The Spokesman-Review


America’s aid dollars shouldn’t have strings

If there’s one thing you quickly learn abroad, it’s that American culture often fails to translate.

Rick Steves’ simple lesson never seemed to penetrate the Bush administration. But by the end of his first week as president, Barack Obama made a quiet adjustment.

He overturned the ban on U.S. aid going to any foreign nongovernmental organization that so much as counsels a woman about abortion.

Sometimes cultural confusion counts as one of the delights of travel.

Donna Flanagan returned home to Spokane last weekend from Hanoi, Vietnam, where she had spent four months supervising a public health group. She was surprised when she heard several Vietnamese express dismay that John McCain would not be the next American president.

“Hoang,” she finally asked one Hanoi colleague, “why would you be for John McCain?”

“Why, Donna,” he answered with a twinkle in his eye. “He used to live here!”

But when millions of dollars and the lives of women and children are at stake, clashing cultural expectations can be disastrous.

In the last seven years, America cut off $244 million from the United Nations Population Fund, which protects the health of women around the world.

Flanagan remembers negotiating three years ago with a maternal and child health group in Bangladesh to provide American aid to help educate girls.

By staying in school, girls in their early teens are less likely to be sold into early marriages where they might die in childbirth.

The NGO in Bangladesh also provided family-planning counseling that included abortion information for women who might otherwise choose to take a vile herb or a toxic black market pill. That prevented them from qualifying for U.S. dollars for the schoolgirls.

Flanagan remembers admiring the integrity of the Bangladeshi group, which turned down the U.S. money rather than dilute its mission. She also remembers her sense of embarrassment over this foolish, arrogant law.

The ban began in 1984 during the Reagan administration. It was never designed to prevent taxpayers from funding abortions. American laws then and now prohibit U.S aid from paying for that procedure. The Reagan ban went further. It prevented groups that applied for U.S. family planning funds from using their own money to provide abortions, from advocating for legal abortion in their countries or from simply making abortion referrals. That’s why it was dubbed “the global gag rule.”

The ban continued under the first President Bush. It was overturned at the start of the Clinton years, and then reinstated by President George W. Bush.

Bush also complicated a $15 billion American effort to prevent AIDS around the world. This time, political deals were twisted around an otherwise admirable goal. The money initially came with strings attached requiring the medications be bought only from U.S. drug companies, quadrupling the price, and that programs designed for Asian sex workers, for example, be laced with abstinence messages.

Public health workers learned long ago that mixing American conventions with the gritty realities of global poverty seldom prevents disease. Progress comes from projects that meet people in the cultures where they live.

One of the successes in the AIDS epidemic has been a Vietnamese center that dispenses methadone to heroin addicts. Flanagan visited it recently and noticed a new line of motorbikes parked out front.

Now, she discovered, the former addicts have extra cash to spend on a symbol of normalcy in their society: their own shiny transportation. As fewer men spend their money on injected drugs, the incidence of AIDS also declines.

It’s possible now that equally devious political deals could be woven into Obama’s plans. The social values that appeal to liberal voters could be tied up with ribbons around America’s millions.

If Bush-era logic were to follow, we’d see new regulations requiring Bangladeshi family planning centers to build only green clinics, Vietnamese addicts to buy only electric motorbikes, and Thai brothels to serve only Honest Tea.

But, of course, that would be absurd.

Jamie Tobias Neely, a former associate editor at The Spokesman-Review, is now an assistant professor of journalism at Eastern Washington University. She may be reached at

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