Parada Lezcano, Mario

Santana Nazarit, Paula

Social Medicine / Medicina Social (E-Journal)

Social Medicine (www.socialmedicine.info) - 213 - Volume 3, Number 3, September 2008The third Social Medicine Semi-nar “Towards Gender Equity inHealth”, held in Valparaiso,Chile (April 25 – 26, 2008) ex-amined unjust gender-basedhealth inequalities which areboth tolerated and perpetuated bysociety. This topic remains a keyconcern of social medicine.In Valparaiso, the seminar pro-vided an opportunity to examinehealth practices and their impacton gender inequalities, one of thekey social inequalities in our cul-ture. The seminar was the workof academics from the Universityof Valparaiso in cooperation withcivil society organizations:Health & Gender Equity Watch,the Women's Health Network ofLatin America and the Carib-bean, and the Latin AmericanAssociation of Social Medicine(ALAMES). It focused on shar-ing experiences in health workfrom a social, gender and com-munal perspective. Participantsalso analyzed and debated thestrategic issues raised by healthinequalities affecting women dueto unfair gender relations. Dur-ing two days case stories fromdifferent regions of the countrywere presented. These covered awide thematic range: cross-cultural work, health care qual-ity, sexual and reproductiverights, occupational health, andpsychosocial health, among othertopics.Due to the critical nature of theseminar, the participants and or-ganizers, mindful of the currentpolitical context, gave priority toa public debate concerning theApril 18 Constitutional Courtruling. Based on a plea pre-sented by 36 Congressmenagainst the Regulation concern-ing the Control of Fertility, theConstitutional Court specificallyprohibited the distribution to mi-nors of contraceptives containinglevongestrel; IUDs; emergencycontraception; counseling; andcontraceptive advice without theexplicit consent of the parents.Athough the only practical im-pact of this ruling is to prohibitthe distribution of emergencycontraception through the publichealth system, the denial of thefundamental right to prevent un-wanted pregnancies and avoidclandestine abortions will have achilling impact on Chilean soci-ety.This ruling turns the clock back50 years to a time when Chileanwomen could not count on a so-cial protection system that wouldallow them to exercise the mostbasic rights over their bodies.This was a time when Chileanfamilies did not have access toeffective contraception in orderto limit their families' size.Chileans were limited in theirability to exercise a responsiblepaternity and be sexually activewithout risking an unwantedpregnancy.News& EventsA Social Medicine Perspective on Gender-based Health Inequities:Defending the right tosexual and reproductive choicein ChileMario Parada Lezcano, Paula Santana NazaritMario Parada Lezcano, Director,Public Health Masters ProgramUniversidad de ValparaísoPaula Santana Nazarit, ChileanCoordinator of ALAMES; NationalCoordinator of the Chilean Networkagainst domestic abuse and sexualviolenceSocial Medicine (www.socialmedicine.info) - 214 - Volume 3, Number 3, September 2008We take this ruling seriously. Itis devastating. It is incomprehen-sible in the context of the 21stcentury. How can one explainthat the society as a whole—andespecially the country’s poorestwomen—will be forced to takeunnecessary risks simply becausea minority with access to formalinstitutional power forces the restof us to live our family and sex-ual lives according to moral prin-ciples that are not necessarily ourown? How can one explain thatwe are willing to see a rise in ma-ternal mortality because of illegalabortions, an increased in un-wanted pregnancies, and moreadolescent pregnancies? Howcan we accept that years of seri-ous and difficult progress in pub-lic health will now be in jeop-ardy?The organizers of this event ex-pressed their public disapprovalthrough a declaration which ex-presses faithfully those principlesthat animate us as defenders ofsocial medicine:LETTER FROM ALMENDRALVALPARAISO, CHILEAPRIL 26TH, 2008In "El Almendral" Valparaiso, wehave gathered for the Third So-cial Medicine Seminar "TowardsGender Equity in Health." This isan important gathering of menand women from social institu-tions and organizations commit-ted to social health.Today, having concluded ouranalysis and debates, we declarethat:We continue to witness the per-manent violation of our sexualand reproductive rights, a situa-tion that has been aggravated bythe recent ruling of the Constitu-tional Court. This decision callsinto question the national Regula-tion concerning the Control ofFertility and attempts to prohibitthe distribution of emergencycontraceptives within the publichealth system.We note that the Law Establish-ing Sexual Rights, presented toParliament in 2000, has not yetbeen discussed by the Congressand, given this recent court deci-sion, a discussion of the new Lawseems all the more remote. Thisnegligence leaves individuals andcouples without any guaranteethat they can make free and in-formed decisions regarding theirreproductive life; moreover itleaves people vulnerable to dis-crimination, coercion or violationfor decisions they make regard-ing their sexual life. Finally, itleads us further away from gen-der equity, which can only beaccomplished when the distribu-tion of benefits and responsibili-ties amongst men and women isdone with justice and impartial-ity.We want to bring light to the ex-istence of institutional forms ofviolence against women, ex-pressed in direct and indirectways. Examples are the persis-tence of social programs insensi-tive to gender issues, the medi-calization of health in general andparticularly in relationship toreproduction.We denounce:The invisibility of the unequalconditions to which women aresubjected, their discriminationand violence in all aspects of life;domestic, professional, civic.The lack of effective participa-tion in healthcare decision mak-ing in political and institutionalspaces and the opportunistic useof social organizations.That the ruling is discriminatoryand violates human rights. Itleaves the majority of Chileanwomen and families -those withless economic resources and whorely on the public health system-without options for avoiding anunwanted pregnancy.That the Chilean state does notyet assume the responsibility ofsexual education as public policy.That it prohibits abortions underany circumstance and does notact up in face of adolescent preg-nancies which harm the life pros-pects of thousands of girls andyoung women.We demand:A constitutional assembly so thatthe people, the majorities of ourcountry, have their rights guaran-teed constitutionally; this in-cludes all human rights and espe-cially sexual and reproductiverights.We commit:To continue striving and pressur-ing the authorities so that ourrights do not continue to be vio-lated, so that the necessary com-plaints are presented in the com-petent International Courts sothat the organized civil societymobilizes and gains the necessaryspace to make itself heard andtaken into account.Leticia ArtilesGeneral Coordinator of ALAMESMaria UrbanejaAmbassador of Venezuela inChile

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A Social Medicine Perspective on Gender-based Health Inequities: Defending the right to  sexual and reproductive choice in Chile

Paula Santana Nazarit

Mario Parada Lezcano

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A Social Medicine Perspective on Gender-based Health Inequities: Defending the right to sexual and reproductive choice in Chile

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A Social Medicine Perspective on Gender-based Health Inequities: Defending the right to sexual and reproductive choice in Chile

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Social Medicine / Medicina Social (E-Journal)

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