Family Planning and the “God Gulf”. The chapter begins with Rose Wanjera, a young pregnant Kenyan woman seeking prenatal care, whose husband had recently been mauled to death by wild dogs. A doctor found that Rose had a life-threatening infection, and enrolled her in a maternal health program. The clinic Rose visited, the authors report, was made possible by a consortium of aid organizations, including AMDD and CARE. Marie Stopes International also funded the clinic, until President George W. Bush cut off funding for Marie Stopes, because of its association with abortion access in China. The funding withheld money for Rwandan and Somali refugees, and for the very program Rose Wanjera attended.
The case of Rose Wanjera highlights the far-reaching, often invisible effects of politics in the U.S. Motivated by personal morals, the conservative mission to prevent abortions in fact led to greater risks for a pregnant woman seeking only to have a healthy child. One lesson here is to consider what unseen effects might follow political decisions in foreign policy.
What happened to Rose and the refugees, the authors argue, reflects the “‘God Gulf’ in American foreign policy.” Different views on family planning polarize liberals and conservatives, preventing the formation of bipartisan coalitions to fight sex trafficking and other issues. Republican presidents have instituted a “gag rule,” preventing funding for any aid group with any link to abortions (even if that link used no U.S. funding). As a Ghanaian doctor said, “the global gag rule results in more unwanted pregnancies, more unsafe abortions, and more deaths of women and girls.” The UNFPA (United Nations Population Fund) has been a conservative target, though it doesn’t in fact provide abortions. UN groups, the authors write, are bureaucratic machines that “probably do more for the photocopier industry than for the world's neediest,” but they’re still indispensible. Conservatives criticized the UNFPA for counseling China when China had coercive abortion policies. But in fact, the UNFPA’s involvement had apparently reduced abortions in China, not increased them, largely by introducing the copper-T IUD, a safe birth control method that averted some 500,000 abortions in China a year.
The failure of the global gag rule to save lives is a further example of false cause-and-effect assumptions that influence foreign policy. That is, the conservative logic to decrease abortion rates by gutting funding for any group linked to abortion makes a kind of sense at first glance. But upon a closer look, those same defunded groups are in fact preventing abortions through other services they provide. As examples in Half the Sky illustrate time and again, simple reasoning is often wrong reasoning. That inexpensive IUDs have prevented millions of abortions in China shows that contraceptive efforts, rather than funding cuts, are more likely to reduce abortion rates.
The authors argue that there is a pattern of conservative anti-abortion positions actually leading to more abortions. They further argue that pro-life and pro-choice factions need to find common ground on reducing abortions altogether, especially unsafe abortions, which often kill women. 122 million women worldwide, the authors report, want contraception and have no access to it. Compounding the disgrace, the authors argue, is that fact that use of modern contraception is hardly increasing.
Kristof and WuDunn imply that rifts between liberals and conservatives have grave consequences most people fail to see. While women’s oppression persist in the developing world, moral disagreements in West about particular issues obstruct progress on some human rights issues that all parties can agree are terrible.
Yet, “curbing population growth isn’t nearly as simple as Westerners assume,” the authors argue. Contraception campaigns often have only a modest effect on birth rates. Encouraging small families by reducing child mortality (increasing a child’s likelihood to live) is an effective strategy, they write. The most effective contraceptive, however, is girls’ education. Giving women more agency in family decision-making may also curb population growth.
The authors suggest that, importantly, tactics such as making condoms plentiful and free—though helpful—aren’t a cure-all to problems of population growth and AIDS. Rather, a multi-pronged, well-rounded, and sociological approach is necessary to meet those issues.
Family planning, Kristof and WuDunn write, is also vital in fighting HIV/AIDS. Biological factors make women more vulnerable to getting AIDS than men are. The authors make the case that, “one of the greatest moral and policy failures of the last thirty years is the indifference that allowed AIDS to spread around the globe.” This rose due in part to some conservatives’ claims that AIDS is God’s retribution for homosexual immorality. Conservative resistance to distributing condoms also exacerbates the problem of AIDS—despite that condoms can be life-saving and cost only two cents each, they are “rationed with extraordinary stinginess.” Ironically, the Clinton administration donated fewer condoms than either Bush in their presidential terms. Even so, the George W. Bush administration primarily used abstinence-only programs to combat AIDS. They describe one tactic, in which lollipops were distributed to girls with the message, “Your body is a wrapped lollipop.” After a man “sucks” on it, all that’s left for the next partner is a soiled lollipop.
This section points out another important point about the global repercussions of American politics—Democratic administrations may not be wholly progressive regarding human rights, and Republican administrations may be more liberal with some aid resources, as the condom distribution example shows. This suggests a possibility that humanitarian issues, including access to family planning, could transcend political divisions. However, the abstinence-only program in the Bush administration shows how the approach can be patronizing, belittling a woman’s body by comparing it to a lollipop, while ignoring the reality that such programs won’t stop girls from having sex, but will result in those girls being uninformed about contraception and STD-protection.
As the authors report, most studies suggest that abstinence-only programs fail in their objective and lead to increases in AIDS, pregnancies, and diseases. Members of the abstinence-only campaign have maintained that AIDS resulted from promiscuity, a claim the authors report to be false. To the contrary, women are more likely to get AIDS from their husbands after marriage than from pre-marital promiscuity. The authors describe the experience of one former prostitute, who had never contracted AIDS in the brothel, but did as soon as she married. This leads to a crucial point: “AIDS is often a disease of gender inequality,” especially when young girls lack the power to say no to older men.
The assumption that women in Africa are promiscuous and therefore more likely to contract AIDS relates to a broader problem: the racist idea that black people are hyper-sexualized. In white American history, this false idea has eroticized black women, leading them to be sexually objectified. Further, the assumption of promiscuity among African women relates to historic colonial impressions that African people have less self-control and civility than white Europeans. What’s more, the authors show that the assumption of female promiscuity is disproved by the inverse—male sexual behavior appears to be more responsible for the spread of AIDS.
Kristof and WuDunn introduce Thabang, a fourteen-year-old girl living in a South African village whom the authors describe as, “tall, flirtatious, and liberal with makeup.” Her father died from AIDS, and her mother, Gertrude, and younger brother have it as well. The family moved from middle class to living off skimpy welfare, since Thabang’s mother could no longer work. Like any teenager, the authors write, Thabang craved fun and distraction, but when Thabang started wearing makeup and spending time with boys—and receiving older male attention—Gertrude beat her in fury. Thabang was the only family member without AIDS, and it wrecked Gertrude to imagine her daughter trapped in the virus. To the authors, Thabang also seemed embarrassed by her mother’s condition and poverty. A violent, sad tension had grown between mother and daughter. Thabang insisted that, though some friends slept with men in exchange for money, she was a virgin. Nonetheless, both women were grief-stricken with both love and anger.
The authors describe Thabang sympathetically, portraying her desire to meet boys and wear makeup as normal teenage impulses. This sympathy invites the reader to identify with Thabang and to see the route that might lead a girl to contract AIDS. Readers can see that Thabang’s desire for independence and diversion, especially given the tragic atmosphere in her home, might reasonably push her to a situation in which being offered attention and gifts from an older man could lead to unsafe sex.
The authors argue that schools should encourage girls like Thabang to be abstinent, but should also give instructions on condom use, and encourage HIV tests and male circumcision, which reduces AIDS transmission. Such preventative measures, they point out, are much less costly than treating AIDS patients. In one study, the most effective AIDS prevention strategy (measured against training teachers in AIDS education; encouraging student homework on condoms; and providing free school uniforms) was warning girls against sugar daddies. These older men provide gifts or money in exchange for a sexual relationship—and have much higher HIV infection rates, the authors write. The warning influenced girls to have sex with boys their own age more than with older men.
The AIDS prevention study demonstrates that solutions are best when based on empirical evidence. Intuitively, one might think that having students research the benefits of condoms would be effective, but the most effective strategy was the simplest and least expensive: warning girls that older men, having had more partners, are more likely to have HIV.
The authors report that, while religious conservatives have limited family planning access, many also sponsor and operate clinics for the most underserved and rural populations. What’s more, the Catholic Church more broadly has been more amenable to condom distribution than the official Vatican position. Because missionaries have been so instrumental in healthcare in the developing world, Kristof and WuDunn argue that were religious aid work channeled into women’s empowerment, it would reap enormous benefits. “Aid workers and diplomats come and go, but missionaries burrow into a society,” they write, and are uniquely situated to improve women’s rights. Pentecostalism has an especially crucial opportunity to advocate for women, as the faith is rapidly growing in the developing world. Though some Pentecostal leaders make false promises, churches do encourage vocal female participation and discourage alcohol and adultery, both of which burden many women. Importantly, as evangelical churches have become more humanitarian-focused in the past two decades, the authors write, “bleeding-heart evangelicals are out in front alongside bleeding-heart liberals in fighting for aid money,” to tackle problems such as malaria and fistulas—a major advancement.
The emphasis on religious missionaries’ success in humanitarian causes serves several functions. First, it shows Kristof and WuDunn as continually open to the most practical humanitarian strategies—although their background isn’t evangelical, they celebrate the good evangelicals have done in the developing world. Meanwhile, the authors argue for more gender-focused tactics within the missionary paradigm. Second, it shows that approaches some liberals might consider too moralizing and intrusive—such as a missionary position against alcohol and adultery—can in fact have positive effects for women who are encumbered by male drinking and sexual behavior. Third, it reflects a viable path for collaboration between liberals and Christian conservatives, whose shared humanitarian values can lead them to a common fight, leaving differences at home.
Kristof and WuDunn suggest that liberals could adopt the traditional Christian policy of tithing, or donating ten percent of their earnings to charity. Americans who attend regular worship services, the authors report, are much more likely to be charitable than those less religious. However, the authors make the case that all people should consider more how their donations are put to use. They also believe that better models for youth volunteer service abroad, demanding less commitment than the Peace Corps does, are necessary.
By invoking the traditional Christian donation model to encourage more non-Christian donors, who are on the whole less charitable, the authors take a pragmatic, nonjudgmental approach to evangelical Christianity—they suggest not converting to another religion, but simply borrowing ideas that are useful.
Jane Roberts and Her 34 Million Friends. The section begins with George W. Bush’s withholding of $34 million from the UNFPA, which irritated many people. But one Californian, Jane Roberts, was beyond irritation, and wrote a scathing letter to the editor in which she detailed the injustices—deaths in childbirth and female genital cutting, for instance—the defunding would lead to, and asked 34 million of her fellow citizens to donate $1 each. A woman in New Mexico, Lois Abraham, had a similar idea, and drafted a chain letter imploring people to send $1 wrapped in a sheet of paper, and mark it “34 Million Friends.” Heaps of envelopes started showing up at the UNFPA office, which was unequipped to handle the deluge of mail and had to hire temporary staff. Most envelopes came from women and contained $1. Jane and Lois began giving speaking tours, and donations soared, eventually reaching $4 million. Even after President Obama restored funding for UNFPA, the group continued to fight for women’s rights.
Jane Robert and Lois Abraham’s story shows the potential power of an ambitious, even improbable idea when it is marketed with tenacity. At the same time, the authors’ mention of how the UNFPA staff at first couldn’t manage the influx of mail serves as a subtle reminder that good intentions often have unforeseen consequences. Although this problem was relatively minor and quickly solved, some aid efforts burden the recipient in unsustainable ways.