After days and weeks of women from all over Croatia making their stories of demeaning, disrespectful and painful medical procedures in reproductive healthcare public during the #BreakTheSilence (#PrekinimoŠutnju) movement, Roda - Parents in Action sent a letter to Croatian Prime Minister Andrej Plenković urging him to steer a multi-stakeholder committee on an Action Plan for Women's Health 2019-2021. The letter includes a suggested deadline of International Day for Human Rights, 10 December 2018.
The text of the letter, sent this morning, can be found below, including a PDF in English.
Roditelji u akciji - Roda
Žerjavićeva 10, 10000 Zagreb
Telephone: 01/6177500
www.roda.hr / roda@roda.hr
Zagreb, 24 October 2018
GOVERNMENT OF THE REPUBLIC OF CROATIA
His Excellency Andrej Plenković, Prime Minister
Dear Prime Minister,
We are writing to you in the name of thousands of women throughout Croatia who have sent Roda their experiences of traumatic, unnecessarily painful and degrading experiences during reproductive healthcare procedures over the past ten days, in the spontaneous movement known as Break the Silence (Prekinimo šutnju). We are doing so in order to ask that You, as Prime Minister, begin procedures and manage the process of preparing an Action Plan for Women's Health in Croatia, with the goal of implementing improvements in the sector of healthcare that cares for women's reproductive rights.
Thousands of shocking stories that have come from women all over Croatia have forced us to confront the fact that women of all generations have been suffering unnecessary physical pain and humiliation during routine gynaecological procedures, pregnancy terminations, medically assisted reproduction procedures as well as during pregnancy, childbirth and postpartum. Painful procedures conducted without adequate pain relief include scaping the walls of the uterus with surgical instruments (cutterage), taking tissue samples from the cervix and vagina (biopsy), suturing tears of the cervix and perineum after vaginal childbirth and egg retrieval procedures during medically assisted fertility procedures. In many cases, women have been denied their right to information and decision-making about healthcare procedures, which are guaranteed by law. Instead, they are insulted, coerced and demeaned and made to undergo painful procedures without adequate pain relief.
Woman of various ages and levels of education from throughout Croatia have reached out to Roda, regardless of their beliefs or political preferences, which shows that the problem of healthcare providers treating women harshly is long-term and systemic. The reactions of leaders of some of the most important Croatian healthcare institutions and professional organisations during this period have been unacceptable. Instead of being the first to protect motherhood and women's reproductive health, many of them were among the first to demean and question the truth of thousands of women's stories of pain and suffering, questioning their intelligence and believability. This is especially significant considering that according to research conducted by Croatian demographers, traumatic experience in maternity care is one of the top five reasons why women decide not to have any more children.
The stories women have sent also show that legislated mechanisms for protecting patient's human rights do not function in practice. Years of attempts and requests made by various stakeholders to the Ministry of Health have not resulted in any improvements, but have instead proven that this difficult situation cannot be solved within a single sector. As a result, we are very worried that gynaecologists would like to solve the problem within a closed circle of professionals, without including stakeholders from other sectors. We would like to take this opportunity to remind you that in 2017, United Nation's Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health reported on the problems of inadequate reproductive healthcare and set out recommendations, which the Ministry of Health has not yet addressed with any specific measures.
In these circumstances, and after many years of having recommended and sought-after changes denied, we are expressing our concern about announcements that inspection teams, that will not include patient representatives or those of other stakeholders, will be visiting Croatian healthcare facilities. Similar inspections to date have sought to bury problems instead of addressing them or implementing improvements, which women have recognised as inadequate and shallow solutions. Closed, non-transparent and obscure procedures cannot be the way decisionmakers address needs expressed by citizens.
As a result, we call on You as Prime Minister to begin urgent procedures for the preparation of an Action Plan for Women's Health for 2019-2021, and show that Your Government protects the dignity of women and their right to life without violence, including reproductive and institutional violence.
The Action Plan should be the first, urgent step and a clear message to all stakeholders in women's healthcare that health is not a good or privilege, but is instead a fundamental human right enshrined in the Constitution of the Republic of Croatia. All vital stakeholders must be included in the preparation of the Action Plan, including the Ministry of Health, public health experts, professional bodies and organisations, ombudspersons' institutions and human rights experts, institutions of higher learning that educate healthcare workers, patient representatives and other experts without whom this Action Plan would not be complete. The Action Plan must express clear goals, activities and responsibilities, have budget funding and an independent body must be named to monitor its implementation.
The Action Plan must show that Croatia understands and wants to implement the European practice recognising that society is responsible for ensuring women's health and that every woman has the right to the highest level of attainable health regardless of her age, financial means, social role or place of residence. We need the Action Plan urgently in order to send a clear message that Your Government is of the stance that unnecessary physical and psychological pain felt by women and caused by the public health system is not acceptable in the Republic of Croatia, whose Constitution guarantees the protection of dignity and gender equality, the right to healthcare and protection from brutality.
We suggest that the Action Plan be sent for public consultations on International Human Rights Day, 10 December 2018, a symbolic way of showing that Your Government understands the importance of human rights in forming all public policies and as a show of your support for improving the level of women's healthcare in Croatia as a national priority.
A modern, high-quality and available public health system that provides evidence-based healthcare is key for the health of women and children, the protection of women's dignity and for the future of Croatia. We therefore believe that you will recognise the importance of a comprehensive solution to this problem and will support this initiative. We would also like to request to schedule a meeting with you where we can discuss the specific direction and content of the Action Plan.
We are available to you with all our resources, because we believe that the issue of women's health deserves not only a general public consensus, but also the mobilisation of all societal actors.
Most Respectfully,
Parents in Action (Roditelji u akciji)
#BreakTheSilence #PrekinimoŠutnju
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