Like many other poor women in rural El Salvador, Manuela lacked education. Her life was just hard work and she married early. She gave birth to two children at home because she lacked access to maternity care. After a few years, her husband left the family and she had to raise the children on her own. In 2006, Manuela began to feel sick with constant headaches, nausea and abdominal pain, and when she went to the local health care facility, she was diagnosed with acute gastritis and was prescribed painkillers. But the symptoms only got worse. During her illness, Manuela became pregnant. One day she got pains in her stomach. When she went to the latrine, she had a miscarriage, and fainted. Her family found her and took her to the hospital, which was two hours away.

Healthcare professionals report the women

El Salvador has one of the world’s strictest abortion laws. Since 1998, there has been a total ban on abortion in the country and a woman who terminates her pregnancy, has a miscarriage, or gives birth to a dead child can be convicted of murder and sentenced to up to 50 years in prison. Women who suffer from serious complications in connection with pregnancy and childbirth become accused of abortion attempts and healthcare professionals often refuse to provide these women with care. They are afraid of being punished themselves, and in many cases the women seeking help are reported to the authorities by hospital staff.

This is what happened to Manuela. When she arrived at the hospital, she received no help, but was questioned by the doctor for three hours. Meanwhile, her condition deteriorated. The doctor assumed that Manuela had had an abortion and reported the crime to the authorities. Manuela was allowed to stay overnight in the hospital where she was interrogated by two police officers who accused her of murdering her child and called her “frivolous” because she had sex outside of marriage. Without a power of attorney, they arrested her and handcuffed her to the bunk on which she lay. Manuela was allowed to lie on the bunk for seven days while the medical staff insulted her.

Sentenced to thirty years in prison

Manuela was assigned three public defenders, but it was a mere formality because she was not allowed to have any contact with them before the day of the trial.

The court sentenced Manuela to 30 years in prison for aggravated manslaughter for throwing her child in the latrine as a way to hide that she had sex as an unmarried person. Manuela’s defense counsel did not appeal the verdict.

In prison, Manuela’s condition worsened. It was not until a year later that she was diagnosed with Hodgkin’s lymphoma. The chemotherapy came far too late, and she was forced to suffer through the severe side effects in the overcrowded prison. When she got even worse, she was taken to hospital where she was guarded by police for three months. On April 30, 2010, Manuela died of her illness.

Lawsuit against the state of El Salvador

In 2012, IM’s partner Colectiva Feminista, in collaboration with The Center for Reproductive Rights, on behalf of Manuela’s family, submitted a petition to The Inter-American Commission on Human Rights (IACHR). According to the Colectiva Feminista, the state of El Salvador has denied Manuela the following basic human rights:

· The right to liberty – she was deprived of her liberty without any legal basis

· The right to legal protection and equality – by infringing, falsifying and failing to obtain evidence, Manuela’s right to a fair trial was violated

· The right to non-discrimination – in the trial, gender stereotypes were used as arguments, including through statements such as “she is an immoral woman” and that “women’s function is to sacrifice themselves for reproduction”.

· The right to privacy and health including sexual and reproductive health – the healthcare staff broke the confidentiality when they reported her to the authorities and Manuela was denied the care she was entitled to, which contributed to her deteriorating condition and death.

· The right not to be subjected to torture and gender-based violence – Manuela was subjected to torture-like treatment when she was detained.

Prejudicial judgment

In July 2019, the IACHR decided to refer the case to the Inter-American Court of Human Rights (IHR). The public hearing in the case will be held on March 10 and 11, 2021. This will be the first case in the IHR Court concerning the impact of El Salvador’s abortion legislation on women’s reproductive rights. IM, which for several years now, together with partners, has been conducting advocacy work to bring about change in legislation, contributes with legal support to Colectiva Feminista.

– The right to abortion is threatened in several places around the world. El Salvador, which has one of the world’s toughest abortion laws, is a terrible example. The outcome in court can be very important, as the verdict may be a guide for any changes in El Salvador’s abortion legislation, says Martin Nihlgård, IM’s Secretary General.