Women's and Girls' Health in South Asia: Challenges for Global Policy

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A woman suffering from HIV/AIDS uses a stick to walk back to her bed in hospital. Cambodia. (© Masaru Goto / World Bank)

Women must also be given special attention because it is clear from these other places that we cannot rely on men to use condoms if women do not insist. A nation-wide, mass media education campaign about how to use condoms and their vital role in preventing the spread of AIDS should be started immediately. One hundred percent condom use in brothels, as is already the case in Thailand, for example, should be required.

Condom use of course is only a part of the prevention answer. We are of course all in favor of the A (abstinence), and the B (be faithful), to the C (condom use). But you need all three. You cannot put lives at risk on a policy that is based more on hope than reality and if you stress abstinence only, you are basing policy on hope.

HIV-infected women have to be treated with the compassion that they deserve. This, tragically, is far from the case in India today. They must not be shunned and they must not be forced to prostitution. This is the most self-destructive policy imaginable. Above all there must be a spirit of openness and honesty, which is a long way from being the present case. There simply is no time for traditional squeamishness and prudishness on the subject. It is far too late for that.

Drugs, anti-retroviral, are becoming more widely available and they make testing for HIV much more than a possible death sentence. They mean that people can live long and productive lives but they must first be tested and that will happen only if HIV is destigmitized. There is really no time to lose. India cannot retreat into wishful thinking that the disease will not spread.

Indian society will benefit in so many ways if women are finally allowed to be full and productive citizens. Skills training of these women is a low-cost, high-return measure. We visited community-based centers, Adrienne, Richard and I, where when we asked young women what they most wanted, they universally answered, jobs. We were also surprised how openly young men and women with us as mediators were willing to discuss subjects that we were led to believe were taboo, how they relate to each other and their knowledge of how AIDS has spread. It seems that their knowledge base does go beyond Bollywood films, where the hero never does kiss the heroine. Given the fundamental inequalities of Indian life, no group is more vulnerable to AIDS than young women. This is true in India and unfortunately it is true almost everywhere. The young women we met were impressive with their spirit and their resilience and their strength but they need information, they need knowledge and they need to know, and their future husbands need to know above all, that violence against them is not acceptable. They need to know that they have rights.

If as a result of HIV, Indian women, the most vulnerable, are finally empowered, accorded the human rights that have been withheld from those not lucky enough to have been born into the right caste, then something positive may yet emerge from this plague. You can only control the spread of AIDS by finally giving women their full rights inside their marriage and inside Indian society. There is no other way.

Thank you very much.

Ms. Germain: Thank you Kati. Now we will listen to the voices of women, directly, from Nepal, through a video created by the Margaret Sanger Center International.

From the Nepal video:
Announcer: Although Nepal is the only Hindu kingdom in the world, its population of 24 million people includes Hindus, Muslims and Buddhists, who contribute to its rich, multi-cultural life. Despite its breathtaking beauty, Nepal has suffered political instability and poverty that has taken a great toll, particularly on the lives of women. They are more likely to die in childbirth than in almost any other country in the entire world. More than 60% of women in Nepal cannot read or write. Most young girls are married by the age of 16 and less than one in three women will ever use contraceptives.

Until recently the legal status of women in Nepal was very low. Women had few legal rights in divorce and many women were imprisoned for having been suspected of having had an abortion.

But thanks to the tremendous efforts of women's organizations, the medical and legal communities, and government officials, the people of Nepal are making significant progress towards greater rights for women. In April 2002, the Nepal constitution, originally drafted in 1990, was amended to be more inclusive of women's rights. The Eleventh Amendment to the Constitution now provides enhanced property and inheritance rights, progressive divorce laws and stronger prosecution of rape crimes.

For the first time in its history, the Eleventh Amendment legalized abortion in Nepal.