I'd never been so far from Capitol Hill in my life as I was three weeks ago--in a small concrete building in the middle of Mongolia's Gobi Desert. And yet I had never felt closer to the heart of a Capitol Hill debate.
Back in Washington, key Republicans were again holding up payment of our U.N. dues unless the Clinton administration agreed to restrict U.S. funds for any overseas population program that advocates abortion. Half a world away, the women's health clinic I was visiting in the bleak town of Umnugovi partly depends on such funding. In a country where abortion is legal and--sadly--has been the traditional family planning method of choice, clinics like this one are giving women welcome alternatives and are improving their medical, social and economic welfare. Even to someone passing through, like myself, it quickly becomes clear that restricting funds to these clinics will almost certainly drive more women toward unhealthy, unwanted pregnancies--and hence more abortions. It was a glimpse of how legislative deals can have unintended consequences in the real world.
I went to Mongolia to start work on a television documentary about archaeology. At my wife's urging--she is a public health professional--I joined a week-long tour organized by the U.N. Population Fund (UNFPA) of several reproductive health projects around the country. UNFPA works with international organizations that carry out the nuts-and-bolts work of running these clinics, including some organizations--like International Planned Parenthood--that do so with U.S. funds.
With a desert sandstorm howling outside, almost a dozen women braved blistering grit to come to the Umnugovi clinic. Wearing the bright silken coats and high black boots of nomadic herders, the women lined up for some decidedly up-to-date medical services. Some had come for prenatal exams; others for their quarterly shot of Depo Provera, an injectable contraceptive. Still others--the youngest among them--were there merely for information: on birth control, on the risks of sexually transmitted disease, on the general turmoil of being a teenager that is much the same from Mongolia to Maryland.
"They ask about everything," D. Delgaersaikhan, one of a growing number of female physicians in Mongolia and head of a regional hospital near the Chinese border, told me through an interpreter. "It's really opened up. Ten years ago, we didn't talk about these things. We had zero knowledge about family planning. If a woman got pregnant, she had no choice but to have the baby or have an abortion. Many women died in either case."
Delgaersaikhan's mother nearly lost her life during the birth of her ninth child. Delgaersaikhan herself has three children and doesn't plan to have another. "Now, a Mongolian woman knows more," she said. "She can choose from various family planning methods and have a child when it's best for her and her family. It makes us feel free."
That freedom may be fleeting. Under the deal worked out last week between the White House and congressional Republicans, no U.S. money will go to groups working with the U.N. and other international family planning programs that perform abortions or advocate liberalized abortion laws even if they use their own funds to do it. President Clinton could waive the restrictions on a case-by-case basis--and has promised to do so--but only by accepting a 3 percent cut in the $385 million U.S. overseas family planning budget.
This compromise promises to have a direct impact on some of the projects I saw. One that I visited--an effort to educate adolescents about reproductive health--is run with U.S. funds by the Margaret Sanger Center International, an arm of Planned Parenthood of New York City. I was impressed by the project--and saw kids all over the country devouring the teen newspaper it produces. Now, the Sanger Center will have to choose between its advocacy of abortion rights and its budget for the Mongolian project. As Alexander Sanger, who is president of the center, told me last week, "At best, our project will suffer a three percent budget cut and that's going to mean fewer birth control pills, fewer TV and radio spots, and more unintended pregnancies."
There's a lot to lose. There were two parts to the progress I found in Mongolia. A set of statistics compiled by the UNFPA shows that more women have access to birth control, fewer women are dying in childbirth, and fewer women are having abortions. And I also found a level of energy and enthusiasm on the part of women--even in the darkening early days of the long Mongolian winter--that goes well beyond statistics.
"What's happening with women here is very exciting," Delgaersaikhan told me. "Girls are staying in school. They are thinking about their future. They have a sense that they have some control over their lives and even over the course of the country." To be sure, the glass ceiling exists. Only seven of 76 parliament members are women, and only one cabinet minister. Yet women are playing a central--even leading--role in the revival of civil society in post-communist Mongolia.
Clearly, more is at work than increased access to reproductive health services. Many women I spoke to say that the organizational role they play in complex nomadic housekeeping has equipped them nicely for the challenges of reorganizing a post-communist society. The legacy of communist egalitarianism also may have something to do with the high level of school enrollment for girls. But whether it's a cause or an effect of Mongolia's strong women's movement, basic reproductive health care is helping make more things possible for women there.
What's more, the U.N. and other family planning groups aren't in Mongolia, as some critics have claimed, to solve a population problem--because Mongolia doesn't have one. Indeed, with 2.5 million people dispersed across more than a half-million square miles--much of it desert--it's one of the most sparsely populated countries in the world. Family planning groups are here, at the government's invitation, because their goal is to enable more women to have healthy pregnancies and healthy babies (and to prevent the spread of sexually transmitted diseases).
On my last day in the Gobi, I stopped to visit some nomadic families as they prepared to settle in with their camels and cattle for winter. In a canvas ger--cozy with lush wool rugs and a camel-dung-fired stove--I met a 68-year-old woman named Tserennyadmid. As she handed me a bowl of fermented camel's milk, she pointed proudly to a photograph of herself wearing a gold star. "I won a medal for having eight children," she says. "We didn't know about contraceptives. I almost died having my youngest daughter."
That same daughter, Baasanhau, lives in a nearby ger. She has only two children, and since the last one was a complicated delivery, she and her husband want to wait before deciding whether to have another. In two weeks, she will travel to the district capital to visit the family planning counselor. She didn't know that UNFPA and its partners had paid for that clinic to be built, as well as the one where she was taken when her last pregnancy got dangerous. And she certainly didn't know that on the other side of the world, the U.S. Congress was debating the wisdom of supporting such programs. All she knew was that the clinics have made things better for her, her family and in particular her 6-year-old daughter, now playing on the piles of folded woolen rugs. "I'm luckier than my mother was," says Baasanhau. "I think, now, that my daughter will be even luckier than me."
Luck, and a healthy life, is what we all want for little girls like hers. But with its recent misguided compromise, Congress may, unintentionally, be making the chances that they will get them a little less likely.
Steve Hendrix is a Washington-based freelance writer and television producer.
Follow the Funding
In 1974, at the first U.N.-sponsored International Conference on Population, the United States joined other nations in calling for measures to halt the "population bomb." Though some developing nations denounced the efforts as a form of genocide, the conference launched large-scale international family planning. Over the subsequent quarter-century, population control has remained a controversial topic, influenced by such political issues as the status of women, China's draconian one-child policy and abortion. Here are some developments in U.S. funding for international family planning:
President Ronald Reagan orders that no U.S. aid go to any overseas family planning organization for any purpose if that organization also performs or advocates abortions. (Direct funding for abortion was already illegal.) This becomes known as the "Mexico City" rule because it is announced at the second population conference, held there.
President Clinton rescinds the Reagan order. U.S. aid subsequently resumes to international family planning organizations that had lost funding.
U.S. funding for overseas family planning peaks at a one-year level of about $583 million. About $35 million goes to the largest multilateral family planning organization, the U.N. Population Fund (UNFPA).
Congressional opponents of abortion, unsuccessfully seeking to write the Mexico City rule into law, compromise by limiting U.S. funding of overseas family planning programs. Funds are essentially capped at $385 million a year; UNFPA aid drops to $20 million.
Congress eliminates all U.S. funding for UNFPA. The funding cap continues.
In a compromise aimed at achieving the U.S. payment of back dues to the United Nations, Clinton agrees to language in a spending bill that in large part echoes Reagan's Mexico City rule. UNFPA funding is reinstated at $25 million, but with restrictions related to programs in China.