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	Amid Abuse in Brazil, Abortion Debate Flares By Alexei Barrionuevo New York Times March 27, 2009 http://www.nytimes.com/2009/03/28/world/americas/28brazil.html?_r=1&ref=world SÃO PAULO, Brazil — The waiting room at Pérola Byington Hospital resembles a small day care center many days. Young girls play on the cold tile floors or rock hyperactively in plastic chairs, while their mothers stare pensively at the red digital readout on a wall, signaling their place in line. But this is a women's health clinic specializing in treating victims of sexual violence. Of the 15 such cases the hospital averages each day, nearly half involve children under 12. While much of Brazil has been riled by the case of a 9-year-old girl who aborted twins this month after claiming her stepfather raped her, her ordeal was an all too familiar one at the clinic. The girl's story of rape and pregnancy at such a young age seemingly caught the nation off guard, reviving a tense debate over reproductive rights in a country with more Catholics than any other. But doctors, clinic workers and other experts say her case is symptomatic of a widespread problem of sexual abuse of under-age girls — one that has long been neglected and may be getting worse. "Unfortunately, this is becoming more and more common," said Daniela Pedroso, a psychologist who has worked here for 11 years. Weighing just 79 pounds and barely four feet tall, the 9-year-old girl, from Alagoinha, a town in the northeast, underwent an abortion when she was 15 weeks pregnant at one of the 55 centers authorized to perform the procedure in Brazil. Abortion is legal here only in cases of rape or when the mother's life is at risk. The doctors' actions set off a swirl of controversy. A Brazilian archbishop summarily excommunicated everyone involved — the doctors for performing the abortion and the girl's mother for allowing it — except for the stepfather, who stands accused of raping the girl over a number of years. "The law of God is above any human law," said José Cardoso Sobrinho, the archbishop, who argued that while rape was bad, abortion was even worse. The storm intensified when a high-ranking Vatican official supported the excommunications. But then a conference of Brazilian bishops overruled Archbishop Sobrinho, saying that the child's mother had acted "under pressure" from doctors who said the girl would die if she carried the babies to term, and that only doctors who "systematically" performed abortions should be thrown out of the church. Finally, the Vatican's top bioethics official, Archbishop Rino Fisichella, also criticized the initial stance, saying the "credibility of our teaching took a blow as it appeared, in the eyes of many, to be insensitive, incomprehensible and lacking mercy." The case has brought to light other instances of young girls being raped and impregnated by family members, especially in the poorer northeastern region. The number of legal abortions of girls ages 10 to 14 more than doubled last year to 49, up from 22 in 2007, the Ministry of Health reported. That was out of 3,050 legal abortions performed last year in a country of more than 190 million. But the vast majority of Brazil's abortions are not legal. The Ministry of Health estimates about one million unsafe or clandestine abortions every year. Brazil's abortion laws are among the strictest in Latin America. Only Chile, El Salvador and Nicaragua, which have banned abortion outright for any reason, are stricter, according to the Center for Reproductive Rights, which supports abortion rights. In some parts of the region, most notably Mexico City, where first-trimester abortions are now legal, laws have been relaxed. But in other areas and countries, legislators have sought to toughen the restrictions on abortion. Twenty years ago, Brazil had just one center to perform abortions. Today, beyond the 55 clinics that can perform them, another 400 or so treat patients that have been sexually abused. "It's still not enough," said Beatriz Galli, a policy associate and human rights lawyer with Ipas, an organization pushing to expand women's reproductive rights. Most state-financed clinics are in capitals that can be as far as an 11-hour boat ride away, and they are concentrated in the wealthier southeast region. Anti-abortion advocates, who represent the majority in Brazil's Congress, are pushing hard to make the law even tighter. Of some 50 abortion-related initiatives being studied in Congress, at least 40 seek to further criminalize abortion, according to a study by the Feminist Center for Studies and Advisory Services, a Brazilian group that supports less restrictive abortion laws. One would require home pregnancy tests to carry labels with warnings like "The penalty for abortion is one to three years in prison." Access to legal abortion clinics is also a challenge. The 9-year-old girl from Alagoinha sought medical treatment after complaining of pain. But with no legal abortion center near her home, she had to be driven about 140 miles to a state clinic in Recife. Doctors there said the girl's uterus was too small to support one baby, let alone two. The 9-year-old girl's stepfather was arrested and accused of raping her and her 14-year-old sister on multiple occasions, the police later said. Luiz Inácio Lula da Silva, Brazil's president, said he regretted the archbishop's decision to excommunicate the two doctors, saying they had done the right thing in saving the young girl's life. She will probably "need decades of psychological care to get her life back to normal," he said. Here at Pérola Byington Hospital, doctors said abortions were often necessary to protect the lives of sexual-violence victims. Of the 47 abortions performed at the hospital last year, 13 were girls under 18, all victims of rape. In more than 80 percent of the cases, fathers or stepfathers committed the sexual abuse, doctors at the clinic said. "A part of Brazilian society still doesn't want to stop treating women like they are property," said Jefferson Drezett, a gynecologist and coordinator of the sexual-abuse victims service at the hospital. "This has to change." Earlier this month, a 21-year-old woman walked into the hospital with her 6-year-old daughter. She said the 6-year-old had been sexually molested by the girl's stepgrandfather, whom the woman was seeking to have arrested. The woman, who spoke on the condition of anonymity, sat for an interview in a room with tiny chairs and dolls that is used for the psychological evaluation of victims. She said she had lived with him until she was 14, when she felt uncomfortable with his advances and asked her mother to leave him. Fighting back tears, she said she worried that the man would abuse other children still living with him, including the daughters of his own son that are close to her daughter's age. "We don't want to believe what happened," she said. "We think this just happens on television, that it's a fairy tale. But the reality is it can happen to any family, and it's very difficult to deal with when it does."
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