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US: More migrant women say they did not consent to surgeries at Ice center

AP review finds no evidence of mass hysterectomies but files show growing allegations of operations women did not fully understand.

 

By Nomaan Merchant

 

The Guardian (18.09.2020) – https://bit.ly/3clezJ8 – Sitting across from her lawyer at an immigration detention center in rural Georgia, Mileidy Cardentey Fernandez unbuttoned her jail jumpsuit to show the scars on her abdomen. There were three small, circular marks.

 

The 39-year-old woman from Cuba was told only that she would undergo an operation to treat her ovarian cysts, but a month later, she’s still not sure what procedure she got. After Cardentey repeatedly requested her medical records to find out, Irwin county detention center gave her more than 100 pages showing a diagnosis of cysts but nothing from the day of the surgery.

 

“The only thing they told me was: ‘You’re going to go to sleep and when you wake up, we will have finished,”’ Cardentey said this week in a phone interview.

 

Cardentey kept her hospital bracelet. It has the date, 14 August, and part of the doctor’s name, Dr Mahendra Amin, a gynecologist linked this week to allegations of unwanted hysterectomies and other procedures done on detained immigrant women that jeopardize their ability to have children.

 

An Associated Press review of medical records for four women and interviews with lawyers revealed growing allegations that Amin performed surgeries and other procedures on detained immigrants that they never sought or didn’t fully understand.

 

Although some procedures could be justified based on problems documented in the records, the women’s lack of consent or knowledge raises severe legal and ethical issues, lawyers and medical experts said.

 

Amin has performed surgery or other gynecological treatment on at least eight women detained at Irwin county detention center since 2017, including one hysterectomy, said Andrew Free, an immigration and civil rights lawyer working with attorneys to investigate medical treatment at the detention center. Doctors on behalf of the attorneys are examining new records and more women are coming forward to report their treatment by Amin, Free said.

 

“The indication is there’s a systemic lack of truly informed and legally valid consent to perform procedures that could ultimately result – intentionally or unintentionally – in sterilization,” he said.

 

The AP’s review did not find evidence of mass hysterectomies as alleged in a widely shared complaint filed by a nurse at the detention center. Dawn Wooten alleged that many detained women were taken to an unnamed gynecologist whom she labeled the “uterus collector” because of how many hysterectomies he performed.

 

The complaint sparked a furious reaction from congressional Democrats and an investigation by the Department of Homeland Security’s inspector general. It also evoked comparisons to previous government-sanctioned efforts in the US to sterilize people to supposedly improve society – victims who were disproportionately poor, mentally disabled, American Indian, Black or other people of color. Thirty-three states had forced sterilization programs in the 20th century.

 

But a lawyer who helped file the complaint said she never spoke to any women who had hysterectomies. Priyanka Bhatt, staff attorney at the advocacy group Project South, told the Washington Post that she included the hysterectomy allegations because she wanted to trigger an investigation to determine if they were true. Wooten did not answer questions at a press conference Tuesday, and Project South did not respond to interview requests Thursday on behalf of Bhatt or Wooten.

 

Amin told the Intercept, which first reported Wooten’s complaint, that he has only performed one or two hysterectomies in the past three years. His attorney, Scott Grubman, said in a statement: “We look forward to all of the facts coming out, and are confident that once they do, Dr Amin will be cleared of any wrongdoing.”

 

Grubman did not respond to new questions Thursday.

 

Since 2018, US Immigration and Customs Enforcement says it found records of two referrals for hysterectomies at the jail, which is in Ocilla, Georgia, about 150 miles (240km) from Atlanta.

 

“Detainees are afforded informed consent, and a medical procedure like a hysterectomy would never be performed against a detainee’s will,” Dr Ada Rivera, medical director of the ICE Health Service Corps that oversees healthcare in detention, said in a statement.

 

LaSalle Corrections, which operates the jail, said it “strongly refutes these allegations and any implications of misconduct”.

 

Women housed at Irwin County detention center who needed a gynecologist were typically taken to Amin, according to medical records provided to the AP by Free and lawyer Alexis Ruiz, who represents Cardentey. Interviews with detainees and their lawyers suggest some women came to fear the doctor.

 

Records reviewed by the AP show one woman was given a psychiatric evaluation the same day she refused to undergo a surgical procedure known as dilation and curettage. Commonly known as a D&C, it removes tissue from the uterus and can be used as a treatment for excessive bleeding. A note written on letterhead from Amin’s office said the woman was concerned.

 

According to a written summary of her psychiatric evaluation, the woman said: “I am nervous about my upcoming procedure.“

 

The summary says she denied needing mental health care and added: “I am worried because I saw someone else after they had surgery and what I saw scared me.“

 

The AP also reviewed records for a woman who was given a hysterectomy. She reported irregular bleeding and was taken to see Amin for a D&C. A lab study of the tissue found signs of early cancer, called carcinoma. Amin’s notes indicate the woman agreed 11 days later to the hysterectomy.

 

Free, who spoke to the woman, said she felt pressured by Amin and “didn’t have the opportunity to say no“ or speak to her family before the procedure.

 

Doctors told the AP that a hysterectomy could have been appropriate due to the carcinoma, though there may have been less intrusive options available.

 

Lawyers for both women asked that their names be withheld for fear of retaliation by immigration authorities.

 

In another case, Pauline Binam, a 30-year-old woman who was brought to the US from Cameroon when she was two, saw Amin after experiencing an irregular menstrual cycle and was told to have a D&C, said her attorney, Van Huynh.

 

When she woke up from the surgery, Huynh said, she was told Amin had removed one of her two fallopian tubes, which connect the uterus to the ovaries and are necessary to conceive a child. Binam’s medical records indicate that the doctor discovered the tube was swollen.

 

“She was shocked and sort of confronted him on that – that she hadn’t given her consent for him to proceed with that,” Huynh said. “The reply that he gave was they were in there anyway and found there was this problem.”

 

While women can potentially still conceive with one intact tube and ovary, doctors who spoke to the AP said removal of the tube was likely unnecessary and should never have happened without Binam’s consent.

 

The doctors also questioned how Amin discovered the swollen tube because performing a D&C would not normally involve exploring a woman’s fallopian tubes.

 

Dr Julie Graves, a family medicine and public health physician in Florida, called the process “absolutely abhorrent”.

 

“It’s established US law that you don’t operate on everything that you find,” she said. “If you’re in a teaching hospital and an attending physician does something like that, it’s a scandal and they are fired.”

 

Binam was on the verge of deportation Wednesday, but Ice delayed it after calls from members of Congress and a request for an emergency stay by her lawyer.

 

Grubman, Amin’s lawyer, said in a statement that the doctor “has dedicated his adult life to treating a high-risk, underserved population in rural Georgia”.

 

Amin completed medical school in India in 1978 and his residency in gynecology in New Jersey. He has practiced in rural Georgia for at least three decades, according to court filings. State corporate records also show Amin is the executive of a company that manages Irwin County Hospital.

 

In 2013, state and federal investigators sued Amin, the hospital authority of Irwin county and a group of other doctors over allegations they falsely billed Medicare and Medicaid.





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It is time for the world to start caring for the caregivers

The ongoing coronavirus pandemic underlines the urgent need for safety nets for domestic workers.

 

By Nisha Varia

Al Jazeera (01.05.20202) – https://bit.ly/2A1rBN5 – Few workers have cause to celebrate May 1, International Workers’ Day, this year. COVID-19 has been accompanied by another pandemic – of job loss and economic insecurity. Domestic workers, primarily women, have particularly precarious jobs and often do not qualify for government support.

 

In mid-March, as New Yorkers prepared for a mandatory lockdown, a person posted on my town’s Facebook group asking what type of protective equipment she should provide to her house cleaner. Replies came fast and furious. “Clean your own home and pay them anyway!” “Cancel and pay!” But in many other communities, and around the world, the response is different.

 

Domestic workers’ organisations and the media are reporting devastating stories of domestic workers catapulted into economic crisis across every region. Faced with lockdowns, social distancing restrictions, and in some cases their own economic hardship, many employers have dismissed their domestic workers or suspended them without pay. The loss of income is devastating for many domestic workers who may have little or no savings.

 

Others, especially live-in domestic workers on migrant visas such as those in the Middle East, might find themselves with extra responsibilities and longer hours, with children out of school and other household members at home.

 

The International Labour Organization estimates that there are 67 million domestic workers globally and that 80 percent of them are women. Yet 90 percent of them are excluded from protections such as paid sick leave and unemployment benefits. This is particularly the case in Asia, Latin America and Africa, where the largest numbers of domestic workers are concentrated.

 

Despite this bleak picture, there are also promising examples of action by private employers, governments and labour groups to create safety nets for this vital group of workers.

 

In South Africa, domestic workers who are registered with the government are provided six weeks of paid sick leave in a three-year period, and are covered by the Unemployment Insurance Act, which provides up to 238 days of unemployment benefits. Gaps remain – those workers who are not formally registered with the government cannot access these benefits.

 

France uses a voucher system for social security safety nets and paid leave for domestic workers, easing administrative formalities for employers and contributing to relatively widespread coverage.

 

A World Bank compilation of emergency relief measures during the pandemic shows that many exclude domestic workers entirely. But some countries are taking steps toward inclusion. Argentina’s president, Alberto Fernandez, issued an executive order providing approximately $155 to domestic workers and other low-wage workers as emergency financial relief.

 

Spain extended unemployment benefits for the first time to domestic workers on March 31. Registered domestic workers can receive 70 percent of one month’s salary if their hours have been reduced or they lost their jobs since the lockdown began. This benefit is smaller than for other workers and not enough to sustain workers through an indefinite crisis but is a step towards bringing domestic workers’ benefits closer in alignment to those of other workers.

 

Workers’ organisations are campaigning to end these gaps, pressing governments to include domestic workers in their relief measures. They are using social media and other means to urge employers to continue paying domestic workers even when they cannot work due to social distancing restrictions. In Brazil, the National Federation of Domestic Workers and Themis, a gender equality group, is campaigning for employers to suspend domestic workers with pay or to provide them with adequate protective equipment. Their high-profile webinar explained domestic workers’ rights, with speakers including former President Dilma Rousseff.

 

In the United States, the National Domestic Workers Alliance is well on its way to raising $4m to distribute to domestic workers. While domestic workers may qualify for economic relief varying by state, a significant proportion are undocumented migrants who cannot access government benefits.

 

Domestic workers perform essential work, caring for the most important parts of peoples’ lives – our children, our parents, our homes. Once restrictions lift, employers would do well to remember how much they missed these services.

 

These caregivers deserve safety nets on par with other workers and treatment with dignity. The few positive models should become the new norm.

 

If you are an employer, pay your domestic worker full wages during lockdowns. If you are a politician, push for the full inclusion of domestic workers in emergency relief funds, including direct cash assistance that does not require formal employment registration or migrant status.

 

And we should all push for longer-term change. In 2011, the International Labour Organization adopted the Domestic Workers Convention, now ratified by 29 countries. These countries are obliged to ensure that domestic workers have legal protections on par with other workers.

 

The COVID-19 pandemic has highlighted deep inequalities in how women’s work is valued and compensated, and the dire consequences when crises hit without safety nets. But the pandemic also provides an opportunity to make long-overdue changes so that women workers emerge stronger than before. And that would give us a real cause for celebration next Labour Day.





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Bangladeshi migrant female domestic workers face violence

By Nayema Nusrat

 

Inter Press Service (28.11.2019) – https://bit.ly/2PeBT0i – Millions of Bangladeshi women are facing violence either as domestic housemaids or as migrant workers in Gulf countries. A few days ago, a video in social media, secretly filmed by a Bangladeshi housemaid employed in Saudi Arabia, caught everyone’s attention where she was helplessly crying and begging to be rescued from her abusive employer.

 

A large number of women from Bangladesh leave their families behind and travel thousands of miles away from home with the hope to get better earnings and ensure a better future for their children and family. While many women realize their expected hope, others face a different reality – suffering through insurmountable cruelty and mistreatment by their foreign employers and find no one to turn to for immediate rescue.

 

Another extremely common form of violence is inflicted by not getting their due salaries as promised despite the hours of hard labor they provide.

 

In the video, this young woman Sumi was hiding in the toilet, crying for help and begging to be brought back home. She said, “I might not live any longer; I think I am about to die, please keep me alive, take me back to Bangladesh quickly”, she said in “Bangla”. In the video she stated that her owners locked her up in a room for 15 days and barely gave her any food. They burned her arms with boiling hot oil and tied her down.

 

She also alleged that she was sexually assaulted by her employers. “They made me go from one home to another. In the first home, they tortured me and hit me repeatedly and then took me to another one where I experienced the same”. She was denied any medical treatment by her former employer.

 

Another very recent story of Husna, 24, surfaced in social media within just a few days of the Sumi incident, who also went to Saudi Arabia through a Bangladeshi broker agency called “Arab World Distribution”. She sent a video message to her husband Shafiullah, begging for help to free her from the abusive work conditions – she had faced physical violence ever since her arrival there.

 

The contacts at the local broker agency in Saudi Arabia denied her of any assistance with derogatory words and attempted to hit her. In the video message to her husband she also describes how her owner turned crueler towards her since she expressed the urge to return home.

 

The recruiting agency in Dhaka demanded an additional 100,000 taka (USD 1178.11) from Akter’s husband if she is to break the two years initial contract to work abroad, as he reached out to them for help.

 

Most Bangladeshi workers are recruited by “Dalals” (chain of sub-recruiters connected to the recruitment agencies in the country). Women who go for work to Saudi Arabia or other Middle Eastern countries come from very poor families in rural areas and are often duped by these “Dalals”, realizing soon after they arrive for work. They often receive false promises of salaries of about 20,000 taka (USD 235) per month but rarely get written job contracts although it’s a legal requirement.

 

These recruiters typically charge them a large amount of recruitment fee for arranging to work abroad. These poor women arrange money either by mortgaging or selling their properties or getting loans with a very high interest rate.

 

Rothna Begum, a senior researcher from Human Rights Watch (HRW) told IPS, “Most of these women are already in debt before they even started to work abroad, as the recruitment fees combined with loans with high interest rates keep accumulating”.

 

These women workers are employed in Gulf countries under ‘Kafala’ immigration system. ‘Kafala’ is an employment framework in the six countries of the Gulf Cooperation Council (GCC) that require sponsorship from a national for migrant workers to be employed and reside in the country. The sponsor, either an individual or a company, possesses substantial control over the worker.

 

(The GCC is a political and economic alliance of six Middle Eastern countries— Saudi Arabia, Kuwait, the United Arab Emirates, Qatar, Bahrain, and Oman.)

 

Begum stressed on how the ‘Kafala’ system across the gulf countries make the domestic workers more vulnerable to abuse. She noted, “in the GCC states under the restrictive ‘Kafala’ immigration rule, migrant workers’ visas are tied to their employers so they cannot change jobs without their employer’s consent. Migrant workers who escape an abusive employer can be punished for “absconding” with imprisonment, fines, and deportation”.

 

Human Rights Watch (HRW) interviewed hundreds of migrant domestic workers in GCC countries over the years, and almost all of them claimed that their employers had confiscated their passports, phones and restricted their communication.

 

Some women claimed that as they are typically already coming with so much debt, they feel trapped in exploitative situations, as they feel bound to stay to recoup their money and pay off debt.

 

Some brave ones risked their lives trying to escape by climbing down tall buildings or jumping off balconies. But those who escaped typically found little or no help from local police. Their employers accused them of criminal activities such as theft or absconding to the police.

 

HRW’s Begum said “often domestic workers dropped any claims against their employers, in exchange for their employers dropping their own accusations, just so the women could go home. Others found the process of appealing for their unpaid salaries or filing criminal complaints prohibitively lengthy and costly, as they are not allowed to work for another employer during an appeal”.

 

Ovibashi Karmi Unnayan Program (OKUP), a Bangladeshi Migrant Rights Group released results of a study with 110 returnees, where the number shows that majority had not been able to effectively or safely make money in Saudi; 86 percent among the women interviewed said their Saudi employers didn’t pay their salaries, 61 percent said they had been physically abused, and 14 percent said their owners sexually abused them.

 

And returning home to Bangladesh doesn’t necessarily guarantee they will still be safe from their ‘Dalals’. Some who returned were beaten up by them for demanding the salaries as promised.

 

This year BRAC (Building Resources Across Communities), one of the largest Non-Governmental Organizations (NGO) in the world, released new figures showing that 1,300 Bangladeshi women had returned from Saudi Arabia in 2018 because of sexual and physical abuse at the hands of their Saudi employers. They also said that this year alone, the bodies of 48 female workers were brought back from Saudi Arabia.

 

Nuri, another Bangladeshi woman who was tortured and worked without pay in the home of a Saudi family for two months told Thomson Reuters Foundation, “My ‘Dalal’ beat me up and broke my leg when I filed a case against him. I was in the hospital for 15 days. I stay with a friend right now, far away from my house because [the broker] lives nearby my place”.

 

Nuri held her ground strongly to find justice and is determined about fighting the case in the court – “After he beat me up, I am not turning back”.

 

Shamim Ara Nipa, a freelance social worker in Bangladesh told IPS, “most of the time these migrant workers do not have proper contact information to reach out to the country of origin agency or the embassy directly for help”.

 

Nipa also noted that the Saudi Government had been helpful in repatriation of these migrant workers as long as Bangladeshi Government is cooperating. The Bangladesh Government typically steps in when the story of a worker gets highlighted via social media or group protest, such as the case of Sumi who is now in a safe place thanks to BRAC, Bangladeshi Government and it’s Embassy in Saudi Arabia; but there are numbers of other similar violence cases in Gulf countries which never surfaced in mass media, therefore remained silent and unresolved due to lack of government intervention.

 

Although the Government admits that Bangladeshi workers face violence while working in Saudi Arabia, it rules out the idea of banning female workers going to Saudi Arabia.

 

Violence against Bangladeshi women workers is still ongoing at an alarming rate; Bangladesh should ensure that it provides the highest protection for its workers abroad, including by increasing oversight over its own recruiting agents, offering protection for its workers in host countries, and aiding workers in distress.

 

It’s understandable that there are actions and policies that are pursued by the Government of Bangladesh and the United Nations; however, better outcomes are expected while the policies and actions are being implemented and monitored closely.


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