Lourdes Rivera, JD, joined the Mailman School in the Heilbrunn Department of Population and Family Health this fall and is teaching Health and Human Rights Advocacy. A nationally and internationally recognized leader in health law and policy, women’s rights, and sexual reproductive health and rights, before joining Mailman’s faculty, Ms. Rivera spent 10 years at the Ford Foundation supporting domestic and global efforts to promote sexual and reproductive health and rights. Ms. Rivera also worked for 13 years for the National Health Law Program, a non-profit organization that advocates for the health rights of underserved constituencies, the Children’s Defense Fund, and the National Women’s Law Center. She has also focused her career on constituency mobilization, organizational development and capacity building, policy advocacy, and developing the leadership of women of color. Ms. Rivera received her bachelor’s and law degrees from Yale University.
How did you come to Mailman and what is your current role?
I was a colleague of [Interim Chair] Terry McGovern’s at the Ford Foundation and she invited me to Mailman. I am currently teaching Health and Human Right Advocacy, which covers the history of the international human rights framework. We go over the key treaties, how governments agree to be bound by them, as well as thematic areas including HIV, sexual rights, reproductive rights, and women’s rights. We also look at the accountability of donors in global development agendas and how that overlays with human rights. We also have highly practical classes that look at how civil society has used human rights frameworks to advocate on specific issues.
Can you give me an example of that kind of work?
One case study is the Treatment Action Campaign in South Africa that used the international human rights framework to really bolster the leadership of people who are living with HIV to demand access to medicine, to hold not just the government of South Africa accountable for access to medicine, but to pressure pharmaceutical companies to make those medicines available. This campaign was instrumental in securing government-provided AIDS treatment programs, including [one that aims] to prevent mother-to-child transmission.
What do you hope students will take away from this course?
I hope students walk away with the understanding that law and policy matter and can directly impact public health [and] that discrimination matters and directly impacts public health. I also hope students appreciate that the needed change does not happen without the leadership of the people who are most affected.
Before joining the Mailman School as a faculty member, you spent 10 years at the Ford Foundation. Can you tell me about that work?
I was a senior program officer and my portfolio throughout was sexual and reproductive health and rights. I managed a U.S. and a global portfolio. The structure of Ford is great because there is a main office in New York but there are also 10 offices around the globe so I really learned from and relied on the colleagues who were working in country and region. I also made a point to use some of the budget that I was managing to ensure that colleagues and grantees from those countries and regions were able to bring their voices, experiences, and agendas to global advocacy spaces, such as the UN.
How did your work address the sexual and reproductive health of adolescents?
Much of our work involved supporting grantees who were working to foster changes in cultural narratives. Here in the U.S., for example, several of our grantees were really pushing back on the overarching narrative that teen pregnancy is the cause of poverty and so many other ills for young people. They were saying that the way young people are treated before and after they become pregnant contributes to those outcomes, that teen pregnancy is not a cause of poverty but a symptom of poverty as well as lack of access to services and resources and opportunities. They were arguing that … if young people are supported in their parenthood and are able to stay in school and are provided with services, including reproductive health services, and opportunities, they can be just as successful as anybody else.
Can you give me an example of a project that aimed to help change that kind of narrative?
My colleague, Rocio Cordoba, and I supported the development of some popular media. One is called East Los High and it’s on Hulu in season four now. We gave a grant to the producers to do the development and also to involve our other grantees to provide input on the content on reproductive health and rights themes of young people ranging from HIV, abortion, and contraception, to relationships, young parenting, and LGBT issues. The show demonstrates the range of issues that young people navigate and that they are capable of making important decisions if they are supported to do so.
You have become known for your efforts to promote intersectionality into practice as a funder. What does this mean in practice?
It’s a framework that acknowledges the overlap or intersections between different kinds of oppression and discrimination. Here in the U.S., Kimberlé Crenshaw, she’s an African American law professor, really pinned this down…For women of color in the U.S., this framing acknowledges that reproductive rights can't be viewed outside of the context of race and class. For communities of color, it’s not just about protecting Roe v. Wade. Although still important, Roe v. Wade is meaningless for many communities when, because of the Hyde Amendment [an annual legislative appropriations ban that prohibits almost all federal funding for abortion,] there are no resources to pay for the service. The All* Above All campaign to end the Hyde Amendment grew out of women of color and poor women and young women organizing and demanding that this be part of the agenda. There is now an explicit call to repeal the Hyde Amendment in the Democratic Platform.
It sounds like a framing that is really shifting the reproductive health and rights movement?
Absolutely. If you look at the work today of organizations like the National Latina Institute for Reproductive Health, [the] National Asian Pacific American Women’s Forum, Forward Together, In Our Own Voice, SisterSong, California Latinas for Reproductive Justice, and [the] Native American Community Board, their agendas reflect what their constituencies are experiencing and those issues are not just about reproductive rights, but also about supporting young parents who are often stigmatized and advocating for immigration reform, or clean water, or addressing police violence. As Loretta Ross [the co-founder of SisterSong] says, reproductive justice is not just about the ability not to have a child but also to have a child, and to raise your child in a nurturing and safe environment. If your children are getting shot down in the street, that’s a reproductive justice issue.
How did you come to do the work you do?
Being among the first generation of people who go to college, you are expected to be a doctor a lawyer or an engineer. I thought I was going to go to medical school but I just could not get over the sight of blood. But I’ve always loved science and health issues. I was also raised to be very civically minded. I grew up in Bedford Stuyvesant, [Brooklyn], and my father used to do door knocking to try to register the community to vote and to exert their power. I am Puerto Rican and when I became older and learned about the history of Puerto Rico and here in New York and not just my community but African American, Native American, young women, quote unquote wayward young women, and women with disabilities, and how they were targeted by health systems and government policies for coerced sterilization, it was just so outrageous. It just enflamed me to no end. And so that is what first inspired me to be interested in this work.
How did you end up using law as a tool for advocacy for reproductive health and rights?
When I was in law school, I was part of the reproductive rights organization and I did a fellowship directly out of law school at the National Women’s Law Center where I worked on a range of issues including some reproductive health issues. I [eventually] went to the National Health Law Program where I was given the opportunity and freedom to create its Reproductive Health Initiative.
What was the impetus for that initiative and what did it do?
I had been out in Fresno doing a training at the legal aid office there with clients. In that area many of the clients are farm workers and one of the women raised her hand and said her daughter had a problem—she can’t get access to a tubal ligation. She didn’t use those words but that is what she was talking about. She explained that the only hospital that accepted Medicaid was a Catholic hospital that would not do the procedure. So the service her daughter wanted, that would fit best for her life, was not available to her. So we started investigating. I partnered with the California Women’s Law Center…and we started figuring out this was part of a reorganization happening in the hospital industry in which Catholic hospitals with access to capital, including federal dollars, were taking over other hospitals and then eliminating access to reproductive health care. That was part of the genesis of the Reproductive Health Initiative [which works] with partners to preserve access to reproductive health for low-income women and adolescents. It really examines federal and state policies to ensure that reproductive rights and access are covered in Medicaid and other low-income health programs.
Do you find it painstaking to use law to promote change?
It is not always the most effective tool but it can be a very powerful one. If you are working in coalition with other civil society and community groups, sometimes it is really is about just being at the table and people knowing that you could sue or supporting the leadership of your partners and providing legal and policy advice as needed. Sometimes it is about litigation, as we saw recently with the Center for Reproductive Right’s case, Whole Women’s Health v. Hellerstedt…There is also a lot of important work to be done just educating stakeholders about what the law is… [and] imaging what the law could be. So working with many great partners, you can shape laws and policies. You often don’t get 100 percent but you continue to move the needle. Patriarchy had a big head start and it is not a linear arc to justice.