[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3810 Introduced in House (IH)]






108th CONGRESS
  2d Session
                                H. R. 3810

To provide a United States voluntary contribution to the United Nations 
    Population Fund only for the prevention, remedy, and repair of 
                           obstetric fistula.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 11, 2004

   Mrs. Maloney (for herself, Mr. Towns, Mr. Crowley, Mr. Jackson of 
 Illinois, Mrs. Christensen, Mrs. Jones of Ohio, Mr. Scott of Georgia, 
 Mr. Stark, Mr. Kennedy of Rhode Island, Ms. McCollum, Mr. Israel, Mr. 
 Waxman, Mr. Doggett, Mr. Nadler, Mr. Evans, Mr. Grijalva, Mr. Lantos, 
  Ms. Norton, Ms. Jackson-Lee of Texas, Ms. Schakowsky, Ms. Lee, Mr. 
   Owens, Ms. Millender-McDonald, Mrs. Lowey, Ms. Slaughter, and Ms. 
Roybal-Allard) introduced the following bill; which was referred to the 
                  Committee on International Relations

_______________________________________________________________________

                                 A BILL


 
To provide a United States voluntary contribution to the United Nations 
    Population Fund only for the prevention, remedy, and repair of 
                           obstetric fistula.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Repairing Young Women's Lives Around 
the World Act''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) Every minute, 1 woman dies from pregnancy-related 
        complications. 95 percent of these women live in Africa and 
        Asia.
            (2) For every woman who dies from pregnancy-related 
        complications, 15 to 30 women survive but experience chronic 
        disabilities. The worst is obstetric fistula which is caused 
        when a woman who needs trained medical assistance for a safe 
        delivery, including Caesarian section, cannot get it.
            (3) Obstetric fistula is a hole that is formed between the 
        bladder and the vagina, or the rectum and the vagina, after a 
        woman suffers from prolonged obstructed labor. In the struggle 
        to pass through the birth canal, the fetus puts constant 
        pressure, sometimes for several days, on the bladder and 
        vaginal or rectal wall, destroying the tissue and leaving a 
        wound.
            (4) According to the Department of State: ``Pregnancy at an 
        early age often leads to obstetric fistulae and permanent 
        incontinence. [In Ethiopia], treatment is available at only 1 
        hospital in Addis Ababa that performs over 1,000 fistula 
        operations a year. It estimates that for every successful 
        operation performed, 10 other young women need the treatment. 
        The maternal mortality rate is extremely high due, in part, to 
        food taboos for pregnant women, poverty, early marriage, and 
        birth complications related to FGM [Female Genital Mutilation], 
        especially infibulation.''.
            (5) Obstetric fistula affects women who survive obstructed 
        labor.
            (6) In nearly every case of obstetric fistula, the baby 
        will be stillborn and the mother will have physical pain as 
        well as social and emotional trauma from the loss of her child.
            (7) The physical symptoms of obstetric fistula include 
        incontinence or constant uncontrollable leaking of urine or 
        feces, frequent bladder infections, infertility, and foul odor.
            (8) The social consequences for women with obstetric 
        fistula include isolation and lack of opportunity, divorce or 
        abandonment, ridicule and shame, inability to start a family, 
        illness, and risk of violence.
            (9) Although data on obstetric fistula are scarce, the 
        World Health Organization (WHO) estimates there are more than 
        2,000,000 women living with fistula and 50,000 to 100,000 new 
        cases each year.
            (10) Obstetric fistula was once common throughout the 
        world, but over the last century has been eradicated in Europe, 
        North America, and other developed regions through improved 
        medical care.
            (11) Obstetric fistula is fully preventable by having a 
        trained medical attendant present during labor and childbirth, 
        delaying early marriage and childbirth, and gaining access to 
        family planning.
            (12) Obstetric fistula can also be surgically repaired. 
        Surgery requires a specially trained surgeon and support staff, 
        access to an operating theater and to attentive post-operative 
        care. Success rates for surgical repair of fistula are close to 
        90 percent and cost between $100 and $400.
            (13) In 2003, the United Nations Population Fund (UNFPA) 
        launched a global campaign to identify and address the 
        incidence of obstetric fistula in Africa and Asia in an effort 
        to develop a means to repair those who are suffering and 
        provide the necessary health services to prevent further cases. 
        The campaign currently supports 20 countries in Africa and Asia 
        and provides surgery to women, trains doctors and nurses, 
        equips hospitals, and undertakes community outreach to prevent 
        further cases.
            (14) The United States Government provided a voluntary 
        contribution of $21,500,000 to UNFPA for fiscal year 2001 and 
        the Administration's budget request for fiscal year 2002 
        allocated $25,000,000 for UNFPA.
            (15) The UNFPA is working in 89 countries to reduce 
        maternal death and disability, including obstetric fistula, 
        through preventive, curative, and rehabilitative methods.
            (16) In the winter of 2001, the Secretary of State 
        submitted written testimony to the Committee on Foreign 
        Relations of the Senate expressing support for the invaluable 
        work of the UNFPA and for securing funding for the 
        organization.
            (17) The United States Government, as part of its efforts 
        to improve the dire health conditions of Afghan women, pledged 
        in October 2001 an additional $600,000 to the UNFPA to address 
        the reproductive health care needs of Afghan refugees in 
        surrounding nations and of internally displaced persons within 
        Afghanistan.
            (18) Congress demonstrated its strong bipartisan support 
        for a voluntary United States contribution to the UNFPA of up 
        to $34,000,000 in the Foreign Operations, Export Financing, and 
        Related Programs Appropriations Act, 2002, which was passed by 
        the House of Representatives on a vote of 357 to 66 and by the 
        Senate by unanimous consent and signed into law (Public Law 
        107-115) by the President on January 10, 2002. However, the 
        President decided not to obligate the funds.
            (19) In May 2002, the President sent a 3-person delegation 
        to investigate UNFPA programs in China and allegations that the 
        agency was involved in coercive abortion practices.
            (20) This independent delegation concluded that such 
        allegations were untrue.
            (21) On May 29, 2002, the delegation sent a letter to the 
        Secretary of State stating the following: ``First Finding: We 
        find no evidence that UNFPA has knowingly supported or 
        participated in the management of a program of coercive 
        abortion or involuntary sterilization in the PRC. First 
        Recommendation: We therefore recommend that not more than 
        $34,000,000 which has already been appropriated be released to 
        UNFPA.''.
            (22) Regrettably, the Administration overruled the 
        recommendation of its own delegation and invoked an overly 
        broad interpretation of the law in order to eliminate funding 
        for UNFPA.

SEC. 3. UNITED STATES VOLUNTARY CONTRIBUTION TO THE UNITED NATIONS 
              POPULATION FUND.

    Notwithstanding any other provision of law, in addition to amounts 
otherwise available to carry out the purposes of chapter 3 of part 1 of 
the Foreign Assistance Act of 1961, there are authorized to be 
appropriated $34,000,000 for fiscal year 2004 and each subsequent 
fiscal year to be available only for United States voluntary 
contributions to the United Nations Population Fund (UNFPA) only for 
prevention, remedy, and repair of obstetric fistula.
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