Article: U.S. Abortion Policy Hits Clinics Abroad - Study

[moominmuppet]

By Maggie Fox
Reuters

Wednesday 24 September 2003

WASHINGTON (Reuters) - President Bush's anti-abortion policy has hit clinics in poor countries hard, forcing some to close and leave entire communities without healthcare, according to a report issued on Wednesday.

Under the policy, known as the Mexico City rule by supporters and the Global Gag rule by opponents, foreign family planning agencies cannot receive U.S. funds if they provide abortion services or lobby to make or keep abortion legal in their own country.

A survey of Ethiopia, Kenya, Romania and Zambia by Population Action International and the Planned Parenthood Federation of America showed the rule had forced clinics to close and left many men and women without access to contraceptives that could prevent both unwanted pregnancies and AIDS.

"Health services have been scaled back and closings of reproductive health clinics have left some communities with no healthcare provider," the group wrote in a statement.

The policy has also hurt AIDS prevention efforts, said the groups, which published the findings on the Internet at www.globalgagrule.org.

As one of his first acts in office in 2001, Bush reinstated the rule that former President Bill Clinton, a Democrat, had lifted. The rule was originally imposed in 1984 by President Ronald Reagan at a Mexico City conference.

Last month Bush ordered the State Department to strengthen the rule by withholding U.S. family planning help from overseas groups that promote or perform abortions with their own money.

PROTECT WOMENS' HEALTH
Supporters say the United States should not be spending taxpayer money to promote abortion. Opponents argue that abortion is legal in the United States and elsewhere and that abortion counseling is part of a wide range of advice that women need to protect their health.

"Our research has found that the Global Gag Rule is taking a toll on the lives and health of women, children and families around the world," the report reads. Five family planning clinics run by nongovernmental organizations have closed in Kenya because they broke the rule and lost funding from the U.S. Agency for International development, the report said.

"The NGOs have also had to cut their staffing by as much as 30 percent, reduce services in remaining clinics and raise fees in order to remain viable."

"In Lesotho, one in four women is infected with HIV/AIDS -- one of the highest rates in southern Africa. Over a three-year period from 1998 to 2000, the Lesotho Planned Parenthood Association received 426,000 condoms ... all donated by USAID," the report added.

"Because of their refusal to agree to the gag rule restrictions, they no longer receive USAID contraceptives."

In Kenya's Mathare Valley a clinic closed, leaving 300,000 people with no healthcare services. "And there is no other family planning or reproductive health clinic nearby," the report said.

In Romania, women may be more likely to get abortions, not fewer, because the rule has meant more women cannot get any information on contraceptives that can prevent unwanted pregnancies, the report said.

"This is the real face of Bush's compassionate conservatism -- a war on the world's most vulnerable women and children, who bear the brunt of Bush's obsession with appeasing his domestic political base," Planned Parenthood's Gloria Feldt said in a statement.

edit: additional article with more detail



By Asjylyn Loder - WeNews correspondent

(WOMENSENEWS)--The Mexico City policy, also known as the global gag
rule, has led to closed clinics, cuts in healthcare staff and dwindling
medical supplies, leaving women, children and families without access to
vital healthcare services, according to a report released yesterday by
policy opponents.

The policy, reinstated by U.S. President George W. Bush as one of his
first acts in office, prohibits any organization receiving population
funds from the U.S. Agency for International Development from using those
or other funds to provide or promote abortion as a method of family
planning.

"I think they are killing these women, just as if they are pointing a
gun and shooting. There is no difference," said Hilary Fyfe, chair of
the Family Life Movement of Zambia. Her organization opposes abortion,
but still lost approximately $30,000 in U.S. funds for telling
adolescents and young adults that unsafe and potentially fatal abortions are one
possible consequence of unprotected sex and unwanted pregnancies.

The report, titled "Access Denied," is the first to document the
effects of the policy on health services delivery around the world. The
policy was reinstated by President Bush on January 22, 2001 and marked the
28th anniversary of Roe v. Wade, the 1973 Supreme Court ruling that
decriminalized abortion in the United States. Three vocal critics of the
policy, Population Action International, Ipas, and the Planned Parenthood
Federation of America, put together the report based on interviews and
field research conducted since the policy was reinstated.

"When we counsel, we have to talk about abortion. You can't do
counseling on reproductive health without talking about the whole business,"
Fyfe said by phone from Washington, D.C. where she is helping publicize
the new report. "We were told, 'you talk about abortion, you're out,'"
she said.

To retain funding, grantees must certify that they will comply with the
rule barring discussion of abortion.

In 2000, Fyfe's organization counseled adolescents and families in nine
provinces in Zambia, offering information on birth control, family
planning and HIV/AIDS prevention. They had to cut services in four
provinces due to the funding cuts. Planned Parenthood of Zambia also scaled
back programs when it lost 24 percent of its funding, according to the
report.

In Kenya, a total of five family planning clinics, two affiliated with
Marie Stopes International, have been forced to close, the report said.

A state department official pointed out that these organizations had
made the choice not to comply with the policy and could have kept their
funding had they chosen to comply. The official also pointed out that
the amount of money distributed by USAID has not been reduced and that
USAID is committed to spending it through other programs and
organizations that agree to comply with the Mexico City policy.

Organizations receiving U.S. funds are also prohibited from promoting
the liberalization of abortion laws in their country. "It denies
organizations the ability to participate in an important policy decision in
their country," said Amare Bedada, executive director of the Family
Guidance Association of Ethiopia in Addis Ababa.

The association lost 12 percent of its funding directly and another 25
percent that it received from the International Planned Parenthood
Federation, which also refused to comply with the policy. The Ethiopian
association curtailed programs, lost members of their senior staff and ran
short on donated contraceptives due to the policy.

In Ethiopia, abortion is permitted when the mother's life or health is
in grave danger. Legislators there are debating liberalizing those
restrictions. The World Health Organization estimates that one in seven
Ethiopian women die from pregnancy-related complications. According to the
Ministry of Health, unsafe abortion is the fifth leading cause of
maternal death in Ethiopia.

In Zambia, women are permitted to have an abortion if three doctors
write letters saying that her life or health is in danger. In practice,
said Fyfe, this is a requirement that few women can satisfy. "They end up
dying, either from the pregnancy or from an abortion induced by
themselves," Fyfe said.

In Romania, women have an average of 2.2 abortions and regard birth
control methods with suspicion due to long indoctrination by Soviet
administrations. Family planning organizations that signed the rule can not
partner with abortion providers, hindering family planning advocates
that try to reach women who undergo multiple abortions in the absence of
information on alternatives.

Rule Cuts Condom Distribution

Bedada's organization also provides contraceptive services and HIV/AIDS
prevention counseling, traveling into isolated rural communities to
treat women who could not make the arduous and time-consuming trip into a
town.

"The whole rural program came to a standstill," said Bedada, who has
joined Fyfe in trying to publicize the damaging affects of the rule. "It
is jeopardizing the programs we have been doing for 37 years," he said.

Both Bedada and Fyfe cited in particular shortages of condoms.
Increasing awareness of HIV/AIDS prevention, especially among adolescents and
young adults, has led to a growing demand for latex condoms--a demand
these organizations can no longer meet. "There are condoms in the shops,
but young people can't afford them," said Fyfe.

Fyfe would send those interested in condoms to Planned Parenthood
affiliates in her area, but those affiliates are running short of condoms
because the International Planned Parenthood Federation based in London
lost $20 million in USAID funds when it refused to sign the rule. The
USAID donations of cash and supplies, including condoms, made up about
one-fifth of the federation's annual budget.

The agency and the United Nations Population Fund are the largest
donors of contraceptive supplies, including condoms, to the developing
world. The agency is the most important single donor, delivering about
one-third of all donated supplies, worth about U.S. $75 million. (In a
separate action, the administration eliminated $32 million in support for
the U.N. fund as well.)

By 2002, the policy had cut off shipments of USAID-donated supplies to
16 developing countries, according to the report, because the only
recipients in those countries were members of the International Planned
Parenthood Federation. The leading family planning organizations in 13
other countries, including Ethiopia and Zambia, were also cut off.

AIDS Funding Reduced

Condoms procured with HIV/AIDS funds are not subject to the rule, but
critics of the rule say that, in practice, organizations that refused to
sign the rule have not been able to get funds earmarked for HIV/AIDS
prevention.

"In practice, that is what is happening. They are getting blackballed,"
said Wendy Turnbull, legislative policy analyst with Population Action
International and one of the authors of the report.

A state department official said it was unclear how USAID determined
which programs qualified for HIV/AIDS funds and which were disqualified
as family planning programs not in compliance with the Mexico City
policy.

The Saint Lucia Planned Parenthood Association affiliate was forced to
cancel plans to train 218 "peer helpers" that would have reached more
than 12,000 primary and secondary school students with information on
HIV/AIDS, according to the report.

The Cameroon National Association for Family Welfare closed a youth
center that taught young people about responsible parenthood and HIV/AIDS.
They also eliminated family planning services in two branches, one in a
province where 9 percent of the population lives with HIV/AIDS and
another in a province where 6 percent of the population is infected,
according to the report.

The International Planned Parenthood Federation distributed condoms
donated by USAID. Bedada's organization, a member of the federation, did
not receive enough donated condoms to supply the demand for nearly a
year and has run low on other contraceptives as well.

"We are not able to supply the youth demand as much as we'd like,"
Bedada said. "We tell them to go to the government health institutions to
get them if they can, but mostly the people that we serve are in rural
areas and they have nowhere else to go," he explained. When they finally
returned to the rural areas, they found women upset and suspicious.

"It was just demoralizing for them and for the community," Bedada said,
"They thought that we were going to abandon them."

President Reagan introduced the Mexico City policy in 1984 during a
U.N. population conference in Mexico City. It has remained in effect as
long as Republicans have held the presidency, and was rescinded by
then-President Clinton in 1993 on the 20th anniversary of Roe v. Wade.

In late August, President Bush extended the Mexico City Policy to cover
U.S. Department of State population funds. A state department official
said it was still unclear what funds and organizations would be
affected by this rule.

Asjylyn Loder is a freelance writer in New York.

For more information:

www.globalgagrule.org--"Access Denied: The U.S. Restrictions on
International Family Planning": - http://www.globalgagrule.org/

U.S. Agency for International Development--Mexico City Policy
information: - http://www.usaid.gov/pop_health/pop/mcpolicy.html

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Copyright 2003 Women's eNews.