The African Women’s Sexual & Reproductive Health & Rights Conference: “Prosperity through Empowerment,”
February 4th to 7th, 2003

Executive Summary

A spirit of partnership enveloped the proceedings at the first conference dedicated to African Women’s Sexual & Reproductive Health & Rights which took place in Johannesburg, South Africa February 4 – 7, 2003. The event brought together close to 200 policy makers, researchers, health care providers, activists, academics, lawyers and advocates from 22 different African countries. The broad range of participants bears testimony to the breadth and depth of the work that is currently being done “to ensure that every woman on this continent has the possibility of realising her reproductive and sexual rights as the core foundation of her wellbeing,” Delegates from the US, Latin America, Asia and Europe were also in attendance contributing to what Adrienne Germain, President of IWHC described as, “diversity of speakers and participants which was exceptional and hugely stimulating,”. The range of participants and the attention raised by the conference reflected the need and timeliness of an event addressing the crucial agenda around African women’s sexual and reproductive health and rights.

Conference Agenda
The agenda reflected the broad spectrum of SRHR concerns, analysing the status of SRHR in the context of international and regional agreements on health and women’s rights. The theme “prosperity through empowerment” addressed the links between SRHR and global development agendas including the Millenium Goals such as NEPAD. Presentations also highlighted successful strategies, sharing best practice examples for future policy and programming.

African Women’s Health & Rights Day
The conference began with a celebration of African Women’s Health & Rights Day, a day implemented by AMANITARE in 2001 to reaffirm African women’s rights to healthy minds, bodies and souls. Celebrations continued throughout the conference with poetry readings and performance punctuating daily events adding creative voices to the dialogue.

The voice of African women and men on further action on ICPDWe the women and men of Africa gathered at the 1st Sexual & Reproductive Health & Rights conference organised by the AMANITARE, the African Women’s Sexual & Reproductive Health & Rights Partnership, in consideration of the fact that next year will be 10 years after the International Conference on Population and Development (ICPD) held in Cairo, reaffirm our strong support for the ICPD and the ICPD plus 5 agreements in their totality and original form.In particular, taking account of the enormous challenges faced by our continent, we call on our governments to meet the commitments systematically and on a priority basis, especially with regard to the following:· Ensure universal access to sexual and reproductive health services in the context of “health for all” at all ages, including sustained investment in health system capacity to provide sexual and rights health care in a holistic manner· Modify HIV/AIDS policies, programmes, and budgetary allocations such that they are designed to reduce the vulnerability of women and girls and ensure that women are fully represented in decision making · Support actions to end all forms of violence against women and girls, including practices such as child marriage and FGM, marital rape and other sexual coercion, and domestic violence, and provide support for girls and women subjected to these abuses· Invest in comprehensive sexuality education, reproductive and sexual health services, and life management skills training, for all adolescentsFurthermore, in order to successfully meet the commitments outlined in the ICPD Programme of Action, and the ICPD + Five priority actions, we call on the Bush Administration to use the funding they have pledged for HIV / AIDS prevention to implement the above agenda.

AMANITARE Awards
It was fitting that the AMANITARE awards be given on this day of celebration. This moving ceremony paid tribute to eight African and three international individuals and organisations for their contribution to African women’s sexual and reproductive health and rights. The awards celebrated the achievements of established individuals [and organisations] such as Professor Fred Sai, Presidential Advisor on Reproductive Health and HIV/AIDS, Ghana for their major contribution in the field of reproductive health and rights. The awards also applauded the work of less well-known organisations such as AVEGA-Agahozo, The Association of Widows of the Genocide from Rwanda who were awarded for the incredible work they continue to do to support and protect women in Rwanda. (Please see list attached for full list of Awardees)

Opening day sessions
The current status of SRHR was debated in two consecutive opening sessions with Charlayne Hunter-Gault from CNN interviewing panelists Angela Melo, Special Rapporteur on the Rights of Women in Africa for the African Commission on Human & People’s Rights, Emma Bonino, MEP, European Parliament, Italy, Dr Nahid Toubia, President of Rainbo and Senior Staff Advisor to AMANITARE and Sisonke Msimang, co-ordinator of the Youth Against AIDS Network, South Africa. An assessment of the position of SRHR in the global health agenda was analysed in the second session, moderated by Bene Madunagu, Girls Power Initiative and Technical Advisory Committee member for AMANITARE. A paper written by the Prime Minister of Mozambique Pacoal Mocumbi highlighted the unfortunate truth that, “across our continent the health status of women remains precarious and in many instances is worsening, not only because of HIV but also because of the many unacceptable inequalities that exist in women’s health, the limited choices that are made available to women and finally, the lack of accountability for their health.” It resolved that, “we must take bold steps to rectify this situation by making available health care programmes that address girl and women’s specific needs, using a life span perspective as well as a holistic approach.”

Afternoon sessions addressed the two pertinent topics Islam and armed conflict. The session entitled, “the role of Islam in enabling SRHR”, moderated by Ayesha Imam, Core Group, Women Living Under Muslim Laws international solidarity network, assessed alternative Islamic theological perspectives on women’s rights, sexuality and identity. The session included presentations of the work of progressive Muslim organisations to break taboos around women’s sexual and reproductive health and promote women’s sexual and reproductive rights.

The implications of armed conflict for SRHR were addressed in a consecutive session moderated by Kate Gilmore, Executive Deputy General, Amnesty International. Key analyses were presented on the SRHR of refugees and internally displaced people, the impact of sexual torture on women’s health and status and reflections on the sexual politics of militarism and democracy in post-colonial Africa. Delegates presented the work of their organisations which are actively seeking solutions to conflict and the impact it has on women’s lives.

Day 2
The agenda of the next three days was formulated according to the three AMANITARE Action Groups: advocating for freedom from gender based violence, integrating rights into health services and reaching out to new generations.

Discussions on day two focused on the theme “Women’s realities: Vulnerabilities, Violations and violence.” The sessions assessed different expressions of gender based violence including trafficking in women, female genital mutilation and domestic violence, and the development of integrated strategies to better address them including changing male socialisation and sexual stereotypes. The importance of different systems of law, constitutional and customary, and their role in securing and protecting individual women’s rights was considered in this context.

An examination of how gender inequality increases women’s vulnerability to HIV/AIDS was central to the day’s discussion. The analysis of HIV/AIDS was placed in the wider context of gendered social and economic inequalities and highlighted the need for a gender sensitive response to HIV/AIDS in terms of government budgeting, and health and legal services and the advancement of female-controlled prevention methods.
Consideration of the unacceptably high rates of maternal mortality in Africa as a violation of the fundamental right to life is a new concept much welcomed by those working on integrating women’s concerns into male dominated human rights agendas and institutions. This concept was a focal part of the day’s discussion.

Day 3
The ways in which gender impacts on health and the need to integrate rights into health services, including the right to safe abortion and sexual rights were central to the discussion on the day entitled “Services: Rights, responsibilities and choices.” The argument was raised that failure to assess if and how gender affects health can lead to ineffectual interventions and lost opportunities to improve women and men’s health and promote their human rights. In the context of this debate, the role of religion in both obstructing and facilitating access to sexual and reproductive health services was analysed and successful approaches to addressing violence against women in health facilities considered.
The range of social and economic barriers to accessing health services was discussed and how market driven proposals to health sector reform may further marginalise the under-serviced and the poor. Participants from countries as diverse as Rwanda, Ethiopia and South Africa demonstrated how rights can be successfully integrated into health services based on models used in their communities.

Day 4
The final day entitled “New Generations: Changing the parameters, the ethos for the future” was an opportunity to consider the future dynamics of the SRHR agenda from the need to involve men in reproductive and sexual health programming to the future of resourcing for SRHR. There was a particular emphasis on young people’s sexual and reproductive health and rights and the need for gender sensitive, rights-based education for young people as a means of promoting sexual and reproductive health.

A central concern of the Conference and the future of AMANITARE work is to find means to attract the attention of governments and regional policy makers to the centrality of women’s reproductive and sexual lives to the economic development agenda.

Mary Maboreke, Director of the Women, Gender and Development Directorate of the African Union presented closing remarks in which she applauded the event, confirmed the commitment of the African Union to gender mainstreaming and undertook to, “build smart partnerships and bring back to the Commission pragmatic strategies that will carry us all forward in this common mission.”

The ICPD + 10 process and implementation of the Programme of Action was the subject of a roundtable discussion where the particular concerns of Africa were addressed. A statement resulted from this meeting outlines the position of the delegates at the conference regarding ICPD + 10 which confirms their strong support for the ICPD and ICPD + 5 agreements in their totality and original form.

The conference succeeded in creating an on-going forum and opportunity for progressive forces in Africa to come together and support each other in their joint efforts to improve the health, social, and civil rights status of women and girls. Further, the range and engagement of representatives present at the conference and the commitment of AMANITARE to continue to project a strong co-ordinated African voice regionally and internationally, bodes well for the work that lies ahead to establish a different reality where every women can enjoy full sexual and reproductive rights to free them to be full participants in the civil, political and economic development of their countries.

AMANITARE Awards 2003

Eleven awards were granted to individuals and organisations for their contribution to the sexual and reproductive health field in Africa as part of the opening day celebrations of African Women’s Health and Rights day at the African Women’s Sexual and Reproductive Health and Rights Conference, Johannesburg, February 4 – 7, 2003

Prevention of Violence against Women Category

Deborah Ana Quènet, formerly Attorney for the Women’s Legal Centre (in memoriam)
Received on her behalf by Anastasia Maw, her life partner, Deborah was awarded for her work at the Women’s Legal Centre in South Africa.where she ran the centre’s violence against women project. She worked fearlessly in the two years she was with the centre to achieve legislative and policy reform and the ultimate goal of being able to litigate on behalf of clients who had been victims of violence. She pushed the boundaries of her role as attorney and demonstrated tremendous empathy with her clients.

AVEGA-AGAHOZO, Association of Genocide Widows, Rwanda
Dancilla Mukandolie, acting president of Avega accepted this award on behalf of the organization. The organisation was established to provide much needed mutual support, health care and counselling to support women who had been tortured, raped and endured untold horrors at the hands of armed men during the genocide of 1994.
The organisation also has a political profile. By lobbying parliament, judges and others, the organisation helped to secure a historic victory for women in 1999 when the government passed a law allowing widows the right to inherit land and their husbands’ property.

Bringing rights to reproductive and sexual health services category

Mafanato Sibuyi, Midwife and abortion activist, South Africa
Mafanato worked in maternity from 1992 – 1999 before she trained to become a master trainer in abortion care services and set up a reproductive health clinic. A trainer, counsellor, nurse, midwife, advocate and activist, Mafanato co-founded the support group Midwives for Choice and has continuously worked to improve maternal and neonatal care, not only to provide services but to educate her colleagues and communities on the new South African law which made abortion legal on demand.

Addis Ababa Fistula Hospital, Ethiopia
This award was received by Dr Mulu Muleta, the longest serving gynaecologist at the hospital. Since its establishment, the number of cases treated in this hospital has risen steadily, from 30 cases in 1975 to 1 200 in 2002 making it the largest repair service of its kind worldwide. More than a treatment centre, the hospital provides specialist training to surgeons from Ethiopia and other countries where obstetric fistulae are endemic. The hospital has trained more than 200 local gynaecologists on basic fistula repair techniques and offers free training at the hospital to surgeons from other countries training on average 12 surgeons a year from different countries.

Reaching out to the New Generations Category

Yetnerbersh Negussie, HIV peer educator, Ethiopia
23 year old Yetnerbersh lost her sight when she was 5 years old after a severe fever.
Now studying for her first degree in Law at the Addis Ababa University, she also works. public relations officer for the anti-AIDS movement at the University and mobilises peer educators in different activities. Serving as a chairperson of the Ethiopian National Association of the Blind Women’s wing, the only body working to bring socio-economic betterment to the lives of blind women, she co-ordinates the reproductive health and HIV/AIDS prevention programme for the women’s wing in the association.

Holo Muchangwe Hachonda IV, Zambia Integrated Health Project, South Africa
Holo has been an activist since the age of 17 when he co-founded the Youth Activists Organisation in Zambia. His organisation focused on various developmental, civic and governance issues and has played an active role in monitoring the 1996 parliamentary and presidential elections of his country. In 1997, the organisation started working in the area of reproductive health and HIV/AIDS prevention working with churches, schools and NGOs to promote young people's rights to access sexual and reproductive health information and services. Holo’s work is distinguished by his innovative approach to addressing the issues of SRHR of young women and girls. He has worked with young men and boys to enable them to understand and respect the reproductive rights of young women and girls.

Lifetime Achievement Award

Fred Sai, Advisor to the President of Ghana on Reproductive Health, HIV and AIDS.
Fred Sai is a Ghanaian family health physician trained in the universities of London, Edinburgh and Harvard. He has devoted his life to working on community health concerns at home and internationally. In the last thirty years he has concentrated on advocacy of sexual and reproductive health policies, programmes and services for women and adolescents.
He has been Director of the Health Services of Ghana, Professor of Community Health in the University of Ghana Medical School, Advisor on food and nutrition in Africa to the FAO, President of the IPPF, Senior Population Advisor to the World Bank and currently Advisor to the President of Ghana on Reproductive Health, HIV and AIDS
He has received international recognition and commendation for his chairing of the WHO/UNICEF conference on Infant and Young Child Feeding which resulted in the International Code of Marketing of Breast milk Substitutes and the Main Committees of the 1984 and 1994 UN conferences on Population.

Historical Award for the Women of Africa

This award was received by Dr. Jane Chege, the first daughter of Phyllis Wairimu Munoru of Kenya, on behalf of all African mothers who resisted FGM. This award celebrated three mothers who resisted FGM and was dedicated to all African mothers who have resisted violation of their daughters against the odds.

International Awards

DAWN, Development Alternatives with Women for a New Era, South-South Network
Sonia Correa, Regional Co-ordinator, Brazil received this award on behalf of the organisation. The DAWN network was established in 1984. The network today covers Africa, Asia, Latin America, the Caribbean and the Pacific. As a south-to-south network Dawn was an important voice in articulating the vision and voices of women before and during the deliberations of the NGO forum of the International Conference for Population and Development in Cairo in 1994. Much of DAWN's global advocacy work involves working in partnership with other organisations and networks to reform international institutions, ensure that governments live up to the commitments they make at conferences, and mainstream gender in NGO advocacy.

Helen Vera Rees
Professor Helen Rees is the Executive Director of the Reproductive Health Research Unit, a Research Unit of the Department of Obstetrics and Gynaecology of the University of the Witwatersrand, where she is also an Associate Professor. Professor Rees is internationally recognized for her expertise in the field of sexual and reproductive health including STIs/HIV/AIDS. She has a particular interest in microbicides, barrier methods, HIV vaccines and adolescent health. Her work on the Medicines Control Council has also given her expertise in drug regulation and clinical trials. She is the Chairperson of the International Clinical Trials Committee of the International AIDS Vaccine Initiative (IAVI), and also serves on IAVI’s Scientific Advisory Committee. She regularly serves as an adviser to the World Health Organization and to UNAIDS on a range of sexual and reproductive health issues, on STIs/HIV/AIDS including microbicides and HIV vaccines, and on drug regulation.

Adrienne Germain & the Africa Program, International Women’s Health Coalition (IWHC), USA
Adrienne Germain has worked for thirty years to promote women’s opportunities, health and rights. She joined IWHC in 1985 and has served as the organisations president since 1998. Adrienne’s personal contribution to the field of sexual and reproductive health and rights is well-known through her writing. The Africa program of IWHC was started in 1988 with a focus primarily on Nigeria. Since then it has expanded its support to groups and individuals in Cameroun and Mozambique. The program provides technical, financial, managerial and moral support to women’s and adolescent health organisations, advocacy groups, individual health and rights activists, and education and clinical service providers in Africa countries.