husbands have the right to beat them if they burn food, refuse sex, or go somewhere without their husband’s consent”(3). While domestic violence is not considered a traditional cultural practice such as female genital mutilation — against which I know you are doing valuable work – I believe that traditional gender norms are responsible for the high prevalence of domestic violence and as such should fall under the umbrella of your organization. Domestic violence is a harmful cultural practice in the sense that it is a behavior both learned and sustained through cultural norms.

Something that provides clear evidence for the fact that violence against women and girls is a culturally accepted behavior learned early on is the involvement of elder brothers in violently disciplining their younger sisters, and being praised for their abusive behavior (4). As I am sure you are aware, there are no laws against corporal punishment at home and allowed forms of punishment include beating with sticks, burning parts of the body, putting hot pepper in the fire and forcing girls to inhale the smoke, and burning the genitals with an iron hot spoon. Boys are learning violence against women at an early age in the form of the “noble” deed of helping maintain order in the home and are growing up with a dangerous view of masculinity and femininity. It is no surprise that the boys who grow up abusing their sisters will one day become men who batter their wives. How can this cycle be stopped? Clearly traditional programs that reach out only to women who are victims is not enough, but what more can be done?

The solution I am proposing broadens the focus from batterers and victims to encompass everyone who is part of the larger community that accepts men’s violence against women as a normal occurrence. The importance for such programs was the topic of the 2003 international conference “Mobilizing Family, Friends, and Neighbors to Prevent Domestic Violence”. One of the organizers said:

We need to get personal with people – to expose the perceptions and practices that lie at the core of violence – how people think about women, the rigidity of gender roles, and the status women hold in their homes, communities and relationships. In this way, we move beyond perpetrators and survivors (both obviously important to engage) to the friends, peers, colleagues and family members – or bystanders (5).

I was excited to read of your impressive youth education program, which has already reached over 250,000 youth and trained them to be peer educators and to mobilize their communities around the issue of FGM. I feel confident that your existing infrastructure can be utilized to implement an effective domestic violence prevention program. I propose a program that involves the formation of small (10-20 members) groups of young boys, men, young girls, and women (in separate groups) led by an expert facilitator. In my research, I have found a few key factors that seem imperative for the success of such a prevention program, some of which are already present in your youth education program. First, the program must be gender-transformative. According to a WHO study that examined 58 violence prevention programs, “programs with men and boys that include deliberate discussions of gender and masculinity and clear efforts to transform such gender norms were more effective than programs that merely acknowledge or mention gender norms and roles.” (6) Second, group education is most effective when a minimum of sixteen weekly meetings are held, which allow time for the participants to apply what they have learned at home and in their communities and to evaluate their own behavior throughout the course of the program. Weekly meetings should empower participants to speak up when witnessing abusive behavior and provide non-violent ways to intervene (7). Third, the program should be integrated with community outreach, mobilization and mass-media campaigns (6), all of which your organization already does exceptionally well. The WHO study found that when mass-media campaigns were coupled with group education, men felt a higher ability to talk to other men and boys about violence against women and to act on what they learned in their weekly sessions. And lastly, it is imperative that the program checks in with past participants every year in order to remind them of what they have learned, as well as to assess the effectiveness of the program.

Such programs have been shown to decrease violence on an individual basis (6), and I feel strongly that the incredible work you have been doing already to educate and mobilize around the issue of FGM could be applied to the issue of domestic violence to create observable change on a macro scale. Please consider my proposal, and let me know if you are interested in discussing this further.


Heidi Kathleen Norton

(1) RN – (RN, United Nations Development Programme, Arab Human Development Report, 2005) 116

(2) CMF – (CMF, Geneva Centre for Democratic Control of Armed Forces, GLOBAL REPORT ON SEXUAL VIOLENCE IN ARMED CONFLICT, 2007) Africa, 16

(3) http://www.huffingtonpost.com/alemayehu-g-mariam/speaking-truth-on-behalf_b_635317.html

(4) GDK – (GKD, Save the Children, Study on Violence Against Girls in Primary Schools and its Impacts on Girls’ Education in Ethiopia, 2008) pp. vii, viii

(5) Mobilizing Family, Friends, and Neighbors to Prevent Domestic Violence: Online Conference, 23-30 July 2003 – Final Report

Close to Home Domestic Violence Prevention Initiative – Dorchester, MA U.S.A. 8

(6) World Health Organization (2007). Engaging men and boys in changing gender-based

inequity in health: Evidence from programme interventions. Geneva

(7) http://www.jacksonkatz.com/mvp.html

Taking Action on Maternal Health

March 3rd, 2011

Dear Senator Barbara Boxer,

Almost every minute, a woman or girl dies from pregnancy-related causes around the world (CARE). More than five hundred thousand women die from complications related to childbirth and millions more are left with life-threatening disabilities (UN). Fourteen countries have maternal mortality ratios of at least one thousand per one hundred thousand live births. Half of all maternal deaths occur in sub-Saharan Africa and a third in Southern Asia Sadly, most of these deaths are preventable, and many of the related health problems are detectable and treatable. According to the U.N., 99% of maternal deaths occur in the developing world, making maternal mortality an indicator of the great gap between the rich and the poor between countries. Such gap is also found within countries—the causes of maternal morbidity and mortality are universal, rooted on issues of human rights violations, poverty, and lack of political will to take care of citizens’ health (UN).

Most of maternal deaths are a result of obstetric complications—including post-partum hemorrhage, infections, eclampsia, and prolonged or obstructed labor—and complications of unsafe abortion. Maternal morbidity and mortality are often a result of three delays related to Emergency Obstetric Care (EmOc): delay in the decision to seek care (women’s decision to go to a health center for delivery or prenatal control), delay in arriving at care (transportation barriers, fees, and women’s lack of autonomy), delay in receiving appropriate care (infrastructure barriers and shortage of doctors and/or equipment) (CARE). Indeed, fewer than half of pregnant women in developing countries have the benefit of adequate prenatal care, and many do not have access to health centers or to professional health providers during delivery (UN). Access to contraception has expanded but the unmet need remains high.  In addition, the number of unsafe abortion-related deaths is increasing. For example, in former Soviet Republics, women have little access to birth control methods, and thus view abortion as an alternative to control parity. This brings up the need for further family planning and interventions for making contraception widely available. Other studies in the field also reveal that the quality of the interventions is extremely important because less than optimal interventions could lead to increased child mortality.

The United Nations recognizes safe motherhood as a human right (x). As part of the Millennium Development Goals, world leaders decided to reduce the maternal mortality ratio by three quarters between 1990 and 2015. In a 2009 report, however, the UN highlights maternal mortality as an area where “accelerated progress is needed” (UN). The report states that greater political will is needed, especially in sub-Saharan Africa and Southern Asia.

As a world leader and supporter of the United Nation’s Millenium Development Goals, it is imperative that the United States takes continues to take a leadership role in fighting global maternal mortality. For that reason, I am writing to strongly urge you to co-sponsor the Global MOMS Act (H.R.5268) to address the issue of global maternal mortality.

Low-cost, simple interventions have been proven to drastically reduce maternal mortality (Physicians for Human Rights). Some of these interventions include family planning, skilled care during pregnancy and delivery and access to quality emergency obstetric care. The promotion of evidence-based guidelines is also crucial for improving the health of mothers (Danishevski).

The Global MOMS Act will help develop a strategy to reduce maternal mortality and improve maternal and newborn health around the world. In 2008, he House and Senate passed resolutions affirming Congress’commitment to fighting maternal mortality abroad and at home.

The bill will be crucial for ensuring that those commitments are respected. It would increase access to maternal health care service including family planning and human rights.  It would also call for a “development of a national strategy for fighting global maternal mortality, and better coordinate existing U.S. maternal health efforts.”

Seventeen different organizations including Amnesty International, CARE, and the White Ribbon Alliance endorse the bill  Eight of Rep. Capps’s House colleagues are on board as co-sponsors.

I ask for your co-sponsorship of this bill. It will certainly demonstrate your commitment to women and children around the world. Now is the time to pass the Global MOMS Act. Please, help the United States keep its promise and commitment on maternal health, and co sponsor the Global MOMS act.


Laura Huaman


Amnesty International (2009). Deadly Inequalities. http://www.amnesty.org/en/library/asset/AMR46/002/2009/en/60b0be04-1cda-45e3-9349-a9b46aa7fd2a/amr460022009en.pdf

Amnesty International. “The Global MOMS Act: From Commitment to Action.”


Danishevski, K. “Delivering babies in a time of transition in Tula, Russia.” Health policy and planning 21.3 (2006):195.

United Nations Development Programme. http://www.undp.org/mdg/goal5.shtml

UN USA http://www.unausa.org/Document.Doc?id=796

USAID http://www.usaid.gov/locations/europe_eurasia/health/docs/reproductive_maternal_and_child_health_chapter01.pdf

A Women’s Voice in Conflict: Social Media Monitoring as a Policy Tool

March 3rd, 2011

Date:          March 03, 2011

To:             Department of State Policy Planning Staff

From:         Ada Kulenovic, Stanford University

Subject:      Women’s Rights in Conflict: Establishing Social Media Monitoring as a Policy Tool


Women play many roles in modern warfare—from victims of systematic violence to combat professionals— however, regardless of what status a woman has in conflict, it is in the interest of the United States to ensure women’s rights and long-term health consequences are taken into consideration in the crafting of wartime policy. International women’s stories present an opportune educational tool for policy makers to better assess the needs of women in war situations. Further, increased international access to the Internet and social media sites have bolstered the potential to effectively monitor and respond to human rights abuses against women.

Global Trends:

  • The spike in ethnic and religious civil wars targeting civilians has resulted in disproportionate numbers of women and children victims. [1]
  • In regions where democratic principles and transparency are scarce, women’s rights violations are being methodically concealed: local authorities turn to falsifying reports and classifying records and statistics. [2] These governments are failing to uphold the UN Declaration of Human Rights, and there is a lack of appropriate mechanism for reporting these abuses.
  • Not only civilian females are victims of abuse in wartime situations; there have been record high reports of abuse of military personnel within US troops. [3] The safety of our female combatants must be made a priority.
  • The U.S. Committee for Refugees and Immigrants gives the world total of displaced peoples as approximately 62 million; about one-third are officially recognized as international refugees, and 80% of these refugees are women and children who are more vulnerable to their unstable conditions. [4] Subsequently, the health consequences facing women during and after conflict (including both physical and mental traumas) constitute an issue that affects US demographic standards and the US healthcare system.

Assessment of Current Approaches:

Current policy does not effectively address the varied needs of women in conflict. While the US has made effective efforts to curtail mass human rights abuses such as the ones seen in the Balkan wars of the 1990s [5], there remain many gaps in policy with respect to women’s issues because there is no mechanism for giving a voice to the female population.  International journalists and popular media have long played a key role in disseminating information on civilian conditions in war. [5] Their efforts supplement the investigations undertaken by US intelligence agencies.

Over the past decade, however the Internet emerged as a new resource for accumulating information regarding human rights atrocities. It is estimated that one third of the world has access to the internet. [6] Global internet usage has grown by 444.8% in the last decade; regions that have seen the fastest growth include Africa (2,257.3%) and the Middle East (1,825.3%). Additionally, world internet penetration rates are steadily growing, meaning more people than ever before are gaining access to the internet on a daily basis. [6] In 2010 Facebook reached over 400 million users worldwide, and Twitter hit a benchmark  reporting of 50 million tweets per day; last year both sites saw number of global users nearly triple, while time spent on social media sites increased over 80%. [7] In many developing nations, social media is driven by the usage of mobile devices. Currently, about half of the global population has a mobile phone. Studies suggest that internet via mobile will become a primary means of internet access in developing countries. [8] Lastly, technology-based development researchers suggest that mobile internet access in developing countries could drastically change the basis for social determinants of healthcare and social service access. [9] The internet it creating a new medium for information exchange and social participation. Current events trends affecting revolutions across the Middle East support theories of the rising importance of social media as a tool for community organization. [10]

Furthermore, as I am sure you are aware, Secretary Clinton and president Obama elevated technology to a high priority for the State Department as a new tool for diplomacy. Jared Cohen’s persistent promotion of the use of existing technologies, including Facebook, Twitter, and Google, transformed the State Department’s approach to diplomacy by bringing the State Department up to speed with existing technology for international mass mobilization. [11] A number of notable projects were initiated to bring together tech delegates across the world to promote the use of social media as a device, particularly in war-torn countries such as Iraq and Afghanistan.  [11] One venture to be highlighted is the 2008 delegation trip to Baghdad, during which Silicon Valley representatives traveled with local engineering students, professors, and government ministers to assess how to make technology more accessible across Iraq. [12] The trip resulted in several innovative ventures including the tweaking of Twitter code to allow basic cell phones to make posts and the introduction of blogging and coding partnerships among youth activists and engineering representatives. [12] The Iraq experiment poses an interesting model for future endeavors.

Another notable predecessor of social media monitoring is the Haiti response effort. The creation of a universally accessible tracking number ‘4636’ used by people to text for help was credited for the success of a series of rescue efforts, and provided a tool for tracking missing persons. In addition, during the Haiti disaster, organizations relied heavily on posts coming in from social media sites to organize relief missions. [13]

There is a need to expand the usage of the internet for policy monitoring– especially with regards to women’s issues. Through social media, women across the globe are given a new means of expression and self-organization. The internet provides a means for an otherwise voiceless group to have clout in the international arena.

Policy Recommendations:

The next step is to take the basic frameworks for social media monitoring that are already coming to fruition and to extend them to the most high needs regions and populations—focusing heavily on targeting women’s empowerment grassroots organizations in regions with a propensity for civil strife such as Africa and the Middle East, where social media and cellular device usage continues to grow.

There is a need for:

  • Support for the strategic use of online media for women to voice their complaints to the international community; including addressing issues of accessibility, awareness, anonymity, and safety.
  • A method by which to monitor abused populations’ complaints and locations across a range of existing social media servers . This monitoring system should track short-term and long-term reporting trends.
  • A coordinated effort to address the concerns provided by this new apparatus, and to manage effective response across government and non-government organizations.
  • Continued tracking and follow-up on the health status of women and children refugees and female veterans in the US.

In order to push forth with these goals, the Policy Planning Staff must designate a Women’s Rights Monitoring Task Force which will help promote the continued establishment of technology delegations comprised of entrepreneurs, political leaders, local community figures, and students, much like the ones championed by Jared Cohen and Alec Ross in 2008. [13] In addition to the delegations, the Task Force should seek to partner with organizations that work with women in war, such as Women for Women International and CARE, to promote the use of social media and cellular devices as a medium for crisis help for use by all women, especially women in the US military. Female military representatives should be trained to report both instances of abuse with the troops and amongst local populations. Further, the Task Force must seek to establish potential monitoring agencies modeled after the monitoring attempts carried out by State Department, Pentagon, and humanitarian groups after Haiti.  These monitoring systems should serve as a means of coordinating response efforts, and continuing metrics measurement post-conflict. The reports generated by these agencies can serve as the basis for further studies, policy recommendations, and immediate action mechanisms.

Given the politically volatile situations facing countries across the Middle East region in the wake of revolutionary reforms, and the strategic importance this region to international security and stability, now is the time to act by instating monitoring of social media across Lybia to assess the situation on the ground.

By pushing for social media access, we ensure Article 19 of the Universal Declaration of Human Rights, securing citizens’ access to information. This is a direct means of promoting transparency and fighting corruption in places that need it most without the use of US military force. The strategic application of the information that results from the use of these social media channels allows for direct citizen communication, gives voice to a silenced minority population under severe repression and helps ensure smart policy-making rooted in the needs of the population.  This policy helps implement smart top-down policy by involving local communities and pushing for bottom-up involvement in political affairs.


[1] Broken bodies, broken dreams: violence against women exposed. Jeanne Ward – Zana Briski – Lisa Ernst – UN. Office for the coordination of humanitarian affairs (OCHA). Integrated regional information networks (IRIN) – 2005.

[2] Camareno, Rodrigo. “The War on Drugs’ Female Victims.” The Guardian | Guardian.co.uk. Web. 27 Jan. 2011. http://www.guardian.co.uk/commentisfree/cifamerica/2011/jan/24/mexico-usa-women.

[3] Benedict, Helen. “The Private War of Women Soldiers.” Salon. 7 Mar. 2007. Web. http://www.salon.com/news/feature/2007/03/07/women_in_military.

[4] “Frequently Asked Questions About Refugees and Resettlement.” International Rescue Committee | The International Rescue Committee Goes to Crisis Zones to Rescue and Rebuild. We Lead Refugees from Harm to Home. Web. 04 Mar. 2011. http://www.rescue.org/frequently-asked-questions-about-refugees-and-resettlement.

[5] Brussels, Belgium. UNFPA. Sexual Violence Against Women and Girls in War and Its Aftermath: Realities, Responses, and Required Resources. By Jeane Ward and Wendy Marsh. 2006. Symposium on Sexual Violence in Conflict and Beyond.

[6] “World Internet Usage Statistics News and World Population Stats.” Internet World Stats – Usage and Population Statistics. Web. 02 Mar. 2011. http://www.internetworldstats.com/stats.htm.

[7] “Led by Facebook, Twitter, Global Time Spent on Social Media Sites up 82% Year over Year | Nielsen Wire.” Nielsen. Web. 03 Mar. 2011. http://blog.nielsen.com/nielsenwire/global/led-by-facebook-twitter-global-time-spent-on-social-media-sites-up-82-year-over-year/.

[8] Tryhorn, Chris. “Developing Countries Drive Explosion in Global Mobile Phone Use | Business | Guardian.co.uk.” Latest News, Comment and Reviews from the Guardian | Guardian.co.uk. Web. 03 Mar. 2011. http://www.guardian.co.uk/business/2009/mar/02/mobile-phone-internet-developing-world.

[9] Boyera, S. “White Paper on Mobile Web for Social Development.” World Wide Web Consortium (W3C). Jan. 2008. Web. 03 Mar. 2011. http://www.w3.org/2006/12/digital_divide/ajc.

[10] “Mass Media, Women and the Middle East.” Home. Web. 04 Mar. 2011. http://www.waccglobal.org/en/20072-mediating-the-middle-east/454-Mass-media-women-and-the-Middle-East.html.

[11] BusinessWeek: Interview with Peter Elstrom & Spencer Ante. BusinessWeek. Video.

[12] Ante, By Spencer E. “Twitter Diplomacy – BusinessWeek.” BusinessWeek – Business News, Stock Market & Financial Advice. Web. 04 Mar. 2011. http://www.businessweek.com/magazine/content/09_26/b4137050286263.htm.

[13] Gentile, Carmen. “Cries for Help via Text Messages Are Used to Direct Aid to Haiti.” New York Times Online. The Nw York TImes, 20 Feb. 2010. Web. http://www.nytimes.com/2010/02/21/world/americas/21text.html?_r=1&th&emc=th.

Intersections of Violence against Women and HIV/AIDS: A Policiy Brief to NGOs

March 3rd, 2011


This brief serves two purpose for: NGOs seeking to bridge connections between communities and grassroots movements and state and multinational organizations. The first is information that is meant to convey how widespread violence against HIV-positive women around the world and the methods in which the virus is passed, often unwillingly and through force and coercion. The second purpose seeks to provide NGOs with a series of possible solutions that call for not only more awareness and education on the issue, which includes awareness of the fact that violence against women is unacceptable and a serious crime, as well as actual policies and legislation that provides protection and services (counseling, healthcare) to these women and their children.

Violence against women constitutes an urgent public health problem worldwide, particularly in the context of the HIV/AIDS epidemic. A growing number of studies document a high prevalence of both physical and sexual violence against women committed at the hands of an intimate partner. For example:

  • In population-based surveys done on violence against women, between 10% and 69% of women report being abused physically by a male partner at least once in their lives. (1, 2)
  • In many countries there is a high prevalence of non-consensual sex particularly among young women. For example, a study in Peru finds that the percentage of young women reporting forced sexual initiation is almost four times higher than the percentage of young men. (1)

Violence against women (VAW) takes many forms including physical, emotional, financial, and psychological abuse. Women can be privy to this violence as a result of conflict and other social upheavals, and are often exposed to violence in public spaces and within their communities. However, by and large, violence against women occurs most frequently in the private sphere by partners, other family members, or acquaintances.

Much of the research I’ve done concerning the intersections between violence against women and HIV/AIDS points to the fact that violence against women can directly or indirectly expose women to HIV infection. For example:

  • Rape can result in vaginal lacerations and trauma and this can in turn increases risk of acquiring an HIV infection.
  • Violence and fear of violence makes it difficult for women to negotiate safe sex including condom usage in their relationships.
  • Women who are exposed to childhood sexual trauma and abuse are more likely to engage in HIV-related risk behaviors (early sex, a greater number of partners, use of drugs and alcohol).
  • Fear of violence prevents women form accessing HIV/AIDS, being tested, disclosing their HIV status, accessing services for the prevention of HIV transmission to infants (which can lead to communities ostracizing the infant as a result of their and their mother’s status), and receiving treatment, care and support services.

Research shows that violence against women is associated with increased risk for acquiring sexually transmitted infections (STI) and HIV infection. For example:

  • A cross-sectional study among women presenting for antenatal care in Soweto, South Africa, shows that women who experience partner violence and controlling behavior by their male partners are nearly 1.5 times more likely to have an HIV infection than those who do not. (3)
  • Another study from South Africa shows that women who experience forced sex are nearly six times more likely to use condoms inconsistently compared to those who are not coerced. (3)
  • In India, a study conducted among men finds that men who report an STI are 2.5 times more likely to abuse their wives compared to those who do not report an STI. Men who have extramarital sex are six times more likely to sexually abuse their wives compared to those who do not have extramarital sex. The researchers conclude that abusive men are more likely to engage in extramarital sex, acquire STIs, and place their wives at higher risk of STI possibly through sexual abuse. (4)
  • In studies from sub-Saharan that look at violence as an outcome of women’s HIV status disclosure, among women who do disclose their HIV status, between 3% to 25% report negative reactions including blame, abandonment, anger, and violence. (5)


This example comes as a result of the recent conflict in the Congo and the widespread use of violence against women in order to control an entire population. The example is meant to describe how even in one of the most jarring examples of violence against women (violence in conflict situations), the threat and transmission of HIV/AIDS is still very much present.

In conflict situations, women and girls are at greatly increased risk of physical and sexual violence. Many women and girls are subjected to rape including gang rape, forced marriages with enemy soldiers, sexual slavery, and other forms of violence (being forced to witness others being raped, mutilations, etc.). Many have fled their homes, have lost their families and livelihoods, and may have little or no access to health care.

All these factors create conditions in which women and girls’ vulnerability to HIV is disproportionately increased. Violence against women and girls has been a feature of all recent conflicts, including the ongoing one in the Darfur region of Sudan as well as in the former Yugoslavia, Democratic Republic of Congo, Rwanda, Sierra Leone, Liberia, northern Uganda, and Chechnya. In many of these conflicts, some of which have been regarded as ethnic cleansing, rape has been and is used as a deliberate strategy to brutalize and humiliate civilians and as a weapon of war or political power. It is also likely that all forms of violence against women, including intimate partner violence, increase during conflicts and this may be linked to a ready availability of weapons, high levels of frustration among men, and a general breakdown in law and order.

Where and how do violence against women and HIV/AIDS intersect in conflict settings?

Sexual violence has always led to direct physical harm, emotional trauma, stigma, and social ostracism for women. It also carries an additional risk of unwanted pregnancies, sexually transmitted infections (STI) and increasingly, of acquiring HIV infections. In conflict situations, being displaced facilitates civilian (especially women and girls’) exposure to STI and HIV through sexual interactions – often forced – with high prevalence groups (e.g. combatants, military). In Rwanda, the HIV prevalence rate in rural areas dramatically increased from 1% before the start of the conflict in 1994 to 11% in 1997. In one survey, of the women who survived the genocide, 17% were found to be HIV positive. (6)

In another survey carried out by the Rwandan Association for Genocide Widows (AVEGA), 67% of women who survived rape had HIV. (7)

What are the opportunities to address violence against women and HIV/AIDS in conflict settings?

Programs in conflict and refugee settings: A number of agencies including the International Rescue Committee (IRC), UNHCR, UNFPA, WHO, and the Inter- national Medical Corps (IMC) are addressing violence against women in health care programs in conflict settings. Addressing violence against women and HIV/AIDS in conflict settings is challenging because the rule of law is virtually non-existent and police, judicial systems, health and other services are often not functioning.

At minimum, in such settings, health services should actively identify women who have experienced violence and provide medical services in a respectful manner. Such medical services should include treatment for physical injuries, pregnancy prevention and termination where legal, testing and treatment for STI, psycho-social support including counseling, and HIV testing. Rapid HIV test kits should be routinely available but there may be problems with HIV testing and counseling in such a vulnerable period just after the violence. Where feasible, health workers should also discuss the risks and benefits of HIV post-exposure prophylaxis (PEP)7 for preventing sexually transmit- ted HIV infections so that they can help their patients reach an informed decision8. However for PEP to work, women who have been assaulted have to access health care services within 72 hours, which may not always be possible in conflict settings.

Conclusions and Key Messages

Violence against women, particularly sexual violence, is widespread in conflict settings. In such situations, women and girls face increased risks of acquiring STI and HIV by:

  • Direct transmission through rape.
  • Being placed in situations where they may be forced to exchange sex for survival.
  • Experiencing increased levels of overall violence including intimate partner violence, which in turn, makes it difficult for them to negotiate safe sex in their relationships.

There is an urgent need for identifying, testing and implementing effective strategies for integrating programs that address both violence against women and HIV prevention and AIDS treatment and care in conflict settings. The challenges of doing this are immense as immediate needs for food, shelter and security often take precedence over addressing other health concerns.


In many countries, inequitable divorce and property laws make it difficult for women to leave abusive relationships. Even where laws against gender-based violence exist, insufficient resources, discriminatory practices by police and courts, and lack of institutional support fail to adequately protect women from violence, particularly those at high-risk (like sex workers). The past 20 years have seen a growing recognition of violence against women in the public policy agenda.

Advocacy campaigns to end violence against women have led to increased awareness of this as a public health problem requiring both government and community intervention. However, violence against women continues to be widespread and it must be addressed, particularly in the context of HIV prevention and AIDS treatment and care programs. A comprehensive response that engages and provides opportunity for coalition-building between communities and policy makers in ending violence against HIV-positive women is required and one that:

  • Mobilizes leadership at global, national, and community levels to promote normative changes that make violence against women unacceptable.
  • Builds evidence on the economic, social, and public health consequences of violence against women including its links to HIV/AIDS.
  • Encourages the development, implementation, and enforcement of legislative changes, new interventions and tools that are effective in ending violence against women.


1.     World Health Organization (WHO). 2002. World report on violence and health. Geneva, Switzerland: World Health Organization.

2.     Heise L L, Ellsberg M, and Gottemoeller. 1999. Ending violence against women. Population Reports, Series L, No. 11. Baltimore, MD: Johns Hopkins University School of Public Health, Center for Communications Programs.

3.     World Health Organization (WHO). 2003. Geneva dimensions of HIV status disclosure to sexual partners: Rates, barriers and outcomes: A review paper. Geneva, Switzerland: World Health Organization.

4.     Martin S, Kilgallen b, Tsui A O et al. 1999. Sexual behaviours and reproductive health outcomes associated with wife abuse in India. JAMA. 282(20): 1967-1972.

5.     Pettifor A E, Measham D, Rees HV and Padian NS. 2004. Sexual power and HIV risk, South Africa. Emerging Infectious Diseases. 10(11): 1996-2004.

6.     McGinn T. Reproductive health of war-affected populations: what do we know? International Family Planning Perspecti- ves. 26(4): 174-180.

7.     ibid 2.

A Call to the U.S. Department of State: Lead Women and Climate Change onto the International Stage

March 3rd, 2011


TO: The Honorable Maria Otero, Under Secretary for Democracy and Global Affairs, Department of State

FROM: Katie Jewett, Stanford University

RE: Incorporating a Gender Perspective into International Dialogue on Climate Change

Dear Under Secretary Otero:

My name is Katie Jewett, and I am writing to inform you of an issue that requires immediate discourse and action. One of the greatest challenges facing us today is the rapid acceleration of climate change and its inequitable distribution of impacts and burden around the globe (1). Climate change is projected to disproportionately impact low-lying regions and developing nations both inland and along the coast that lack the resources or infrastructure for effective mitigation (2). Major research organizations and international bodies warn that impoverished populations in the world’s developing nations will be hardest hit by climate change. When we examine the demographics of those populations most vulnerable to climate change, we see that women are among the majority, and therefore will bear the burden of a rapidly warming planet (3). In short, women are the face of climate change.

So what does the future hold? Climate change will have varying impacts across geographic, occupational, gender, economic, and social lines (4). Women are most vulnerable to drastic alterations attributable to climate change in the agricultural and food production sectors. In the developing world, women produce over 50% of food (5), and yet only 18% of women hold titles to land (6). Furthermore, despite women’s valuable expertise as natural resource managers, they are left out of important land use decisions considering warming temperatures, increased incidence of floods and droughts, and altered growing seasons projected for future decades. In coastal nations, women are closely tied to the marketing, harvesting, and processing of marine fisheries, which provide nearly 15% of our global protein intake, and yet are systematically excluded from crucial fishery decisions (7). Given the projected changes for our planet, the reality is that women—especially those who are elderly, disabled, pastoralists, of indigenous background, or impoverished in rural and urban areas (8)—will be the hardest hit. It is also understood that poverty rates are higher for women than for men in all racial and ethnic groups (9) and that impoverished areas are most vulnerable to climate change. Therefore, if we understand the link between poverty and climate change, why don’t we understand the link between climate change and women? Climate change exacerbates a number of historical disadvantages facing women that are discussed in human rights debates but never in the context of climate change legislation or policy. I write to you today to urge the United States of America to take a leading position on women and climate change on the international stage through the diplomacy of the Department of State.

There are various admirable efforts underway to empower women as powerful leaders rather than helpless victims in the face of climate change, but there is still significant progress the Department of State can help achieve. Some successes worth celebrating include the efforts of organizations like the Women’s Earth Alliance (WEA) that have created effective campaigns empowering grassroots women with the skills and resources necessary to implement safe drinking water programs in their communities. As the planet heats up, women will be forced to walk further to collect drinking water for their families, often from contaminated reservoirs, and these longer distances further jeopardize women’s safety (10). Thus, by implementing community-based safe drinking water programs, WEA proves that effective grassroots training can achieve victories across the globe for both women and the communities within they live.

While a grassroots approach is effective, we need action as widespread and influential as climate change itself, and the only method by which this is possible is on the international stage. The research exists: credible international organizations such as the World Health Organization and the Intergovernmental Panel on Climate Change have scientific evidence that climate change and gender are inextricably linked (11). However, the governing international convention on this issue, the UNFCC or United Nations Framework Convention on Climate Change, fails to include a gender perspective on climate change (12). We need the UNFCC to codify a gendered perspective of climate change into international law. Until this happens, the scope of funding and support that is needed for grassroots organizations such as WEA to make a significant impact will not arise at a rate fast enough to defend against climate change’s accelerating challenges.

The United States, given its status as a signatory to the UNFCC (13), has the political clout necessary to urge a re-evaluation of UNFCC’s goals, which are stated as follows: to launch national strategies for addressing greenhouse gas emissions and adapting to expected impacts, including the provision of financial and technological support to developing countries (14). In the effort to launch an international strategy for adapting to expected impacts, it is absolutely necessary that the global community evaluate the disproportionate impacts of climate change on women. Women cradle the world in their hands as caregivers, natural resource managers, food providers, mothers, economic drivers, but perhaps most importantly, they are powerful leaders capable of guiding us toward wise and practical climate change mitigation. While we cannot slow warming temperatures, melting glaciers, or rising seas, we can take advantage of the opportunities opening around the world to involve women in critical leadership decisions that will defend our planet. If the Department of State can urge for the creation of international support and policy that takes advantage of traditional knowledge systems, respects human rights, and is gender sensitive, then the current face of climate change—women—will assist in fortifying defenses and revel in the preservation of our planet.

Works Cited

(1) Scripps Institution of Oceanography. “Climate Change Accelerating Beyond Expectations, Say Scientists.” Scripps News, UC San Diego. Web. 1 March 2011. <http://scrippsnews.ucsd.edu/Releases/?releaseID=1033>

(2) EPA. “Climate Change: Health and Environmental Effects.” U.S. Environmental Protection Agency. Web. 1 March 2011. <http://www.epa.gov/climatechange/effects/polarregions.html>

(3) United Nations Interagency Network on Women and Gender Equality. “Women, Gender Equality, and Climate Change.” United Nations. Web. 3 March 2011. <http://www.un.org/womenwatch/feature/climate_change/>

(4) Intergovernmental Panel on Climate Change. “Contribution of Working Group II to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change 2007.” IPCC. Web. 3 March 2011. <http://www.ipcc.ch/publications_and_data/ar4/wg2/en/contents.html>

(5)“Women’s contributions to agricultural production and food security: Current status and perspectives.” FAO Corporate Document Repository. Web. 2 March 2011. <http://www.fao.org/docrep/x0198e/x0198e02.htm>

(6) Leyesa, Daryl. “Climate Change and Women in Agriculture.” CENTRO SAKA, Inc. Web. 23 Feb 2011. <http://www.google.com/url?sa=t&source=web&cd=2&ved=0CCEQFjAB&url=http%3A%2F%2Fwww.capwip.org%2Fdarylclimate%2520change_women%2520in%2520agri.pdf&rct=j&q=climate%20change%20women%20agriculture&ei=uAY5TYK3C424sQOVurDLAw&usg=AFQjCNF-i-NSNrPoVVyMyGTTx3TMTzcltw>

(7) Britannica Encyclopedia Online. “Seafood (food).” Britannica. Web. 3 March 2011. <http://www.britannica.com/EBchecked/topic/530850/seafood>

(8) Global UN Commitments, Resolutions, and other Intergovernmental Outcomes Linking Gender Equality, Climate Change and Sustainable Development. “Statement of CEDAW Committee on Gender and Climate Change.” Women Watch: Information and Resources on Gender Equality and Empowerment of Women. Web. 25 Feb 2011. <http://www2.ohchr.org/english/bodies/cedaw/docs/Gender_and_climate_change.pdf>

(9) Center for American Progress. “The Straight Facts on Women and Poverty.” Web. 27 Feb 2011. <http://www.americanprogress.org/issues/2008/10/women_poverty.html>

(10) Leduc, Brigitte, Shrestha, Arun, and Bhattarai, Basundhara. “Case Study: Gender and Climate Change in the Hindu Kush Himalayas of Nepal.” The International Center for Integrated Mountain Development. Web. 20 Feb 2011. <http://docs.google.com/viewer?a=v&q=cache:o63AfCC5ROYJ:www.wedo.org/wpcontent/uploads/nepalcasestudy.pdf+case+study+women+and+climate+change&hl=en&gl=us&pid=bl&srcid=ADGEESj74Ayrf8Uoy4IGy_8X91G6yDShjRESX_fBCoFXQgyd1pTJgvBnq16VcmHDW_GxpgsLk9sSiY9Hj0aH58km3Jjg8_T2xpjIQrRGevjfa3Ey6Z0r7U-X62xdfE8Yr2kh6v4bEVf3&sig=AHIEtbQAJk6Sj4khaCR00WuTZCYX3eCUXA>

(11) Climate Change and Human Health. “Gender, Climate Change, and Health: Draft Discussion Paper.” World Health Organization. Web. 3 March 2011. <http://www.who.int/globalchange/publications/reports/gender_climate_change/en/index.html>

(12) Global UN Commitments, Resolutions, and other Intergovernmental Outcomes Linking Gender Equality, Climate Change and Sustainable Development. “Statement of CEDAW Committee on Gender and Climate Change.” Women Watch: Information and Resources on Gender Equality and Empowerment of Women. Web. 2 March 2011. <http://www2.ohchr.org/english/bodies/cedaw/docs/Gender_and_climate_change.pdf>

(13) “Status of Ratification of the Convention.” United Nations Framework on Climate Change. Web. 1 March 2011. <http://unfccc.int/essential_background/convention/status_of_ratification/items/2631.php>

(14) United Nations Framework on Climate Change. Web. 1 March 2011. <http://unfccc.int/essential_background/convention/items/2627.php>

(15) Division for the Advancement of Women. “Full Text of the Convention on the Elimination of Discrimination against Women.” Department of Economic and Social Affairs, United Nations. United Nations, 2009. Web. 22 February 2011. <http://www.un.org/womenwatch/daw/cedaw/

Working towards expanding the definition of "Beauty": A letter to L'Oreal

March 3rd, 2011

Dear L’Oreal,

As you are undoubtedly aware, the pressure on women these days to be both thin and attractive is overwhelming. Advertisements featuring both very attractive and very thin/fit models are ubiquitous and have certainly contributed to the pervasive cultural norm that in order to be beautiful, one must be blessed with certain physical attributes. In response to these pressures, women have gone to extreme lengths to conform to society’s perception of beauty, oftentimes endangering their physical and mental health. For example, in cultures where tan skin is idealized, women have increasingly turned to tanning beds to achieve their desired golden skin tone. In cultures where pale skin is preferred, women have turned to skin bleaching creams – which oftentimes contain dangerous chemicals – to lighten their skin. Furthermore, in recent years there have been an increasing number of elective plastic surgeries performed, with women receiving breast augmentation, nose jobs, and other procedures in order to be “beautiful.” I cannot stress enough the potential physical risks associated with these types of activities. Tanning increases one’s risk of developing skin cancer, and there are numerous risks associated with any surgery.

Despite the physical risks, the mental effects society’s high standard of beauty has on women is incredibly alarming. In a study commissioned by Dove, it was reported that most women around the world believe that the definition of beauty has become both “limiting and unattainable” (Dove.com). Thus, it should come to no surprise that this is having a largely negative effect on women’s self-esteem. In the study, over 3,200 women ages 18 to 64 were surveyed, with women from the U.S., Canada, Italy, Great Britain, France, Portugal, the Netherlands, Brazil, Argentina, and Japan participating. The results of the study were not only startling, but show the harmful consequences our limited perception of beauty has had on the well-being of women worldwide. In the study, only 2% of women reported that they thought they were beautiful. Additionally, and more specifically as it pertains to this memo, 81% of women in the US believe that the media and advertising set unrealistic standards of beauty that most women can never achieve (Etcoff, et al). Thus, I am writing to ask that L’Oreal help in changing this unattainable perception of beauty. One way in which to do this is to feature ‘real’ women in your advertisements. Not only has this proved effective for other organizations in terms of increasing their sales and revenue, but it would also serve a larger social justice cause.

One of the largest and most successful campaigns that has gone on to begin to change our perceptions of beauty has been Dove’s Campaign for Real Beauty. Launched in 2004, this campaign relies on using ‘real’ women – not models – in their advertisements. With a mission to “make women feel more beautiful every day by challenging today’s stereotypical view of beauty and inspiring women to take great care of themselves” Dove uses women of all shapes, sizes, and ages in their campaigns. Most importantly is that the strategy has been generally successful in not only increasing sales of their products, but also in sparking debate and dialogue about the role and meaning of beauty in today’s world (Brodbeck, Evans).
Noticing the success of Dove’s Campaign for Real Beauty, other companies also started using ‘real women’ in their advertisements, thus helping to slowly change our perceptions of beauty. For example, both Glamour magazine and British lingerie retailer Bravissimo have begun featuring heavier women in their advertisements (Elliott). Nike also launched an advertising campaign featuring ads declaring things like “I have thunder thighs” or “My butt is big.” The Body Shop campaign approached the topic of beauty and appearance even more directly in its campaign, with ads proclaiming “There are 3 billion women who don’t look like supermodels and only 8 who do.” The companies theme of “Love your Body” was meant to question conventional standards of beauty (Elliott).

The successes of these campaigns – for example, researchers found that of 22 articles written about Dove’s Campaign for Real Beauty, 17 articles were positive reviews – reflect that society is not only willing to but wants to expand the definition of beauty (Brodbeck, Evans). In a time when women are becoming increasingly curvaceous and imperfections like cellulite are unavoidable, both women and men have respected the use of more realistic models in product advertisements. However, for all the good these campaigns have done in attempting to challenge what our society considers beautiful, there are still countless advertisements that feature rail-thin, stereotypically beautiful models. Thus, these advertisements continue to perpetuate the belief that ‘beauty’ is hard to attain.

As the world’s largest cosmetics and beauty company, L’Oreal must take an active role in changing our society’s perception of beauty. Undoubtedly women of all shapes and sizes have purchased items from one of your 20 brands. In fact, within the U.S., Maybelline is the number one selling mass market brand (Forbes.com). Globally, L’Oreal products are used in almost every country. Thus, it is necessary for your company to use women in your advertisements that reflect your customer base. In the past, celebrities such as Jennifer Lopez, Beyonce and Eva Longoria have served as spokesmodels for L’Oreal. And while these celebrities are readily identifiable, a size 10 women with some laugh lines and a few stray gray hairs is also identifiable and much more relatable for many women who purchase your products. To support my point, research has shown that average-sized models, around a size 10 or 12, are just as effective at marketing beauty and makeup products as a thin model (CBC News). The use of ultra-thin models in advertising is thus not only unnecessary from a marketing perspective, but it also has detrimental effects to a women’s mental health. It was found that overexposure to media images of ultra-thin women resulted in both lower-self esteem and in unhealthy eating patterns (Smeesters, et al).

On your website you list that “diversity is a core value for L’Oreal” and that it has “always been a priority” for your company. However, this passion for diversity has not translated over into the ad campaigns that you have for your beauty products. I am asking that you reconsider your sole reliance on models in your advertisements, and instead consider using ‘real’ women in your ads. Not only could this prove to be a lucrative marketing strategy, but it is also an ethical one. As I have shown, being ‘beautiful’ is increasingly difficult to be in the eyes of most women, causing many detrimental effects to women’s physical and emotional well-being. The women of this world – who come in all shapes, sizes, hair colors, and ages – deserve to be thought of as beautiful too. Thus, please reconsider using these types of women in your advertisements, because beauty shouldn’t be the sole terrain of supermodels. Instead all women should be considered beautiful, “because we’re worth it” too.


Kelsey King
Stanford University, Class of 2011



“Should Advertisers use skinny models?” By Dirk Smeesters, Thomas Mussweiler, and Naomi Mandel. 1st Quarter, 2010.



“For everyday products, Ads using the everyday woman” by Stuart Elliott. New York Times. August 17, 2005.



“Dove Campaign for Real Beauty Case Study” by Melinda Brodbeck and Erin Evans. March 5, 2007.

“The Real Truth about Beauty: A Global Report” : Findings of the Global Study on Women, Beauty, and Well-Being. Septemeber 2004. By Nancy Etcoff, Susie Orbach, Jennifer Scott, Heidi D’Agostino.


Bottom-Up Meets Top-Down: Local Approaches to Water Access and Gender Equity

March 3rd, 2011

To: UNEP and CSW

From: Leslie Brian, Class of 2012, Stanford University

Subject: A Local Approach to Gender Equity and Water Access

Date: 3 March 2011

Lack of access to improved sources of water, specifically in Sub-Saharan Africa, disproportionately affects women and young girls.  While the international community has recognized this issue, treaties and documents have not provoked enough substantive change on the ground.  In addition, literature has been primarily focused on either water access or gender equity, but rarely the intersection of the two.  Therefore, I recommend that the United Nations Environment Programme (UNEP) and the Commission on the Status of Women partner in order to better address this environmental and gender equity.  Specifically, efforts should focus on investing in NGOs or IGOs and giving them the resources to empower local women.

As you are no doubt aware, access to safe, clean drinking water is a fundamental human right.  In 2010, the number of people without a source of improved water fell below 1 billion for the first time, yet 884 million people still suffer, and 37% of those people live in Sub-Saharan Africa, where climate change and a lack of basic infrastructure exacerbate the problem.  In many countries in Sub-Saharan Africa, under 50% of the population lacks these basic water resources (1).

Due to their hugely important role as domestic caretakers, specifically in developing countries, women disproportionately feel the effects of water scarcity.  Firstly, women face what the 2006 UN Human Development Report called a “time poverty” due to the amount of time they spend collecting water for everything their family needs.  In fact, the same report states that 40 billion woman-hours per year are devoted to fetching water in sub-Saharan Africa alone (2).  With increased water access, these hours could be devoted to other activities, improving overall quality of life as well as potentially increasing school attendance of young girls and enabling women to participate in other economically-profitable activities.  A source of income, however, small, could give these women greater power within their communities (3) (4).  Women also face health risks associated with gathering water.  First, as addressed by the United Nations Millennium Goals, women face a higher risk of sexual assault as they spend hours walking to water sources (5).  Second, the burden of fetching water for their families, sometimes several times a day, puts a physical strain on women, who suffer pelvic and back problems (6).  In addition, some 30% or more of a woman’s daily energy intake is spent collecting water, due to globally high rates of female malnutrition and iron deficiency (7).

Yet, despite these problems, woman are natural allies in the fight for water access.  The fact that women shoulder the brunt of water collection (64% of water collected is by women, 12% by children) makes them more acquainted with household water needs and better managers of this resource (8).  Even though only 2% (9) of private land is owned by women worldwide, women produce between 70-80% of all household food in sub-Saharan Africa (10).  Accordingly, women possess access to valuable resources pertaining to irrigation and food production.

Put simply, women have a higher stake in sustainable water practices, and, thus, often come up with creative and effective solutions.  In fact, one study by the International Water and Sanitation Center (IRC) of 88 community water and sanitation projects in 15 different countries found that projects were much more effective and sustainable when they included women’s voices (11).  The United Nations Millennium Goals also corroborate this evidence (12).

Because of these natural insights into water production, the international community has coalesced around the importance of including women’s voices in water access.  The 1992 Dublin Principles, 1992 Rio Earth Summit, 1994 UN Conference on Population and Development, 1995 Beijing Declaration, Millennium Goals of 2000, and 2002 Johannesburg Summit all effectively stated the need for increased female participation in crafting more effective water distribution policy.  However, these measures have not gone far enough.  There is still too little research on the intersection of women’s equity and water access, which is why I recommend a partnership between the UNEP and CSW in order to address this need (13).

Specifically, this new partnership should focus on funding emerging NGOs, like the Women’s Earth Alliance (WEA), in order to make the most effective change on the ground.  Not only does its creative approach improve water access for the village as a whole, it also truly empowers local women in the face of cultural barriers to manage their own water programs.

WEA’s bottom-up, community-based approach is designed around a series of simple, but effective principles, empowering local women with the technological, entrepreneurial, networking, and financial support they need in order to fund their own sustainable water access programs.  Looking to local women for leadership better enables their programs to creatively address community-specific cultural barriers that may obstruct full female participation.  As an example, one WEA representative stated that one team of women bought alcohol for the chief of their village prior to implementing their project; from that moment on, they never faced community opposition.  WEA also groups women into pairs when implementing projects in order to better withstand any opposition they face.  Finally, they also operate on a “each one, teach one” approach, with each women they teach sending a ripple effect through her own community by spreading her knowledge.

The WEA Africa Program, or Global Women’s Water Alliance, takes leaders from over 13 different countries and 30 different community organizations and gives them training sessions on everything ranging from solar cooking, water sanitation hygiene (WASH strategies), rainwater harvesting, business planning, proposal writing, and water testing (5).  They then learn from African women who, themselves are experts in the field of sustainable and effective water technologies.  Finally, women are grouped into pairs in order to design their own water access program, custom tailored to their community’s particular needs.  Each team also receives a microloan to launch the project.  GWWI follows up with each team and also gives every woman a flip camera with which to document her progress and write about it online (14).

These kinds of program has a huge amount of potential.  Because the barriers to female participation in water management are often so culturally and community specific, international policies can only do so much in order to make effective local change.  Rather, women on the ground must look to international norms in order to make change for themselves.  By giving these groups proper funding, they can expand their programs to other regions and dramatically increase their impact.  In addition, these groups would provide invaluable insight into local practices that are often more difficult to obtain for international organizations.  Therefore, I strongly urge you to pursue the recommendations of this policy brief, allowing the newly created international norms from the alliance between UNEP and CSW to meet the local, sustainable, and more culturally-sensitive actions of community organizations.


Leslie Brian, Class of 2012, Stanford University


Works Cited:

1) http://www.wssinfo.org/fileadmin/user_upload/resources/1278061137-JMP_report_2010_en.pdf

2) http://www.eoearth.org/article/Women_and_water_in_the_developing_world

3) http://www.un.org/womenwatch/daw/public/Feb05.pdf

4) http://www.eoearth.org/article/Women_and_water_in_the_developing_world

5) http://www.unwater.org/downloads/unwpolbrief230606.pdf

6) https://www.wateraid.org/uk/what_we_do/the_need/206.asp

7) http://www.eoearth.org/article/Women_and_water_in_the_developing_world
8) http://www.wssinfo.org/fileadmin/user_upload/resources/1278061137-JMP_report_2010_en.pdf)

9) http://www.unwater.org/downloads/unwpolbrief230606.pdf

10) http://www.womensearthalliance.org/section.php?id=68

11) “Gender, Water, and Sanitation: A Policy Brief.”  Inter-agency Task Force on Gender and Water (GWTF).  06-24641.  June, 2006.

12) http://www.unwater.org/downloads/unwpolbrief230606.pdf

13) http://www.eoearth.org/article/Women_and_water_in_the_developing_world)

14) https://stanford.edu/class/humbio129/cgi-bin/blogs/blog/2011/02/10/a-solution-to-the-seemingly-unsolvable/

The Fight Against HIV and Sex Trafficking Begins With the Government

March 3rd, 2011

Dear Coalition Against Trafficking in Women,

It is our responsibility, as members of the community in which HIV and sex trafficking exist as a serious issue, to take action to combat them by raising awareness and rallying our government to take responsibility and help, instead of further victimizing, the women in need. Sex trafficking and the spread of HIV/AIDS are two devastating problems in themselves.  Unfortunately, they are also linked in many ways and drive each other, which makes designing interventions that address both issues especially difficult.  A study in Sierra Leon showed that 70.6% of those engaged in commercial sex in Freetown were HIV positive, compared with data from two years earlier that showed a prevalence of only 26.7%.1 Another study showed that HIV seroprevalence among female sex workers in Nepal rose 24-fold between 1992 and 2002.2

The United States is not exempt from the problem of sex trafficking.  In fact, this country is one of the most popular trafficking destinations in the world.3 HIV/AIDS is not as serious a problem in the US as other countries, but as trafficking increases into the US, so will HIV infection. At the moment the US Department of State is working vigorously to fight sex trafficking and decrease prostitution, but their hostile approach towards sex workers may not be the best way to decrease the rates of STD and HIV infection among sex workers in the United States.  Effective change and efforts aimed to eliminate these problems require collaboration at both the government and community level.  Thus, I am proposing that change begins with the government.  Rather than criminalizing sex workers and women who have been trafficked, the government needs to support these people and community interventions to empower and encourage them to participate in the fight against sex trafficking and HIV transmission.  I am not suggesting the government legalize prostitution, but rather shift the emphasis of blame from the sex workers to the people who are buying the sex, because as long as the demand for prostitution remains high, so will the supply.

After deciding what the government should focus on, the next challenge is how the government should go about carrying out these proposals.  To design an effective intervention, we must examine models of other interventions that have proven successful.  The Sonagachi Project in Calcutta, India is a prime example of a sustainable community empowerment project that has successfully reduced rates of HIV transmission among sex workers.  It has accomplished this by reframing the issue of HIV infection among sex workers as a responsibility of the community rather than a problem that can be addressed on the individual level through behavioral changes.  The Project redefined sex work as a form of employment and political advocacy fought for sex worker rights that allowed sex workers to exert more influence in their communities and gain recognition and respect.4

The Sonagachi Project also took into consideration the importance of the relationship between sex workers and the agents of change.  Previous interventions in Calcutta addressing the issue of HIV infection in sex workers were unsuccessful because they took on a dominating relationship over the target group, rather than a supportive one.  These projects mandated mandatory STD testing of the sex workers and one program even used police to force the workers into their clinics for testing.  These programs humiliated these women, increased the stigma associated with both sex workers and STDs, and thus deterred the women from seeking any resources from these programs.  On the other hand, the Sonagachi Project recruited sex workers to work in local clinics that provided education, health care, and medication to their peers.  The peer health workers took on a role that was based in trust and respect, and because these outreach workers came from within the target community, they were able to evaluate the effectiveness of their programs based on first-hand experiences and develop them accordingly.4

The US government can follow the example of the Sonagachi Project to address the issue of HIV infection in sex workers in the United States by accepting these problems as a community responsibility.  The government must realize that changes in individual behavior alone will not solve these problems. Through supportive, rather than forceful interventions, the government can eliminate the stigma associated with sex workers and provide the necessary resources to treat, reduce, and prevent HIV transmission in sex workers. Stigma against sex workers in the United States is one of the first obstacles that needs to be overcome to encourage sex workers to seek and receive medical care and preventative education.  In the USA, arrests of prostitutes often involve the use of entrapment, an invasion of privacy, and discriminatory practices by police officers and physical violence is not uncommon.5 Police have been reported of confiscating condoms during routine sweeps in districts where prostitution is prominent.  The police claimed that the possession of condoms is evidence that these women have the intention of engaging in prostitution.6 Like the Sonagachi Project, the government should take on a collaborative role rather than a discriminatory and forceful position over sex workers.  The government should offer, or support, programs that provide sex workers with health care services.  However, these health services should not condemn the women for their work or for the diseases that may be a consequence of their work.  They should also offer educational and preventative resources to the women who come to seek care.  The government should not penalize or incarcerate women for being sex workers, especially those who come to seek health care.  Sex workers then will not seek treatment because they fear exposing themselves as sex workers and to the risk of arrest.

However, this proposal does not necessarily advocate legalizing prostitution.  Rather it suggests a shift in focus in who is punished.  The majority of prostitution-related arrests are female sex workers (70%), followed by male sex workers (20%).  Prostitution clients only make up 10% of those arrested.5 Prostitution clients should be the primary target for arrest.  Arresting clients reduces the demand for prostitution. Clients are less likely to seek prostitution because there will be much more risk involved for them, where before the actual sex workers usually faced the blame.  Arresting clients rather than sex workers also makes it easier for police to offer protection from physical violence towards sex workers.  A shift in the government’s focus on prostitution clients as the primary offender may influence a positive shift in society’s perceptions of sex workers.  Even if that may not happen right away, sex workers will be more willing to seek treatment and preventative measures against STDs and HIV because they are no longer afraid of being punished for it.  This will lead to a decrease in rates of transmission.

The US government needs to readjust its approach in regulating prostitution in order to address the relationship between HIV infection and sex trafficking.  It is already difficult for sex workers and victims of trafficking to seek health care and resources to protect them against infection for many reasons, including lack of freedom, access, and money.  However, the stigma and risk of punishment if they expose themselves as sex workers further deter them from seeking care, thus undermining any interventions aimed to decrease rates of HIV infection in sex workers.  We cannot expect significant changes on the individual level, especially if a whole society is working against these women.  The significant changes will come once the government steps up and accepts its responsibility to make changes at the community level. We as members of the communities that are being affected by this issue must rally our government to take action.


Aileen Bui


  1. http://physiciansforhumanrights.org/library/2003-06-25.html
  2. http://www.cdc.gov/eid/content/14/6/pdfs/08-0090.pdf
  3. http://www.iast.net/thefacts.htm
  4. Jana S, Basu I, Rotheram-Borus M, Newman P: The Sonagachi Project: A sustainable community intervention program. Aids Education and Prevention 2004, 16(5):405-414
  5. http://www.bayswan.org/stats.html
  6. http://www.who.int/gender/documents/sexworkers.pdf

Leading in the Coordination of Efforts at all Levels of Society to Combat Human Trafficking in the USA

March 2nd, 2011

The Department of State: Office To Monitor and Combat Trafficking in Person

To Whom It May Concern,

My name is Vaughan Bagley and I will be your intern this coming summer. In preparation for my upcoming tenure with you, I have conducted a significant amount of independent research on human trafficking, particularly sex trafficking, in our country. Although it may be a bit presumptuous, I would like to offer my initial observations and suggestions for fighting trafficking nationwide.

Let me begin by asserting that human trafficking is a threat to our national security. This industry holds the same roots and conditions as terrorism, and yet receives much less attention. How is it that in our domestic airports, security officials are trained to confiscate tweezers and water bottles, and yet they so easily miss a young captive walking directly through their metal detectors?

Human trafficking is inherently hidden from the public eye, and yet our government exacerbates this by failing to educate our law enforcement, immigration officers, and communities. Aimee Grace, a Stanford University Hospital MD, is working with other Bay Area Hospitals to educate ER doctors on how to recognize trafficking victims. In a recent presentation she gave, she proclaimed “Health Care professionals play key roles because they are among the only professionals likely to encounter the victims while they are held by their trafficker” (Grace et al). Similarly, Innocents at Risk, a 501c3 dedicated to combating human trafficking, began their Flight Attendant Initiative in 2008 to educate flight personnel. In just two years, nearly one third of American airlines and over 19,000 flight attendants have been reached with flyers and other educational paraphernalia.  But still, there are 90,000 flight attendants worldwide in need of training and airlines have yet to enforce human trafficking education as part of their official training programs. However, air travel is not the only missed checkpoint. Border patrol is also in dire need of enforced training and more oversight in order to ensure a lack of corruption within the forces. Since our government is expected to have spent 1.29 trillion dollars on the War on Terrorism by the end of this fiscal year, we should be capable of transferring some of those funds to combating a different form of terrorism occurring in our own neighborhoods through these types of programs.

As I am sure you are well aware of, while the Victims of Trafficking and Violence Protection Act of 2000 was a major landmark law at the time, its promises have not been entirely upheld. According to a 2005 Stanford Policy Review, researchers found that the bureaucratic process that victims must adhere to in order to receive assistance is very long and strenuous, and often bordering impossible. With requirements for extensive paperwork, often in English, and in depth background checks on the girl and her story, many victims are still extremely fearful of coming forward (Hussein et al.). With immigration reform at the forefront of our current political debates, we are in dire need of heightened advocacy for stricter temporary visa obtainment, as well as an understanding of trafficking dynamics by all related parties. For conservatives, in particular, who are very adamant regarding the immediate deportation of illegal aliens, there has been continued controversy over who should be considered a victim of human trafficking. A woman who initially agrees to work in the sex industry, for example, did not realize she was signing up for a life of slavery. A woman who knowingly comes to the US illegally to work as a domestic housekeeper, but is then beaten, isolated and starved, should not be treated as an illegal alien but as a human being who was abused and mistreated by American citizens.

However, requirements for deportation are only one of many issues that continue to persist today, over a decade after the TVPA was enacted. Even if the girls are allowed residency in the United States, for example, they are often extremely traumatized after their release from confinement and lack reliable support networks. In order for psychological and community assistance to increase, public awareness campaigns must be conducted nationwide.  The recent demolition of Craigslist’s adult services section would not have been successful without strong activism from the community, proving the importance of citizen education. In accordance with this milestone, the massive growth of the industry over the last decade has been largely due to the increased connectivity provided by the Internet. This fact alone proves that it is high time for Congress to review our nation’s pornography and adult services laws to amend any loopholes and account for the new wave of Internet capabilities.

H.E. A. T Watch (Human Exploitation and Trafficking) is an “innovative, multi-system, multi-jurisdictional collaborative approach” to combating human trafficking. Begun by the Alameda County District Attorney, H.E.A.T Watch is a partnership between the district attorney’s office, health care, social services, law enforcement, courts, probation officers, businesses, and the community, working on a local and regional level. While the program recently received a $300,000 2-year federal grant to expand its regional efforts, I believe that the government needs to take on a more direct approach. For example, state laws, if they exist at all, are often wrought with vague and ambiguous statements that do not necessarily uphold the national law, leaving much of the interpretation in the hands of the courts.  Only through training and outreach by federal officials such as FBI agents, Judges, and Representatives (the majority of whom are currently uneducated themselves), will the local and state systems develop a victim centered response where the victim’s protection and support are not conditional on her ability or willingness to cooperate with law enforcement. H.E.A.T Watch is the ideal example of how the Bay Area is leading the fight against trafficking, and it is about time the rest of the country follows suit.

Over 150 years ago, Congress passed the 13th amendment, officially abolishing slavery: to this day considered one of our country’s proudest moments. And yet, modern slavery persists today in the cruelest of forms, targeting the weak and vulnerable: our women and children. As our global experts on human trafficking, the power lies in your hands to increase public awareness and rally our nation’s leaders to initiate coordinated efforts at all levels of our society.

With respect and admiration,

Vaughan E. Bagley

Stanford University Undergraduate

March 1, 2011


“Airline Initiative.” Innocents At Risk. http://www.innocentsatrisk.org/blue-lightning-flight-attendant-initiative March 1, 2011.

Grace, A.; Collins, K. D.O. “Human Trafficking and HealthCare: Modern Day Slavery and Its Effects on The Health of Teens and Children in the US” Stanford University Presentation. August 19, 2009.

Belasco, A. “The Cost of Iraq, Afghanistan, and Other Global War on Terror Operations Since 9/11,” Congressional Research Service Report for Congress. RL33110, p. CRS9

“District Attorney’s Office Unveils H.E.A.T Watch.” Office of the District Attorney. Alameda County. Nancy E. O’Malley. http://www.alcoda.org/news/archives/2010/jan/office_unveils_heat_watch. January 31, 2010. Accessed 1 March 2010.


Multinational Organizations Providing Relief for Women Refugees

February 25th, 2011

This week, I’d like to offer an overview of two of the most important organizations in providing relief to refugee populations: the Women’s Refugee Commission and the UNHCR. There are many organizations that work in the refugee regime (the ICRC, the IRC, WFP, WHO, among many others). I have chosen these two because they are most relevant to the well-being of women refugees; the WFC because of its focus, the UNHCR because of its scope. I would encourage any of my classmates who are interested in working in the refugee regime after graduation to investigate both of these organizations.

Women’s Refugee Commission: www.womensrefugeecommission.org
This organization is an offshoot from the larger IRC (International Rescue Commission). The WRC is a US-based advocacy organization that works with the American government and other international entities to ensure that opportunities and livelihoods refugee women and children. They do not work directly with refugees, nor do they administer any refugee camps. Instead, they provide education for humanitarian workers by conducting research on best practices and publishing their findings.

One of the interesting programs that the WFC has taken on in recent years is their MISP online certification module. MISP stands for “Minimum Initial Service Package”. In their online course, the WFC provides training for humanitarian workers on how to create a MISP that is adequate for women’s reproductive health. Their module offers a certification process, so NGOs that work directly with refugee populations can require certification by the humanitarian workers. When appropriately implemented, an adequate MISP can prevent unwanted pregnancy and HIV infections in highly vulnerable situations.(1)

UNHCR (United Nations High Commissioner for Refugees): www.unhcr.org

UNHCR is the oldest and most well-established organization in the history of the refugee regime. It was founded after WWII, to help resettle the displaced victims of that war; today, UNHCR works all over the world (most often in Africa and Asia) with refugees, internally displaced peoples, and with the stateless — those people who have no citizenship in any country. They administer refugee camps, provide for basic needs of refugees, negotiate with governments on behalf of refugee populations, work internationally to muster up support for the world’s refugees, and provide publications and statistics on the world’s refugees. UNHCR is frequently called upon to take on new tasks relevant only to particular crises — in the Yugoslavian war, the UNHCR operated an airlift of essential supplies to Sarajevo for 16 months, an unusual task for an organization more used to organizing refugee camps.

As a UN agency with a solely humanitarian mandate, the UNHCR walks a difficult line between fighting for the rights of those people under their protection, and avoiding direct political action. Sadako Ogata, the UNHCR’s high commissioner from 1991-2000, once said, “There are no humanitarian solutions to humanitarian problems.”(2) Because refugees come from political upheaval, there must be political solutions in order to return them safely home. Because the UNHCR is not a political organization, this requires other UN agencies to act in tandem with the UNHCR. Because of its place within the UN framework, the UNHCR is more powerful than any other refugee relief organization.


(2) Ogata, Sadako. “The Turbulent Decade.” Norton&Co.: New York, 2005.