[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2811 Introduced in House (IH)]






109th CONGRESS
  1st Session
                                H. R. 2811

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


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              June 8, 2005

   Mrs. Maloney (for herself, Mr. Crowley, Mr. Rush, Mr. Lantos, Ms. 
 Jackson-Lee of Texas, Ms. Lee, Mr. McDermott, Mr. Owens, Mr. McNulty, 
   Ms. Eddie Bernice Johnson of Texas, Mr. Smith of Washington, Mr. 
   Grijalva, and Mr. Honda) 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 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, one woman dies from pregnancy-related 
        complications. Ninety-five 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. The 
        consequences are life-shattering. The baby usually dies, and 
        the woman is left with chronic incontinence.
            (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. 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.
            (6) The physical symptoms of obstetric fistula include 
        incontinence or constant uncontrollable leaking of urine or 
        feces, frequent bladder infections, infertility, and foul odor. 
        The smell often drives husbands and loving family members away. 
        In many communities, women with fistula are considered 
        ``unclean'' and stigmatized.
            (7) Fistula is a relatively hidden problem, largely because 
        it affects the most marginalized members of society: young, 
        poor, illiterate women in remote areas. Many of these women 
        never seek treatment. Because they often suffer alone, their 
        injuries may be ignored or misunderstood.
            (8) Adolescents are at greater risk of complications during 
        childbirth that can lead to fistula because they have less 
        access to health care and are subject to other significant risk 
        factors. Young girls suddenly find themselves marginalized, 
        alone, and are often blamed for their condition.
            (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. These figures are based on the number of women 
        who seek medical care. Many more suffer in silence, unaware 
        that treatment is available.
            (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, 
        access to emergency obstetric care in the event of 
        complications, delaying early marriage and childbirth, and 
        gaining access to education and 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 can be as 
        high as 90 percent and cost an average of $300.
            (13) In 2003, the United Nations Population Fund (UNFPA) 
        launched the first-ever global Campaign to End Fistula. This 
        campaign includes interventions to prevent fistula from 
        occurring, treat women who are affected and support women after 
        surgery.
            (14) The Campaign to End Fistula currently supports 
        projects in more than 30 countries in sub-Saharan Africa, South 
        Asia, and the Middle East. In each country the Campaign 
        identifies the extent of the problem and the resources 
        available to treat fistula, develops a national strategy and 
        builds partnerships to address the problem, and implements 
        activities to prevent and treat fistula, including efforts to 
        reintegrate women into their communities once they are healed.
            (15) 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 2006 
        allocates $25,000,000 for UNFPA.
            (16) UNFPA is working in more than 79 countries to reduce 
        maternal death and disability, such as obstetric fistula, and 
        to save women's lives.
            (17) 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 UNFPA and for securing funding for the organization.
            (18) 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 UNFPA to address the 
        reproductive health care needs of Afghan refugees in 
        surrounding nations and of internally displaced persons within 
        Afghanistan.
            (19) Congress demonstrated its strong bipartisan support 
        for a voluntary United States contribution to 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.
            (20) In May 2002, the President sent a three-person 
        delegation to investigate UNFPA programs in China and 
        allegations that the agency was involved in coercive abortion 
        practices.
            (21) This independent delegation concluded that such 
        allegations were untrue.
            (22) 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.''.
            (23) 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 2006 and each subsequent 
fiscal year to be available only for United States voluntary 
contributions to the United Nations Population Fund (UNFPA) only for 
prevention and repair of obstetric fistula.
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