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«Bien que les partisans des droits des femmes soient venus aux droits hu- mains en exigeant une obligation de rendre compte pour tous les droits ...»

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Although women's rights advocates came to human rights demanding

accountability for all human rights, this demand has been stymied.

Specific elements of violence against women (VAW) as a human rights

issue, coupled with sexual harm's particular operation to make VAW vis-

ible, produced a parodox: the harms themselves are not yet effectively re-

sponded to, yet women's sexual vulnerability is now firmly on the global

agenda. This piece explores the state-oriented focus of rights work on the suffering body, its reliance on criminal law, and its failure to develop a theory of economic justice. Health and human rights work must consider the complexities of portraying women as sexual agents, targets of abuse and citizens at the same time, if it seeks to fulfill its original promise.

Bien que les partisans des droits des femmes soient venus aux droits hu- mains en exigeant une obligation de rendre compte pour tous les droits humains, cette demande n'a pas abouti. Des ?l?ments particuliers de la violence ? l'?gard des femmes en tant que sujet des droits humains, com- bin?s ? la fagon particuliere dont les exactions sexuelles rendent la vio- lence visible ? l'?gard des femmes, ont abouti ? un paradoxe : il n'a pas ?t? rem?di? effectivement aux torts par eux-memes, mais la vuln?ra- bilit? sexuelle des femmes figure maintenant fermement dans le pro- gramme d'action mondial. Get article explore la priorit? accord?e par les ?tats ? la protection du corps contre la souffrance, son recours au droit d'une th?orie de la justice p?nal et l'absence de formulation ?conomique. Les activistes d?fendant le droit ? la sant? et les droits hu- mains doivent tenir compte des complexit?s des femmes productives dans leur role sexuel, comme objets d'abus et comme citoyennes, tout en slefforpant de tenir leurs promesses initiales.

A pesar de que los partidarios de los derechos de la mujer se dirigieron a las instituciones de derechos humanos exigiendo el respeto de todos los derechos humanos, tal demanda ha sido frustrada. Elementos especi- ficos de violencia contra la mujer (VCM) como tema de derechos hu- manos junto al papel particular del dano sexual en hacer visible la VCM, produjo la siguiente paradoja: auin no se responde efectivamente a los danios en si, y, sin embargo, la vulnerabilidad sexual de la mujer se en- cuentra ahora bien establecida en la agenda politica mundial. En este articulo, se estudia el enfoque sobre el estado del campo de los derechos humanos, y como con relaci?n a la sexualidad el teoria ha centrado en el sufrimiento del cuerpo, y ha mostrado una dependencia en las leyes penales y una falta de desarrollar una teoria de justicia econ6mica. El campo de salud y derechos humanos, para cumplir con su promesa orig- inal, debe considerar las complejidades de presentar a la mujer como agente sexual, blanco de abuso, y ciudadana-todo al mismo tiempo.


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begin this essay with a paradox: varietyof sexual The I harms experienced by women or men are nowhere understood, effectively prevented, or responded to; and yet, sexual threats to girls and women are in the headlines everywhere.

Not only are they in the headlines, but increasingly they are framed as women's human rights issues. A moment that epitomizes this extraordinary combination of partially successful rights advocacy and its incongruous results can be seen in the speech of the President of the United States to the UN General Assembly in September 2003 in which he condemned the practice of "sexual slavery of girls and women" and called for action against this horror as an example of the kind of steps toward "moral clarity" required in the global "war against terror."1 A critical success of women's human rights has been the increased global recognition of sexual harm as an element of Alice M. Miller, JD, is Assistant Professor of Clinical Population and Family Health in the Heilbrunn Department of Population and Family Health at the Mailman School of Public Health, Columbia University.

Please address correspondence to Alice M. Miller, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, 60 Haven Avenue #B2, New York, New York10032, USA or to am808@columbia.edu Copyright C 2004 by Alice M. Miller.

HEALTHAND HUMAN RIGHTS 17 the harms done by violence. Indeed, preventing violence against women has been one of the founding themes of the health and human rights movement.2 However, the extraordinary prominence of high-level calls for action to protect women from sexual harm signals interests other than women's rights at work. Analyzing this new attention and the particular ways in which it manifests itself is of critical importance, especially as new national laws and international treaties with transborderpower over crime are being rapidly created in ostensible response to these concerns.3 Sexuality intersects with rights at places where the internal tensions of human rights-particularly whether to focus on protection or push for freedom (and the ways by which to do either)-are either unexplored or fiercely contested. While the protection/freedom quandary arises in other aspects of rights work, and has been specifically critiqued for its neo-colonial forms, it unfolds in particularly dangerous ways in regard to women and violence, and is even more volatile with regard to sex.4 Exploring the specific connections and interactions between protection, freedom, sexuality, and human rights can reveal how some restrictive and regressive responses to sexual harm-"protecting women, rather than protecting their rights," as Sunila Abeyesekera says-can be inadvertently produced.5 However well intentioned, a single-minded focus on sexual harm that avoids consideration of other issues and effects can inadvertently frustrate other goals in human rights, particularly those of building enabling conditions that expand women's and men's capacities.

This essay explores an aspect of the "protection of women" vs. "protection of women's rights" quandaryby examining how very diverse women's rights advocates made the call to human rights and how violence against women succeeded as the main motor that powered their sucVAW) cess. Sexual violence was effective in this cause because it seemed to provide a means to make the gender-specific content of this violence visible to the key human rights bodies and actors. How did violence, and in particular sexual violence, take the lead among the many claims of women's rights? Until the late 1980s, it was exceedingly difficult to get the human rights world to pay attention either to Vol. 7 No. 2 18 women as rights claimants or to sexual harm as a form of harm.6 However, once sex was accepted as an area of concern, a "hyper-attention" to sex perversely operated to exclude attention to other aspects of harm, as epitomized by President Bush's move to use sexual harm to focus the world on "moral clarity"-not global labor equity, not participatory equality, and not life-saving health interventions and systems for women and men.

This article explores the various streams within both human rights doctrine and practice and traditional women's human rights that combined to produce a hyper-visibility of sexual harm without producing an equal attention to remedies and enabling conditions. This analysis intersects with the history of mainstream human rights' failure to take on economic and social rights until recently. This story, therefore, also intersects with the history of health and human rights, as well as with an older, troubled history of sexuality and health. Fundamentally, this is a dangerous excavation project, digging at the foundations of the rights claims around sexual harm at a stage when these claims are barely incorporated in the formal human rights system and are facing serious counter-challenges. The balance is a delicate one: We must defend against attacks on sexual rights and sexual health, even as we simultaneously critically examine the role that protection from sexual harm has played in the recognition of women's human rights. This balance, while delicate, is key. The recognition that sexual harm has begun to operate in isolation from other injustices as the worst abuse that can happen to a woman should alert us to the uncomfortable similarities, and differences, between this position and a position we fight against-that the most important thing to know about a woman is her chastity.

A personal disclosure: I write from the position of an activist who played a role, alongside many extraordinary people globally, in pushing mainstream human rights organizations to accept VAWand women's sexual harm as key human rights issues. Therefore, I am both complicit with and proud of the story I am telling. This article explores the dynamics of an on-going story about which I claim no objectivity. At the same time, if we take seriously the imperative to evaluate our work against the broadergoals of human 19


rights, it would seem that, more than 10 years into human rights policy and campaigning against violence against women, we should be at a place where reflective evaluation can play a helpful role in determining our next steps.

Women's Human Rights and the Trajectory of Violence Against Women As a Human Rights Issue in the UN System A number of different worlds in the UN and in the mainstream human rights movement had to be transformed to make women's rights "human rights": the under-funded and undervalued (and structurally separate) world of women's rights/women's status and economic rights had to be integrated and elevated; the mainstream world of human rights had to be convinced to take on gender analysis and apply it to state accountability; and the separate world of humanitarian law had to be brought closer to human rights.7 And, fundamentally, health and human rights as a practice had to be developed and accepted. This section is a selective history and analysis of some of the interests and accidents underlying these events.

A Reflection on the Short Version of the Success of Women's Human Rights at the UN Women's rights advocates had struggled with a basic question for years: How could women's issues, including but not limited to violence, be made a priority on the international agenda? The solution finally came with the exploding power of human rights in the 1990s, a force that women's rights proponents sought to harness. As Arianne Brunet said at the Vienna World Conference on Human Rights in 1993, "Women's human rights provided for the 'mainstreaming of feminism."'18 The UN had failed to effectively promote women's rights, even though non-discrimination on the basis of sex was built into the UN Charter at its creation.9 At the 1985 World Conference on Women in Nairobi, violence against women did emerge as a major issue for women, but even so it suffered marginalization as a "women's issue" in the Vol. 7 No. 2 20 gender-blind world of the UN's human rights work.10The late 1980s saw the concurrent evolution of a health and human rights discourse, which, when joined to women's human rights in general and VAW in particular, strengthened the call for governments to take VAWseriously. Health responses became key services that had to be provided as elements of a rights-based remedy to VAW.

Also in the 1990s, global attention to the role of rape in notorious armed conflicts (other armed conflicts at the same time were ignored), first in the former Yugoslavia and later Rwanda, amplified women's claims at the 1993 World Conference on Human Rights in Vienna and then again at the 1995 Fourth WorldConference on Women in Beijing,leading to legal, structural, and political victories in international venues."1Human rights approaches compelled the international humanitarian law system to re-characterizerape as a form of violence (instead of a crime against community or honor) in armed conflict. Many new mechanisms and norms

came into being in response to these campaigns, including:

the incorporationof gender crimes in the statutes/practice of the ad hoc War Crimes Tribunals, the creation of a UN Special Rapporteur on Violence against Women, a UN Declaration on the Elimination of Violence against Women, and the integration of gender into the definition of crimes and expertise of the judges for the International Criminal Court 12 (ICC).

By recounting this short history as a "triumph narrative," I do not mean to diminish its importance; but I do mean to make explicit that it needs more examination to expose the many other forces and interests (national, North/South, mainstream non-governmental organization (NGO)) at work in this history and to explain both what the triumph contained and what it left out. Violence worked in progressiveand regressiveways simultaneously. As Charlotte Bunch has asserted,VAWas a claim to rights worked because it embodied a horror that could not be ignored; and it also worked, as Ratna Kapurnotes, because stories of the victim subject could enter the mainstream of representation and reaffirmthe image of women (especially Southern women) as without power and in need of protection.1314 HEALTHAND HUMAN RIGHTS 21 Did sexual harm gain prominence also because it epitomized what made gender violence visibly gendered?15 Was it because the public-policy world had discovered (in the emergence of health and human rights responses to HIV/AIDS)that we could talk about sex-and in turn about sexual violence-as a matter of life and death? Was it because "sexual" had become a site of knowledge about an individual's selfhood and personhood, an aspect that needed protection and promotion?'6 Can it be that the focus on sexual harm sprang from and re-affirmed both progressive and regressive ideas about women and sexuality, and that some part of the engagement with human rights amplified the regressive aspects?

Exploring Women's Human Rights in the UN Context:

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