As part of its work in Cambodia, the UN Population Fund trains doctors on abortion issues and tells women that abortion is a family planning option.
Now the program may lose its funding from the US due to President George W Bush’s recent decision to reinstate full abortion restrictions on US overseas aid.
Bush’s memorandum prevents international organizations that receive US money from providing information on abortion. The January order also prevents groups from lobbying foreign governments on abortion policy.
Yoshiko Zenda, the UN Population Fund’s country representative, says she would rather see her organization lose money than to follow Bush’s order, which she says will ultimately limit accessibility to safe abortions for women in developing countries.
“We’re not going to consent,” Zenda said. “We are not going to refrain from giving information to women, including information about abortion.
“It’s un-American to not provide information. And it’s hypocritical to say American women can have safe access to abortions, but women in other countries, especially developing ones, can’t.”
Most organizations that work in family planning and reproductive health in Cambodia, including the UN Population Fund, do not offer abortions or assistance in providing the service, which is prohibited under the Bush memorandum.
But many of these organizations at least provide information about abortion services, including giving referrals. These agencies have tough decisions to make on whether to give up US money, stop providing information on abortions, or try to get around Bush’s order while keeping the US aid.
Zenda said the UN program, which received $25 million from the US to use worldwide last year, has faced similar problems in the past, and has always refrained from following the restrictions. In the 1980s, the US wanted the program to leave China, which was strongly pushing its one-child policy, because the agency was “supporting abortion.”
The US “could say they are not going to fund us,” she said. “That’s a distinct possibility and a real worry. But what Bush has done infringes upon the right to information, and we cannot follow that.”
The Reproductive and Child Health Alliance, which receives almost all of its funding from USAID, provides abortion counseling at the grassroots level, where a majority of people lack knowledge about family planning.
A RACHA official said it is unclear how Bush’s order will affect the agency because it depends on how far the restrictions on providing abortion information will actually go.
A USAID internal memo said the scope of Bush’s order will not be known until it is incorporated and implemented in a new USAID contract that explains the terms. The memo also said to expect a “rocky four years” for USAID.
“It’s all foggy right now,” the RACHA official said. “It is safe to say that we are waiting for the other shoe to fall. We’ll see how this will be implemented.”
Var Chivorn, associate executive director of the Reproductive Health Association of Cambodia, said he doesn’t know much about Bush’s order. He received a phone call from USAID staff, asking whether the association provides abortions or abortion counseling. The association receives about 70 percent of its $2 million budget from USAID.
Var Chivorn said the association, which helps about 300 clients a day in its five clinics, does not do abortion counseling, but does makes referrals on where women can receive safe abortions.
“Abortions should be a service for women,” Var Chivorn said. “If the abortion information is not provided and the woman doesn’t know about it, she will be harmed psychologically and physically.”
He said many women who come to the association’s clinics have had anywhere from one to five abortions in their lifetime. This stems mainly from lack of knowledge of, access to, or money for, family planning, Var Chivorn said.
Democrats in the US Congress have introduced legislation to reverse Bush’s order. But the efforts likely will fail in the Republican-controlled Congress.
US Representative Nita Lowey, a Democrat who made a recent trip to Cambodia, noted that 70 percent of Cambodian women want family planning and contraceptives, but only 14 percent of women have access to them.
“Family planning groups work overseas to change these shocking statistics,” Lowey said during a press conference in the US on the legislation to reverse Bush’s order. “President Bush’s decision to reinstate the global gag rule will block their efforts.”
Officials from the European Union have criticized Bush’s order and said their countries may have to make up for the aid that would no longer be given by the US.
Alan Cole, country representative for Marie Stopes International, which operates the Cambodia Women’s Clinic, said he found a way to get around the abortion services restrictions back when his agency still received US funding. The clinic that was receiving the US money provided abortion counseling, and the abortions were performed in another building behind the clinic.
The problem with Bush’s order is the component restricting information on abortions, which will be harder to get around, Cole said. He said the result will be more women getting back-alley abortions from unqualified people at higher prices.
“This will have no effect on domestic [abortion] service in America,” Cole said. “It’s another example of America waving its dollars at developing countries to get them to follow America’s rules.”
The Cambodia Women’s Clinic is the only local NGO that performs first-trimester abortions as part its family planning package. Of its 400 to 500 clients a month, about 60 percent are seeking abortions, Cole said.
His organization does not currently receive US funding. Whether the agency will seek US money in the future will depend on what happens with Bush’s order.
Cole said 90 percent of health care aid agencies would be ineligible for funding, because most can’t avoid talking about abortions. “Even staunch religious organizations give referrals for abortions because it’s better than [a woman] getting a coat hanger shoved into her,” he said.
“It amazes me that American law allows one man to make societal changes that will affect millions of people with the flick of a pen,” Cole said. “What gives Bush the eyes of God?”