The UN Committee on the Elimination of Discrimination against Women (CEDAW) has found various violations of a woman's rights as she had no access to affordable, medically appropriate, gender-sensitive drug dependence treatment and rehabilitation services during pregnancy.
The Committee has issued its Decision in response to a complaint filed by Oksana Shpagina, who claimed that her rights to non-discriminatory health care services, including appropriate medical services in connection with pregnancy, had been infringed. She was unable to obtain justice from Russia's judicial system before she died in 2019.
"Through the Committee's decision in the case of Oksana Shpagina, who unfortunately did not survive, we recall that special attention should be given to the health needs and rights of women belonging to vulnerable and disadvantaged groups," said CEDAW Vice-Chair Genoveva Tisheva.
Shpagina was an orphan, widow, and single mother who suffered from chronic drug dependence. She became pregnant in 2011, but her gynaecologist advised her to undergo an induced labour to terminate her pregnancy because her medical condition would prevent her from giving birth to a healthy baby. When she decided to continue her pregnancy, she was admitted to a drug rehabilitation clinic where doctors refused to treat her because she was pregnant. When she was finally admitted to a hospital, she was merely given sedatives and discharged after only nine days of treatment without any outpatient follow-up.
The victim eventually gave birth to a healthy baby girl in August 2011. However, she developed a fear of doctors and medical procedures due to the humiliation and inferiority that the narcologists and gynaecologists had caused her.
She experienced frequent health problems in the following years, including several relapses in illicit drug use. She was arrested twice for making and possessing drugs for personal consumption and was finally imprisoned.
While battling her health issues, the victim raised her claims at the domestic level since 2012, stating that the Government had not provided her with evidence-based, gender-sensitive drug dependence treatment, such as opioid substitution therapy, and that there was a lack of rehabilitation facilities for women with children.
Her civil cases against the Russian authorities, however, were dismissed by various courts. She then brought her complaint to the Committee in 2018.
The Committee observed that the State party's measures to eliminate discrimination against women are inappropriate because its healthcare system lacks appropriate services for pregnant women with drug dependence. Moreover, the Committee considered that the State party's intolerance for drug use could lead to social stigmatisation of drug users, which would be more severe for women, particularly pregnant women.
The Committee found that the Russian Federation had breached its obligations under the Convention on the Elimination of All Forms of Discrimination against Women. In particular, the Committee found that the State Party had failed to ensure that the victim was protected from discrimination in the healthcare system and had failed to take appropriate measures to eliminate such discrimination.
"Thanks to Ms Shpagina's perseverance, this case demonstrated that women have the rights to require gender-sensitive drug dependence treatment and appropriate health services related to their pregnancy without stigma and gender stereotyping," said Tisheva.
The Committee requested that the Russian Federation provide full reparation, including adequate financial compensation to the victim's daughter. It also asked the State party to modify its legislation to prevent and address discrimination against women in the healthcare sector, and to ensure the availability of drug dependence treatment and rehabilitation tools to women, including pregnant women.
