After only a few weeks in Hanoi, I walked into a small family-planning clinic in rural Viet Nam, stepped over some bloody instruments resting in a dirty basin and sat near a women lying on a straw mat on a mud floor of the 'Recovery Room,' and asked her questions about the abortion she had just had. I have not relinquished my ambivalence about abortion, but each day I spend in the provinces convinces me a little more that damaging family-planning organizations by keeping money away from them will only hurt the women these organizations try to help.
In news time, President Bush's decision to prevent much needed family-planning aid from going to foreign organizations that advocate, perform or even discuss abortion is already old, and media sources have moved on to fresher items. But here in Hanoi, the President's statements ring hollow, and they will resonate deeply for years to come.
Bush reinstated a policy in effect under his father and President Reagan, which states simply that U.S. aid cannot go to foreign organizations that are remotely involved with abortion issues. Americans who work for such organizations may no longer discuss a constitutional right granted in their own country if they wish for funding to continue. American organizations have not provided abortions abroad since the Helms Amendment in 1973; this time around, though, U.S. policy is again enforcing a law abroad on foreign-run and mostly foreign-funded organizations that would be considered deeply unconsitutional at home.
In Viet Nam, a population of 80 million is squeezed into an area the size of Massachusetts. Every square inch of land is farmed to excess. The average income per year ($350) is equivalent to 43 hours of work-study in Firestone Library. Women have little to no access to basic, informed, accurate and safe family-planning options. And since abortion is legal, subsidized and readily available, it unfortunately takes precedence over preferable forms of family planning. Most family-planning agencies provide information and access to other kinds of family-planning techniques, and a very small minority concern themselves with safe abortion practices.
Bush's reinstatement of the Mexico City Policy is not a compassionate act and is certainly not worthy of the man who promoted tolerance and understanding in his inaugural speech. It is tremendously short-sighted and shows a misunderstanding of the extremes people must resort to in order to survive.
It's too easy to preach without practicing. Perhaps President Bush should stroll through the slums of Calcutta or hike through the northernmost isolated provinces of Viet Nam and look these women in the eyes. He should try telling them that they have to have more children because America said so. He should sit behind a small desk in a commune health center and patiently turn these undereducated, underfed and overworked women away because the funding that pays for their care — anything from antenatal care to breastfeeding information to requests for contraception — has dried up.
Bush's reinstatement of the 'global gag rule' will obviously have different effects in different situations. In Viet Nam, cultural habit dictates that children are revered and cared for from the moment they are born. That's why women don't want more than they know they can love, support, feed and educate. The Vietnamese government is also continuing its 'two-child' policy, loosely based on China's, complete with targets, incentives, fines and other enticements not to have more than two children.
Women will not stop having abortions so long as it remains the only way they know to control their fertility. It's as simple as that. It will simply go underground, to back-alleys, unlicensed practitioners, home-made remedies and self-imposed mutilations — especially in developing countries, where access to reliable family planning is often a day's walk away, and the occasional free condom is not enough.
No one likes abortion. No one thinks it is a good idea. No one wants an abortion if alternative options are available. But sometimes the concept of the lesser of two evils makes perfect sense.
With the increasing liberalization of Viet Nam's urban social scene, over 30 percent of abortions are performed on young, unmarried women who don't know that other options are available. The answer to the abortion problem is choice. When a practitioner tells a woman that she can use an IUD, the pill or condoms, the IUD must not be rusty, the pills must be present in sufficient quantity and the condoms must be used before the expiration date. And until (or unless) that happens, the abortion rate in Viet Nam will continue to be absurdly and horrifyingly high. Cutting off funds to organizations that provide precisely these much-needed alternative solutions, therefore, is purely counterproductive.
These funds are used for family planning, not abortion services. Abortion services are provided by the Vietnamese government; organizations try to offer safe, sustainable alternatives and safer procedures for the women who have no other options. These non-governmental organizations provide funds to clinics: it is these same clinics that will start to shy away from providing lifesaving care for women who come in from botched illegal abortions.
The vast majority of women around the world who will be most hurt by this decision are precisely the ones who do not have the time or money to sit around wondering how to anger a small anti-abortion rights minority. The new guidelines allow local non-governmental organizations to refer women to hospitals if they come in with botched abortions, but in these cases the damage — psychological, physiological or otherwise — has already been done. Preventing abortions in the first place is the concern of all family-planning organizations. Many of these agencies, however, will be faced with a dilemma that touches on the core of their mission and beliefs. They must either agree to a policy they consider counterproductive and amoral or risk losing money for contraception that is vital to the health of women around the world. Restricting funds by reinstating the "global gag rule" was a major misstep for a compassionate conservative agenda.
(Natasha Burley, a former history major, is working in Viet Nam for a family-planning and reproductive health organization. She can be reached at ncburley@yahoo.com)
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