Article 12 of the Convention requires States Parties to eliminate discrimination against women in all areas of health care and to take gender-specific measures in all areas of pre-natal and post-natal care and services.

A.China's Assessment: "General Improvement"

China's Report makes no mention of health care and Tibetan women. Its Report states that "[s]ince the beginning of the 1990's, China has further upgraded its maternal and child care services resulting in a general improvement of women and children's health." China's Report points out the Law on Maternal and Infant Health (in effect 1995), yet provides inadequate discussion of this law's provisions. The Report claims that 65 percent of expectant mothers in the countryside have access to prenatal check-ups. The Report clearly shows need for improvement in maternal and child mortality rates.

B.Our Assessment: Tibetan Women Lack Access to Basic Health Care

All evidence from a variety of sources, including our own investigation, indicates that most Tibetan women have almost no access to basic medical care. The little medical care available to them is far too costly. Our findings indicate that discrimination against Tibetan women in the provision of health care exists because they are Tibetan and because they are women.

Even in Lhasa city, Tibetans suffer extreme cases of nutritional deficiency diseases (anaemia averages 40 percent in children under seven; rickets averages 38.4 percent). The TAR also has a significantly higher maternal mortality rate (up to 20 per 10,000 as opposed to six per 10,000 for China) with 70 to 80 percent of such deaths considered preventable.

Tibetan women interviewed during the Mission confirm a lack of access to basic health care as well as excessive costs of what is available. For example, one woman stated she had to pay 2000 yuan (US $240) before she could be admitted to a hospital to deliver her baby. Women in urban areas could obtain health care if they had "political connections" and funds. Even in those circumstances, Tibetan women shun medical care because of fear that the authorities will force unwanted birth control methods on them. Health care in the rural areas was described as "dismal." The little medicine available to the few doctors in huge areas is sometimes limited to some anti-diarrheal medicine.

The recent interviewees could give no information regarding AIDS prevention or medical services available for victims of rape or violence. A Tibetan exile who recently visited Tibet reported that at the hospital he visited, 40 to 50 patients shared a single needle for injections, anecdotal evidence which would indicate a serious lack of awareness of and training to prevent the transmission of AIDS. That same person indicated that without a deposit of 5000 yuan (US $600), the First People's Hospital (Lhasa) will not admit even a person in critical condition. Another person reported that at Shigatse People's Hospital where he spent one month in 1995, Chinese did not have to pay while Tibetans had to pay an 800 to 1000 yuan (US $100 to $120) deposit, 20 yuan (US $2.50) per night for the bed and 200 yuan (US $25) for a bottle of glucose among other costs.

Some of the problems relating to health have already been addressed in the sections on torture and reproductive rights. As indicated above, the health situation of women detainees is extremely grave in many instances. Even if detainees are not tortured, they still face degrading treatment in the form of denial of basic health needs such as failure to provide sanitary materials for menstrual cycles and facilities for bathing. TCHRD has found that some prisoners could not bathe at all and were only allowed to wash their faces twice in six months. Other former prisoners report being able to wash their faces only once every several weeks. Nearly all former prisoners attest to not being given any cotton or other types of sanitary cloths during menstrual periods. Some women cut up their few clothes, others simply bled on their clothing (which they were not allowed to wash). Some who were already in the "conviction" stage were able to receive sanitary items from visitors. Another woman reported that she was forcibly internally examined without consent or explanation, which resulted in sustained bleeding and discharge; she was 13 years old at the time.

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