These days, you have to be thankful for the good news on reproductive health, no matter how small or fleeting.
So, in an effort to see the cup as, say, an eighth full, let’s take a gander at some happenings in the world of international women’s health. Pessimists might be inclined to focus on the fact that the House budget bill would slash international funding for family planning by nearly one-third, entirely defund the United Nations Population Fund and make the Global Gag rule permanent.
But I’d like to point out that at least the House didn’t put forward the proposal from Ohio’s Representative Bob Latta (pictured here in a fashionable red-patterned tie) that would have entirely eliminated international family planning funds that provide life-saving care to 27.5 million of the world’s women. (Perhaps Latta will have better luck with his other big effort to improve life on this planet, a proposal to introduce a Ronald Reagan commemorative coin.)
In other good news, the Senate rejected their spending bill that would have cut Obama’s request for international family planning and reproductive health funds by 39 percent. Of course, that means we might have to shut down the government—and that whatever spending bill we end up with might not treat the poor women of the world kindly. But why borrow trouble?
In the spirit of optimism on the international health front, I’m going to turn our attention now to an area that's ripe for improvement. That’s right, this is not a story about failures, really, but instead about our potential to serve the women of the world better, a potential that can be fairly easily realized. I say that last part because the politicians standing in our way this time aren’t antichoice Republicans but prochoice Democrats—and because we don’t need to pass any new laws to do it. (With this Congress, this is happy news indeed!)
Instead, the story of Chisale Mhango, a Malawian ob gyn and public health expert, is about interpreting existing restrictions on abortion—an issue on which, it turns out, the Obama administration isn’t as forward-thinking as you might hope. Let me explain. Mhango recently ran into trouble with US Agency for International Development, which had been paying his salary while he worked for the Malawian Ministry of Health. Mhango was told he couldn’t go to a conference this past August where he was going to present research about the magnitude of unsafe abortion in his country. And though he didn’t speak at the meeting, some months afterward Mhango and USAID agreed that his contract should be terminated early.
At first glance, it can seem that Mhango ran afoul of the Helms amendment. But while some may think that the 1973 law banned the use of US dollars to pay for anything having to do with abortion, in fact it narrowly bans the use of money to “pay for the performance of abortions as a method of family planning.” While the law also plainly prohibits US money from being used to lobby either for or against abortion, other uses are clearly legal. Thanks to Senator Patrick Leahy, the law even clarifies that it’s okay to use USAID funds to refer women to safe abortion services.
Mhango was going to address the health consequences of unsafe abortion, something that seems well within his purview. Indeed, that’s how representatives of Ipas, the reproductive health organization that was organizing the August conference, saw it. “To us, he was going to speak at a meeting to disseminate the results of a study and to discuss how to address unsafe abortion in Malawi,” says Patty Skuster, Senior Policy Advisor and an attorney at Ipas. “By no definition is that lobbying.”
Elizabeth Maguire, the president of Ipas and herself a former director of the USAID Office of Population and Reproductive Health, even wrote to USAID, complaining that the current “interpretation of the wording has effectively precluded support for abortion even in cases of rape, incest and threats to the life or health of the woman as well as research, technical assistance, publication and awareness raising on the issue.”
Maguire’s letter went on to say that, though Ipas and other organizations have brought the matter of interpreting the Helms amendment up to the Obama administration, she’s been “extremely disappointed with the response.”
The agency responded to Maguire, explaining that, because the August meeting was expected to “include discussion of study findings, as well as possible changes to the legal status of abortion in Malawi,” Mhango’s presence there “raised concerns.”
Of course, it’s easy see why Democrats would live in terror of doing anything that might be seen as controversial. And such scuffles can seem niggling—little political tiffs where the only stakes are political careers—until you see them into context. In Malawi, where abortion is illegal except to save a woman’s life, there are around 100,000 unsafe, illegal abortions every year. As a result, about 30,000 women a year arrive at clinics in need of treatment after incomplete attempts to end their pregnancies or infections that arose from abortions. Hundreds die. In developing countries around the world, nearly 47,000 women die every year because of unsafe abortions.
Mhango has already found another source for his salary and continues his work. But, elsewhere in the developing world, including in Nepal, health care workers are still constrained by a needlessly conservative interpretation of abortion restrictions.
Luckily, USAID could easily fix the situation. All the agency would have to do is clarify its guidelines.
Now that’s good news!