Uganda and the "Global Gag Rule"

Off Our Backs, 2006 by Klink, Jenna

Bush administration policies are limiting the effective ness of family planning organizations in Uganda, thus contributing to women's deaths due to unsafe abortions and causing decreased access to emergency contraception, post-abortion care, and condoms.

The Global Gag Rule, formally known as the Mexico City Policy, prohibits foreign non-governmental organizations that receive U.S. aid from using their own, non-U.S. funds to provide any abortion-related services. Reagan introduced the policy in 1984, Clinton repealed it in 1993, and in 2001 George W. Bush reinstated the policy on his first full day in office, which was, ironically, the anniversary of Roe v. Wade.

The Global Gag Rule gives foreign family planning NGOs two choices. The first is to continue receiving U.S. Agency for International Development (USAID) family planning funds and stop providing any abortion-related services, including education, referral, counseling, and advocacy. The second is to continue to provide these services, using their private, non-U.S. funds, but then have their USAID family planning funds cut.

The 1973 Helms Amendment already prohibited the use of U.S. foreign aid funds for abortion. The Global Gag Rule takes the Helms Amendment to the next level by telling NGOs what they cannot do with their private money and by restricting them from lobbying for the legalization of abortion in their country, a restriction that in the United States would be a violation of the First Amendment.

In 2002, the Bush administration revoked $34 million from the UNFPA (the United Nations Population Fund) because of their alleged involvement with coercive abortion in China. Although an investigation proved the allegations false, the administration has continued to withhold funding.

In 2003, the Global Gag Rule was officially expanded to include funds from the U.S. State Department in order to defund the Reproductive Health for Refugees Consortium. The administration justified this by saying that one of the organizations in the consortium worked with UNFPA in China, which was never investigated. The consortium includes seven organizations that work toward providing reproductive health and HIV prevention services for refugee women. Refugee women are particularly in need of these services because of the potentially high incidence of rape in some refugee situations.

The policy has resulted in the closing of seven health clinics in Bangladesh, five clinics in Kenya, and many health centers in Tanzania and the cancellation of numerous outreach programs in Ethiopia and Zambia.

Unsafe Abortions

Even though abortion is illegal in Uganda unless the life of the mother is at risk or a woman can prove she has been raped, a review of medical records in four major hospitals estimated that 5,000 women and girls are admitted to the hospital for incomplete abortions every year, and unsafe abortions are the cause of a third of all maternal deaths.

In many of these cases, the women perform the abortion themselves, by inserting the root of poisonous plants or sharpened sticks into their vagina and cervix, according to Dr. Annette Namayanja, an obstetrician from Mulago Hospital, Uganda's largest hospital.

When asked if she thought the legalization of abortion in Uganda would help reduce the number of maternal deaths, she would only say that making abortion safe would reduce the number of maternal deaths.

Decriminalizing abortions would make them safe, legal, and accessible.

One of the first female physicians in Uganda told me, "Nobody wants to talk about abortion because it is illegal." She said that women's rights advocates have tried to lobby for change in the past but were not successful with the politicians.

Health professionals have had debates on the issue of legalizing abortion, and many of them think it would lead to promiscuity and a higher number of pregnancies, according to John Kakitahi, MD and Professor at the Uganda Institute of Public Health. This common belief may be due to the fact that about 45 percent of Uganda's population is Catholic.

Kakitahi also said that the idea of legalizing abortion hardly ever receives press coverage. Open communication and public debate is essential before advocating for change in the current Ugandan law will be effective.

The Global Gag Rule restricts NGOs receiving USAID funds from "actively promoting abortion," which includes lobbying to legalize or make abortion available as a method of family planning and conducting public information campaigns regarding the benefits and/or availability of abortion.

Bush foreign policy, as seen in the Global Gag Rule, contributes to the silence that surrounds abortion in Uganda. The policy was meant to reduce the number of abortions; instead, women who need these services are dying from complications due to unsafe abortions.

Emergency Contraception and Post-Abortion care

Family planning organizations are afraid to participate in anything that may be associated with abortion. This includes the promotion and use of emergency contraception (also known as the moming-after-pill or Plan B). This is due largely to the fact that they are unclear about what exactly is or is not allowed if they sign the gag rule.