Bidding Bali bye-bye

My previous column on “human rights in the delivery room” was intended as a prologue of sorts to the holding of the International Conference on Family Planning (ICFP) that was supposed to open Monday at the Nusa Dua Resort in Bali, Indonesia. I was to be part of a group of media women from all over the globe attending the conference, which was to close on Nov. 12. In fact, I had been packed and ready to skedaddle for my second visit to Bali, my only problem being how to foil the “laglag-bala” scammers at the airport.

It was my son who casually asked, while we were visiting our grandson Wednesday evening, what would happen to the conference since a volcanic eruption had led to the closure of the Bali airport. My initial reaction was: “Whaaat? What are you talking about?”

A quick check on the Internet yielded the information that Mount Rinjani on Lombok Island had erupted that morning, leading to the closure of three airports, including the Ngurah Rai International Airport in Bali. As a result, “thousands” of tourists were left stranded in the closed airports, while many more—including the conference-goers—were left in limbo in airports around the world, waiting in vain for news of the resumption of their connecting flights to Bali. Yesterday morning, e-mails from the organizers informed ICFP participants that the gathering had been “postponed.” A terse reminder from those organizing the team of media women covering the event simply said: “Please don’t board your flights. The conference has been cancelled.”

So, with “all my bags packed and ready to go,” I am left contemplating the “empty” days ahead, the vision of walking the sands of Bali quickly fading from consciousness. Sigh.

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But let me return to the subject of human rights in relation to reproductive rights, including the right to practice family planning.

While earlier scholars studying the link between family planning and human rights looked on the issue in terms of coercive policies and clinical abuses, lately, the discussion has shifted to “learning how human rights principles can systematically improve the way that clinic-based family planning programs are planned, implemented, monitored, and evaluated, ensuring that they go beyond rhetoric.”

Karen Newman and Charlotte Feldman-Jacobs, authors of the policy brief on “Family Planning and Human Rights” under the auspices of the Population Reference Bureau, cite one instance where the observance of human rights principles in service delivery can result in improved health and morale among the clients.

“For example, policies must be in place so that payment systems reward service providers who spend time explaining to clients the strengths and weaknesses of various methods—thereby enabling clients to make more informed choices,” they say.

“Where service providers are paid according to how many IUDs they insert, or how many people they see in an hour—which incentivizes them to see people as quickly as possible—clients are prevented from making a choice based on full, free and informed consent,” they add.

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Policymakers and service providers make the right noises about “empowering” the women who are most commonly on the receiving end of family planning and other reproductive health services. But it is often too easy to overlook the need to respect a client’s dignity and rights when one is under pressure to produce results.

Still, the authors stress that “human rights concepts are … critical to women’s empowerment and to advancing women’s agency, so that women can access the services they need, decide for themselves whether and when to become pregnant, and become agents of change in their communities and nations.”

The United Nations has detailed the elements of what constitute the “highest attainable standard of health” for women, men and children around the world, regardless of the development status of their nations.

These elements or state obligations include making health services available in sufficient quantity; accessible in ways that are nondiscriminatory and ensure that services can be accessed physically and financially; acceptable, that is, respectful of the culture (and preferences) of individuals; and of good quality.

The same guidelines when used together, say the authors, “can help service providers focus, for example, on specific population groups who are not being reached by existing services, such as young people, and help to identify what needs to be in place to make such services available.”

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In Papua New Guinea, for instance, authorities fashioned an “integrated health package” specifically for young people, providing a “well-youth” check.

The service package includes “a range of critical services including a general medical checkup, HIV voluntary testing and counseling, sexually transmitted infections screening, contraceptive counseling, pregnancy testing, breast or testicular cancer checkups, and antenatal care if the client is a young mother.”

The service, says the article, has proven to be highly popular, with more than 1,400 young people receiving a well-youth check within its first year.

There’s one hitch, though: Young people proved reluctant to seek the service and even enter the health center when adults were present. But by gathering feedback from the youthful clientele, clinic managers were able to devise means to put the young people at ease, including “adapting client flow to reduce young people’s exposure to adult clients and provide them with privacy in waiting rooms and other common areas.”