the women as victims long before the onset of fistula. The second class of
rights are those trampled upon as a consequence of fistula, occurring after the
individual has fallen ill such as being shunned by the public. Whilst not
denying the relevance of both genres of affront to human rights, the focus of
this section is on the former, an examination of those adverse circumstances
(human rights violations) which subject some but not others to subpar human
existence – a life of shame, ridicule and misery.
There are, of course, a sizeable number of human rights frameworks that
are relevant to the plight of fistula patients, but the most significant is the
International Covenant on Economic, Social and Cultural Rights
(ICESCR).129 The ICESCR is the foremost human rights instrument on
economic, social and cultural rights and amongst the most widely ratified –
162 countries as of September 2014.130 Regardless, we begin our analysis
with the Universal Declaration of Human Rights (UDHR),131 for the simple
reason that not only does the Declaration predate the ICESCR, it is also its
foundation. Eleanor Roosevelt’s speech on the Adoption of the Universal
Declaration of Human Rights in 1948 was striking for quite an array of
reasons, but by far the most important was that it stated the “basic character
of the document” – not a “statement of law or of legal obligation” but a
“Declaration of basic principles of human rights and freedoms . . . to serve
as a common standard of achievement for all peoples of all nations.”132
Despite not being a “document stating obligations on [S]tates,” some of the
provisions of the UDHR have, over the years, acquired legally binding
Striding from a reaffirmation of a core tenet of human rights, that Member
States of the UN “have pledged themselves to achieve, in co-operation with
the United Nations, the promotion of universal respect for and observance of
human rights and fundamental freedoms” (a point to which we shall return
shortly),134 the UDHR proceeds to stipulate a number of far-reaching
provisions which now comprise the citadel of global human rights protection.
A key provision of the UDHR is the equal entitlement of everyone,
129. G. A. Res. 2200A (XXI), U.N. GAOR, 21st Sess., Supp. No. 16, U.N. Doc. A/6316
(Jan. 3, 1976) [hereinafter ICESCR].
130. Chapter IV Human Rights: International Covenant on Economic, Social and
Cultural Rights, UNITED NATIONS TREATY COLLECTION, https://treaties.un.org/Pages/
ViewDetails.aspx?src=TREATY&mtdsg_no=IV- 3&chapter= 4&lang=en (last visited Nov.
131. See Universal Declaration of Human Rights, G. A. Res. 217 (III) A, U.N. Doc.
A/RES/217(III) (Dec. 10, 1948) [hereinafter UDHR].
132. Eleanor Roosevelt, On the Adoption of the Universal Declaration of Human Rights
(Dec. 9, 1948) (transcript available at AmericanRhetoric.com); see also UDHR, supra note
133. Roosevelt, supra note 132.