In one of his first acts as president last January, Donald Trump reinstated the Global Gag Rule. That executive order bars the government from giving money in foreign aid to nongovernmental organizations (NGOs) that do so much as talk about abortion. So if an NGO either provides abortions or tells patients that abortion is an option, the organization is cut off from U.S. governmental funding. In the year since the rule was reinstated, the Global Gag Rule's effects have been far-reaching and devastating.
Amos Simpano, director of clinical services at Family Health Option Kenya (FHOK), an NGO affiliated with the International Planned Parenthood Federation (IPPF), tells me in an emailed interview with Elite Daily how the rule has been severely limiting the care the organization has been able to provide. FHOK rejected the Global Gag Rule — as a family planning group, not even discussing abortion would have been antithetical to the organization's purpose.
"Women now can’t get their preferred method of family planning from us. Our Mombasa-based women call us most of time and ask us where we are," Simpano says. "It is very difficult for us even to answer questions asked by the women, for they don’t want to know what happened with funding, they want to get their routine services whenever it is due."
The effects of the Global Gag Rule are not limited to women's ability to access abortion. When a health care NGO loses funding because it chooses to discuss abortion, that prevents its staff from being able to provide other health care services, like cancer screenings and HIV treatment. By making a point on the issue of abortion, the Global Gag Rule effectively impacts all aspects of care for families that rely on NGO care. An October 2017 report from Human Rights Watch found that the rule restricts about $8.8 million in funding, which is used for reproductive care, child health, nutrition, malaria, infectious diseases, water, sanitation, and HIV/AIDS care.
Because FHOK refused the Global Gag Rule, the organization lost $640,000 in funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). This month, FHOK "lost out from bidding on projects with U.S. funding [totaling] $840,000, despite our abilities, expertise and experience, and relevance," Simpano says.
The loss of funding translates into a loss of care that the organization is able to provide. FHOK had to close a clinic in Mombasa, a major city in Kenya, and limit work at a clinic in Kibera, a slum in Kenya's capital city of Nairobi. FHOK also had to close its mobile outreach services. From the mobile outreaches alone, Simpano says, "76,000 women lost their choice services."
These effects are not limited to Kenya and FHOK, as ABC reported last week. Marie Stopes International is facing a funding gap of $80 million, which translates to more than 2 million women potentially losing contraceptive services and 870,000 women potentially facing unsafe abortions. The International HIV/AIDS Alliance will lose up to $60 million over the next three years, and the International Planned Parenthood Federation is losing an estimated $100 million in funding. More than 1,275 NGOs also are potentially affected, with $2.2 billion in global health funding in play.
"Abortion should not just be looked in the context of terminating a pregnancy, but in a holistic approach including counseling a woman to accept and carry the pregnancy to term and successful delivery. The Global Gag Rule prohibits the counseling option, and so what option does it leave a woman with?"
"We are very frustrated because we are unable to serve our needy patients and clients who for many years have known us as a trusted, reliable, and quality service provider," Simpano says.
There is one attempt to undo the Global Gag Rule. Last year, Senator Jeanne Shaheen (D-NH) and Representative Nita Lowey (D-NY) introduced the Global Health, Empowerment, and Rights (HER) Act, which would end the rule. However, with a Republican-controlled Congress and Trump still president, the success of this bill seems unlikely. Should Congress flip in the midterm elections this year, there at least would be more support for it.
Ultimately, because Trump wanted to send a message about abortion, tens of thousands of women in Kenya who relied on FHOK are unable to get care options for anything from contraceptives, cervical cancer screenings, HIV and AIDS treatment, and — of course — abortion itself. Simpano says that women in Mombasa have been "stranded and bitter" without their care.
And without access to comprehensive reproductive care, women get pregnant. Women who used FHOK's mobile outreach services, for instance, "have started getting unwanted pregnancies blaming us that we did not avail to them the routine family planning services," Simpano says.
An abortion is a safe procedure when done by a trained medical professional in a clean environment. But when abortion rights are restricted, it can become deadly as women seek any option to end a pregnancy. In 2014, about 16,000 deaths in Africa were due to unsafe abortion, according to the Guttmacher Institute. Additionally, an estimated 1.6 million women in Africa are treated for complications from unsafe abortion every year, per the Guttmacher Institute.
"Abortion should not just be looked in the context of terminating a pregnancy, but in a holistic approach including counseling a woman to accept and carry the pregnancy to term and successful delivery. The Global Gag Rule prohibits the counseling option, and so what option does it leave a woman with?" Simpano says.
The longer the Global Gag Rule stays in effect, restricting funding from reliable NGOs, the fewer options the most at-risk women in the world have. The results of lost health care options are nothing short of devastating; they're also dangerous.
"Understand that women and girls are human beings and should enjoy their human rights as well, including access to health care services [such as the family planning methods of their choosing]," Simpano says. "Let the young people fight for the rights of women and girls and never give up."