Visit to Colombia

“There are lions in the jungle,” the boy said. He had cropped hair, protruding ears, and wry smile. He looked eight, nine maybe, and wore a yellow shirt and a pair of bright orange crocs.

Leones?” I ask. Lions.

Si, senor, leones. Hay muchos.” There are many, he says.

I’m in a jungle in Colombia, on a wooden walkway fortuitously elevated a few feet above the vegetation that surrounds us. I figured the walkway was to prevent spiders or snakes from getting to us—but lions? Don’t they live on the other side of the Atlantic?

I call over a fellow traveler, a Colombian, and have the boy repeat what he said. “Leones,” he insists.

“Are you sure it wasn’t a panther?” my friend asked. “No.”

“A jaguar?”

“Nope.”

“A panther?”

No. Un leon.

We are in Bete, a remote village nestled in northwestern Colombia with a whopping population of 120. It’s 90 degrees, the humidity is at 100%, and luckily it’s cloudy—I can’t imagine I could have handled much more heat.

We arrived on 30-foot boat with medical personnel and supplies, there are no roads that lead to these remote villages. I had imagined a beautiful waterway, lined with stunning vegetation, but had a rude awakening.

The river was filthy. Garbage was caught in the weeds, and the water was muggy in a way that I knew wasn’t natural. Illegal mines in the area are known to dump chemical waste with impunity.

I watched as the helmsmen pulled trash out of the props, thinking about how close the boat was to the water, and the supplies we had on board. Other boats passed, filled to the brim with bright plantains.

          

I chuckled at the thought of crocodiles lurking, a thought rudely interrupted when I looked down at the quality “life jacket” I was wearing.

Colombia’s made many a headline this past year; the country rejected a closely-watched referendum to end the armed conflict. FARC is the most well-known of these groups, and they’ve participated in the ongoing negotiations, but other groups have not. Just that day, a group called the ELN took over a village along the river, forcing its 300 inhabitants to flee. They territory is fertile, both for coca cultivation and illegal mining. One of their boats came alongside ours, inspected our supplies, and waved us along.

The teen pregnancy rate in the remote villages we’re serving   is nearly universal, averaging seven children per woman. It’s a stark contrast to the 2.1 average children per woman across the country.  75% of children don’t finish high school in this community, and most recently, 20,000 women have been infected with Zika.

Environmental racism is ever-present, and the majority of the indigenous population lives in abject poverty. Illegal mining, soil erosion, non-existent infrastructure leaves the community so ill-prepared it can’t even capture the rainfall—even though it’s one the of the rainiest cities in the world.

Upon our arrival in Bete, we’re met by our escorts, a unit of 25 men armed with automatic rifles. The good news is that we are protected—the bad news is that we need protection.

          

Mobile health staff set up in the local clinic, run by one of Colombia’s insurance companies, which refuses to cover sexual and reproductive health services. One of International Planned Parenthood Western Hemisphere Region’s partners, Profamilia, fills the void by providing contraceptives, GYN exams, tests for sexually transmitted diseases, and screenings for breast and cervical cancer.

They bring life-saving care to the village about once a month, in an area that for all intents and purposes has been ignored by the Colombian government.

While the work is admirable, the obstacles are daunting. Adolescence, for girls at least, doesn’t seem to exist. Too often it is brutally cut short, mired with sexual violence, assault, and forced pregnancy.

Many women come to the clinic. Cancer screenings costs about a dollar, an injection three and an implant five. Profamilia takes a significant loss for each service provided.

These are precisely the type of crucial services that are affected by the expanded Global Gag Rule.

Issued by the Trump Administration only a few weeks ago (and oxymoronically re-branded as ‘Protecting Life in Global Health Assistance’) it is an unprecedented expansion of a policy that flies in the face of science. For many it will be a death sentence.

US foreign aid is already prohibited from being used for abortion services, so that is not the issue at hand. The issue is the scope of work of these organizations. If they are in any way associated with offering or advocating for abortion, even  if the procedure is legal in the country in which they operate, then they are not eligible for US aid. It even bars an organization from accepting funds from a separate entity, aid organization, or grant that does not have similar anti-choice restrictions.

This is why the policy is well known as a gag.

Previously, the GGR affected roughly 600 million dollars in funding. Under the expansion, it will affect up to 8.8 billion dollars in aid.

In practice, that means community organizations that work across a spectrum of issues—from improving maternal and child health, reducing teen pregnancy and abortions, promoting access to contraception, HIV prevention, reducing environmental degradation, public health initiatives that work on Zika, malaria, or tuberculosis—are barred from receiving US funding if they can be linked to supposedly advocating for abortion.

The expansion is not based on research—which demonstrates that when funding for family planning services decrease abortion rates increase—not fact. It is the product of alt-right ideology that is now codified into our laws and rebranded to suggest it ‘encourages life.’ It does not by any stretch of the imagination—in fact, it does the opposite.

Worldwide, the International Planned Parenthood Federation is set to lose 100 million dollars in funding. We will not sign onto the gag because we refuse to compromise our values. We are a public health organization that believes in science. Keeping abortion illegal and unsafe harms women, period.

But the costs are high. We expect 20,000 preventable maternal deaths, 4.8 million unintended pregnancies, and 1.7 million unsafe abortions.

It’s been a tough few weeks, and I think back to my time in Colombia with the mobile health unit. I remember saying goodbye to my friend.

There were still lions in the jungle, he insisted. There are many enemies in the jungle, I thought. Guerrillas. Zika. Byproducts from the mines that poison the water.

The irony isn’t lost on me that there’s now one more lion in the jungle: us.

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