Nicaragua Must Provide Medical Treatment to Pregnant Woman with Cancer

San José, March 3, 2010

The Strategic Group for the Decriminalization of Therapeutic Abortion, Ipas Central America based in Nicaragua, Women's Link Worldwide, based in
Colombia, and the Center for Justice and International Law (CEJIL), are informing about the recent adoption of precautionary measures granted by the Inter-American Commission on Human Rights (IACHR) in favor of Amalia, a young Nicaraguan who is 10 weeks pregnant and who suffers with metastatic invasive cancer. This grant has to be offered by the State of Nicaragua, who was previously denied timely medical treatment, which is necessary to combat this disease due to pregnancy.

The IACHR sat a historical precedent on this type of cases, due to the explicit request to the Government of Nicaragua:

1. Adopt the necessary steps to ensure that the recipient has access to medical treatment needed to treat her metastatic cancer;
2. Implement such measures in consultation with the beneficiary and her representatives, and
3. Reserve the identities of the beneficiary and her family, referring to her always  as "Amalia".

The IACHR also requested the State of Nicaragua to present, within a period of five days, information regarding compliance to the measures and upgrade such data periodically.

For organizations who requested interim relief measures, the criminalization of therapeutic abortion exposes all women, and more severe, poor women in the country, to the slowdown in the denial of medical care or health services compromising their human rights to life and health, as happened in the case of "Amalia".

The State has declared on various occasions that the implementation of the Protocols of Obstetric Emergencies from MINSA (Health Department), provide timely and adequate responses to these situations. However, in this case it was evident that health personnel were afraid to be identified, charged, and judged to comply with their duty as medical experts and apply the treatment to "Amalia". They knew that if any injury or harm had derived from it, affecting the unborn, they would be committing a crime.

This decision made by health officials follows the current Nicaraguan legislation, valid since the end of 2006, which criminalizes therapeutic abortion. A criminalization of this sort clearly violates the right of women to protect their health and personal integrity. Furthermore, if the case is being reported, lack of access to therapeutic abortion and absence of proper medical treatment for their respective disease, exposes women to lose their lives in order to protect the consequences of the disease from the fetus.

In this regard, the Women’s Rights Rapporteur for the IACHR expressed their concern in a letter to the Nicaraguan government stating that "the denial of therapeutic abortion presents an obstacle to the work of health professionals, whose job is to protect life and provide appropriate treatment to their patients". Other bodies of international protection, such as the Committee against Torture, the Human Rights Council, the Committee on the Elimination of Discrimination against Women, the Committee on Economic, Social and Cultural Rights, and the Human Rights Council in UN, similarly urged the Nicaraguan state to retake into consideration the possibility of therapeutic abortion.

While it is true that, according to recent newspaper reports, the Health Ministry finally decided to apply chemotherapy to "Amalia", the adverse consequences that may result from the delay of medical care still remains to be the State’s responsibility, as well as not proposing the termination of pregnancy, as part of cancer treatment and further prolongation of her life.

As petitioner organizations we would like to remind the binding decisions of the international human rights protection, and reiterate the urgent need to take necessary measures to guarantee the life, health, and personal integrity of Amalia.

In order to prevent situations such as "Amalia’s”, we enthusiastically appeal again to the Supreme Court, National Assembly and the President of the Republic Daniel Ortega Saavedra to comply with the recommendations of treaty bodies of the United Nations and tailor the abortion legislation in accordance with the provisions made by various international human rights instruments.  In addition, we would also like to emphasize on the fact that there are exceptions to that rule against cases of danger to life and health of women, such as cases of congenital malformations which are incompatible with human life, and also cases of rape or incest.

Contact in San José

Marcia Aguiluz

Lawyer

Tel (506) 2280-7473

maguiluz@cejil.org

The Center for Justice and International Law (CEJIL) is an advocacy of human rights in the Americas. CEJIL's main objective is to ensure full implementation of international human rights standards in the Member States of the Organization of American States (OAS), through the effective use of the Inter-american human rights system and other international protection mechanisms. CEJIL is a nongovernmental nonprofit with consultative status at the OAS, the Organization of the United Nations (UN) and observer status with the African Commission on Human Rights.