Foreign Affairs Committee on March 7th, 2023

[The Chair, Liberal, Ali Ehsassi]

Dr. Bermejo, you're considerably over time. Thank you ever so much.

[Dr. Alvaro Bermejo]

I'm sorry. I took my last chance to say something.

[The Chair, Liberal, Ali Ehsassi]

Absolutely.

For the final minute and a half, we will go to MP McPherson.

[Heather McPherson, NDP, Edmonton Strathcona, AB]

Thank you very much, Mr. Chair.

It wasn't your last time to speak, Mr. Bermejo. I have some questions for you.

My concern is always around access to SRHR for women. Of course, one thing I'm quite proud of is that one of the provinces in Canada just recently made contraception products free for all the people living in that province. I know that when I spoke with you, we spoke a little about pharmaceutical abortion and how that has made access easier. It made it easier for women to access the health care they require.

Could you talk a bit about that, a bit about access and a bit about how much we have to lose if we don't get this right in Canada and around the world?

[Dr. Alvaro Bermejo]

Thank you so much for that question.

Medical abortion, or pharmaceutical abortion as you're calling it, is increasing everywhere as the preferred method for many women, even though we still have to keep traditional methods available as well. That is because it responds to two things. I think it's a good response to the operational challenge of increasing access to safe abortion in countries where it's difficult. It's also a response to the political challenge, the global opposition that is making access more and more difficult in clinics by either picketing the clinics and embarrassing and discriminating against women when they try to access abortions or threatening the providers.

In a way, medical abortion provides a response to both those situations. I would argue that it is a very important tool in our tool box to guarantee access to safe abortion to the women and pregnant people who need it.

[Heather McPherson, NDP, Edmonton Strathcona, AB]

Thanks very much.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

I have a point of order, Chair.

The gentleman from Planned Parenthood made some very critical comments about the oil industry. I just wonder if he can clarify whether those comments were his own opinion or on behalf of his organization.

[The Chair, Liberal, Ali Ehsassi]

We're out of time, Mr. Genuis.

At this particular point, I'd like to thank Ms. Sully, Ms. Akello and Dr. Bermejo. I'm terribly sorry for the technical challenges. We will ensure that your remarks are translated into French and distributed to all the members. Thank you very much, all three of you, for your perspective and your expertise.

We will suspend for approximately three or four minutes so that we can go to the next panel.

For those who are online, you can remain on your current link. You don't have to go out and come back in again.

Go ahead, Ms. Bendayan.

[Rachel Bendayan, Liberal, Outremont, QC]

On a point of order, Mr. Chair, would it be possible to extend the meeting, given that we are past 12:20?

[The Chair, Liberal, Ali Ehsassi]

We can extend by, maybe, 10 minutes.

Thank you.

[The Chair, Liberal, Ali Ehsassi]

Pursuant to Standing Order 108(2) and the motion adopted by the committee on Monday, June 20, 2022, the committee is resuming its study of sexual and reproductive health and rights of women globally.

It is my pleasure to welcome to the committee three witnesses. First, we have Ms. Krystyna Kacpura, who is with the Foundation for Women and Family Planning. Second, we have Ms. Julie Théroux-Séguin, who is with the Centre for International Studies and Cooperation. Last, we have Dr. Theresa Okafor, who is with the Foundation for African Cultural Heritage.

Welcome to all three of you.

I'd like to make a few comments for the benefit of the witnesses who are joining us by video conference today. Please wait until I recognize you by name before speaking. You should be clicking on the microphone icon to activate your mike, and please mute yourselves when you are not speaking. Interpretation for those on Zoom is at the bottom of your screen, and you have the choice of floor, English or French. For those in the room, you can use the earpiece and select the desired channel. This is a reminder to all three witnesses that all comments should be addressed through the chair. You will each be provided five minutes. After the five minutes for all three are over, we will go to the members for questions. Should I put this sign up, that means you should be wrapping up either your comments or your response to questions within 30 seconds.

First, we will go to Ms. Kacpura. You have five minutes.

[Krystyna Kacpura, President, Foundation for Women and Family Planning]

Thank you, Mr. Chair.

I am president of the Foundation for Women and Family Planning, which is the very first Polish NGO leading the process of advancement of sexual and reproductive health and rights in Poland. It was established in 1991. Since then, we have been monitoring the implementation of the law and advocating for the liberalization and decriminalization of abortion.

Since the outbreak of the war in Ukraine, FEDERA—which is the short form for our organization—has provided help accessing SRHR for women and girls from Ukraine. Moreover, we take part in various advocacy initiatives, along with the international NGOs and partners, ensuring a SRHR and GBV response for the refugees.

The very purpose for the creation of FEDERA was the existence and counterbalance of the consequences of Polish women’s gradual loss of autonomy in access to legal abortion care. For almost 30 years, the law allowed access to abortion under three minimum grounds, as stipulated in the act of January 1993 on family planning, human embryo protection and conditions of legal pregnancy termination.

In October 2020, things got worse by means of the political Constitutional Tribunal’s ruling. The Constitutional Tribunal found that certain provisions of the act that provide for the legality of women’s access to abortion care are unconstitutional, specifically on the grounds of fetal abnormalities. The tribunal’s decision came into effect in January 2021. It has severely rolled back the already severely limited protection for women’s access to legal abortion in Poland, and resulted in a near total ban on abortion.

Apart from almost no access to legal abortion, there is limited access to contraception, especially emergency contraception. Polish teenagers suffer from a lack of comprehensive sexuality education.

We cannot look at what is happening in Poland with regard to SRHR backsliding without considering the impact of the transnational antigender movement, which is quite powerful in Poland and operates in synergy with the current ultra-conservative government.

The regressive ruling is contrary to Poland’s obligations under international human rights treaties and the European Convention on Human Rights. As a state party to seven international human rights treaties, Poland is obliged to ensure that abortion is legal, at a minimum, when a woman’s life or health is at risk, when the pregnancy involves a severe or fatal fetal impairment or when the pregnancy results from sexual assault.

Furthermore, by removing a pre-existing legal entitlement to accessing abortion, Poland acted contrary to the international law principle of non-retrogression, which prohibits states from taking steps that undermine, restrict or remove existing rights or entitlements. Moreover, the ruling prevents Poland from complying with the above-mentioned judgments from the European Court of Human Rights and, as such, further undermines respect for the rule of law.

The regressive legal change has exposed women’s health and lives to serious harm by forcing them to carry pregnancies to term against their will, by forcing them to travel to other European countries to obtain safe and legal abortion care or by forcing them to seek clandestine abortion care outside of the scope of the law in Poland.

The CT’s ruling has had fatal consequences. Women die as a result of this ruling and its chilling effect on doctors, who are afraid of activities that could be qualified as abortion. They wait too long to induce stillbirths. They procrastinate in removing a dead fetus in time, and they hesitate to remove an ectopic pregnancy.

Hear their names: Justyna died in December 2020. Izabela, Anna from Świdnica and Dominika died in 2021. Agnieszka and Marta both died in 2022.

The ruling has significantly decreased access to antenatal tests. We hear from women contacting FEDERA that the doctors don't refer for antenatal testing or don't provide sufficient explanation of the results. There are more children born with severe and fatal defects who die shortly after birth. There is almost no institutional support for families who decide to take care of an ill child.

FEDERA and other women's rights organizations organized to provide information on access to medical abortion, abortion abroad and in some narrow cases—

[The Chair, Liberal, Ali Ehsassi]

Ms. Kacpura, I would ask that you conclude your remarks in the next 20 seconds or so.

[Krystyna Kacpura]

Okay.

Obviously, abortions do happen. The very restrictive law didn't stop women from getting abortions, but the process to get one might be burdensome and costly and generate distress.

This is also a kind of reproductive injustice, especially because this law beats on the poorest.

Thank you very much.

[The Chair, Liberal, Ali Ehsassi]

Thank you very much, Ms. Kacpura.

We next go to Ms. Théroux-Séguin.

You similarly have five minutes.

[Julie Théroux-Séguin, Global Thematic Leader, Women and Girls Rights, Centre for International Studies and Cooperation]

Thank you so much for the opportunity to meet with you today.

I'm speaking to you on behalf of CECI, the Centre for International Studies and Cooperation, a Canadian organization founded in 1958 and headquartered in Montreal. CECI is active in over 15 countries, in Africa, Latin America, the Caribbean—mainly in Haiti—and Asia.

CECI's mission is to fight poverty, exclusion and inequality, through such means as women's rights programs, economic empowerment and adaptation to climate change, and work in communities living in fragile environments.

CECI has been carrying out sexual and reproductive health projects for over 35 years, advocating for equal access to health care and quality health services for mothers and children, and reducing violence against women and girls. In the past decade or so, it has completed projects of this kind in Haiti, Mali, Rwanda, the Democratic Republic of Congo and Burundi, among other countries.

We're currently seeing a decline in sexual and reproductive health rights. Various factors are to blame, but some appear to us to be predominant and recurring in a number of countries around the globe. I will address just four of them for now.

The first factor is the decline in public and international funding for sexual and reproductive health care, comprehensive sexuality education and outreach. This has led to a reduction in counselling services, outreach to rural areas and decentralized services. It's also had an impact on conflict-affected areas. Systems are becoming less efficient, and the use of technology for things like teleconsultations is relatively rare.

The second factor is the rise of a global narrative that is resistant and sometimes hostile to women's and girls' rights, gender equality, family planning, methods of contraception and comprehensive sexuality education, and this has set back sexual and reproductive health rights, especially for the most marginalized people.

The third factor is the disparity between women's and girls' needs and clinical training or training that promotes more egalitarian approaches. For example, in countries where abortion is illegal, medical staff lack knowledge about postabortion care, even in cases of involuntary termination. This staff also lacks the counselling skills to address women's needs or the difficulties women may face.

The final factor is the fact that sexual and gender-based violence continues to happen. The lack of skilled attendance among health care providers to assist victims and survivors of sexual and gender-based violence leads to fewer women seeking help, which may cause them to take health risks like unsafe pregnancy termination.

A few of the witnesses before me have said it, and I would also like to point out that, according to the World Health Organization, 13.2% of maternal deaths each year can be attributed to unsafe abortion. The WHO also says that restricting access to abortion does nothing to reduce the number of abortions, but it does affect their safety and the mothers' dignity.

Based on this experience and best practices from our various projects, CECI recommends that Canada take several steps.

First, it should increase funding for sexual and reproductive health, with a special focus on recognizing and building the capacity of Canadian expertise, including that of non-governmental organizations and universities that work internationally to support people around the world. In particular, these institutions help support collaborative initiatives to harmonize the work of health care services stakeholders with that of civil society organizations, particularly women's groups and decentralized communities.

Next, it should urge local civil society organizations to get involved. I'm making a connection with the localization of assistance in particular. This work needs to be done specifically with women's organizations that can connect with official health services. This has proven to be particularly effective in encouraging victims of gender-based violence to seek help, and in ensuring adequate follow‑up.

Support should also be provided for the use of new technologies and approaches that enable health care coverage in remote, underserved or prolonged crisis areas.

Lastly, formal medical education should be provided, with university curricula that are egalitarian and address sexual and reproductive health issues, including abortion, as public health rather than cultural issues. In addition, clinical knowledge would be paired with gender-sensitive coaching skills.

In closing, I'd like to make a recommendation regarding the political and legislative impact Canada can have legislatively. Either directly or through multilateral institutions, Canada can encourage amendments to discriminatory legislation in some countries or advocate for stronger legal mechanisms through new legislation or implementation laws.

For example, Mali passed sexual and reproductive health legislation 20 years ago—

[The Chair, Liberal, Ali Ehsassi]

Ms. Théroux-Séguin, you're considerably over time. Could I ask that you wrap up your comments in the next 20 seconds, please?

[Julie Théroux-Séguin]

Sure. I will do that.

Finally, we recommend that Canada support legal mechanisms, which could be done through the United Nations Human Rights Council's Universal Periodic Review, and promote recommendations to improve sexual and reproductive health.

Thank you very much.

[The Chair, Liberal, Ali Ehsassi]

Thank you very much, Ms. Théroux‑Séguin.

We will now go to Ms. Okafor.

You, similarly, have five minutes. The floor is yours. Thank you.

[Dr. Theresa Okafor, Director, Foundation for African Cultural Heritage]

Thank you, Mr. Chair.

Good afternoon, everyone.

It's an honour and a privilege for me to address you on this motion calling on the Standing Committee on Foreign Affairs to undertake a comprehensive study of the sexual and reproductive health and rights of women globally.

These rights in question do not represent the governments nor the citizens of African countries, except for four countries. It is pressure groups pursuing special interests without being mindful of the impact this can have. As one who has represented my government as a delegate of the United Nations in New York for four years and one who has worked closely with the African Group, I can say that we have been deeply concerned by the paternalism that interferes in another person's affairs coercively or through incentives motivated by claims that the person will be better off. This hand-out approach is what continues to perpetrate beggary, hunger, illnesses, oppression and modern-day slavery in Africa.

Support for the African woman should not be one that strips her of a right to family stability, a right to raise her intellectual tone and moral compass, or a right to economic empowerment and social inclusivity, a.k.a. equity and proper health care. These rights are largely ignored and are substituted with unsolicited rights to abortion, safe abortion—whatever that means—contraception, and comprehensive sexuality education, to mention a few

I am aware that Canada has committed to increase funding to an average of $1.4 billion per year by 2023-24. Canada has also committed to maintain this level of funding until 2030. Of this total funding, $700 million is to promote global sexual and reproductive health and rights, which includes contraception, abortion and comprehensive sexuality education.

I was shocked and scandalized by the language used by members of the committee, representatives of Global Affairs Canada and other witnesses, who have demonstrated an imperialistic approach to helping underdeveloped nations. Advocacy to liberalize laws in countries that oppose abortion amounts to undermining the legislative and democratic processes of sovereign states and to subverting the deep values and good cultural traditions of these nations.

It is increasingly clear that foreign funding and the feminist international assistance policy are becoming less about aid, empowerment, health care and poverty reduction, and more about ideological colonization.

If this is about rights, then I'm wondering if any government has a right to impose its belief in abortion on other nations that continue to reject it. The majority of African countries continue to protect life in all its stages and prefer to prioritize genuine health care that achieves best outcomes for women, mothers, their children and families. I sincerely hope we can all agree that these are the priorities we should be focusing on.

By way of conclusion, please note the following four points. There is no international right to abortion and comprehensive sexuality education, which is a key component of SRHR, because too many United Nations member states are strongly opposed to establishing such rights. On the contrary, United Nations consensus language indicates that member states have agreed to help women avoid abortion. Even the United Nations agencies are prohibited from promoting abortion as a method of family planning.

In Africa, the reproductive health care is maternal health care. It's suicidal to import practices and lifestyles that are alien to Africa. In 1994, the International Conference on Population and Development's outcomes document instructed that “Governments should take appropriate steps to help women avoid abortion, which in no case should be promoted as a method of family planning”.

Let me say, with your permission, Mr. Chair, that I am aware that many African countries are overflowing with condoms and contraception from the west sent to us to fulfill a fictitious, unmet need for contraception, when what we really need is water, food, housing, employment and quality education that can break the intergenerational cycle of poverty and employability, that can make education an equal playing field, regardless of the circumstances surrounding one's birth. The true unmet needs are in the maternal health care provision, which should set up blood banks to provide blood to prevent death caused by bleeding, which contributes a whopping 33.9% to maternal mortality.

Another unmet need is the hygienic—

[The Chair, Liberal, Ali Ehsassi]

Ms. Okafor, you're considerably over your allotted time.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

On a point of order, Chair, I've been timing the witnesses, and you allowed Ms. Kacpura to go to six minutes and fifteen seconds. You just told the currently speaking witness that she's considerably over her time at the five minutes and one second mark. I think given—

[The Chair, Liberal, Ali Ehsassi]

No, it's six minutes according to my—

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Mr. Chair, I think given that there are different views being expressed, you should ensure that witnesses with different perspectives on this topic are afforded equal time to present those perspectives—

[The Chair, Liberal, Ali Ehsassi]

You can rest assured, Mr. Genuis, that will be the case.