"It kills me that I can't ask lawmakers from my own country, 'Can you imagine how horrible it is for us when a 13-year-old rape victim walks into a clinic and we can't tell her anything?'" says Galdos. "This is especially difficult when we know there are options and choices. We have to sit there silently, gagged."
Of the 53 countries affected by the gag rule, nowhere is the impact more chilling than in Nepal, where abortion is illegal under any circumstance and is often equated with infanticide. One in five women prisoners currently in Nepal's jails have been incarcerated-sometimes for life-for having an abortion. Herbal mixtures, powdered glass, sticks, and cow dung are the wire hangers of Nepal. Unsafe abortions account for 54 percent of the country's rising maternal mortality rate of 830 deaths for every 100,000 live births. Yet despite severe restrictions on women's reproductive freedom in Nepal, activists recently succeeded in getting an important piece of legislation before Parliament that would overhaul the national laws dealing with marriage, property, and abortion rights for women. But now that the gag rule is back, lobbying for the law has become less vigorous. And Nepalese activists receiving USAID money feel that they can no longer work with their own Ministry of Health because it supports the legalization of abortion.
"It is hypocritical of the United States, the supposed champion of democracy, to impose the Global Gag Rule on other countries, when it could not impose this in its own country," says Anand Tamang, director of the Center for Research on Environmental Health and Population Activities (CREHPA) in Nepal. "The rule inappropriately seeks to influence Nepal's democratic process." The group is one of the few international NGOs that rejected USAID funds when they realized there were strings attached. Tamang says his decision was difficult, but adds, "The work we are doing to save women from dying from unsafe abortions in my country is far more important than the USAID money we would lose."
But most NGOs are unable to reject USAID funding, since it is often a major source of support for their family planning programs. Cheating the system is also out of the question: not only do NGOs have to sign an ironclad contract, they've got to contend with spot inspections from USAID field officers.
"As part of the contract," explains Rahman, "USAID can ask to see an NGO's expenses, procedural logs, and whatever else on a moment's notice." This looming threat, along with the complex wording of the rule's conditions, leaves many health workers unsure as to what constitutes a contractual violation and what doesn't. USAID illustrated this in a 1990 internal study. They reported that the fear of losing funding drove one Bangladeshi NGO to instruct staff members not to mention the word abortion even when they were off-duty, while a Brazilian NGO fired a clinic worker just for being pro-choice, and a Pakistani group decided not to purchase a dilation and curettage kit that was to be used for non-abortion-related services lest people think it was for abortions.
While civil rights groups and health workers around the globe fight to stave off Bush's anti-women, anti-choice policy, it remains to be seen how the battle will play out in the U.S. Boxer has said she will continue to fight for the repeal of the rule regardless of Bush's presidential memorandum. "The gag rule is not stopping abortion; it's leading to an increase in the number of deaths related to unsafe abortions by denying women access to information, adequate care, and counseling," she says. Boxer and other senators are now pursuing the Global Democracy Promotion Act, a bill that would reverse the gag rule. But at press time, the bill's passage seemed unlikely given the fifty-fifty split between Republican and Democratic senators and President Bush's veto power.
Rahman agrees that the choice most international NGOs are be