Eighteen years ago, people everywhere cheered as apartheid fell. But despite the collapse of the despised regime, conditions in South Africa remain bleak and large segments of the population continue to live in abject poverty, with little access to healthcare or schooling
According to The Lancet, under ANC rule life expectancy for both men and women has plummeted to age 60. HIV/AIDS is at epidemic levels, with 5.5 million of the country’s 50 million residents living with the virus. In addition, the injury death rate, 157.8 per 100,000, is twice the global average. What’s more, each year 23,000 newborns die within the first four weeks of life and an additional 23,000 births are stillborn. Other health problems including diabetes, cardiovascular and kidney disease, and mental illness are also on the rise. And then there’s domestic violence. The Lancet highlights the fact that the nation’s female homicide rate is six times the world average, with 50 percent of victims killed by partners with whom they’d once been intimate.
Abortion, however, has been legal since 1997. Although 14 African nations presently outlaw the procedure, South Africa—along with Cape Verde, Tunisia, and Zambia—has liberalized its law to allow women to terminate unwanted pregnancies—for any reason during the first trimester and in specific circumstances later on.
Aaron Motsoaledi, the country’s health minister, reported that 77,771 legal abortions were performed in 2011, a 31 percent increase over 2010. This statistic has rattled South Africa’s growing anti-abortion movement, sending it into a frenzy of activity to roll back the Choice on Termination of Pregnancy Act passed 16 years ago.
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Not surprisingly, this pleases the U.S. antiabortion movement and they’ve primed their African allies to organize Life Chains, rallies, marches and picket lines in front of the clinics and hospitals that offer abortion care. But that’s not all. Heartbeat International, a 41-year-old anti-abortion group that is headquartered in Ohio, is one of several groups that have assisted the troops in establishing a network of nearly 100 Crisis Pregnancy Centers throughout the country. Their ethos? Opposing not only abortion, but contraception, too. According to Heartbeat International’s website, their mission is to “promote God’s plan for our sexuality: Marriage between one man and one woman, sexual intimacy, children, unconditional/unselfish love, and a relationship with God.” Consider them cookie-cutter replicas of their U.S. counterparts—luring women into mock health centers through offers of no-cost pregnancy tests, ultrasounds, and counseling.
The anti’s strategy, of course, extends beyond setting up and running CPCs. A recently established umbrella organization called the National Alliance for Life has pulled together a coalition of secular, evangelical, and Catholic activists, among them conservative U.S. stalwarts including Birthright, Focus on the Family, Life Coalition International, and Operation Save America. Their goal? Revving up–and funding–South African Christians, and getting them committed to the anti-abortion/anti-sexual liberation cause.
Karen Trueman, country manager for an international reproductive health organization called IPAS South Africa—reports that a wide array of tactics, all of them U.S. staples, have been imported to her country. Take legislation. “The latest attempt at changing the Choice Act was adding a mandatory ultrasound, and viewing of the ultrasound, and a mandatory waiting period,” she wrote in an email. Sounds familiar, eh? Although Trueman reports that these attempts fell flat, she stresses that the African Christian Democratic Party continues to advocate for these measures and is unlikely to stop until it achieve an outright ban on abortion.
Trueman further notes an uptick in tactics meant to intimidate providers. “Work colleagues call Termination of Pregnancy, TOP, providers names and often cause a great deal of nastiness within communities by pointing out the provider for ridicule,” she wrote. “Sometimes providers receive threats either via phone or via letter. Sometimes providers are overlooked for promotions or other career development. In the private sector every second Saturday anti-choice groups stand outside Marie Stopes Clinics with posters and tiny white coffins protesting against the services.”
The impact, Trueman concedes, has been significant. “They are always there and it seems as though they are getting more organized. They make inroads in health systems by delaying implementation, refusing to allow terminations to be provided in public facilities that they manage, and by other delaying tactics such as refusing to order medication, equipment, or by transferring termination providers to other wards.”
Worse, Trueman concludes, is the fact that these maneuvers have led to a reduction in the number of licensed abortion providers. “Access to legal services through the public sector is not as it should be. Less than 50 percent of facilities are licensed, and while TOP is free in public sector facilities, women have been forced to seek TOP along back street routes.”
It’s the bad old days writ large and while some anti-choice groups have acknowledged the risks posed by back-alley services, most of their fury has been directed at two targets: The state and providers of reproductive health care. The lesson, gleaned from U.S. mentors, is obvious: Without providers, there is no choice. In concert with attempts to elevate the stigma and chip away at the law permitting abortion, the movement has captured headlines and gained a toehold on the body politic. In fact, the Guttmacher Institute reports that a recent survey of medical students at the Walter Sisulu University found a full 20 percent of them opposed to abortion in all circumstances. Even more telling, numerous groups, including one called Izintombi Zemvelo, have popped up to encourage celibacy among unmarried people and link contraceptive use and promiscuity in the public eye.