This week, it hit the headlines that authorities in Kenya have forbidden Marie Stopes International(MSI) from carrying out abortions in Kenya. The Kenya Medical Practitioners and Dentists Board (KMPDB) issued this order after it was noted that Marie Stopes was advertising abortion services, despite a prohibition on all abortion advertising. Earlier this year, the Kenya Films Classification Board asserted thatMarie Stopes adverts were promoting abortion, which is against the Kenyan Constitution. It observed that such advertising ‘targets teenage girls by giving them alternatives for unwanted or unplanned pregnancies” and it demanded a public apology from Marie Stopes.
Kenya is not the first country to become a victim of the abortion giant. In 2012, it was found that the organisation had carried out over 500 illegal abortionsin Zambia – on the basis of social reasons, or simply because the pregnancy was unwanted.
This is of direct concern to the UK as we spend millions of taxpayer money, via the Department for International Development (DfID), on MSI, including Marie Stopes Kenya.
In Kenya, abortion is not permitted unless the life or health of the mother is at risk. This legislation reflects societal values – the belief that life begins at conceptionand that every person (thus including the unborn child) has the right to life. The KMPDB condemned MSI for spreading misleading information on its website and through their advertising campaign, and has instructed the organisation to submit a weekly reportdetailing all the services offered at its clinics for 60 days. Given that MSI claims to act in accordance with the law in all the countries where it practices, this is highly concerning.
In addition, MSI has been the subject of public complaints. A petitioncalling for the Kenyan Secretary for Health to stop MSI advertising abortions states that Kenyan women are becoming victims of the ‘blood thirsty clinics’ which are using ‘cunningly crafted’ adverts to promote abortion. Adverts on social mediain August 2018 caused many to believe in fear that the organisation was covertly advertising abortion services. This shows that the people of Kenya are concerned about the prevalence of abortions carried out by MSI, and are demanding that their law is upheld.
It is notoriously difficult to determine the exact number of abortions that MSI is responsible for in each of the 37 countries where it works. In total, the organisation proudly states that it provided more than 4.1 millionsafe abortion and post-abortion care services in 2017. Furthermore, it claimed that Marie Stopes Kenya had increased their CYP (Couple Years of Protection) delivery by 18% since 2016. (A CYP is a measurementused by family planning services, which represents the contraception required by a couple to prevent pregnancy for one year. Part of this increase was due to safe abortion/post-abortion care services which rose by 13%.
The UK government has committed £36 million to increasing access to modern family planning in Kenya; yet it is (apparently) not known how much of this money will be spent on abortion – see hereand here.
However, the UK government assures usthat any funding given with regards to family planning is used in accordance with the recipient nation’s legislation. UK Aid cannot be used to fund illegal services. Surely it is worrying that in Kenya, MSI has so blatantly been violating the law by advertising and offering abortions to healthy women whose lives are not at risk?
Furthermore, how can we be confident that this is not happening in other countries? From 2012-2017, the UK Government provided £163.01 millionto MSI, via DfID. In August 2018 the government announced that a further £200 millionwould be spent on the ‘Women’s Integrated Sexual Health’ (WISH) programme. However a recent reportcarried out by the Independent Commission for Aid Impact (ICAI) highlighted significant failures by DfID to improve maternal health services thus far – the report suggests that there was an ‘intensive focus on family planning’to the detriment of other causes of maternal morbidity and mortality. Although unsafe abortions are a cause of maternal mortality, these only account for 7.9% of maternal deaths. The biggest contributors to maternal deaths are haemorrhage (27.1%), hypertensive disorders (14%) and sepsis (10.7%). These arenotprevented by family planning services. Despite the money thrown at developing countries to improve access to contraception and abortion, the report found that ‘progress on improving emergency obstetric and neonatal care has been well short of targets’.
A ComRes poll in 2017 found that 65%of UK taxpayers oppose the use of tax payer money to fund abortions overseas. How can we guarantee that funds provided to DfID are being used in a responsible manner?
It is not the first time that MSI has come into the spotlight. In 2017, the CQC suspended certain servicesat UK abortion clinics due to concerns around safety and the gaining of informed consent. At the time, reassurances were given that the DfID has ‘robust monitoring and evaluation procedures’ to review the way that funds are used in developing countries.
It is worrying that such ‘robust monitoring’ has failed to notice the covert illegal advertising and abortions taking place in Kenya using MSI (and by implication, DiFD) money.
It cannot be denied that the slogan promoted by MSI has at its heart a very Western agenda: ‘At the heart of all our work is our mission to build a world where every birth is wanted and where women can have children by choice not chance.’ However according to a 2014 survey carried out in Kenya by Ipsos Synovate, 87%of Kenyan citizens do not support abortion on demand. Interestingly, voices from other sources in Africa are also speaking up on this issue. One such example is Obianuju Ekeocha of Culture of Life Africa, who opposes the push from ‘rich western philanthropists’ to impose an ‘anti-life culture’ on African nations through funding abortions and contraception.
Is it right for Western cultures to impose our own views on abortion onto other cultures?
Maternal mortality is undoubtedly a complex and devastating issue. But shouldn’t we be targeting resources at organisations which take a holistic view of maternal health? Instead of funding organisations which march ahead with their own agenda, without consideration of local laws or of the culture in which they work, shouldn’t we consider how to tackle the biggest killers?
Kelly Hibbert is a junior doctor