Gagging more than abortion information

THE NORTH West Department of Health has issued a public apology for injecting female pupils with contraception without their written consent.

It would appear that nurses arrived at Pitso-letlhogile Secondary School and administered pregnancy tests to Grade 12 pupils.

Those deemed not pregnant were summarily given contraceptive injections. The SA Human Rights Commission noted in February that it was investigating, which seems to be the current status of the case.

A different but related violation of women’s rights to bodily autonomy and reproductive choice has been taking place in South Africa and other countries in the region – less visible but as insidious as school and health authorities forcing contraceptives on to young women in a rural village.

January 23 was the first anniversary of US President Donald Trump signing into existence the “Protecting Life in Global Health Assistance Policy”.

It is colloquially known as the Global Gag Rule (GGR). Put in simple terms, the GGR prevents organisations receiving US global health assistance money from giving women information about abortion and informing them on choices in pregnancy termination.

Organisations receiving US funds are allowed to do so only if the pregnancy is due to rape or incest, or poses a significant health risk to the pregnant woman.

If organisations do not obey these restrictions, their funding will be removed.

The GGR goes as far as to say that organisations that receive US money are not allowed to provide abortion information even if they do so with other funders’ money.

Some organisations have fortunately put forward the legal argument that health-care providers in South Africa such as nurses and doctors have a duty to counsel and refer women for abortion services under current South African law and the GGR would not apply in these situations.

But the GGR probably would still apply to community workers, counsellors and social workers, who are important sources of information on abortion but who are not deemed health-care providers under the National Health Act.

A bumper sticker popular with sexual and reproductive health activists reads: “If you don’t like abortions, then don’t have one.”

Surely, some might argue, this principle should hold true for organisations receiving US foreign aid? If organisations are receiving US taxpayers’ dollars, they should not kick up a fuss over some conditions set about the money.

This argument ignores the ethical imperatives and global geopolitics of development funding from the so-called First World to Third World countries.

It ignores the millions of women who die from backstreet abortions and the high rate of disease associated with incomplete abortions.

The World Health Organisation estimates 68 000 women die from unsafe abortions annually and of those who survive, 5million will suffer long-term health complications.

Clearly, to protect their own health and the health of the broader public, women should be provided with information about all their reproductive options, including abortion, and have access to safe services where they elect to terminate their pregnancy.

It is not just pregnant women who are affected by the GGR. It also has far-reaching implications for the work that organisations do within the fields of health and human rights, gender equality and violence prevention.

Sonke Gender Justice is an example of how the GGR has a direct impact on the work that could be done to prevent and address violence.

Established in 2006, Sonke is one of the largest non-profit organisations in South Africa focused on addressing genderbased violence. It has won many awards.

In South Africa, intimate partner violence is the leading cause of death of women murder victims, with 56% of female murder victims committed by an intimate partner.

Recently, Sonke noted with enthusiasm new calls for funding proposals issued in South Africa to address the vulnerabilities to HIV experienced by women and adolescent girls because of rigid and inequitable gender roles, domestic violence and rape.

Calls for proposals from the US such as the recent “Preventing HIV/AIDS in Vulnerable Populations in South Africa” are intended to address and prevent gender-based violence and reduce women’s vulnerability to HIV.

They carry allocations of $150million (R1.7 billion) in total US Aid funding over a five-year period.

This is a lot of funding support that could make a fundamental difference to the lives of many in South Africa.

In various ways, Sonke is ideally placed to apply for such grants and to expand its important, evidence-based work.

Yet its commitment to sexual and reproductive health and rights means Sonke cannot sign the GGR.

Sonke is often the only source of information about safe and legal abortion for women in rural areas and it needs to be consistent in providing this vital information.

Staff know that the legalisation of abortion in 1997 in South Africa dramatically decreased death and disease for women.

Sonke must be able to give information on abortion and be able to engage in advocacy to sustain women’s rights to safe and legal abortion so as to safeguard the advances to women’s health brought about by abortion legislation.

Sonke therefore applied for an exemption from the GGR by writing to US authorities.

Early indications are that few organisations will receive an exemption.

Richter is the unit head of policy development and advocacy at Sonke Gender Justice.