Women Status in the Arab World from Reality to Expectations

1. Women Status in the Arab World from Reality to Expectations BahaaDarwish Current Challenges in Women’s Health Care and Medical Research Cairo, 7th – 8th Dec. 2011

2. Why Caring for WomenShe is a mother

3. She is the sister She is the daughter

4. Women Status in the Arab World • Education • World Economic Forum Report the Arab World Competitiveness Review 2010: • “Between 1980 and 2008, average literacy rates in the region increased from 39 to 73% and the literacy gap between males and females narrowed considerably” (World Economic Forum 2010: 12). • “An analysis of gender differences shows that gaps in enrolment rates have closed significantly over the past years and that girls appear to have caught up with boys in terms of learning performance” (ibid 15).

5. Health • Arab Human Development Report 2009 • “the Arab countries made greater progress in forestalling death and extending life than most other developing regions. This can be observed through the 23 –year increase in life expectancy and the reduction in infant mortality rates from 152 to 39 per thousand births” (UNDP 2009: 149)

8. Premarital Genetic Testing Prophet Mohamad: "Select your spouse carefully in the interest of your offspring because lineage is a crucial issue” • 1998, Kuwait “Genetic Engineering, Human Genome and Gene Therapy from an Islamic Perspective” • Recommendations: • Genetic screening is highly recommendable for the couples before marriage. • The resulting information should be kept confidential and the decision of marriage should be entirely left in the end to the couple • It is voluntarily for the couples to undergo genetic counselling. • Mandatory in several Arab countries, such as Egypt, Qatar

9. Female Genital Mutilation (Circumcision) • On the 22nd and 23rd November 2006 a conference on “preventing the mutilation of the women’s body” was organized by Dar al-Ifta’ in Egypt • Recommendation • “female circumcision (FGM) is an old custom that appeared in some human societies and that some Muslims practiced in some countries without any basis in Qur’anic versus or in hadith sahih” (Arda, p. 215). • And then: • “The circumcision which is practiced today harms women physically and psychologically. Therefore, it should be avoided to comply with one of the highest values of Islam that is to avoid harm to the human being, as the Prophet said: “ la dararwa la darar fi- l- islam” (ibid)

10. During the session of 28th June 2007, the Islamic Research Council of al-Azhar took part in the debate. All the members agreed that there is no basis in Shari’a for female circumcision, and that it “ is a harmful custom that spread and grew steadily in a small number of Islamic communities”. • This opinion has been shared by Dar al-Ifta’, that in fact issued a fatwa in July 2007 where it stated that “female circumcision belongs to the category of traditions and not of religious obligations”.

11. There are similar arguments in the booklet Khitan al-inathlaysa min shari’a al-Islam (female circumcision is not an Islamic rite), published in 2007 by the Ministry of Auqaf. In his introduction, the Minister Zaqzuq says: • “It is outrageous to burden Islam with the responsibility of the spread of this custom in these countries or elsewhere. We have to differentiate between what is religiously Islamic and is just a traditional custom that is verily unacceptable and absolutely rejected but widely spread in some Muslim countries”. (ibid, p. 216)

12. In the same booklet, Tantawi states:” one of the basic principles that is established by sari a is : “when it is proven that an act is harmful , it is obligatory to stop this act “. Moreover he remembers that this tradition is unknown in a great number of Arab and Islamic countries: “I personally visited a great number of Arab and Islamic countries, and they had not heard of female circumcision” (ibid: 217).

13. These arguments are identical to those used by al- anba Musa , the bishop of Youth of the Coptic Church , in khitan al –inath : ilamata, published in 2005. • Al-anba Musa says: ”When God created man, he did it in the best form and every part of his body has a function and a role .” He also declares that chastity has nothing to do with a harmful practice, because ”chastity does not come from the body, but from will and spirit “ and it is built “through good family, educational and religious upbringing” (ibid: 217).

14. A positive change: • A statistic from 2008 says that 91% of women in Egypt between 15 and 49 have been cut. • Despite the high percentage, it is anticipated that over the next 15 years this percentage will go down to 45% due to the help given to the anti-FGM campaign by religious scholars who made declarations that FGM has no source in Qur’an or hadith.

15. Women’s right to Consent (decide for themselves in health issues) • Assisted Reproductive Technologies (ART) • Egypt, all ART services , regulated by (decree No. 238/2003), stipulate couple informed consent • Libya, artificial insemination (law No. 75/ 1972) • Qatar, (IVF) • Saudi Arabia, ART regulated by Regulation of Infertility management No. 2870/1/12 (IVF and storage of embryos) • Tunisia, ART governed by Medically Assisted Procreation Decree No. 1027/2003(selective abortion, embryos and gametes’ preservation for reproductive purposes) • UAE, proposed Federal law (2007) (pre-implantation genetic diagnosis for identifying genetic diseases) • Yemen (IVF) (UNESCO Cairo Office 2011: 51-55)

16. Role of the Network • Awareness Raising • Legislation 1- More strong health care systems(management) 2- Saving women in Global Clinical Research 3- Saving women against Pharmaceutical companies 4- Legal binding of consent form

17. Saving Women Against Pharmaceutical Companies • 1996, in Nigeria, Pfizer sponsored a clinical trial testing trovafloxacin under the trade name Trovan. • tested on children during an epidemic of meningitis • Follow up spinal tap (optional) • Drug given orally, in US intravenously • blood tests on two separate occasions. 2ndblood test was abandoned for the shortage of staff • Children told they were sick • Signed informed consent??(Macklin 2003: 476, 477).

18. Legal Binding of Consent Form? • Study (2006), Abou-Zeid and colleagues: 64% of researchers who submitted proposals for funding to the Eastern Mediterranean Regional Office (EMRO) thought that informed consent was needed in the study. • Description of risks, assurances of confidentiality and voluntariness of participation (missing in 30% of forms) (Al-Riyami 2011: 61) • Study (2008), AbdurRab and colleagues: investigators did not think that informed consent was needed in 29% of the proposals (ibid).

19. References • Al-Riyami, A and DEEPALI JAJU, SANJAY JAJU AND HENRY J. SILVERMAN 2011. The adequacy of Informed Consent Forms In Genetic Research In Oman: A Pilot Study. In Developing World Bioethics , vol.11, no.2 pp.57-62 • Islamic Organization of Medical Sciences 2005 Al-Meethak Al-Islami Al-AalamilelAkhlakeyyat Al-TebbeyaWalSehheya (International Islamic Code of Health and Medical Ethics). Kuwait IOMS • Macklin, R. 2003 Bioethics, Vulnerability and protection. In Bioethics Vol.17, no.5-6 pp. 472-486 • Pratt, B and BebeLoff 2011 Justice in International Clinical Research in Developing World Bioethics Vol.11, No.2, pp. 75-81 • UNDP 2009 Human Arab Development Report. Beirut, Arab Regional Office: United Nations Development Planning. • UNESCO 2000 the Ethics of Freshwater Use: A Survey, Reykjavik, UNESCO • UNESCO 2004 Best Ethical Practice in Water Use. Paris: UNESCO • UNESCO Cairo Office 2011 Ethics and law in Biomedicine and Genetics: An Overview of National Regulations in the Arab States. UNESCO Cairo Office. • World Economic Forum 2010 the Arab World Competitiveness Review 2010 Switzerland: World Economic Forum.