U.S. defunding UNFPA could cost women their lives

By — April 13, 2017

I remember I was 5 years old as I watched my mother repeatedly climb to the highest part of the bed only to jump right back off again. I was confused. I could see that she was in emotional and physical pain. I was sad for her.

“What are you doing, Mommy?” I asked.

“I just can’t have this baby right now, not again. I don’t want it,” she said.

This was before we had immigrated to the United States. At the time, we were still living in Egypt and this was my mother’s way of forcing herself to miscarry. My father was off travelling the world. He had already cheated on her several times and mistreated her. Although she remained married to him out of fear of letting go, she didn’t want to bring more children into the world at a time when she was alone, confused, and mentally and physically unwell.

But it wasn’t her choice. Abortions were and still are uncommon and illegal in Egypt, except in the rarest, most extreme cases.

My mother would tell me that story over and over again when I got older, of how much agony she faced as she tried to force herself into miscarrying before she hit the two-month mark of her unwanted pregnancy. I used to get frustrated with her, because she was being repetitive, but now I understand why she stressed it so much: so history wouldn’t repeat itself.

Like other women, my mother had become desensitized as a result of how society ingrained in her a belief that her body was not hers. For the longest time, women like her in developing countries were conditioned to believe that, as women, their basic rights were secondary—and that sometimes—those rights didn’t even matter. In many places today, women’s rights still don’t.

Access to reproductive services under threat

Today, most of the women who don’t have access to family planning methods live in 69 of the poorest countries in the world, according to the United Nations Population Fund (UNFPA). At least 225 million women worldwide want to use safe planning methods but can’t because they lack access to education, services, or the support of their communities. Egypt—which is the most populated country in the Middle East and the second-most populous country in Africa—is on that list.

UNFPA provides some of the only access for refugees to contraception, seen here at a UNFPA clinic at Zaatari refugee camp in Jordan. (Lauren Wolfe)

My mother didn’t have easy access to contraceptive methods until she immigrated to the U.S.

But even when my mother was still in Egypt in the early 1990s, there was one place women could go for health services and information. Founded in 1972, UNFPA Egypt has worked to help the country’s national family planning and population program support marginalized women and overcome widespread opposition. Although challenges like female genital mutilation, maternal mortality rates, and lower contraceptive prevalence still remain, Egyptian women have begun to learn through the years more about their reproductive health to avoid unwanted pregnancies, and fight against ancient societal rituals like female genital mutilation (FGM) with the help of organizations like UNFPA. However, new U.S. cuts to the agency, said a UNFPA Egypt representative, are going to hurt women—and the country as a whole.

The U.S., one of UNFPA’s founding members, has decided to pull its support for the program, slashing nearly $70 million in aid. In 2015, the US was the fourth-largest donor to UNFPA, giving $75 million in aid, Reuters reported. 

“The U.S. administration’s decision will prevent us from assisting the government of Egypt in their efforts to implement their national population strategy and stabilize population growth, which might in turn have serious implications on stability, water, and food security, and economic recovery of the country,” said Aleksandar Bodiroza of UNFPA Egypt.

The decision, he said, “will provide conditions for an additional increase in the rates of gender-based violence.”

As of 2014, the unmet need for family planning was at 13 percent, according to the Egypt Demographic and Health Survey (DHS), and there persisted many misconceptions around fertility and family planning, as well as concerns about side effects of contraceptives. The survey found that fertility rates had risen half a percent, and women were using contraceptives at a 1 percent lower rate from 2008. These “are indications that family planning programs in Egypt have lost momentum and must be reinvigorated,” Bodiroza said.

While there are other initiatives that work with the Egyptian government toward helping women and girls—such as the Egyptian Family Planning Association—the country, with a population of 95 million, is in need of all the aid it can get.

On a broader level, the Trump Administration’s decision to cut aid to UNFPA won’t just endanger the lives of vulnerable women and children in Egypt.

“With previous United States contributions, UNFPA was combatting gender-based violence and reducing the scourge of maternal deaths in the world’s most fragile settings, in areas of conflict and natural disasters, including Iraq, Nepal, Sudan, Syria, the Philippines, Ukraine, and Yemen,” UNFPA said. The organization was able to prevent 947,000 unwanted pregnancies, save the lives of more than 2,000 women from dying during childbirth, and prevent 295,000 unsafe abortions in 2016 alone with support from the U.S.

‘Times are better now’

Years after I witnessed my mother jumping off her bed, I discovered that this wasn’t the first time this kind of thing had happened to women in my family. As a young woman, my grandmother, my mother’s mom, had forced herself to miscarry several times using a metal clothes hanger, with boiled water and over-the-counter rubbing alcohol to sanitize afterward. She had already given birth to four kids at the time, and her husband had threatened to leave her if she had the fifth (as if she had conceived the child on her own).

Back then, they were living in a one-bedroom in the busy and bustling district of Downtown Cairo, and they were struggling to make ends meet. My grandfather didn’t want another hungry mouth to feed, clothe, and put through school. Married to him since the age of 14, my grandmother couldn’t stand the idea of being abandoned by him, the sole provider for herself and her children.

For an impoverished family of six in Egypt during the mid-1960s, contraception basically wasn’t an option. The idea wasn’t really known at a time when child marriages were common (and still are in the rural parts of the country). Many child brides like my grandmother didn’t know the first thing about reproductive rights.

I remember my grandma telling me that although she somehow grew to love my grandfather—who was 26 years old at the time they got married—she’d never wanted to marry him.

“All I cared about at that age was dressing up and sneaking off to the movies with my little sister and our girlfriends,” she said, as she tried to smile through the pain. She thought she concealed her pain well, but I still felt it.

Could you blame her? She was a teen who had undergone FGM—the cutting of the clitoris. She’d been deprived of her childhood and the right to her own body. In fact, every woman in my family, with the exception of my generation, had undergone FGM, a painful, unnecessary operation that can cause infection and even death.

In 2008, the Egyptian parliament finally agreed to criminalize FGM in the penal code, establishing a custodial sentence of three months and a maximum of two years, or a penalty of 1,000 Egyptian pounds. However, no one has ever been convicted yet according to the law, UNFPA reported. And we know that the practice is still widespread throughout much of North and East Africa. According to Egypt’s DHS in 2014, a staggering 92 percent of married Egyptian women between the ages of 15-49 have undergone FGM; only 72 percent of them by doctors.

In 2008, another DHS survey showed that 63 percent of women aged 15-49 believed that the practice should continue. Even the women believed in their own genital mutilation, and their daughters. Among the reasons cited by these women were their husbands’ preferences for “circumcised” women and the prevention of adultery. With proper education, like the training programs UNFPA provides, these women’s lives could be changed for the better. In turn, they could educate and save the lives of other women and girls.

UNFPA currently contributes to the elimination of FGM in Egypt by supporting the National Strategy to Combat FGM, a government initiative, and by developing a training program for prosecutors on FGM that includes forensic experts and judges. The group has also worked to raise awareness among women and healthcare providers.

“Your generation has access to things we never had,” my granny would sometimes say to me.

“Times are better now.”

But, I am just not so sure that we do anymore. At least, that’s not the message the United States is sending to the world with by slashing funding for UNFPA.

Going backward

U.S. has chosen to regress and curb the choices and reproductive rights education that women can receive in places like Egypt through its UNFPA cuts. The decision tells the world that the U.S. no longer cares to sit at the decision-making table when it comes to global health.

United Nations Secretary-General Antonio Guterres has already publicly warned that the decision by the Trump administration to withdraw all UNFPA funding could have “devastating effects” on vulnerable women globally.

But you don’t have to take his word for it. Just look at the regions in which UNFPA serves and operates, such as South Sudan, Iraq, or Syria. Look at women like my mother and grandmother in Egypt; look at women in other parts of Africa. Rape is literally being used as a method for ethnic cleansing in South Sudan, WMC Women Under Siege reported in December 2016. Without access to contraception and abortion, this forced ethnic cleansing—or wiping out an ethnicity with a new generation of children born of rape—may be successful.

Look to the Democratic Republic of Congo, which is known as the “rape capital of the world.” In 2012, nearly a third of men in DRC told researchers that women “sometimes want to be raped and that when a woman is raped she may enjoy it,” WMC Women Under Siege reported. What happens to women in war zones who turn to organizations like UNFPA for help, and it no longer has the capacity to help?

UNFPA is one of the only organizations that provide health services to millions of vulnerable refugees, from Africa to the Middle East. It has been the main clinic at Jordan’s Zaatari refugee camp that offers reproductive health services like contraception, and delivers babies, keeping both maternal and infant mortality down.

Not only is the Trump administration now pushing for laws that will keep refugees from seeking asylum in the United States—such as the infamous Muslim travel ban—they are also cutting off a major lifeline around the world for these asylum seekers. Denying basic health care to women in their own countries or places they’ve fled to seems counterintuitive to keeping people from wanting to move to a country, such as the U.S., that offers such much-needed care.

The U.S. State Department has claimed that UNFPA has been cut off because it supports, or participates in the management of, a program of coercive abortion or involuntary sterilization in China. While UNFPA has already refuted this statement, the allegation proves that the Trump administration, which is dominated by conservative, right-wing males, is simply out of touch with reality.

Fortunately, we women are simply not so easily coerced or manipulated as Trump and his administration seem to think. We know our rights, and we will continue to fight for them, with or without funding.