The Means of Reproduction: Sex, Power, and the Future of the World (15 page)

Millions of men were bribed, threatened, or physically forced into vasectomy camps. One story in the
Indian Express
described what happened to a Muslim village that resisted: “At 3 a.m. on November 6, the villagers of Uttawar were shaken from their sleep by loudspeakers ordering the menfolk—all above 15—to assemble at the bus-stop on the main NuhHodol road. When they emerged, they found the whole village surrounded by the police. With the menfolk on the road, the police went into the village to see if anyone was hiding.... As the villagers tell it, the men on the road were sorted out into eligible cases... and about 400 were taken... to clinics to be sterilized.”
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When democracy returned to India in 1977, such abuses led Indians to sweep Gandhi’s Congress Party from power for the first time since independence.

In the following decade still worse abuses would be reported in China. Though some still refused to see it, it was becoming clear that demographic targets, once blandly accepted by pillars of the American establishment, could be tools of tyranny. The emergency, said Germain, was “a profound indicator of what can go so wrong if you only look at demographic control goals and don’t understand the human dimensions.”

P
lenty of people continued to do exactly that. Still, in the United States, the family planning field was slowly being remade in Dunlop and Germain’s image. In 1976, the Population Council needed a new president, and at Dunlop’s suggestion Rockefeller chose George Zeidenstein, the former head of the Peace Corps in South Asia and someone who was onboard with the feminist critique of population control. Franklin Thomas, a liberal-minded man raised in poverty by a widowed mother from the West Indies, became the new president at the Ford Foundation, and he ordered a massive review of the way the foundation’s programs affected women. Soon there was a specific budget for women’s programs and staffers specializing in women’s issues in country offices. And in 1981 Germain, then thirty-two, was sent to run the Ford Foundation’s office in Bangladesh.

Right away Germain started making grants to groups that were getting family planning money from USAID but needed additional resources to give pregnant women and their children other kinds of care. After several months she got an infuriating letter from someone in the USAID mission asking her to stop, apparently because he felt the new programs were distracting NGO workers from the more important work of birth control.

Germain didn’t limit herself to health care; she also overhauled the agriculture program to make it more supportive of women. Most donors were pouring money into staple grains like rice and wheat, and Germain saw that no one was supporting the women who processed the food, grew secondary crops in their home gardens, and raised chickens. Several years earlier she’d gotten to know Muhammad Yunus, the Bangladeshi economist who would win the Nobel Prize in 2006. In her new posting she helped him get an eight-hundred-thousand-dollar Ford grant to expand his nascent Grameen Bank, which would become famous for demonstrating the symbiotic relationship between women’s economic power, their rights, and the development of their communities.

Yunus had recognized the connection between women’s oppression and poverty. When he started Grameen Bank, women made up less than 1 percent of bank borrowers. “The banking system was created for men,” he said.
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He set an ambitious goal: He wanted half of Grameen’s clients to be women. This focus had a great deal to do with his success. “The more money we lent to poor women, the more I realized that credit given to a woman brings about change faster than when given to a man,” he wrote.
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He found that women worked harder, spent more of their earnings on their children, and repaid loans more reliably. By 2007, 97 percent of the bank’s 7.27 million borrowers were women.

Family planning is part of the Grameen Bank credo. Though it is motivated by women’s well-being rather than by population control, it has proven to be far more successful at the latter than the neo-Malthusian policies of previous decades. Women involved with the bank use family planning at twice the national rate, and their birthrate is well below the national average. “Once they have increased their incomes through self-employment, Grameen borrowers show remarkable determination to have fewer children, educate the ones they have, and participate actively in our democracy,” wrote Yunus.
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Unlike Pakistan, Bangladesh as a whole has experienced a sharp drop in fertility, from 6.3 children per woman in the early 1970s to 3.3 in the mid-nineties.
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During that time contraceptive use increased dramatically, from 3 percent of married women to 40 percent.
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Amartya Sen connects these trends to such organizations as the Grameen Bank and the Bangladesh Rural Advancement Committee, or BRAC, another microlender with a focus on female empowerment. “[T]he sharp decline in fertility rate that has occurred in Bangladesh in recent years seems to have clear connections with the increasingly higher involvement of women in social and economic affairs, in addition to much greater availability of family planning facilities, even in rural Bangladesh,” he wote.
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N
one of this means that contraceptive supply—Ravenholt’s obsession—doesn’t matter. It just means that supply alone is not enough. Indeed, for all her differences with Ravenholt, Germain will always be grateful to him for developing the manual vacuum aspiration syringe and for getting birth control commodities into the developing world. “Even though I had criticisms about the way he made them available, the fact was that AID leadership in getting contraceptives out was enormous,” she said. The MVA syringe proved especially important in Bangladesh, where Germain helped support a pioneering abortion clinic run by Sandra Kabir, who would become a major figure in the global reproductive health movement.

Like many countries in the developing world, Bangladesh’s government took a deliberately ambiguous approach to abortion rights. It retained the British colonial law banning abortion, but it allowed a procedure widely called menstrual regulation. Performed with an MVA kit, menstrual regulation is essentially an early abortion, but it’s spoken of as a cure for a late period or, in the local vernacular, as a “wash.” No pregnancy test is done.

The practice was first introduced in 1972, in the aftermath of the civil war that led to Bangladesh’s independence. The Pakistani army had used mass rape as a weapon of war against Bangladesh; hundreds of thousands of women were systematically violated in a campaign the feminist writer Susan Brownmiller has compared to the Rape of Nanking. “Girls of eight and grandmothers of seventy-five had been sexually assaulted during the nine-month repression,” she wrote in her classic history of rape,
Against Our Will
. “Pakistani soldiers had not only violated Bengali women on the spot; they abducted tens of hundreds and held them by force in their military barracks for nightly use. The women were kept naked to prevent their escape. In some of the camps, pornographic movies were shown to the soldiers, ‘in an obvious attempt to work the men up,’ one Indian writer reported.’ ”
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This rape offensive left around twenty-five thousand women pregnant. Their revulsion at their pregnancies was compounded by the certainty that if they gave birth both they and their children would be ostracized. Mother Teresa opened her convent’s doors to those who wanted to put their babies up for adoption, but few were interested. Instead, many resorted to crude self-administered abortions, suicide, or infanticide.
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These atrocities marked the first time that systematic rape in war received widespread international attention. Merle Goldberg, an American journalist turned abortion rights activist—she had opened one of the first legal outpatient abortion clinics in the United States, in New York City, a couple of years earlier, and was close to Harvey Karman—wanted to do something. At her instigation the International Planned Parenthood Federation arranged to send a team, including Karman and Malcolm Potts, to Bangladesh to perform abortions and train local medical workers to do them as well. At the time Karman was free on bail in the United States, having been arrested for performing illegal abortions in California, but Bangladeshi prime minister Mujibur Rahman welcomed him and publicly urged women to take advantage of his services.
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Karman’s team set up a temporary clinic in an abandoned house in Dhaka, and women came from as far as two hundred miles away seeking help.
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Using a Red Cross helicopter the providers traveled all over the country, distributing thousands of MVA kits and teaching health workers how to use them. At one point Mother Teresa showed up at Karman’s hotel room to lecture him, but he and his colleagues were otherwise received with gratitude. Some patients at the Dhaka clinic even trained to become providers themselves.
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Goldberg went on to coordinate a similar effort in Cyprus, responding to the widespread rape accompanying the Turkish invasion in 1974. A few years later she turned her attention back to Bangladesh, traveling to Dhaka to investigate the possibility of opening menstrual regulation clinics in the country. She was staying at the Ford Foundation guesthouse in Dhaka when she met Sandra Kabir, who would later describe her as “an older sister and a mother rolled in one.”
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T
he daughter of a Bangladeshi father and an English mother, Kabir was raised in England until she was thirteen, and she had never adjusted to the passivity that was expected of women in her father’s country. Headstrong and passionate, she eloped as a teenager, only to find herself trapped in a conservative Muslim family in a provincial town; the young man she’d been madly in love with was revealed as a violent and domineering thug. After nine terrible years she was finally ready to leave her husband when she found herself pregnant. She went to a government-funded model clinic, had a termination, and emerged as a fierce advocate for choice. That same year she joined Family Planning International Assistance (FPIA), a USAID-funded arm of Planned Parenthood, as an administrative assistant. Within a couple of months she was promoted to program officer.

Yet even before Reagan came to power, political forces in the United States were pushing USAID to cut off funding for agencies that performed abortions. Unlike Catholics, most evangelicals had not initially been much concerned with abortion (Jesse Helms was an exception). The origin myth of the Christian right holds that it rose up in outrage over
Roe v. Wade,
but as Columbia historian Randall Balmer has shown, that story isn’t true. Conservative evangelicals first started organizing politically in the early 1970s in response to government efforts to revoke the tax-exempt status of private, whites-only Christian schools. When
Roe
was decided, wrote Balmer, “the vast majority of evangelical leaders said virtually nothing about it; many of those who did comment actually applauded the decision.”
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As the 1970s progressed, though, and the feminist movement became more powerful in the United States, abortion emerged as a tangible symbol of women’s emancipation and the declining authority of the patriarchal family. The Protestant right developed a deep concern for fetal life and formed an alliance with Catholic conservatives that would shape American politics for the next three decades. As a synecdoche for American social chaos, abortion was a powerful political motivator. With
Roe
the law of the land, though, there was little that politicians could do for their pro-life constituents at home (though eventually some would figure out ways to chip away at abortion rights through various regulations and restrictions).

Internationally, however, there was more scope for action. By 1979, congressional restrictions forced USAID to stop supporting NGOs involved in menstrual regulation. “Even if it was a referral, they would no longer get USAID funding. And that
outraged
me,” Kabir said.
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Such a restriction would be unconstitutional in the United States, since it would interfere with free speech, but Bangladeshi women weren’t protected by the American constitution.

Angry as she was, it fell to Kabir to implement the new policy, making sure that no organization getting grants from her group had anything to do with menstrual regulation. Soon there wasn’t a single NGO performing safe abortions in the whole country.

One day, as Kabir was railing against the new American policy, Goldberg suggested that she start her own clinic. “I said yeah, where’s the money coming from?” Kabir recalled. “She said, ‘I’ll get it for you.’ ” Goldberg went to the Population Crisis Committee, which agreed to support the new venture for the first year.

There were several hundred manual abortion kits at Kabir’s old office, and the staff there was desperate to get rid of them lest an auditor spot them and report them to Washington. So Kabir took them, and with Goldberg’s help she set up shop opposite one of the most prominent USAID-funded family planning clinics in Dhaka, which made surreptitious referrals. She called her clinic the Bangladesh Women’s Health Coalition, after a group Goldberg had formed in the United States called the National Women’s Health Coalition (later changed to the International Women’s Health Coalition). Soon Kabir’s organization was training government health workers to provide safe abortions at the local level all over the country. As so many women worldwide would, she was able to take American population-control resources and turn them into instruments of liberation.