The Republic of T.

Black. Gay. Father. Vegetarian. Buddhist. Liberal.

Fistulas & Fairy Tales

I loves me some Anderson Cooper. Goodness knows I do. But, Andy, Andy, Andy. When I see stuff like this on your blog I begin to wonder why you aren’t telling the rest of the story, and if it’s because Tucker Carson has you tied up somewhere and has hijacked your laptop for nefarious right wing water-carrying.

“She never says anything to men,” one of the hospital counselors explained, and then she told us why.

The little girl was raped. Gang-raped. It was allegedly done by soldiers engaged in a complicated regional war that has claimed millions of lives. The war officially ended in 2003, but outbreaks of violence and rape continue. The girl is now five years old. She was raped when she was three.

I wish I could tell you this was an extraordinary event. I wish I could tell you she was the only child attacked. The hospital was full of rape victims, and the doctor had seen other small children victimized.

Because the rapes are so violent, women often develop fistulas — ruptures in their vaginas or rectums that make it impossible to control bodily functions. A charity called Heal Africa was running this hospital, and the doctor said he was able to fix about 70-80 percent of the fistula cases, but of course some wounds never heal.

Heal Africa has opened up a residence for women with fistulas that can’t be surgically fixed, at least not here in the Democratic Republic of the Congo. The women can’t go home. Often they’ve been rejected by their husbands because they were raped. The stigma here is strong.

I’ll give you credit. It’s touching, and it’s great that Heal Africa is helping these women. But it’s not the whole truth.

You see, women like those mentioned in the article were getting help, from an organization called the United Nations Population Fund (UNFP) and its campaign to end fistula, until the Bush administration blocked those efforts in 2001 and has continued to stand in the way.

President Bush announced on Friday that he is withholding the $34 million Congress had allotted for UNFPA, the United Nations Population Fund. This is the fifth year President Bush has withdrawn funding from UNFPA — a total of $161 million dollars lost in funding. UNFPA provides services to over 140 struggling nations, territories, and areas, funding programs to lower infant and maternal mortality, stop the spread of HIV/AIDS and sexually transmitted disease, increase access to contraceptive services, and decrease incidence of obstetric fistula.

President Bush has withheld funding for UNFPA since 2001, after spurious claims that funding was going towards forced abortions and sterilizations in China. The claim was proven false by a Department of State investigation in 2001, though President Bush still uses the claim to withhold funding from UNFPA. The $34 million could have prevented 385,000 infant and child deaths, 27,000 maternal deaths, and four million induced abortions, or funded contraceptives to prevent 12 million unwanted pregnancies, according to PlanetWire.

“This is the 5th year in a row that this administration has listened to its far right constituency at the expense of the world’s neediest women and children … It’s another in a series of actions that pander to the base while severely impacting women’s health. The administration didn’t let facts get in the way of its decision, and women suffer,” said Congresswoman Carolyn Maloney (D-NY). “…The Bush administration is playing politics at the expense of providing women with the means to take control of their health, their families and their lives,” said Dr. Lawrence Smith, Jr., president of the Population Institute, in a statement about the withdrawal of funding.

Nevermind that Bush sent a hand-picked State Department delegation to investigate the claims. Their findings, namely that the UNFP didn’t support forced abortions or sterilizations and thus should have its funding restored, didn’t jibe with the administration’s ideology. There are a couple of things about Heal Africa that do jibe with the Bush ideology, though.

HEAL Africa is a Christian organization whose mission is to support DOCS Africa to care for the vulnerable through physical, spiritual, and social healing by training health professionals and strengthening social activists.

Though at least that much was included in Andy’s blog post

The funding for the Heal Africa house comes from a non-governmental organization. They say their funding ends in April. It’s not clear what will happen then.

Actually, it doesn’t. It also doesn’t say just how closely Heal Africa follows what’s now widely considered a failed Bush ideology (are there any other kind?), at least to people who value evidence and results.

HIV prevention and counseling is another part of their work. In 2004, 80,000 people attended prevention and education classes. In 2005, HEAL Africa began encouraging youth clubs “to make a decision of abstinence.” It also supports initiatives to care for foster families, prevent mother-to-child transmissions, and offer antiretroviral therapy. World Food Program helps HEAL Africa provide monthly food rations to 2,000 people infected or affected by HIV.

The article doesn’t go into any other means of prevention, and neither does the HIV/AIDS section of the Heal Africa Website except for focusing on educating communities on “modes of transmission” and “prevention of mother to child HIV transmission and not much else. So, it’s not a far leap to guess that the focus in terms of prevention is “abstinence-only.” I mentioned earlier about how well that’s working.

It is easy to see how Aids is responsible for creating a missing generation across Africa, devastating economies, and crippling health sectors as it strikes. Across the continent, 6,500 Africans are dying every day, the equivalent of a village being wiped from the map every 24 hours. A further 9,000 are infected each day by HIV/Aids, which is the leading cause of death in Africa. …

… But it is not just a lack of appropriate medicine that is preventing Africa from saving a generation. Other major obstacles are preventing the Aids pandemic from being conquered. One of these is ignorance of how the virus spreads.

… A second obstacle holding up progress is the issue of abstinence, with programmes in Africa promoted by the Christian right wing in America and advocated by such prominent politicians as Colin Powell, the former secretary of state.

How well is the Bush administration’s ideology working in Africa? Ask someone who’s been there, who doesn’t share that ideology.

“Just remember, whatever you do, don’t mention condoms.”

I froze halfway inside the hot, dusty classroom in Kampala, Uganda. I turned to Crystal, the coordinator for ASK Africa, an initiative promoting HIV/AIDS awareness and education in Ugandan primary and secondary schools. I must have looked bewildered because she again made it clear that my impending speech about the ASK program could not include any shout-outs to the Trojan Man. Apparently the headmistress would be present, and as far as she is concerned, “safe sex” is an oxymoron.

…It’s bad enough that $1.3 billion has been spent domestically in the United States on these unproven and controversial abstinence-only programs, many of which are soiled with subliminal religious messages passed as scientific fact. But it’s criminal, even unpardonable, that we have forced our own policies on countries unable to deny them, undermining the potency of programs needing every resource at their disposal in their educational arsenal to adequately equip vulnerable populations against a virus that continues to purge their countries.

When the year 2000 rolled around, and Africa’s increased dependence on foreign donors coincided with a resurgence of Western radicalism, the continent’s impoverished countries, including Uganda, were forced to conform to the ideologies of America’s political elite in order to receive funds necessary for combating the deadliest pandemic in history. Seemingly ambitious and disturbingly arrogant, the President’s Emergency Plan for AIDS Relief (PEPFAR), George W. Bush’s global prevention program, was born. PEPFAR mandates that 33 percent of its funding is funneled into abstinence-only projects, and prioritizes abstaining and fidelity over safe-sex methods. Meanwhile, it fails to provide support for comprehensive prevention programs aimed at young people.

While PEPFAR has jeopardized AIDS programs in a multitude of countries, the Ugandan case has been especially tragic. During the 1990s, the country was seen as a poster child for eradicating AIDS rates in Africa, consistently hailed for its effective efforts in combating the global epidemic. At the cornerstone of its initiatives was a quality contraceptive program, which included a virtually unlimited supply of condoms, many of which were handed out for free at local bars to promote safe sex.

Yet, less than a month ago, data presented at the International AIDS Conference in Toronto confirmed that the tremendous gains Uganda made in the fight against HIV have withered away in the past five years — since Bush took the reins of U.S. policies. The cited reason? More unprotected sex, stemming mainly from a significant condom shortage that, according to Stephan Lewis, U.N. Special Envoy for HIV/AIDS in Africa, is a crisis “being driven and exacerbated by the extreme policies that the administration in the United States is now pursuing.” Such statistics reiterate what past evidence from an array of countries have already shown: that abstinence-only education not only persistently fails to curb the AIDS pandemic, but increases the risk of it spreading by discouraging the use of contraceptives.

Keep in mind that Uganda is also a country where homosexuality is illegal and carries a penalty of life imprisonment, and where the national media has launched an outing campaign against Ungandan gays and lesbians. Maybe America’s far right has had more success than it gets credit for.

And maybe that means that in order to hear get the rest of the story, we need to hear from them. Again.

At Reclaiming America for Christ, Stenzel told her audience about a conversation she’d had with a skeptical businessman on an airplane. The man had asked about abstinence education’s success rate—a question she regarded as risible. “What he’s asking,” she said, “is does it work. You know what? Doesn’t matter. Cause guess what. My job is not to keep teenagers from having sex. The public schools’ job should not be to keep teens from having sex.” Then her voice rose and turned angry as she shouted, “Our job should be to tell kids the truth!”

“People of God,” she cried, “can I beg you, to commit yourself to truth, not what works! To truth! I don’t care if it works, because at the end of the day I’m not answering to you, I’m answering to God!”

Later in the same talk, she explained further why what “works” isn’t what’s important—and gave some insight into what she means by “truth.” “Let me tell you something, people of God, that is radical, and I can only say it here,” she said. “AIDS is not the enemy. HPV and a hysterectomy at twenty is not the enemy. An unplanned pregnancy is not the enemy. My child believing that they can shake their fist in the face of a holy God and sin without consequence, and my child spending eternity separated from God, is the enemy. I will not teach my child that they can sin safely.”

And what’s good enough for America is good enough for Africa. Right? If AIDS isn’t the enemy here then it isn’t the enemy there either. And that’s no fairy tale. No happily ever after either.


  1. Good post Terrance. You really pulled all those loose ends together into a coherent picture.

  2. Yes, Terrance. As always, you’re on time with the full story here. Say, when can I get you on my show?

  3. Pingback: Link Farm & Open Thread #38 « Creative Destruction