Tough times, tougher choices: an interview with Thoraya Obaid, executive director of UNFPA.

THE UNITED NATION'S POPULATION FUND (UNFPA) supports family planning and maternal health programs that have helped women make reproductive choices and reduce infant and maternal mortality rates in more than 140 countries. Yet, despite its impressive track record, it has long been a target of antichoice members of Congress in the United States who have used the "Global Gag Rule," the statute that prohibits any US support of overseas family planning programs that include abortion, as a cudgel. From 1986 until 1992 these zealots succeeded in blocking US support for the fund. This stranglehold was broken when Bill Clinton stepped into the Oval Office, and surprisingly continued during the first year of the George W. Bush administration. That ended in 2002 when the Bush administration froze an appropriation of $34 million for UNFPA, after antichoice politicians in Congress charged that UNFPA was sup porting China's coercive abortion policy. In July 2002, after months of stalling, the administration officially announced that it was withholding the money. A letter announcing the decision, signed by Colin Powell stated, "regardless of the modest size of UNFPA'S budget in China, or any benefits its programs provide, UNFPA'S support of and involvement in China's population planning program activities allows the Chinese government to implement more effectively its program of coercive abortion." This despite the fact that a review of the Fund's program in China by the US State Department had found "no evidence that UNFPA has knowingly supported or participated in the management of a program of coercive abortion," and recommended that the money be released. The Bush action also cynically ignored that US funding has always required that UNFPA, A maintain a separate account for US funds and prohibited their use for abortion-related programs and for any of its work in China.

This mean-spirited decision not only distorts the facts in regard to UNFPA'S work in China, it places the health and lives of millions of the world's poorest women and children at risk. According to UNFPA, the loss of the US contribution--12 percent of its $270 million budget--will translate to two million more unwanted pregnancies, 800,000 more abortions, 4,700 more dead mothers and 77,000 more deaths among children under five. Although the US funds will be directed to international health programs run by the United States Agency for International Development (USAID), that organization's reach is only slightly more than half of the countries UNFPA serves. Commenting on this action in the Washington Post, David S. Broder aptly stated, "when our government allows special-interest pleading to cost lives, it shames us all."

Late in 2002, I met with Thoraya Ahmed Obaid, the executive director of UNFPA, to discuss the organization's work, and the impact of the withdrawal of US funds. The third person to hold this position, she was appointed in October 2000 by Kofi Annan, the UN secretary general, and took over the post in January 2001. Helping governments establish programs to empower women has long been a central focus of her work. The former director of UNFPA'S Division for Arab States and Europe, Obaid also served as the deputy executive secretary of the Economic and Social Commission for Western Asia, where she provided technical assistance to counter gender inequality, as an integral part of social development programs. In 1975, she set up the first women's development program in Western Asia helping governments establish national organizational units for women. Obaid is the first Saudi Arabian woman to receive a government scholarship to study at a university in the United States. Of her work Obaid--who divorced and remarried and is the mother of two daughters--says, "I've had a good life. I got an education, I have good health and healthcare, I have healthy children and a happy family--I've been able to make choices. And that's what I want for all the women of the world."

ON THE WORK OF UNFPA

"Seventy percent of our resources go to the area of reproductive health in terms of decreasing maternal mortality, increasing the number of trained birth attendants, decreasing teenage pregnancy, prevention of HIV and other sexually transmitted diseases, preventing violence against women, and promoting girls education. Those are the basics. Our main focus is to create an environment and provide tools so that women and men can determine the number and spacing of their children. Our focus is not on control, it's on planning. For example, in Afghanistan we are assisting the government with censuses, building statistical services, training personnel and monitoring information systems in the area of demographics and health.

I believe that creating a better dialogue that includes and addresses religious and cultural beliefs and practices is extremely important. Last year we began to become more active in this area with the help of the Swiss government's funding of a post for gender and culture. And we have also created an organizational unit focused on culture, gender, and human rights in the technical area. The idea is that no issue is one-sided and each issue must be explored from every side. Gender crosses everything. Human rights is the framework for all of our work and includes much more than civil rights, it encompasses social, economic and cultural rights as well. And there is so much in religion and culture that resonates with human rights.

At the country level, when we are developing a program or project, we first have to assure that the community is on board with us. This will not happen unless you speak their language, understand and work to incorporate their values, and cultural and religious beliefs. And there is so much in religion that is compassionate. So the question becomes, how do you use this compassion to stop violence against women, or promote women's rights, or prevent maternal mortality for example? The idea is to build on those positive beliefs within the society so that communities can help themselves within their own context.

HOW DO YOU ADDRESS OR CIRCUMVENT PATRIARCHAL BELIEFS AND PRACTICES WITHIN CULTURES AND RELIGIONS?

I believe that essentially all religions are pro-people. It's a matter of interpretation. I was brought up in an Islamic context. My parents saw Islam as a force for good, a force for change, rather than as a restrictive belief system. So I know that it is how you interpret religion and the spirit of the religion that is important. We should be able to select the interpretation of the religion that is closest to its essential spirit which I believe is the happiness of human beings. And I believe that we can do a great deal if we can establish a dialogue based on the principle that women should not die giving birth, that women should be able to plan their lives, and that women should not be beaten and suffer violence.

DESCRIBE YOUR WORK IN CHINA

We are working in 32 provinces at the invitation of the Chinese government. To demonstrate how choice for people can make sense and be effective we asked that they remove quotas. That was the condition that we set. As a result, we were also able to dialogue with them and get them to support and implement reproductive health services that are based on complete information, choices of contraceptives, informed decisions, guidance and counseling for the women, something they didn't have before. And this has proved quite successful so far. The number of abortions has decreased as compared with other provinces. Health workers in these provinces are using a different language when talking to clients than in the rest of China, and the people are better informed.

We are the only population organization working in China. If we were to withdraw there would be nobody there talking about the human rights of women to make choices about their families. We are the only ones pushing the agenda. Of course there are still problems to deal with, but the fact that abortion rates have decreased means that what we are promoting is pro-life in the best sense of the issue. We save women's lives and that makes us pro-life.

The Population Research Institute [a conservative organization opposed to family planning and abortion, see p.25] has taken the position that just by being in China, we are supporting the government's coercive one-child policy. But we have made our position clear about our opposition to the social compensation fee where women and families who have a second child must pay a penalty and we are mobilizing to change the fee.

Unfortunately, the PRI was able to sway the current US administration. So although the president had allotted $25 million in his budget to UNFPA and the US Congress increased that to $34 million, he has refused to release the funds. That represents 12 percent of our income, which means that we are hurting the very women that we say we want to support. It has caused a financial crisis. We are still hoping that the US government will reconsider its position and that we can find a way to work together to get around this.

Since 1998, after countries agreed to abolish quotas and birth targets, our project in China has been the most monitored development project in the world. During 2002, the UN, the UK, and the US all sent missions to investigate the project. And all of them said that the UNFPA is not supporting coercive policies. The US team suggested that the US government release the funds, after stipulating that the funds not be used in China because there is coercion in the rest of the country. But the agreement that we have had with the US was that the money would be put in a separate account and we use it for the rest of the world.

What is also being overlooked is that--based on what we achieved in those 32 provinces in China--the government is planning to expand the program.

THE FINANCIAL IMPACT

Although several governments have stepped in to help, nobody can fill a gap this huge. For example, the European Union, in a vote of confidence in UNFPA, pledged 32 million euros, an equivalent amount of US dollars. But that money is not for one year--20 [euro] million was designated over several years for use in 13 countries. Although we are trying to minimize the impact on the countries by making significant cuts here at headquarters--in administration, travel, and staff training--we are a small organization and our administrative costs are not very high. The overwhelming majority of the money in our budget goes to our programs, so we will have to make cuts there. Programs that were slated to start this year have been cancelled. There will be no expansion of many existing programs and no major purchases of equipment and other related tools and supplies. As a result, we will be serving fewer people, and the quality of our services will be impaired, and in the end women will suffer from it. For example, a program in Kenya focused on safe delivery and maternal and infant survival in eight rural districts will have to be cut. In India, in the state of Maharashta, a safe delivery program in remote villages may not be initiated and other pre- and post-natal programs will be cut; several projects to treat and reduce the spread of sexually transmitted infections will be discontinued; and plans to open a counseling and legal aid center for women who are victims of violence will be put on hold. In Burkino Faso our work rehabilitating safe health care facilities will be curtailed, as will a program in Vietnam to train 4,000 health-care workers and supply 500 clinics in remote mountainous provinces with essential medical equipment and drugs. And in Bangladesh, where one woman dies every hour from complications during pregnancy and childbirth, a program that trains doctors in emergency obstetric procedures is now in jeopardy.

WOULD YOU LEAVE CHINA?

I was asked if I would be willing to withdraw from China to secure the US funding, and I said "No." With the board's authority I will remain there. The UN is a universal organization, a multilateral organization. It works with every country as long as they abide by the principles of human rights and the Cairo Agreements."

Funding UNFPA

In response to the Bush administration's decision not to fund UNFPA in 2002, Lois Abraham of New Mexico and Jane Roberts of California initiated a campaign to encourage 34 million people to donate a dollar or more to the UNFPA. Donations are accepted by check made payable to "The UN Population Fund," to The UN Population Fund, Attn: Chief, Resource Mobilization Branch, 220 East 42nd Street, 23rd floor, New York, NY 10017. Alternatively, you may make a tax-deductible donation at www.uscommittee.org.

RELATED ARTICLE: In her own words: Thoraya Obaid on religion.

Religion Counts

"Religion is a powerful motivating force. I can name five main reasons why religion counts when addressing such a sensitive agenda as the Programme of Action for Population and Development [agreed at the 1994 International Conference on Population and Development OCPD) in Cairo] that guides our efforts.

First, religions share a common moral position with regard to the vulnerable in societies and this moral concern meets the concerns of the United Nations for justice, compassion, solidarity, equality and respect. Furthermore, most people worldwide derive their values from religious beliefs.

Secondly, religion counts because it is a safe haven for people. It is a way of trying to bring order and meaning to the chaos of the rapid changes that are taking place-chaos that is often perceived in the South to be a result of globalization, growing inequality, poverty, and military conflict- in other words, a result of an unjust global system.

Thirdly, religions have constituencies who serve in public and political spheres who decide on major issues, such as policies, resources and programs. Religions have constituencies who are beneficiaries of such programs, and who are capable of mobilizing communities that are empowered to articulate their demands.

Fourthly, religions have institutions that are well-established in communities and provide much-needed services to the poor, the disadvantaged and the excluded. Constituencies respect their clergy and see them as both spiritual and societal leaders. Consequently, religious leaders exert an influence on how people think and behave.

And finally, religion counts because the dialogue within the United Nations between North and South, and East and West has been about culture and religion, as well as about the politics of power. Thus, the tension ends up being a political confrontation over religious beliefs and cultural values; conflict between the belief and value systems of the various societies.

Over the years, the United Nations Population Fund has partnered with religious institutions and faith-based organizations to fashion ground-breaking initiatives to advance common goals and to save lives. Many religious leaders have been supportive of efforts to prevent the spread of HW/AIDS, to encourage safe motherhood and to uphold the dignity of women and men by affirming their moral capacity to make personal decisions concerning their own reproduction. In our work around the world, we have found that building alliances with and involving members of religious traditions are factors that can actually determine a success or failure. This is especially critical in traditional societies where women's actions to regulate fertility may disturb a social contract and where control over women is strong."

["Building Bridges for Human Development: The Role of Culture and Religion in Promoting Universal Principles of The Programme of Action on Population and Development," Statement by Thoraya Ahmed Obaid, Executive Director, United Nations Population Fund, at the Center for Contemporary Arab Studies, Georgetown University, Washington, DC, on April 25, 2002.]

MARCIA ANN GILLESPIE, former editor in chief of Ms. magazine, is a writer and consultant based in New York City.