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<strong>INTERIGHTS</strong> <strong>Bulletin</strong><br />

Volume 16 Number 4 2011<br />

179<br />

International<br />

Law Reports<br />

right to special protection as girl-children under Article<br />

VII of the ADRDM; (3) the State violated the right to<br />

judicial protection of JL and her next of kin under Article<br />

XVIII of the ADRDM; (4) there was not sufficient<br />

information to find violations of Articles V and VI of the<br />

ADRDM; (5) the claims under Articles IV and XXIV of<br />

the ADRDM had been addressed under Article XVIII of<br />

the ADRDM.<br />

WOMEN; HEALTH;<br />

EQUALITY, DISCRIMINATION<br />

Violation of Article 12(1) and (2) – access to healthcare<br />

services and Article 2 – establishment of policy<br />

measures to eliminate discrimination – of CEDAW<br />

Alyne da Silva Pimentel Teixera (deceased) v<br />

Brazil<br />

Communication No 17/2008, Decision of the<br />

CmEDAW, 25 July 2011<br />

AT was a Brazilian national of African descent. In her<br />

sixth month of pregnancy, AT went to the health centre<br />

complaining of severe nausea and abdominal pain. She<br />

was given medication and sent home. Two days later she<br />

returned to the health clinic, at which time the doctor<br />

could not detect a foetal heartbeat, which was confirmed<br />

by ultrasound. AT was then given medication to induce<br />

the delivery of the stillborn foetus.<br />

Fourteen hours after delivery, AT underwent surgery to<br />

remove parts of the placenta and afterbirth, but her<br />

condition continued to worsen. The doctors at the health<br />

centre then sought to transfer AT to a hospital. The<br />

municipal hospital had available space but was unwilling<br />

to use its only ambulance to transfer AT. AT waited in<br />

critical condition for eight hours, manifesting clinical<br />

symptoms of coma for the last two hours. On arrival at<br />

the hospital she was in critical condition and needed to<br />

be resuscitated, but the hospital placed her in a<br />

makeshift area in the emergency room hallway. She died<br />

the next day of digestive haemorrhage caused by delivery<br />

of the stillborn foetus.<br />

MT, the mother of AT, submitted a communication with<br />

the CmEDAW claiming that AT was a victim of a<br />

violation by Brazil of her right to life and health under<br />

Articles 2 and 12 of CEDAW. MT argued that Article 2<br />

required immediate action by Brazil to address<br />

discrimination against women when a woman’s right to<br />

life is violated by failure to secure her safety during<br />

pregnancy and childbirth. MT contended that CEDAW<br />

required Brazil to ensure practical implementation to<br />

combat discrimination, not just legal guarantees.<br />

Brazil argued that a number of public policies aimed at<br />

eliminating discrimination against women in the field of<br />

health care are under development and that the failures<br />

in the medical care provided to AT were not because of<br />

discrimination against women but through deficient and<br />

low-quality service to the population, specifically by the<br />

private for-profit hospital. Brazil did not contest that the<br />

services provided to AT were inadequate.<br />

The Committee held that: (1) AT’s death was ‘maternal’<br />

within the meaning of Article 12(2) of CEDAW; (2) AT<br />

was not ensured appropriate services in connection with<br />

her pregnancy; (3) Brazil is directly responsible for the<br />

actions of private medical services outsourced by the<br />

State; (4) the lack of appropriate maternal health services<br />

fails to meet the distinctive health needs and interests of<br />

women, in violation of Article 12(2) of CEDAW,<br />

constitutes discrimination against women under Article<br />

12(1) and Article 2 of CEDAW, and has a differential<br />

impact on the right to life of women; (5) AT was<br />

discriminated against not only on the basis of her sex but<br />

also on the basis of her status as a woman of African<br />

descent and her socio-economic background; (6) it is<br />

recommended that Brazil: provides appropriate<br />

reparation including financial compensation, ensures<br />

womens’ right to safe motherhood and affordable access<br />

to adequate emergency obstetric care, provides adequate<br />

professional training for health workers, especially on<br />

women’s reproductive health rights, including quality<br />

medical treatment during pregnancy and delivery, as well<br />

as timely emergency obstetric care, ensures access to<br />

effective remedies in cases where women’s reproductive<br />

health rights have been violated and provides training for<br />

the judiciary and for law enforcement personnel,<br />

ensures that private healthcare facilities comply with<br />

relevant national and international standards on<br />

reproductive health care; ensures that adequate<br />

sanctions are imposed on health professionals who<br />

violate women’s reproductive health rights, reduces<br />

preventable maternal deaths through the<br />

implementation of the National Pact for the Reduction of<br />

Maternal Mortality at state and municipal levels,<br />

including by establishing maternal mortality committees

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