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Are US Policies Killing Women Abroad?
By Michele Kort
Ms. Magazine
Friday 15 February 2008
Even as we commemorate the landmark 35th anniversary of Roe v. Wade this year,
U.S. reproductive health policies are having an inordinately negative effect
outside of our borders. They're causing women to die or be maimed. Harsh words,
but true.
For the past 24 years, except during the Clinton presidency, U.S. administrations
have maintained a global gag rule against providing counseling or referrals
for abortions at U.S.-funded clinics in developing nations. It's a rule that
only thwarts safe abortions, while reducing the already limited availability
of other family planning services. The global gag rule has also led to a pullback
in overseas delivery of contraceptives, according to recent testimony by Rep.
Nita M. Lowey (D-N.Y.) before the House Foreign Affairs Committee: "U.S.
shipments of contraceptives have ceased to 20 developing nations in Africa,
Asia and the Middle East. In some areas, the largest distribution centers for
contraceptives have experienced decreased access for over 50 percent of the
women they serve."
Women's health and rights activists in the U.S. have spent the past two decades
fighting against such actions, and advocating on behalf of global reproductive
health issues. But progress has come slowly. While maternal mortality has been
declining at 1 percent annually, it needs to decline by 5.5 percent a year in
order to be three-quarters reduced by 2015 (one of the United Nation's Millenium
Development Goals). Sounds like a lot - but it would require just about $6.1
billion more in annual funding - the price of three weeks of the Iraq war -
to achieve that goal. Without that commitment, more than 500,000 women will
still die annually from childbirth and its complications, with an estimated
70,000 of those deaths due to unsafe abortions.
Take, for example, the situation of women in Kenya, where abortion remains
illegal unless the pregnant woman's life is in danger (a loophole some compassionate
doctors interpret liberally, as they know that desperate women will risk their
lives to abort anyway). An estimated 250,000 to 320,000 abortions are carried
out in the country each year, with unsafe procedures causing a shocking toll:
Globally, 13 percent of maternal deaths result from abortion-related complications,
but in Kenya it's as high as 40 percent.
In public hospitals such as Kenyatta National in Nairobi, about 20,000 Kenyan
women are treated each year for abortion-related complications. Nearly two-thirds
of the beds in the notorious gynecological section - Ward 1D - are occupied
by those patients, who suffer everything from excessive bleeding to injured
organs to sepsis. Those sufferers include women such as Wangui (not her real
name), who drank a boiled concoction made from trees and took several doses
of an anti-malaria drug in order to abort because her impoverished household
couldn't support a fifth child. She ended up in Ward 1D because she required
an urgent blood transfusion to save her life.
Women's rights groups in Kenya have been pushing for a new national law on
reproductive rights, as well as supporting a continental protocol on the rights
of African women and a patients' bill of rights. But they're not helped in their
efforts to improve reproductive health care by the global gag rule, which has
forced a number of clinics to turn down U.S. funds rather than stop discussing
abortion. Three clinics of the Family Planning Association of Kenya (an affiliate
of the International Planned Parenthood Federation) and two clinics of Marie
Stopes International (the U.K.-based reproductive-health NGO) have been closed
for loss of funds, according to a 2004 report from the Center for Reproductive
Health Research and Policy in San Francisco.
Maternity care in general is problematic in Kenya's public hospitals. The 2007
report "Failure to Deliver," produced by the Federation of Women Lawyers-Kenya
(FIDA Kenya) and the Center for Reproductive Rights in New York, pointed out
that public health facilities often suffer from lack of supplies and congestion.
Claris Ogangah-Onyango, legal counsel for FIDA Kenya, points out the obvious:
When the majority of beds in maternity hospitals are occupied by women with
post-abortion complications, there is not enough space and care for other women.
"The government is mostly concerned with post-abortion care," she
says, "and most of the funding goes to that. But they're not doing anything
to stop [unsafe] abortions."
"What has really affected our work in Kenya is that we have very few women
in our parliament [just 18 of 222 members]," says Ogandah-Onyango. "When
we take our issues to the government, they are blocked. FIDA and other women's
organizations have approached the candidates for the next parliament to sign
a document that they will support gender-friendly bills. Putting more women
in government would make a big difference."
And what can women in the U.S. do to help their Kenyan sisters? "Lobby
for change in the policies that govern reproductive health," she says.
U.S. women can also support the efforts of groups such as FIDA Kenya, which
is now part of the Reproductive Health and Rights Alliance in Kenya.
Sisterhood is a global mission. Economics and politics and even social conscience
aside, we know that only by empowering all women can we ensure the future of
the world.
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Michele Kort, with Mary Kathomi Riungu reporting from Nairobi
For the full article, see the Winter 2008 issue of Ms. magazine, now
available on newsstands and by subscription from www.msmagazine.com.
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