The Dangers of Silence

Well, we are officially one month into the Trump presidency (words I still can’t fully believe I had to type together). Like many of my fellow liberals, I had hoped that Trump’s outsider status and clear disinclination to put in the work needed would translate to a presidency stuck in neutral- spinning its wheels, making plenty of noise, but never actually getting anywhere.

Sadly, we were mistaken.

Instead, we’ve seen such a flurry of activity over the last month that it has become nearly impossible to keep up- entire websites have now been created to try to track this presidency. They have acted so quickly and so haphazardly, we barely have time to assess the damage of their half-baked plans before they move on to another. Even worse, Congress has taken advantage of the distracted populace to push forward disturbing pieces of legislation along with approving nearly every (often unqualified) Cabinet nominee.

It’s dizzying. As someone who has actively been politically engaged since middle school (I was super-popular), who reads the news daily, and who regularly reviews events with other former government workers, I myself am having trouble keeping up- I can’t even imagine how the average person, whose life and career exists outside the political sphere, can even attempt to follow this.

So, I’m going to follow the Administration in one aspect of their work and take a step back. But, in my case, it will be to thoroughly examine particular issues that I think deserve greater attention and analysis- and would have received them from other sources had there simply been enough time before the next big piece of news. I’m not going to do a blow-by-blow of this presidency (because, to be honest, living through it once is bad enough), but I am going to highlight topics that I strongly believe deserve more focus than they’ve received.

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The first and perhaps strongest example of this is the global gag order signed the first Monday morning of the administration. The order received some attention for being one of the earliest actions for the new administration (many wondered if it was in part a response to the Women’s March, which needled the new president with its large turnout), and for the optics of the signing- the order, which primarily affects women, was signed by the male president as he was surrounded by a smiling group of men. The photo of the signing has since been mocked and even parodied by other governments, but the details of the order have been lost among the imagery and the whirlwind of subsequent acts.

The so-called Mexico City Policy was initially passed in 1984 under President Reagan, and has been policy under both President George HW Bush and President George W Bush; it is a staple of modern Republican presidencies as a nod to its anti-abortion base. The order blocks federal family planning funding to global healthcare organizations that are involved with abortion. What is often forgotten is that this is in addition to the 1976 Hyde Amendment’s prohibition of the usage of federal funds for abortion, which was codified in a 1994 law with exemptions for protecting the life of the mother, rape, and incest- given that the Hyde Amendment has existed in some iteration or other since the 1970s, federal funding has not gone to abortions for over a quarter of a century. Many assume that the global gag order’s purpose is to prevent abortion funding, but that policy is already in place; the order prevents any federal funding to be used for family planning with any foreign organization that is involved with abortion.

Even proponents of the global gag order saw that it could have potentially troubling consequences, and worked to carve out exemptions to mitigate those concerns. George W. Bush specifically exempted organizations affiliated with the President’s Emergency Plan for AIDS Relief (PEPFAR) because he and his administration recognized that the implementation was not only impractical, but also potentially removed key partners in a much broader global fight: in some cases, it was imperative for PEPFAR to partner with standalone clinics in rural areas, so to create conditions or barriers would only be counter-productive to the overall goal of tackling the disease.

The Trump Administration, however, did not simply reinstate the global gag order, nor did it look into exemptions to serve broader goals. Instead, it took a ham-fisted approach to the gag order- not only did it block federal family planning funds, but it blocked all federal funding to any foreign organization that is involved with abortion. Thus, even if US funds were going toward malaria treatments, if the organization is involved in abortion (whether it be performing abortions or even advising on them), the organization is now at risk. When the choice was to lose US funds for family planning, many organizations were able to do so and to come up with funding for those specific services through other sources; this would result in many organizations losing a significant portion of their operating budgets, or force them to deny vital services.

This means that global health organizations now face a difficult choice- they can either cut off all abortion-related services in order to keep the funding needed to provide other health services, or they can continue to provide abortion-related services and risk their ability to serve their communities entirely- funding from the US makes up a significant portion of the budgets for these organizations, and goes toward everything from machinery and medical supplies to staff to medications.

Opponents of abortion applaud the global gag order because they assume that decreased funding for abortion services means decreased abortions. However, various reports from the World Health Organization, Guttmacher Institute, and The Center for Health and Gender Equity have all noted that global abortion rates decreased when the gag order was lifted under President Obama. By providing funding to family planning in general, the US helped ensure that health organizations were able to provide a variety of care options for their patients, and the results were fewer abortions and lower childbirth-related mortality rates for both mothers and their children. In fact, these organizations have noted that decreased funding for abortions only results in a decrease of safe abortions- women, especially those whose lives are at risk- will seek out the abortion through other channels if they can’t get them through their healthcare providers, and this can subject them to unsafe and life-threatening conditions.

This is troubling in its own right, but the sloppy expansion to block all US funds carries even greater risks; in addition to the likely increase in unsafe abortions and mortality rates, the expanded global gag order puts all other areas of healthcare at risk as well. Organizations that are struggling to prevent the spread of HIV/AIDS will surely be susceptible to this order, as no Bush-style exemption has been granted. Even those organizations that address other global health concerns- malaria, Ebola, measles- or even basic health needs- such as access to eyeglasses or treatment for infections- see their funding and their ability to provide healthcare services threatened by uninformed dogmatists. They will be forced to weigh their financial concerns against their goal to provide necessary healthcare, and no one benefits from their having to make that choice.

The main reason this seems to have fallen off radars is because it seems to have the least immediate and direct impact on the American people. Truthfully, that makes this all the more insidious- like many of the actions of this Administration, it’s envelope-pushing to the point of endangering the lives of millions as well as the standing of the US, but it’s a low-alarm fire amidst an arson spree, so we don’t focus on it because we see more immediate pressing concerns. The administration is banking on this- if we’re distracted, we’re less likely to oppose (for a great example, see the reshuffling of the National Security Council on the heels of the Travel Ban- the latter certainly drew away attention from the former).

I’d argue, though, that this global gag order is equally as dangerous as the travel ban, and reflective of a lot of the same ideologies- it puts millions at risk to promote an incorrect doctrine. The travel ban endangers those in active war zones, but the gag order puts lives in danger as well by putting their healthcare at risk- in theory, it could kill just as many people (if not more), but in a quieter way, which makes it less likely to catch our attention. But, just like the travel ban, this gag order is dangerous, and goes against what we as a country are supposed to stand for. It plays politics with the lives not just of our citizens, but citizens in the most vulnerable corners of the world.

The United States has long sought to be a global leader; if we actively endanger vulnerable populations- be they refugees of war or women facing health risks- we cannot and will not be able to maintain that standing.