Twelve years on the family of Alyne Pimentel received the compensation but the poor quality of health services and racial discrimination are still the reality of public health services in Brazil.
The Rapporteurship on the Human Right to Sexual and Reproductive Health of the Plataforma de Direitos Humanos – Dhesca Brasil – took part of the ceremony in which the payment of the compensation determined by the United Nations’ Committee on All Forms of Discrimination Against Women (CEDAW Committee) was awarded to the mother of Alyne Pimentel.
Since the beginning of the present mandate, the Rapporteurship has been following up the implementation of the recommendation of the CEDAW Committee on the case of Alyne Pimentel. Although we recognize that the payment of the compensation is an important step towards the full implementation of the reparations awarded bt the CEDAW Committee and that it signals the recognition by the Federal Government of the responsibility for the avoidable death of Alyne, it must be accompanied by effective public policies to protect and prevent maternal mortality in Brazil so that other similar cases do not occur.
In its final decision, the CEDAW Committee recommended that Brazil adopted several non-repetition and prevention measures amongst which; fulfilling women’s right to a safe maternity and to access adequate emergency obstetric care; providing adequate professional training for health professionals; guaranteeing means of prosecuting cases of human rights violations in health care; and taking the appropriate measures to reduce avoidable maternal deaths by implementing the National Plan for the Reduction of Maternal Mortality in the states and local instances.
In Brazil, the maternal mortality ratio (MMR) is still high and it is estimated – not considering sub-notifications – that it is around 75 deaths for every 100,000 live births, which is more than the triple of developed countries and over twice the objective set out in the Millennium Development Goals for 2015. Also researches demonstrate that the risk of maternal death is directly related to factor such as race, place of residency, schooling, and socioeconomic status, affecting mostly afro-descendent women, from a poor background and that live in the suburbs of rural areas.
Mission to the Baixada Fluminense
As part of the efforts to monitor the implementation of the recommendations, the Rapporteurship on the Human Right to Sexual and Reproductive Health did an on-site mission in the beginning of 2013 to the health care centres that treated Alyne Pimentel 12 years ago. On this mission it was ascertained that the health care provided to women during the antenatal period, childbirth and puerperium is still precarious. Through interviewing the health care staff we concluded that there was an absolute lack of adequate infrastructure, human resources and equipments to provide the minimum conditions for a quality health care in the centres that were visited.
These health centres also did not have intensive care unit, an efficient system for transferring patients, nor blood Banks for the cases of obstetric emergencies. This, if Alyne was cared in one of these centres, there would still be a risk of death. In this sense, the Rapporteur for Sexual and Reproductive rights, Beatriz Galli, questioned if Brazil is really doing its part in guaranteeing that other women in reproductive age, particularly afro-descendents, poor and who live away for great urban centres, have access to quality health services that would guarantee her integrity during pregnancy, childbirth and post-partum.
In its final decision the CEDAW Committee made strong recommendations to Brazil; guaranteeing women’s right to safe maternity and access to emergency obstetric services; awarding adequate professional training to health professionals, specially on women’s reproductive rights, and guaranteeing access to remedies when women’s right to reproductive health were violated during health care, and that private health services that provide care for the public system respect the national and international normative and Standards on human rights and reproductive health.
The case of Alyne Pimentel
Alyne Silva Pimentel, 28 years old, female, afro-descendent, and resident of Baixada Fluminense (suburbs of Rio de Janeiro) died due to a chronic lack of appropriate health assistance on the 16th of November 2002, when she was 6 months pregnant, and 5 days after registering at a public hospital with symptoms of a high-risk pregnancy. Alyne left behind a 5 year-old daughter. Her death could have been prevented if she had had access to quality basic obstetric care, which is the responsibility of the State of Brazil according to the 1988 Constitution.
On the 10th of August 2011 the Committee on the Elimination of All Forms of Discrimination Against Women (CEDAW Committee) found Brazil responsible in the case Alyne Pimentel. The decision of the CEDAW Committee concluded that Brazil failed in its duty to protect Alyne’s rights to life, health, equality and non discrimination in access to health care. It also found that the State failed in not ensuring effective access to justice to Alyne’s family.
The payment of the compensatory reparation to the mother of Alyne Pimentel is an important step that must be followed by other measures of reparation and non-repetion as the implementation of health policies that guarantee women’s physical integrity, life and health and that are effective in avoiding similar cases.