Killing Them Softly

September 20, 2003
By NICHOLAS D. KRISTOF

NAIROBI, Kenya

In fairness to President Bush, he presumably meant well
when he cut off funds for some of the world's most
vulnerable women.

The Bush administration announced a few weeks ago that it
was halting payments to the Reproductive Health for
Refugees Consortium because, it said, one of the seven
charities in the consortium was linked to abortions in
China. So I decided to do what the White House didn't -
come out and see these programs we are slashing.

That's where I met Rose Wanjera, a 26-year-old woman with
one small child and another due about November (she isn't
sure because she hasn't had any prenatal care). This month
her husband was mauled to death by wild dogs, and she
developed an infection that threatens her health and the
unborn baby's.

She turned to a clinic affiliated with Marie Stopes
International, where a doctor treated her infection,
palpated her bulging stomach and enrolled her in a
safe-motherhood program. Unfortunately, this is the very
aid group that the White House is campaigning against for
supposedly being involved in abortions in China. Even
before the latest cuts for aid to refugees, the Kenyan
program of Marie Stopes International had already had to
close two clinics and lay off 80 doctors and nurses because
the Bush administration had applied its "gag rule" (no
money to groups that mention abortions) and cut off grants
for it.

So because of White House maneuvering, girls and women in
Africa's shantytowns are losing programs that offer them
prenatal checkups, well-baby care, childbirth and
family-planning assistance, and, above all, help fighting
AIDS.

Consider Deka Hamid, a 25-year-old Somali refugee who
brought her 5-month-old son to a Marie Stopes clinic
because he is too weak to hold his head up. Doctors offered
some treatment, but there may be no cure because the health
problem arose from a flawed delivery by an untrained Somali
midwife.

Complications of pregnancy and childbirth kill a
quarter-million African women each year, and those deaths
are what the refugee consortium is trying to prevent. I
visited five Marie Stopes clinics in Kenya, spoke to the
patients and front-line doctors, and found them to be a
lifeline for destitute girls and women who have few
alternatives.

At one clinic, doctors fought to save the unborn baby of
Gladys Wambui, an impoverished 27-year-old woman who was
close to her due date - but whose fetus had abruptly
stopped moving. Ultimately, she lost the baby.

It was horribly discouraging, as work here in the slums
often is. The doctors and nurses in these clinics are
fighting AIDS, rape, sexually transmitted diseases and
genital mutilation of girls, and instead of being hailed as
heroes, they're denigrated and stripped of funds by White
House ideologues who don't know what an African slum is.

Because of the cutoff of U.S. funds to the refugee
consortium, the head of Marie Stopes in Kenya, Cyprian
Awiti, says he is having to drop a planned outreach program
to help Somali and Rwandan refugees.

"Bush does not realize how many people are going to
suffer," Mr. Awiti said. "If you don't give money to the
consortium, does he know how many deaths he will cause?"

U.S. officials acknowledge that the refugee consortium
(which also includes CARE and the International Rescue
Committee) does great work. But they said this was
outweighed by Marie Stopes's activity in China.

It's true that Marie Stopes International operates in China
- providing contraceptives that reduce the number of
abortions there. If Mr. Bush were trying to do something
about coercive family planning in China by denouncing such
abuses, I'd applaud him. But instead he's launching his
administration on an ideological war against groups like
the U.N. Population Fund and Marie Stopes. In fact, these
groups are engaging China in just the way the White House
recommends most of the time.

When the topic of human rights abuses in China is raised,
Mr. Bush usually argues, wisely, that it would be wrong to
impose sanctions that punish the Chinese people. So it
seems odd that when the issue is Chinese family-planning
abuses, Mr. Bush responds by punishing African women.

Mr. Bush probably sees his policy in terms of abortion or
sex, or as a matter of placating his political base. But
here in the shantytowns of Africa, the policy calculation
seems simpler: women and girls will die.

http://www.nytimes.com/2003/09/20/opinion/20KRIS.html?ex=1065240939&ei=1&
en=19a1056965a6402b

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