Saturday, 2 April 2011

Morality at a distance and killing babies

The USA is a large donor. They give lots of money and plenty of in-kind food aid. Whether the latter is good or not, the fact is they are important. And foreign aid is an important part of their budgeting process, even if only because the public thinks it is a far larger part of their budget than is actually true. As a result, it has the potential to become a political issue. It gets to be the playing field for US morality battles. Enter the global gag rule.

The global gag rule is an horrendous example of conservative America imposing on countries they've never seen, or sometimes heard of, a morality their own fellow-citizens would never, in a million years, allow them to impose at home. The rule means that no US foreign aid fund can go to organisations or clinics that counsel or perform abortions. The limitation is not restricted to funding abortions - the clinic cannot be one that performs abortions, even if the abortions are funded entirely separately from the US funding. And it gets worse - the clinics cannot even counsel abortions. When presenting options to women, doctors and nurses are not allowed to tell them that one of their options is to terminate the pregnancy. Basically, clinics that even talk about abortion as one of the options open to women may not receive funding.

Many people have strong feelings on the issue of abortion. Even if you don't agree with abortion, the practical impact of the global gag rule is potentially devastating (again). Clinics that provide for family planning, maternal health, infant care are few and far between in developing countries. 94% of pregnant women in Ethiopia give birth without the help and support of a skilled birth-attendant (midwife), never mind at a clinic or hospital. Maternal health services are crucial and they're missing. Where they do exist, they're very often run by aid agencies. This means clinics that exist and have staff and (occasionally) supplies because of donor funding.

The proposed introduction of the global gag rule doesn't only apply to new funding - it would require that existing clinics are de-funded because their programmes include mentioning the option of abortion. The clinics would be closed down. This isn't a high-return, profit-driven market. When a clinic closes down in rural Zambia, someone else doesn't rush in to take over or start their own, alternative (abortion-free) clinic. Especially when you're simultaneously cutting all other funds that you can find that might possibly provide family planning or maternal health funding in these countries.

When a clinic closes, it's gone. The services that used to be offered are not available any more. Limiting funding based on abortion doesn't just reduce the number of abortions (if that even happens, instead of simply pushing them into the more dangerous black market), it reduces the number of clinics. It reduces affordable maternal health facilities available to poor women.

And when less women have access to family planning and maternal health services, more babies (and mothers) die. Infant survival dramatically decreases when clinics supposed to supply basic infant and maternal health services do not exist. These republicans are not saving babies from murderous abortion-performing doctors, they're killing them by removing health support for mothers and babies altogether. For what? To make a point. To prove that they can apply their moral principle somewhere, even if they can't get everyone else to subscribe to it at home.

Morality at a distance - doing in someone else's country what the hippie, liberal, commie, pro-rights, big-government people won't let you do in your own - isn't limited to abortion. The same problems existed with Bush-era abstinence-only limitations on HIV funding in the face of clear evidence that abstinence-only doesn't work (including evidence from the states). And it is equally unacceptable every time. Just because you have the money and (some of you) don't believe in something, doesn't give you the right to ignore the (evidence-based) practical implications of your actions. The global gag rule is a disaster for the very babies it's proponents claim to want to help. Saving babies in poor countries requires increasing women's health, education and choices, improving (not de-funding) health care and training more midwives. It can only be made worse by the imposition of a morality that is naive at best and misogynist (and baby-killing) at worst.

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