Archive for children

15 de Junio: Cuando la “promiscuidad” forzada deja indefensos a los más vulnerables

Posted in Bolivia, sexual violence with tags , , , , , , , , , on June 15, 2011 by eugeniadealtura

Readers… if you still exist… I apologize for the long hiatus.  Work responsibilities have not allowed me to post to the blog as frequently as I would like, and time limitations will continue to prevent me from commenting in much detail on the posts that I am able to make to the blog.  So, today I write to you humbly with this brief reflection.

Some years ago, when working on a research project on Bolivia’s 1952 national revolution, my interest was piqued by the revolutionary party’s constant complaints of the “promiscuity” of the nation’s rural indigenous populations.  And no, I do not mean sexual promiscuity–although I think the deliberate choice of the word “promiscuous” to describe traditional one-room living quarters was indeed designed to raise concerns about children’s unwitting exposure to their parents’ “marital relations.”  In political pamphlets of the 1950s and early ’60s, journalists and commentators of the nation’s ruling Movimiento Nacionalista Revolucionario (MNR) party would frequently denounce the deplorable “promiscuous” living conditions of the poor rural majority, in which parents and children lived in one-room homes in which kitchen and bedroom were one and the same.  In part, revolutionary-era authors complaining of promiscuity revealed sincere humanitarian concern over the  poverty of rural dwellers; at the same time, however, MNRistas often used these complaints to highlight the party’s role in “saving” indigenous populations from their poverty, denying the agency of Indians themselves.

Today, the issue of “residential promiscuity” has come back to haunt us.  Readers in the U.S. and Europe may be shocked to discover that in most of Bolivia’s prisons, the state forces prisoners to live in “the most deplorable promiscuity” with one another–and also allows the live-in presence of inmates’ wives & children.  Institutions such as La Paz’s San Pedro prison and Santa Cruz’s Palmasola prison constitute virtual “prison cities,” where wealthier inmates are able to lease comfortable cells & where less fortunate inmates sleep in the halls of the jail.  Inmates, who may have “jobs” inside the jail–making and peddling food or providing other services–circulate with relative freedom inside these prison cities.  Children and their mothers often leave the prison gates in the morning to attend school or go to work, only to return in the afternoon or evening.  Although sixty years ago members of Bolivia’s ruling party denounced the “promiscuity” of non-criminal rural peoples, now the state allows women and children to live in close quarters with convicted criminals.  Sure, some of those guys are innocent, and some of them were convicted of tax fraud.  But some of them were convicted of rape.

Palmasola Prison, Santa Cruz, Bolivia.  Courtesy of Infosur Hoy.

Case in point (for readers of Spanish).  This week, Cochabamba’s Los Tiempos newspaper reports on the case of 63-year-old Sabino Paredes Condori, an inmate of Santa Cruz’s Palmasola prison who was lynched last Monday night by his fellow inmates.  Paredes allegedly sparked the fury of a mob of inmates after gloating over photos he’d recorded on his cell phone of two naked female children and of unspecified sexual acts.  The two children were daughters of a fellow inmate.  Paredes was in the process of serving a 25-year sentence for rape.  Once inmates were able to steal his cellphone and examine the images, they subjected Paredes to an hours-long ordeal culminating in his hanging.

Despite his heinous crimes, Paredes’ lynching is, of course, horrible.  What concerns me more, however, is the unchecked “promiscuity” of Bolivia’s prisons, in which adolescent girls and boys and their mothers rub elbows in the “city streets” of Palmasola and San Pedro.  Although Los Tiempos alleges that this case has “reopened the old debate of the voluntary presence of inmates’ wives and children in [Bolivian] prisons,” it’s unclear what, if anything, will change.  And funny, that–I thought that “promiscuity” was high on the state’s list of concerns.

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26 de Septiembre: Hasta en las ciudades…

Posted in Bolivia, health care with tags , , , , , , , , , , , on September 26, 2010 by eugeniadealtura

Earlier this week, the UK’s Guardian released a video chronicling the efforts of UNICEF representatives and their local allies to improve sanitation and access to clean water in Bolivia’s rural communities.  The video features interviews with Bolivian community members about the frequency of child death due to diarrhea and describes recent latrine construction projects in what looks like the country’s temperate and tropical regions in the east.  Sanitation projects in the area are being undertaken by UNICEF in an effort to speed progress on the UN’s “Millennium Development Goal” 7: to decrease the population lacking access to clean water and sanitation services by half by 2015 (the MDGs were established in 2001).

The infamous “camino de la muerte,” on which this truck is driving, carries travelers between La Paz and rural communities in the Yungas.

The state of sanitation services in Bolivia is undoubtedly the worst in rural areas, where lack of running water and sewer systems make illness frequent, even for the most dedicated of hand-washers.  If UNICEF truly wants to speed progress on MDG 7 in Bolivia, however, it would be wise to install potable water in city taps, and to support hand washing in cities, as well as rural areas.

In La Paz and El Alto, the majority of Bolivians buy their produce and other food stuffs in busy outdoor markets lacking adequate bathroom facilities.  Vendors and customers have to pay .50Bs to visit public toilets where, even if there is running water, soap is rare.  Market-goers then handle produce, passing whatever bichos they may have acquired at toilets on to consumers back at home. While it is standard practice in these cities to wash fruits and veggies before eating them, most use tap water to do so–a water that is so contaminated that it often emerges from the tap smelling of sewage.

This health care facility sits right above a public market.  The fact that hand washing is rare in both arenas provides ample opportunity to spread communicable disease.

Even more distressing, many hospitals and clinics in La Paz and El Alto fail to provide adequate sanitation services to patients and their families.  Over the past couple of years, my work has taken me for several hours each week to both public and private medical facilities in La Paz and El Alto. At the public hospitals I visited, neither public nor staff bathrooms provided toilet paper or soap to users. This means that not only patients’ families, but likely medical personnel had a hand in passing illness on to patients with vulnerable immune systems.  At one private clinic I visited in El Alto, three pans of blood and human tissue lay on the floor in the corner of the bathroom, ostensibly standing in for legitimate biohazard containers.  I was lucky to not have tripped over them and spilled them on the way to the toilet.

Poor hygienic conditions in Bolivia have often been explained in racist terms by policy makers and other professionals who pointed the finger at the country’s “dirty Indians” as vectors of disease transmission.  Arguments that indigenous populations were “naturally filthy” or resistant to personal hygiene were often promoted by western doctors attempting to push indigenous midwives and traditional medicine practitioners from the country’s health care scene.

The above observations, however, reveal a different truth: Bolivia’s western, state-run hospitals lack proper sanitation infrastructure.  Doctors, nurses, and patients alike are denied the tools they need to ensure their own and others’ safety.  And this is occurring not just in rural communities miles from the nearest “modern” clinic–this is happening in your mother’s, your sister’s, or your daughter’s hospital room in the center of La Paz city.

4 de Julio: Un caso de abandono

Posted in Bolivia, child abandonment with tags , , , , on July 4, 2010 by eugeniadealtura

When you ask people in La Paz and El Alto whether there are many children abandoned in Bolivia, they will often comment on the infants that are left in garbage heaps.  I have always been under the impression that so many cite these cases not because they are common circumstances in which children are abandoned, but because they are so horrible that they make a lasting impression.  The garbage bin stories, however, seem to be sometimes true–last Thursday, La Paz’s daily La Razón reported on a two-month-old child that died after being found in a garbage can.

One of the questions I often ask people in Bolivia is why some individuals facing unwanted pregnancy abandon their children rather than having an abortion during the pregnancy.  Many believe that those who abandon their infants are typically adolescents who were unable or unwilling to “deal” with their pregnancies during the gestational period. Others, such as some orphanage workers, note that many abandoned children suffer from a variety of physical and psychological disorders that may have been factors in their abandonment.  Differently abled children or those who suffer from physical deformities not only present challenges to parents that they may not feel willing or able to face, but they also may suffer discrimination due to societal taboos.

The two-month-old that was discovered about two weeks ago in a garbage bin close to the El Alto airport had Down’s Syndrome and a cleft lip.  While Down’s Syndrome is a chromosomal disorder that can cause some developmental disabilities, cleft lip is a genetic deformity that can be treated with surgery, usually shortly after birth.  When the child was discovered by a market vendor, he was still alive, but suffered from respiratory difficulties due to malnutrition and exposure.  After being treated unsuccessfully at two El Alto hospitals, the infant died last Sunday.

This story sparks compassion in me from many angles.  On the one hand, it is crushing to realize that disability is burdened by so much discrimination in Bolivia that many children–not just this one–are abandoned due to it.  On the other hand, in the poorest country in South America, parents raising children with abnormalities enjoy very little state support, even when these kids’ conditions are treatable, such as the cleft lip.

Finally, we must return to the image of the garbage bin.  Why do some who abandon their children choose to leave them in garbage bins? While the idea of a parent leaving their child in a garbage can obviously sparks the thought that the parent thinks of their child as something unwanted and disposable, the reality could actually be quite different–perhaps parents leave their kids here because they know it’s a place where the child is likely to be found, either by neighbors or city workers.  Or maybe they leave their kids here because, despite the filth, it is a communal place where any person may take responsibility of the child–rather than leaving him or her on an individual doorstep, which targets one family as the new caretakers.  In any case, this story sparked a sort of realization in me this week–not only do these stories of garbage bin abandonment indeed leave an impression; sometimes, they are true.

13 de Junio: Cuando un país también es pobre

Posted in Bolivia, poverty with tags , , , , , , , , , , , on June 13, 2010 by eugeniadealtura

This week I discovered a few articles that emerged in the Bolivian press over the last several months that reminded me of the stunning variety of personal consequences to national poverty.  So often in this blog, I have identified particular government policies or cultural attitudes that affect Bolivian women, without placing these phenomena within the larger national and regional context.  It is this context that I would like to discuss today.  A context in which we recognize that Bolivia is the poorest country in Latin America (with the exception of Haiti).  And when an entire country is poor–not just its citizens–its infrastructure and institutions also suffer.  And suffering institutions, of course, means that many people’s basic needs are not being met.  This is what is happening in Bolivia.

Last January, La Paz’s daily La Prensa reported on striking health care workers at one crumbling local hospital that serves both the urban El Alto and surrounding rural populations.  Situated in the more middle-class, Ciudad Satélite neighborhood of El Alto, the Hospital Municipal Boliviano Holandés–often simply called the Holandés–was opened in 1999 to provide more health care options to alteños and to the rural population that often passes through the city.  According to one social worker I spoke with that works at the hospital, up to 80% of the clientele of the Holandés are rural migrants, many of whom speak exclusively the Aymara indigenous language.  (Most of the hospital staff also speaks Aymara.)

One of the reasons I was surprised to read this article is because, as part of my work in Bolivia, I have spent considerable time at the Holandés and the facility seems comparable to other hospitals in La Paz and El Alto.  Clearly, this is evidence not of the health of the Holandés, but of the deteriorated condition of most Bolivian health care centers.  As the La Prensa reporter notes, “In the pharmacy there are no medications, the [hospital] cots are rusted, they lack anesthesia for operations, there’s no food to give the hospitalized patients, the ambulances do not work, and when it rains, thanks to the broken roofs, there is almost as much water inside as out” (all translations mine).

Even more disturbing, one nurse at the Holandés commented that hospitalized patients–despite the existence of universal basic health insurance in Bolivia–must pay a daily fee for their care.  He notes, “‘The Holandés functions currently as a private clinic.  Whoever needs care has to buy their own medications.'”  Before reading this, I was under the erroneous impression that much had changed since the 1990s, when women seeking treatment for incomplete abortions would be left waiting sometimes for days in their hospital beds until they could afford to pay for the dilation and curettage or the manual vacuum aspirator procedure they required.  The deteriorated condition of the Holandés is taking its toll on both patients and staff.  Said one worker, “‘It’s been two months since they have paid our salaries, but this isn’t that important…The most serious [problem] is that…the infrastructure [of the hospital] is very deteriorated.”

Patient medical records stuffed into boxes are kept in this storage room in one local hospital.

Our second story of crumbling Bolivian institutions comes this week from Cochabamba, where one Defensoría de la Niñez lacks the necessary staff to investigate all of the cases it receives.  In Bolivia, the Defensorías are public institutions responsible for seeing cases of mistreatment of minors–including rape, physical and psychological violence, and abandonment.  These agencies are also instrumental in facilitating the adoptions of abandoned and orphaned children, since the Defensorías provide children with the personal documentation and the court order of release necessary to be adopted.  That is to say, when these institutions are not falling apart, they perform these functions.

In La Paz and El Alto, too, the Defensorías are facing difficulties.  As minors are becoming more familiar with their rights, more and more cases of mistreatment–particularly of rape of adolescent girls–are arriving at these institutions, and most lack the resources to deal with the cases effectively. Most of the safehouses where adolescent rape survivors could be placed are already over-burdened, and the foster system in Bolivia is so inefficient as to be almost useless.  Despite working long hours, most Defensoría staff feel unable to meet the needs of community members–and these community members, for their part, often opt not to report cases of abuse when they know they will face long lines and little follow-up.  I will never forget what one Defensoría worker told me when I called her to request an interview; she said: “Sure, come whenever you want–I’m here 24 hours a day.”

In any country affected by crushing poverty, women (and children) are generally hit the hardest.  Often dependent upon their male partners and extended families, and facing machista attitudes and sexist discrimination, women must struggle harder to achieve financial and social independence for themselves and their children.  However, women’s struggles do not occur in a vacuum.  The same phenomena that daily test women also test all Bolivians–patients and hospital workers, children and parents, government officials and social workers.  There are a few wealthy folks that escape, but many are in the same boat.  Because when it’s an entire country that’s poor, most discover that the effects of poverty trickle down to all.

15 de Mayo: Lo que es ilegal, se puede ignorar

Posted in abortion, adoption, Bolivia, child abandonment with tags , , , , , , , , , , on May 15, 2010 by eugeniadealtura

This week, New York Times blogger Nicholas Kristof opines, “my sense is that the illegality of abortion isn’t as large an element in maternal mortality as some people believe it is.”  On the one hand, Kristof points to a certain truth–just because abortion is illegal does not mean that it is not available.  Thousands of women undergo relatively safe abortions every day in countries where the procedure is illegal.  However, in these same countries, many more thousands of women end up getting unsafe abortions, since the key to accessing a safe pregnancy termination is usually money.  And most women worldwide–let’s face it–are poor.

The problem with abortion’s illegality is that it creates a class-based abortion industry, where women with money can access safe procedures, but women without, cannot.  Since where it is illegal abortion officially does not occur, government and public health officials can ignore the glaring class disparities in abortion care and in the resulting maternal deaths.  Since it is difficult to regulate an industry that officially does not exist, unscrupulous, unsafe abortion clinics exist alongside relatively safe medical centers, and most women do not have the information they need to make careful decisions about which to visit.

Reflecting on Kristof’s comments, I am further struck by how many aspects of unwanted pregnancy operate on the margin of the law in Bolivia.  The illegality of abortion–just one strategy for confronting unwanted pregnancy–is by far the most glaring.  Womankind estimates that 30,000 illegal abortions occur per year in Bolivia.  According to the country’s penal code, the individuals who perform abortions and the women who have them are subject to incarceration for three to six years.  However, as of 2004 only two judicial cases were ever brought against abortion practitioners, and both cases were later dismissed by the Supreme Court.  As far as I know, no woman has ever been incarcerated in Bolivia for having had an abortion.  In other words, the law criminalizing abortion doesn’t work on two fronts–it doesn’t prevent illegal abortions, and it doesn’t penalize abortion practitioners or the woman who undergo the procedures.  Finally, as I have mentioned before, laws allowing for legal abortions in Bolivia–in cases of rape, incest, or to protect the woman’s health–are equally ineffective.  Since 1973, when a stipulation was made in Bolivia’s penal code to allow abortion in the above cases, only a handful of legal abortions have ever been performed.

Other women, when met with unwanted pregnancy, end up abandoning their children rather than having abortions.  This may be because they are so traumatized by the pregnancy, or too poor to afford an abortion, that they are unable or unwilling to terminate the pregnancy before the child is born.  In other cases, women may abandon children that were and are “wanted” due to crushing economic circumstances or domestic abuse.  While some women will abandon infants in orphanages like the one pictured in this post, others will leave their children with neighbors, on street corners, or, notoriously, in garbage bins.  Like laws penalizing women who get abortions, laws targeting parents who abandon their children seem to be equally ineffective–in 2003, the national police registered two cases of child abandonment in the La Paz department, while local anti-abandonment activists argue that 17,000 children are abandoned in the country yearly.

Regardless of where they are left, most abandoned children will end up in orphanages. Orphanages in Bolivia come in several varieties; some depend on the state, some on private institutions and donors, and still others are illegal and even clandestine, with no relationship to local authorities.  One association of young people who grew up in orphanages recently told me that children residing in illegal orphanages have little chance to be adopted–at least not through legal channels.  (Even worse, sexual abuse in all types of orphanages is apparently the pan de cada día, or an everyday occurrence.)  While adoptions do take place, most Bolivian parents hope to adopt children under the age of one, who they can pass off to neighbors as a natural child.  The bureaucratic processes required to adopt children are so lengthy, however, that few children are adopted before they reach their first birthday, and once s/he turns one year old, a child’s chance of being adopted plummets.

Although it is difficult to find trustworthy data, activists in the fields of child abandonment and adoption insist that illegal adoptions are likely more numerous in Bolivia than legal ones.  While some of these adoptive parents have discovered children on their doorsteps or taken in kids from neighbors and friends, others, desperate to adopt, resort to illegal channels to bring kids home from orphanages.  Even adoptive parents who have completed the adoption process legally admit that they were tempted to go the illegal route to avoid the costly and lengthy processes associated with adopting a child.  Because of the increased legal and ethical issues involved with international adoptions, most of these are subject to rigorous scrutiny to ensure their legality. Since the rise of President Evo Morales, however, international adoptions face new restrictions and are on the decline.  In the meantime, nearly all of the orphanages in La Paz and El Alto are facing serious over-crowding–even the illegal ones, to which the state, when in a pinch, occasionally sends children.

In sum, abortion is not the only consequence of unwanted pregnancy that is illegal in Bolivia–child abandonment, the housing of abandoned children, and even adoption often operate under the table.  On the one hand, these institutions, even illegal, function–women get abortions, and children are adopted.  But how well do these institutions function?  I must say that I have to disagree with Kristof.  Illegal abortion does lead to devastating rates of maternal death. Illegal child abandonment, and the housing of these children in clandestine orphanages, leads to children who lack the possibility of legal identities and families.  When the state allows problems of this magnitude to languish in dubious legal territory, it reserves the right to ignore their consequences.  But avoidance will not work forever.  Eventually, something has got to change.

8 de Mayo: No tiene que ver con el agua

Posted in Bolivia, sexual violence with tags , , , , , , , , , on May 8, 2010 by eugeniadealtura

This week, two brief but terrible stories about sexual violence in El Alto, Bolivia.  First, “a thirteen-year-old boy has been accused of attempting to rape a seven-year-old girl” in an El Alto school building.  A week later, police arrested a 24-year-old man for allegedly raping and impregnating a 15-year-old girl who he claims was his “girlfriend.”  Evidently, “the mother of the minor realized that her daughter was pregnant” and reported the crime.

ENOUGH with violence against women.

There is so much to unpack in these two brief notes that it is difficult to know where to begin. First, there is the disturbing prevalence of sexual violence against women in Bolivia. Reproductive rights organization IPAS reports that “four of ten Bolivian women have suffered some form of sexual violence.”  Often, women suffer sexual violence at the hands of their lovers and husbands, upon whom they and their children may be financially dependent, and so do not report the crimes.  Other women who are raped by strangers or acquaintances also may fail to report the attacks due to fears that police or family members may blame them, rather than their aggressors. This means that actual rates of sexual violence may be much higher.  IPAS director Eliana Del Pozo also notes that few rape cases that women do report actually make it to the courts, much less result in convictions.

Why do so many men sexually assault women in Bolivia?  The guarantee of impunity alone cannot explain it.  In Bolivia–where until recently a married woman had to obtain the signature of her husband in order to undergo a tubal ligation–machismo dictates that women’s bodies belong to men.  Sexism permeates much home life in Bolivia, so that young boys learn from an early age that they enjoy privileges that their sisters and mothers do not.  Although we do not know much about the background of the thirteen-year-old who nearly raped a child in an El Alto school, the culture of machismo alone in Bolivian (and Latin American) society makes these incidents more common here than in many other countries.

An advertisement for a church-led seminar on violence in families.

In the case of the 15-year-old rape survivor, fear also seem to have played a role in delaying the aggressor’s arrest.  As the article notes, the girl’s attacker threatened her family with violence if she ever revealed the rape.  Only six months later (most likely when she was no longer able to hide her pregnancy) did the girl’s mother discover that her daughter was pregnant and file the report for the crime.

Even in cases where an attacker does not threaten his victim’s family, young women in Bolivia often fear to tell their parents that they have been raped since so many are blamed for provoking men’s advances.  If an adolescent girl becomes pregnant in Bolivia, whether through rape or consensual sex, her parents often hold her accountable for the pregnancy and excuse the man involved.  Many women I have spoken with who became pregnant at an early age report that they waited months before telling their parents, since parents are often very concerned with the que dirán de la gente, or, of what people will say.

Recently, I had the opportunity to speak with several members of the community police force in Bolivia, a special division of the police that engages with average folks through personal interventions and community orientations on a variety of topics.  According to these six men, rising rape rates in the busy, La Paz market district of Max Paredes are due to an increase in adolescent drinking.  Although alcohol abuse doubtless exacerbates many social problems, I find adolescent drinking a poor explanation for the high prevalence of rape in Bolivia.  The truth is, if a man would not rape a women sober, he would not rape a woman drunk.  If when sober, a man does not believe that a woman owes him something, or that her body is his property, he is unlikely to develop these beliefs after five or six cervezas. Let’s face it–the propensity to rape is not something that’s in the water, or in any other beverage.  It’s something that’s in the machismo.

7 de Febrero: Cuál es la noticia aquí?

Posted in Bolivia, children, Press, sexual violence, women with tags , , , , , , on February 7, 2010 by eugeniadealtura

I just discovered an article that was published last week in La Paz’s La Razón newspaper, entitled, “A Taxi Driver Rapes a Young Girl in the Valley.” (All translations here are my own.)  Apparently, on the evening of January 25 in Valle de Sajta, Bolivia, a considerably sloshed couple got in a taxi along with their nine-year-old daughter and, when they arrived at their destination, inadvertently left the girl behind.  The taxi driver, realizing the couple’s mistake, drove off with the young girl and was caught soon later in the act of raping her.

Clearly, no matter how this “story” is written up in the paper, it is absolutely terrible.  A young girl was raped.  And her parents made a horrible, perhaps inexcusable, mistake.  But what should bother us more–that these drunk parents left their kid in the car, or that this taxi driver saw that fact as an opportunity to RAPE the kid?

And yet, if we read the article carefully, the “news story” that this reporter seems to find most relevant is the parents’ negligence.  The full title of the article, with the subtitle, reads, “A Taxi Driver Rapes a Young Girl in the Valley: CARELESSNESS-Inebriated Parents Forget Their Daughter in a Taxi Cab in the Tropics.”  A paragraph later, the article states, “…last Monday night, the drunk parents of the victim got out of a taxi without their daughter, and the driver, taking advantage of their state of inebriation, drove away with the child to sexually abuse her.”  This reads disturbingly like an implicit validation of the driver’s decision–as if anyone in a similar situation, facing a similar “opportunity,” would naturally take advantage, were it not for the watchful eye of the parent (or, perhaps, of the husband, boyfriend, or other protective father figure).

The article closes with a matter-of-fact review of the statistics of child rape in the region of Cochabamba, where this crime occurred.  (At least the reporter has the decency to call these stats “alarming.”)  In 2009, there were 400 reported cases of child rape in Cochabamba.  (How many, I wonder, unreported?)  The final sentence of the piece informs us dryly, “Of these cases, only 1% of [these victims’ rapists] were sent to prison.”