Issue 16 – Friday 07 August 2020

Gender-based violence and women's health

LGBTQI+ rights

Refugee camps

Prisoners and detainees

Disability rights

Religious Discrimination

Gender-based violence

As an estimated 740 million women are employed in the informal sector and women represent 70 per cent of health care workers globally, economic instabilities coupled with a higher risk of catching Covid-19 on the front lines calls for urgent action to be taken to protect vulnerable women worldwide. Instances of gender blindness, which greatly disadvantages female healthcare workers on the front line, is noted in Europe, as the majority of nurses and healthcare workers are women, but most personal protective equipment is sized primarily for men. Further, the abuse of vulnerable workers – such as those deemed essential – has increased at an alarming rate during the Covid-19 pandemic, leaving many facing starvation or forced to accept exploitative conditions. Further, the United Nation’s Sustainable Development Goals Report 2020 shows that women and girls are facing the hardships of government-instructed lockdown measures in their households, with domestic violence, child marriage and FGM on the rise. Moreover, school closures prevents any development of gender parity for women and girls worldwide, as girls face a heightened risk of female genital mutilation (FGM) and early marriage, which is detrimental to their bodily integrity, physical health and mental wellbeing. Marie Stopes International, which provides contraceptive care and safe abortions, has estimated that the pandemic could prevent up to 9.5 million girls and women from accessing their services this year.

In many countries, government-run hotlines have been inundated with calls reporting sexual violence. Peru’s hotline received 17,000 calls about sexual violence against children during the first 107 days of lockdown. In Colombia, nearly 22 cases involving sexual abuse against girls were reported per day on average from the start of the lockdown on 25 March until 23 June. A Plan International online survey conducted in June of 350 teenage girls in 12 countries, including five Latin American countries, showed that most teenage girls were worried about gender-based violence during the pandemic. Additional fears are that poverty, due to economic instabilities during the Covid-19 pandemic, will force girls into wedlock or to live with a partner as their parents become too poor to feed them – early marriage and unions are often seen as an escape from poverty but are often just another space for abuse.

Mexico

From the offset of the Covid-19 pandemic, the Mexican government has significantly cut gender-based violence services and government expenditure for victims of domestic violence. The National Institute for Women – the governing body for gender equality in Mexico – approved a 75 per cent budget cut on 15 July. This move, justified by the President Andres Obrador, coupled with his suggestion to withdraw state funding for women’s shelters, is alarming. During the pandemic, such services are vital to the disproportionate amount of women facing abusive, hostile environments because of government-instructed lockdown measures to combat the spread of Covid-19. The National Network of Shelters, an organisation based in Mexico, has received 80 per cent more calls since the pandemic started, and the number of women and children admitted to its shelters has increased by 50 per cent. As reported in the previous Monitor, government statistics show that more women were murdered in Mexico in April than any month on record, and femicide went up by 7.7 per cent in the first half of 2020 compared to the same timeframe in 2019. President Obrador, however, claimed that 90 per cent of calls to emergency services over domestic violence were false.

Africa

In the last few months, numerous states in Africa have reported a surge in cases of domestic violence and sexual violence. In May, South Sudanese activists protested the gang rape of an eight-year-old girl by three men who held her mother at gunpoint. In South Africa, calls to the government-run GBV and femicide centre had reportedly doubled during the nationwide lockdown. In early June in Nigeria, the #WeAreTired campaign started after two young women (22 and 18 years old) were raped and killed five days apart and in the same month, a Nigerian popstar faced allegations of rape and abduction. In late June, campaigners in Sierra Leone protested the rape and killing of a five-year-old girl. In July, Liberian human rights activists called on President George Weah to announce policy responses to the alarming increase of rape cases. In one county in Kenya, 3,964 girls became pregnant in first five-months of 2020; similar trends have been registered in neighbouring Uganda. The idea that home is a safe place for children is highly disputable, as majority of these cases of sexual violence are perpetrated by people known to the children, which provides further evidence that home is hardly a safe place, according to Al Jazeera.

Women’s health

Latin America

Experts across Latin America have warned of a rise in teenage pregnancies as health care resources are diverted to deal with Covid-19 and access to abortion and contraception becomes more limited, even though most Latin American countries allow abortions in cases of rape. Government-instructed lockdown measures that have resulted in school closures places girls at home with abusive family members in further turmoil. Therefore, the already high-unmet need of contraceptive care for adolescents has gotten worse due to the global pandemic. Mexico’s government estimates there could be nearly 22,000 more unwanted pregnancies than normal in 15–19-year olds this year and next due to lack of access to contraception. Across Latin America, 18 million women and teenage girls could stop using contraception due to the pandemic, which could lead to more than 600,000 unwanted pregnancies as per estimates by the United Nations Population Fund.

Kenya

In Kenya, healthcare workers have reported a significant rise of maternal deaths during the Covid-19 pandemic, due to the redirection of women’s healthcare services. Jemimah Kariuki, a gynaecologist at the government-run Kenyatta National Hospital, stated: ‘When the curfew started we had open hospitals but no women, and we would hear reports of women delivering at home with very dire consequences: Women would come in the morning with babies who passed in the night or they had ruptured the uterus or had significant tears’. Along with the redirection of services, from the offset of school closures, there has been a reported 100 per cent rise in underage pregnancies and transactional sex, as young girls have been met with economic insecurity, isolation and desperation during government-instructed lockdown measures. Further, as the Covid-19 pandemic has gravely affected Kenya’s economy, leaving a vast number of people in unemployment, families are facing increasing levels of hardship and poverty, which has prevented access to vital services and essential goods. Such instances can be seen in Taita Taveta County, where an increased number of women and girls lack access to sanitary towels, which compromises their menstrual health.

United Kingdom

In the UK, restrictions on accessing women’s healthcare services has caused detrimental effects on the health and wellbeing of women reliant on contraceptive care. In Norfolk, the local council reported that over 200 women were unable to access their usual contraceptive prescriptions, or were met with significant delays, due to Covid-19 lockdown measures. Due to these restrictions, the British Pregnancy Advisory Service has reported that there has been an increase demand for abortion services between April and July. For women in the UK seeking to access abortion pills online, the consequences are dire, as buying abortion pills online could led to a life imprisonment sentence for an abortion at any stage of their pregnancy without getting the permission of two doctors. For women in abusive relationships, access to these services is vital and necessary, as it allows for privacy for an urgent care during a time where healthcare professionals and services are unavailable.

Russia

In Russia, women’s healthcare facilities in four cities including the capital, Moscow, have either closed or been repurposed during the Covid-19 outbreak, according to Open Democracy. Open Democracy’s investigation follows warnings by Russian women’s rights activists in April that Covid-19 restrictions in Moscow put more than 100,000 pregnant women at risk of unwanted pregnancies or botched abortions. Petra De Sutter, a Belgian lawmaker, gynaecologist and president of the European Parliamentary Forum for Sexual and Reproductive Rights (EPF) told Open Democracy that ‘research clearly reveals how unnecessary restrictions constitute an alarming pattern of women's health and rights being deprioritized during the crisis’.

LGBTQI+ rights

United States

A recent study published by the UCLA School of Law’s Williams Institute has shed some light on the health-related and economic vulnerabilities of LGBTQ+ people during the pandemic. The Williams Institute relied on data from the California Health Interview Survey, to assess health and economic characteristics, which would increase the vulnerability to Covid-19 of California’s 1.7mil LGBTQ+ population. According to the study, 361,000 LGBTQ+ adults in California ‘were in fair or poor health’ before the onset of the pandemic, and living with illnesses like diabetes, heart disease, asthma and HIV. This figure is exacerbated by the fact that 134,000 LGBTQ+ people were found not to have health insurance, which is a major factor in whether or not a person will seek medical care. 612,000 LGBTQ+ people were living below the federal poverty line, and 251,000 were working in industries that would face serious job losses, including retail, hospitality, construction and healthcare. In total, 814,000 LGBTQ+ people were working in industries that were significantly impacted by Covid-19 lockdown measures, 140,000 were unemployed, and 300,000 were experiencing food insecurity. In San Francisco, one quarter of the homeless in California identify as LGBTQ+, which makes it crucial for the local and state governments to implement affordable housing and homelessness prevention measures. Moreover, LGBTQ-owned businesses will need economic support as cities, states that the country attempt to recover from the economic consequences of pandemic-related restrictions.

Saudi Arabia

A Yemeni blogger living in Saudi Arabia, Mohamad al-Bokari, has been sentenced to ten months’ imprisonment, a fine of 10,000 riyals (€2,270), and deportation for posting a video on Twitter supporting the human rights of gay people. Al-Bokari had been living as an undocumented migrant in Saudi Arabia since June 2019, when he fled Yemen in fear for his life. Al-Bokari was arrested on 8 April this year following public outrage to his video, in which, in response to a question on same-sex relations, he stated, ‘Everyone has rights and should be able to practice them freely, including gay people.’ In a statement to Saudi media, the police department of Riyadh characterised the statement as including ‘sexual references’ which ‘violate public order and morals’. There are no laws in Saudi Arabia governing issues of sexual orientation or gender identity. However, the nation relies on uncodified Islamic law to govern and punish acts of ‘immorality’, including extra-marital sex and same-sex relations. Al-Bokari was charged with violating public morality laws by ‘promoting homosexuality online’, and ‘imitating women’. Human Rights Watch has contended that al-Bokari was arrested and criminally charged because of perceptions surrounding his sexual orientation.

Al-Bokari was detained in solitary confinement for 6 weeks before the trial, in a cell with no windows, air conditioning or adequate ventilation. During his detention, he was subjected to forced anal exams because of his perceived sexual orientation, and beaten and verbally abused. Moreover, he was denied legal representation, and following his sentencing, he was forced to share cells with detainees who insulted him, calling him a ‘devil worshiper’ who ‘deserved the death penalty’. Al-Bokari’s sentence was handed down on 20 July, and he has 30 days to appeal the court’s decision.

Brazil

Despite being diagnosed with Covid-19, President Jair Bolsonaro not only recently denounced the use of facemasks, but also used a homophobic slur in doing so. It is no secret that the far-right President is anti-LGBTQ+. His homophobia was widely known even before he put himself forward as a candidate in the Brazilian presidential elections. Bolsonaro has notably stated, ‘Yes, I’m homophobic – and very proud of it’ and ‘Brazilian society does not like homosexuals’. Bolsonaro used his anti-LGBTQ+ sentiment as a rallying cry during the 2018 elections, so much so that activists attributed a new wave of attacks and threats to his statements on the campaign trail.

Refugee camps

This week, UNHCR called on states to urgently release refugees and asylum-seekers who are being unlawfully and arbitrarily held in detention. Despite the consequence of worsening the misery of people who have already suffered and undermining efforts to limit the spread of the virus, some states are still using the pandemic as justification to resort to increasingly regressive measures, including detaining refugees and asylum-seekers in greater numbers.

Under international law and in line with UNHCR guidance, detention of refugees and asylum seekers for administrative purposes must be used as a last resort, based on individual assessment. Maximum periods of detention should be set and asylum seekers must be immediately released once the justifications for their detention are no longer valid, while children should never be held in immigration detention. UNHCR is calling on states to adopt immediate measures release all refugees and asylum seekers who have been arbitrarily or unlawfully detained and scale up and implement community-based alternatives to detention, in order to help avert a catastrophic outbreak of Covid-19 in detention centres.

Greece

On 30 July, frontline medical charity Médecins San Frontières (MSF) announced that it has been forced to close its Covid-19 isolation center on Lesbos after authorities imposed fines and potential charges. Asylum seekers and recognised refugees in Greece, especially those with serious medical conditions, can no longer access healthcare or see a doctor for treatment, leaving many of them in a desperate position. Despite efforts from relevant stakeholders to urge the authorities to quash the fines and potential charges, Lesbos’ government is continuing to enforce the regulations. The outbreak of Covid-19 adds to the tensions between the EU and Turkey along the Greek border, causing further deterioration of refugee camps on Greek islands. With the lockdown of the refugee camps and the new regulations, refugees are facing exacerbated health problems and potential evictions, leaving many refugees in Greece facing a difficult situation.

Libya

According to the International Rescue Committee (IRC), almost all of the 200 children trying to reach Europe, who have been intercepted at sea and returned to Libya, have been arbitrarily detained. The majority of them were Eritrean, Somalian and Sudanese, with over a quarter of them unaccompanied minors. They are facing overcrowded, unsanitary detention centres with even greater risks than before, not only because of Covid-19, but also because of violence and abuse. Currently, the IRC is at the front-line of providing additional isolation units, mobile support to the Ministry of Health and the training of health workers in Libya. The IRC is calling for an immediate end to arbitrary detention and for those brought back from sea to receive all necessary health care and emotional support. Covid-19 testing capacity across the country is urged to be scaled-up, and health and protection services for migrants, refugees and asylum seekers must be expanded.

Yemen

With the Covid-19 pandemic hitting Yemen’s infrastructure already devastated by five years of war, the healthcare system in Yemen is buckling. According to a report from the non-governmental organisation MedGlobal and the Center for Global Health at the University of Illinois, US, 97 healthcare workers have died from Covid-19 in Yemen, exacerbating the situation in the country, as18 per cent of Yemen’s333 districts have no doctors, and many of those who remain have been unpaid for nearly two years. Malnutrition is also on the rise. On 22 July, the United Nations warned that food security would affect three million people over the next six months – around 40 per cent of Yemen’s population. WHO has urged governments to ramp up testing capacity and to remain vigilant in the face of a slower rise in cases than in Europe and the Americas.

Prisoners and detainees

Iran

In Iran, leaked official letters sent to the Iranian government by senior officials at Iran’s Prisons Organization highlight the urgent need for more preventative equipment in Iranian prisons. In the leaked letters obtained by Amnesty International, indicate severe shortages of ‘protective equipment, disinfectant products and essential medical devices’ which is likely to cause significant harm to the prison population. Diana Eltahawy, Amnesty International’s Deputy Regional Director for the Middle East and North Africa, stated: ‘These official letters provide damning evidence of the government’s appalling failure to protect prisoners. Requests for urgently needed disinfectant products, protective equipment and medical devices have been ignored for months’. Due to the fact that the Ministry of Health has failed to respond to the letter, the prison population continues to face the possibility of a widespread outbreak of Covid-19 in prison facilities and in communities at large.

Zimbabwe

In Zimbabwe, issues pertaining to a lack of adequate protective equipment, unsanitary facilities, overcrowded prisons and lack of information on preventing infectious diseases may lead towards an outbreak of Covid-19 in prison facilities across the country. Although emergency measures to combat the spread of Covid-19 has been ordered by the President Mnangagwa, with 4,800 of the 22,000 prisoners being released in March, overcrowding and a lack of vital public health measures still disproportionately affect the wellbeing of those incarcerated. In a recent report by Human Rights Watch, a significant proportion of anti-corruption activists remain incarcerated during the pandemic, and the Zimbabwean government continues to increase the prison population by detaining journalists and activists for invoking ‘political violence’. On 20 July, Hopewell Chin’ono, a prominent journalist and activist, was arrested and detained for his participation in ‘exposing high-level corruption in Zimbabwe and calling for nationwide anti-corruption protests on 31 July’. Given Section 59 of the Zimbabwean Constitution, to protect the right to peaceful protest, and the ratification of the United Nations Standard Minimum Rules for the Treatment of Prisoners stating that prisoners should enjoy the same standards of health care available in the community, Zimbabwe must take urgent in compliance with international and national human rights law.

Australia

In Australia, reports have emerged of six prisons being placed in lockdown in Victoria after a prison worker tested positive for Covid-19, according to the Guardian. Lawyers have argued that the consistent transfer of prisoners, along with prison staff, increases the likelihood of a severe Covid-19 outbreak. As there are around 12,800 adults in custody in Australia, many of them are highly vulnerable if they contract Covid-19. Further, the Australian prison system has a large Indigenous population, high levels of drug use and mental health issues, and widespread chronic diseases including heart and lung disease, diabetes and hepatitis C, which can cause detrimental, long-standing effects on prisoners if adequate measures to combat Covid-19 are ignored. Greg Barns, representative for Australian Lawyers Alliance, stated ‘the need to release selected prisoners is even more urgent now. Lockdowns mean solitary confinement and no programs, and an increased risk of mental harm’. Moreover, Barns argues that in these unprecedented times, society needs to adapt to ensure protecting health of citizens is their first priority, and that non-violent prisoners and prisoners who are on remand are not left out of emergency contingency planning simply because they have no home address.

United States

In the United States this week, around 1,000 people demonstrated against conditions in San Quentin State Prison, which has witnessed a severe outbreak of Covid-19. As of 3 August, the California Department of Corrections and Rehabilitation (CDCR) had reported 8,290 positive Covid-19 cases and 49 deaths among the prison population. In order to safeguard the prison population, prison staff and society at large, the grassroots organisation, No Justice Under Capitalism, and a coalition of prison reform advocates protested to denounce ‘the lack of action from Gov. Gavin Newsom and state policymakers as prisoners continue to suffer the consequences of the global pandemic. As mentioned in the previous Monitor, San Quentin State Prison has one of the largest outbreaks of Covid-19 in any state prison facility in the United States. So far, 21 deaths have been recorded as well as 1,636 infections, more than a third of the facilities’ population. Evidence of the direct cause of the outbreak has been linked to a transfer of 121 prisoners in May, highlighting the need to prevent the transfer of prisoners from different facilities at all costs.

Immigration detention

United States

In the United States, over 20 per cent of Immigration and Customs Enforcement (ICE) detainees have tested positive for Covid-19, however statistics released thus far show a significant under-reporting of Covid-19 cases, with ICE detainees remaining incarcerated in unsanitary and overcrowded conditions. Further, as reported in the previous Monitor, over 450 deportation flights have taken place this year, with detainees sent to Latin America and the Caribbean, which has proven to have exported the virus to these nations.

Saudi Arabia

In Saudi Arabia, undocumented migrants detained for working without a visa remain incarcerated during the pandemic. At Al-Shumaisi, a large-scale prison holding 32,000 prisoners, comprises of ‘crowded series of bunk bed-filled halls, which each hold around 80 people’, according to the Guardian. In a series of interviews by reporters at the Guardian with detainees at Al-Shumaisi, all mobile phones are confiscated upon arrival in order to prevent any documentation of the prison conditions. One detainee told the Guardian: ‘We are packed as animals. We sleep on metal beds with no mattress, no proper sanitation’. Further, the detainee highlighted the lack of access to water: ‘we [detainees] drink water from the toilet. If you have money, you can buy clean water. If don’t have any, you just take dirty water from the toilet.’

Given the lack of access to healthcare services, medical professionals and the closure of hospitals, detainees are living in constant fear of a possible Covid-19 outbreak. Another detainee stated: ‘There are sick people, fever, vomiting and coughing, and nobody taking care of them’. Various immigration detainees have stated that bribes and paying for essential goods is one means of survival in Saudi Arabia’s Immigration Detention Centres. Several instances of Saudi authorities asking for money in exchange for the facilitation of a ‘safe and easy deportation’’ has been reported.’ For the majority of undocumented migrants unable to pay bribes, due to poor working conditions and limited financial gain, this is far from a possibility. These alarming accounts of negligent and degrading treatment calls for urgent action to be taken by Saudi authorities in order to safeguard the health and wellbeing of immigration detainees during the pandemic.

Disability rights

A report published on 16 July 2020 by an international group of clinicians, mental health experts and users of mental health services argues that the pandemic and subsequent lockdowns, social distancing and the resulting economic breakdown could increase mental health problems and exacerbate existing health inequalities, but conversely that the pandemic provides an opportunity to improve mental health services. Despite the heterogeneity of worldwide health systems, the report notes that efforts have been made to adapt the delivery of mental health care to the demands of Covid-19 and sustainable adaptions of delivery systems for care must be developed and utilized in the wake of the pandemic. These adaptations include remote therapy, medical ethics and rights driven considerations, such as ethic and racial disparities in access to mental health care and mental health service user knowledge and involvement, and widespread community monitoring and mental health screenings to assess longer term mental health needs post-pandemic.

United Kingdom

On 23 July 2020, Disability News Service (DNS) published research that illuminated 17 different ways the UK government breached the Equality Act, the European Convention on Human Rights and the UN Convention on the Rights of Persons with Disabilities during the pandemic. From restricting rights under the emergency Coronavirus Act to failing to ensure that individuals with disabilities had access to personal protective equipment, the government failed to meet obligations under a variety of domestic and international obligations and as result, the report argues, must launch an ‘urgent inquiry’ to learn lessons from the pandemic in order prevent similar abuses in the future. Joining the DNS’ call to action, just last week disability organisation Inclusion London called on EHRC to launch an inquiry into how the UK government had failed to meet its obligation under the Equality Act. Reflecting on the horrifying number of deaths of people with disabilities during the pandemic, Inclusion London’s Campaigns and Justice Officer Jon Abrams noted: ‘It is imperative, therefore, that the EHRC – as our national human rights institution – takes robust and muscular action and launches an enquiry to challenge the policies and practices that are causing significant disadvantage and damage to disabled people across the country.’

United States

On 27 July 2020, Senate Republicans unveiled their $1tn proposal to address the pandemic. The legislation, known as the HEALS Act, calls for another round of stimulus payments to individuals, liability protections for businesses and funding for schools. Despite months of concentrated advocacy from the disability rights community, the Bill includes no new funding for Medicaid or for home and community-based services – programmes that many Americans with disabilities are entirely reliant upon. In contrast, Senate Democrats passed a $3tn proposal two months ago with an additional $13bn in federal funding to states to pay for Medicaid, home and community-based services, and added benefits for direct support professionals. Julia Bascom, executive director of the Autistic Self Advocacy Network explained: ‘As the disability community has made clear, this funding can be the difference between a person with a disability staying safely in their own home, versus a person with a disability going into an institutional setting where Covid-19 is spreading like wildfire.’ As relief proposal negotiations continue, disability advocates remain hopeful that their needs will be factored into the final bill.

Serbia

On 31 July 2020, disability advocates and organisations released a joint letter to Serbian Prime Minister Ana Brnabic calling for the collection, analysis and publication of data on Covid-19 infections and deaths inside institutions for people with disabilities. Since April, Human Rights Watch and Mental Disability Rights Initiative Serbia have sent private letters requesting information on what measures the government has taken to prevent the spread of Covid-19 in residential institutions for Serbians with disabilities, and on the total number of infections and deaths. To date, the government has not provided any information. Emina Cerimovic, senior disability rights researcher at Human Rights Watch, explained: ‘An important part of addressing the Covid-19 pandemic is understanding the scale and circumstances of infections and deaths. Collecting this data is necessary to inform government policy, decision-making, and response. Publishing this data helps the wider public understand the impact of the outbreak on social care institutions.’ As the IBAHRI has previously reported, individuals with disabilities living in institutions have been disproportionately affected and killed by Covid-19, illustrating the physical, mental and social risks people with disabilities face when they do not have access to accessible, affordable and supportive housing and are forced into institutional settings.

Religious discrimination

South Korea

In South Korea, leaders of the Protestant Church have called out the South Korean government for banning any small church gatherings, other than Sunday worship, to fight the Covid-19 pandemic, according to the Korean Times. Leaders of the Protestant Church have argued that placing harsh restrictions on church prayers directly constitutes as religious discrimination as no other religious groups, such as Buddhists or Catholics, were included in these orders. A statement released by the United Christian Churches of Korea, emphasised that the South Korean government has been contacting churchgoers every Sunday, ‘urging them not to go to church’. Further, the statement adds, ‘this text is sent indiscriminately to everybody regardless of their religious affiliation. The government is interfering with Sunday worship and this must be stopped.’ A report by the United States of America Commission on International Religious Freedom urged the South Korean government to ensure the liberty and freedom of religious expression during the pandemic and the ‘intolerance, violence, and discrimination against Shincheonji should be put to an end’.

United Kingdom

In the UK, a surge of religious-based discrimination against Muslim communities emerged this week, after several regions across the UK were placed on lockdown shortly before the celebration of Eid Al-Adha. The reinstated lockdown measures, banning separate households from meeting indoors in Greater Manchester, East Lancashire and parts of West Yorkshire was justified by Craig Whittaker, a Conservative MP for Calder Valley, arguing that the ‘vast majority of those breaking the rules in his constituency were from Black and minority ethnic (BAME) communities’. Stephen Bush, a journalist for the New Statesman, has argued that the scapegoating of the Muslim community lacks clear and credible evidence. In light of the disproportionate deaths among BAME communities, Bush argues the reasons for this could be due to BAME communities being ‘concentrated among the ranks of Britain’s key workers: being more likely to work for the NHS, on public transport, as cab drivers and in shops’.Further, Public Health England (PHE) found that statistical data of Muslim communities, for example people of Bangladeshi heritage who tested positive for coronavirus, shows that a complex of range of factors caused the discrepancies among these communities. These factors are that BAME people were more likely to live in overcrowded and urban areas, and to work in jobs that put them at risk of catching Covid-19.