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Number 156 - September 2015
We mark United Nations International Day of Peace on 21 September. According to the United Nations’ website, the theme of this year’s commemoration is “Partnerships for Peace – Dignity for All”. It highlights the importance of all segments of society to work together for peace. From what we are currently hearing in the media about people fleeing from conflict situations, peace in most countries is in short supply.
While it is only part of a very complex picture, national expenditures give an indication of where our priorities lie. According to the Stockholm International Peace Research Institute, military expenditure worldwide in 2014 was US$ 1,776 billion (SIPRI 2015 Fact Sheet). The world's top fifteen military spenders spent $US 1,426.50 billion in 2014.
By contrast, “the world spends just $1[US] on conflict prevention for every $1,885 it spends on military budgets. In the U.S., less than 2% of income tax goes to civilian foreign affairs agencies; meanwhile, 39% goes to the military. And though taxpayers provide almost $1 billion per year for military academies, they pay only about $40 million for the United States Institute of Peace—the only U.S. agency dedicated to conflict prevention and peace-building [Friends Committee on National Legislation report, Prevention is 60:1 Cost Effective, 2011].
In this newsletter you can read about the recent Irish Humanitarian Summit, which Sister Anna Finnegan attended. Anna’s experience has included being part of MMM’s many responses to crisis situations. Our Sisters in South Sudan tell you about encouraging developments at our mission there, involving others also working for peace and human development. You can share our excitement in learning that Sister Maura Lynch was one of the two recipients of the 2014 North South Prize, in recognition of her work and that of her team for women affected by obstetrical fistula.
Two articles describe other efforts to combat fistula, a terrible affliction affecting millions of women in poorer countries. MMM joined in support of a Statement at the UN Human Rights Council.
No doubt some will consider the editor naïve for asking why so many of the world’s women have inadequate access to health care, especially obstetric care, and humanitarian causes in general are so grossly underfunded. There didn’t seem to be a problem about finding the almost two trillion dollars for arms.
Thank you again for your continued support of our work to bring God’s love, healing and peace to others. We remember you in prayer each day. Please pray for us as well. May we work and pray together for peace.
“Refugees are people like anyone else, like you and me. They led ordinary lives before becoming displaced, and their biggest dream is to be able to live normally again....Let us recall our common humanity, celebrate tolerance and diversity and open our hearts to refugees everywhere.” UN Secretary General Ban Ki-moon, World Refugee Day 2015
A timely gathering
Sister Anna Finnegan told us about her participation in the First Irish Humanitarian Summit, held on 2 July 2015 at University College Dublin (UCD). The Medical Missionaries of Mary were present at the invitation of Misean Cara, an Irish-based charity working to bring about transformation by supporting missionary organisations and their partners. MMM is on the Mission Cara Board. As a Congregation, we have been involved in the response to many humanitarian issues around the world.
Sister Anna, a nurse-midwife, served in Nigeria for twenty-five years. She also worked in Haiti in the wake of the catastrophic earthquake there in 2010.
Convened by the Irish Government and UCD's Center for Humanitarian Action, this meeting was held in preparation for the World Humanitarian Summit, which will take place in Istanbul in May 2016.
The World Summit has been called by UN Secretary General Ban Ki-moon in view of the urgency of the current humanitarian situation and its global nature. The World Summit will address the humanitarian consequences of both natural disasters and those that flow from war and conflict.
According to its website, the Irish Summit was “an opportunity for the Irish humanitarian community to engage in and affirm recommendations to improve humanitarian action on a national level." It was the result of ten-month consultative process.
Over two hundred Irish humanitarian leaders were present, including representatives of many NGOs. There were participants from UN agencies, research institutions and private sector companies, as well as students from UCD pursuing humanitarian studies. Irish Minister for Foreign Affairs and Trade, Charlie Flanagan, TD, and the Minister for Development, Seán Sherlock, made contributions.
An opportune address After welcoming remarks by Professor Deeks, President of UCD, the President of Ireland, Michael D. Higgins gave the keynote address.
He declared, “We are at a critical moment in world history...I spoke in January, at the launch of the European Year of Development, of my belief that 2015 is on a par with 1945 in terms of the potential that it has to reshape how humanity deals with the challenges we face.” Irish people in responding to crises “are embracing their responsibilities as global citizens.”
President Higgins said that we should consider “the true nature of what we are witnessing at present. The UN High Commission for Refugees confirmed that the number of refugees and displaced persons is now at its highest level since figures were first recorded in the 1950s. Global forced displacement has seen accelerated growth in 2014. By end-2014, 59.5 million people were forcibly displaced worldwide as a result of persecution, conflict, generalised violence, or human rights violations - the highest annual increase in a single year.”
Crucially, the leading countries receiving refugees “are not the most developed states but those neighbours who receive grossly inadequate support. At the end of 2014, Turkey hosted 1.59 million refugees, Pakistan 1.51 million, Lebanon (with a total population of less than 4.5 million) 1.15 million, Iran 982,000, Ethiopia 659,500, and Jordan 654,100."1
This is not to deny that migration is a complex issue. All the same, many millions of people, especially women and children, are often powerless victims of disasters and conflicts that are not of their choosing. Somehow weapons causing enormous devastation can be supplied to fuel these conflicts and provide profits - from organisations that operate from a safe distance.
"The top 100 list of arms-producing and military services companies in the world is dominated by North America and Western Europe" (The Guardian, 2 March 2012). Many disasters, such as drought and famine, are not 'natural' events but are the end result of corrupt practices in land use.
Remembering our common humanity The President said, “We must begin to consider the reality of the conditions people are leaving and the conditions where they later find themselves. The principle of universality of rights and human dignity, as expressed in the Universal Declaration of Human Rights, is the very foundation of the United Nations and this principle, our common humanity in all its dimensions, must be our starting point.”
He continued, “If compassion is to be grounded in empathy, then we would all do well to remember ethically the experiences of our own forebears. For Ireland, we remember that among the one million who fled famine and disease during a few short years, many were driven to make perilous journeys in inadequate vessels to harbours or populations which at times rejected them with hostility, but at times there were those who accepted them and afforded them the opportunity to begin new lives.
“Beyond the immediate issue of search and rescue and receiving refugees, and that of supporting institutions in the frontline countries, we must also look at resettlement....The international community has a moral as well as a legal obligation, not merely to rescue those crammed into often makeshift and extremely dangerous vessels, but to provide long term solutions afterward.”
The President called for “leadership that is courageous, grounded in an unqualified commitment to human rights, and informed by a long-sighted understanding of the gravity of the present situation....Responding to the consequences of conflict is not enough. The international community must also consider how to take preventative action to enable them to engage actively in advance of conflicts.”
He stressed that “other factors contributing to global instability must also be addressed. The effects of climate change make international borders appear even more irrelevant. Those most affected by these climate change-related events are those who are already the poorest and the most vulnerable. Global inequality is most strikingly exemplified in the manner in which climate change most affects those who have least contributed to it.
He concluded, “It is essential that aid workers, parliamentarians, academics, activists, like many of you in the room today, hold world leaders to account and ensure that they deliver on the promises made.”2
The way forward Anna felt that the meeting was particularly crucial at this time. With 35% of humanitarian requirements remaining unfunded, the system is struggling to cope.
After the morning sessions participants discussed the suggested recommendations from the consultative process. The outcomes concerned how to improve the nation’s contribution to the global response, to provide faster, better, and more effective assistance.
The Process Recommendations are: 1. Reaffirmation of Ireland’s commitment to international humanitarian law and the humanitarian principles, particularly in conflict contexts; 2. Enhancing participation of disaster-affected people in humanitarian decision-making; 3. Giving support to local actors for enhanced emergency preparedness and response; 4. Prioritisation of protection and prevention of gender-based violence in disasters; 5. Initiatives to improve disaster risk reduction, resilience and early warning; 6. Giving support to greater coordination and consultation in the humanitarian system.
The Summit also saw the launch of Ireland’s new Humanitarian Assistance Policy.
Sister Anna said, “I felt this summit was important because it is so much a part of our concern as Medical Missionaries of Mary. Present-day events are causing so much suffering to our brothers and sisters throughout the world. It was essential to be more aware of what can be done to help them.”
Sisters Magdalene Upev, Josephine Nabisere, and Irene Balzan, our MMM community in South Sudan, told us how they marked a new phase in the life of our mission among the people of this strife-torn young nation.
“South Sudan’s fourth anniversary of independence occurred on 9 July 2015. We also celebrated a landmark on 2 July with the blessing and laying of the foundation stone of the MMM Healing Centre in Wau, Western Bahr El-Ghazal. It was a very simple celebration, with great meaning for MMM and for the future of the community in Eastern Bank.
“The stone bore the words ‘Rooted and Founded in Love’. We pray that as our mission is grounded in these profound words, God’s healing touch may extend to a country that has been devastated by so many years of conflict.”
Sister Irene commented, “As I inscribed the words ‘Rooted and Founded in Love’ with nail varnish, it was hard to write on the rough rock. It spoke to me so much of the roughness in our lives and how God writes straight with our crooked lines.
"Our situation in South Sudan is permeated by trauma. As MMMs we still embrace and work with the trauma of people's lives.”
Many join hands for development and peace Local people and workers attended the ceremony. Also present were the Vicar General of the Diocese of Wau, Father Germano Bernardo; Father Romano, Diocesan Administrator; and Fathers Wilfed and Kumar, MMI Fathers, who are constructing the parish church near the new centre. After the blessing they shared a simple meal at the temporary MMM residence in Wau.
A number of other individuals and groups are involved in the building of the centre, including members of KENBATT (Kenya Battalion) UN peace-keeping troops, who are helping to supervise the construction.
The Healing Centre will consist of primary health care and social departments to cater for needs such as trauma counselling, youth activities, and possibly literacy education. According to the contract it should be completed by 8 April 2016.
The Sisters said, “We thank our generous donors from Malta Mission Fund, our MMM Mission Fund and HoPE. We also thank each of you for your prayerful support.”
2. A groundswell for women's rights
Around the same time, not far away, another important announcement came from Wau Teaching Hospital. On 24 July 2015 the Catholic Information Service for Africa (CISA) noted that a campaign against fistula began there the previous day. Hundreds of midwifery and nursing students from Wau are being trained in the management of fistula patients.
Wau Teaching Hospital registered forty-three fistula patients from different states across South Sudan for operations. Health authorities say they could admit more to meet the initial target of 150 repair procedures. Patricia Asikiwe, the campaign focal person working with the International Medical Corps, said that it is very important for students to be prepared to prevent and handle similar complications.
CISA noted that this is the third fistula campaign in Western Bahr El-Ghazal, conducted by the Health Ministry in collaboration with UNFPA at Wau Teaching Hospital. According to UNFPA, South Sudan has one of the world’s highest maternal mortality rates and approximately sixty thousand women and girls suffer from fistula.
A human rights issue
1. A very special award
Sister Doctor Maura Lynch and Mr. André Azoulay of Morocco were the recipients of the 2014 North-South Prize in Lisbon on 1 July. The prize is given by the North-South Centre of the Council of Europe, which aims to “promote dialogue and cooperation between Europe, the South of the Mediterranean and Africa, and build a global citizenship based on human rights and citizens' responsibilities.”
The President of the Republic of Portugal, Professor Aníbal Cavaco Silva, presented the awards at the Assembly of the Portuguese Republic, in the presence of the Secretary General of the Council of Europe, Thorbjørn Jagland; the Chair of the Executive Committee of the North-South Centre, Jean-Marie Heydt; and several other personalities. Sister Maura’s sister, Breda, was able to attend.
Irish Ambassador to Portugal Anne Webster nominated Doctor Lynch for this prestigious award. It has been given each year since 1995 to two candidates who have stood out for their exceptional commitment to promoting North-South solidarity. The candidates, preferably a man and a woman, must have distinguished themselves in the following areas: protection of human rights, defence of pluralist democracy, public awareness-raising on issues of global interdependence and solidarity.
Despite the variety of nationalities and fields of action of those that have received the prize since its creation, they all have in common a strong commitment to the promotion of North-South partnership. Previous winners include Kofi Annan, Simone Veil, Queen Rania of Jordan, Mary Robinson, Mário Soares, Lula da Silva, and Graça Machel.
"Work with all people of good will" (MMM Const.). Mr. Azoulay has been a senior adviser to His Majesty the King of Morocco since 1991. An economist, he devoted himself to promoting dialogue between cultures, populations - women and men from both banks of the Mediterranean. He is known for his contribution to the peace process in the Middle East, promoting reconciliation between Jews and Muslims, and to intercultural dialogue (Website of the North South Centre).
The North South website noted that Doctor Lynch is a surgeon, "working tirelessly to promote and protect the fundamental human rights of the poorest and most deprived people in society, in particular young women. She continues to perform life-changing operations to treat obstetric fistula at the clinic she helped to found at Kitovu Hospital in Uganda."
In her acceptance speech, Maura said that the honour was not only for her but also for her own family, for her family of the Medical Missionaries of Mary, for her colleagues in Kitovu Hospital in Masaka, Uganda, and for the fistula team, without whom the programme would not be possible. She also acknowledged the generous donors and supportive friends in Ireland, the UK, the USA and in Uganda.
She greeted the women who suffer from fistula, “who have suffered incontinence of urine with all its inconveniences of being wet all the time, smelling of urine and undergoing degradation, loss of dignity and being marginalised in extreme poverty for many years. They may also be incontinent of faeces if rectal damage has ensued.”
She explained that all this misery has resulted from birth injury due to neglected/unassisted/obstructed labour. She told the story of an 85-year-old woman whom she treated only last year. The woman had been leaking urine following birth injury forty years previously – forty years of indignity after losing nine of her children.
Doctor Lynch asked, “Can you imagine the joy of new life, dignity and self-worth this dear lady enjoyed on full restoration of health and continence, following surgical repair? She and I danced together!”
Prevention is the key. She said that while it is a privilege to be part of this ministry, “today, in 2015, birth injuries should not occur because all are preventable.”
We must focus on prevention, aimed at: • Education of the girl-child and adolescent. • Better nutrition for girls. • Antenatal care in pregnancy to predict the likelihood of problems. • Professional help, i.e. the presence of a midwife, in labour and delivery. • Emergency care and resources at hand – availability of Caesarean section and non-traumatic delivery.
She noted that "we must not forget the hundreds of thousands of women already suffering from obstetric fistula. They live in appalling circumstances, trying to hide in the shame of their wetness and smell. These women have a right to their dignity."
Doctor Lynch said, “In Uganda the most recent surveys estimated that there are 142,000 sufferers from fistula, mostly vesico-vaginal fistula; 5% also have a recto-vaginal fistula. About 10% of these women have sciatic nerve damage resulting in ‘dropped foot’ or an inability to raise one or both feet in walking.
"So the challenge before us is to reach the target of an end to fistula by reducing the back-log of existing fistulas and total prevention of fistula."
The needs are: • Training for medical personnel to repair vaginal and rectal defects • Free surgical repair for these women because they cannot afford treatment. Funding is essential. • Re-integration back into society of healed, continent women, with their dignity restored • Training in income-generation, crafts and other simple means to help the women to be self-supporting • Encouragement for young, fertile women to attend antenatal classes and have Caesarean sections for safe delivery of their babies after repair operations
In conclusion, Sister Maura said, “Let us go forth together to do what we can to bring about a more just, pleasant and happy world.”
2. A ground-breaking Statement
In keeping with the theme of fistula prevention, a significant event took place in Geneva, Switzerland on 17 June 2015. The Medical Missionaries of Mary joined VIVAT International and Franciscans International in sponsoring a Statement on the Issue of Obstetric Fistula at the 29th Session of the UN Human Rights Council.
As part of interactive dialogue with the UN Special Rapporteur on the Right to Health, this was the first time that fistula was presented to the UN as a human rights issue; previously it was presented only from a medical perspective.
In view of time constraints in presenting the issues involved, some points were simplified. For example, women with a fistula often resort to sex work just to survive, not only to pay for the surgery, which they may not even know is available.
In conflict situations, an increasing concern is fistula as a result of rape and other forms of deliberate violence to girls’ and women’s reproductive organs. While an obstetric fistula may result from pregnancy after rape, a fistula can also result from the trauma of rape itself.
According to Global Voices, 29 July 2009, rape has being used as a weapon of war in the DRC. “Often this rape takes on extremely violent forms and can cause injuries to a woman's reproductive organs...Also called traumatic fistula when caused by sexual violence, it's hard to know how many women in the DRC have this condition. But it's been estimated that thousands of Congolese girls and women have been impacted, and one assessment of six DRC provinces found that out of 432 fistula cases, around 14 per cent were because of trauma.”
The following is the text of the “Joint Statement by VIVAT international, Franciscans International and MMM Sisters on the Issue of Obstetric Fistula”, delivered by Susan Price.
We welcome the report of the Special Rapporteur on the Right to Health, particularly, the references made on reproductive health issues. Given that this session of the Human Rights Council features a number of important discussions on the universal rights of women we think it is important to raise the issue of maternal healthcare, specifically pertaining to obstetric fistula. This condition is caused by prolonged and obstructed childbirth and typically results in the loss of child and chronic incontinence if left untreated.
Improved maternity care has largely eliminated the issue in developed countries, but inadequate and inaccessible healthcare systems have prevented other countries from fully addressing this debilitating, but fully preventable condition. Fistula is estimated to affect roughly two million women, particularly in less developed areas of Sub-Saharan Africa and South Asia. The absence of systematic and appropriate prenatal and postpartum care contributes to its prevalence in these regions. In most communities doctors are inadequately trained to handle the relatively simple surgery, or else they lack access to the appropriate resources. Also of concern is the increasing occurrence of Obstetric fistula as a result of rape in conflict situations.
Young women are at an increased risk, as their bodies are often not developed enough to give birth without medical support. Other serious possible side effects include infection, physical debilitation, and infertility. In most cases, family members and local communities ostracize these women, leaving them isolated and unable to reintegrate into society. Due to their physical condition and the stigmas associated with their situation, they often struggle to find work and have difficulty to pay for reparative surgeries.
We commend the proactive initiatives several UN bodies have taken to combat this issue. However, we believe that further measures can be taken to improve maternal healthcare systems, particularly in regions with significant rural populations, as is the case in many parts of sub-Saharan Africa. Awareness programs on the risks of early pregnancy and education about proactive prenatal care can greatly reduce the occurrence of this condition. Obstetric fistula is preventable and with increased global cooperation and targeted resource allocation, the international community can make significant steps towards eradicating it in the coming years.
May 23 is International Day to End Obstetric Fistula.
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