pathfinder pioneer advocacy news friends of pathfinder 14 6 2 e 5 . Gifts That Provide ofit ostag on, MA d Miguel Gutiérrez Dear Pathfinders, Cheryl Tomchin i ermit No Non-pr U.S. P P a Bost P Income to You for Life and Help Change Pathfinder’s Peru Beyond Peru, Dr. Gutiérrez has Ten years ago, world leaders gathered to make a historic promise at the United Nations Millennium Summit: The Tomchin Family drawn to Pathfinder’s work when been a strong voice for reproductive to achieve the Millennium Development Goals by 2015. While important progress has been made, the world she learned it was one of the only the Lives of Those Country Representative, rights in Latin America. The region is still not on track to fulfill its promises, most notably in one major area: improving maternal health. Why? Charitable Foundation organizations in India that delivers Dr. Miguel Gutiérrez, has high rates of unsafe — In part, because our leaders are not willing to address politically sensitive topics such as abortion. made their first gift comprehensive reproductive Served by Pathfinder around 94 percent of all health services for women includ- has long been an are unsafe—resulting in injury to Pathfinder in 2006 ing contraception, prenatal care, We know that is one of the leading causes of maternal death. According to the WHO, nearly one-fifth, A Publication of Pathfinder International Fall 2010 and death of countless women. safe delivery, and safe abortion. advocate for safe abortion or roughly 78,000 maternal deaths annually, are the direct result of complications from unsafe abortion. This figure does because of Pathfinder’s In Peru, where abortion is highly not include the untold millions who suffer severe health effects. Yet as much as maternal health has become the ”cause Consider the impact of a charitable and postabortion care. restricted and legal only to preserve commitment to safe “What impresses me about Pathfinder célèbre” at the UN, in the United States Congress, and in the media, this fact is rarely mentioned. Politicians, medical gift annuity. In exchange for a gift a woman’s health or save her life, is how they engage the community. A tireless leader in ending maternal abortion work. of money or securities, Pathfinder Dr. Gutiérrez and the Pathfinder professionals, scholars, and activists will talk about the need to address maternal mortality and morbidity and never even They work with community lead- mortality, Dr. Gutiérrez joined will pay you or a loved one an team have been working to ensure mention the word abortion. ers to build acceptance, and enlist Pathfinder in 1997 to lead a major annual income. At the same time that public-sector hospitals have respected community members in postabortion care initiative in Peru. In recent months, several large-scale, international your gift will support those whom medical protocols for abortion in education, contraceptive distribution, The initiative focused on improving Pathfinder serves. place and are also implementing campaigns have been launched to improve mater- Politicians, medical professionals, and referrals, which ultimately low- services women received after an them. The lack of protocols in many nal health. Bi-partisan bills have been introduced ers maternal and newborn deaths,” incomplete or unsafe abortion by You receive a fixed dollar income facilities has been a barrier for the in Congress to purportedly restore our nation’s scholars, and activists will talk about said Cheryl. “Pathfinder’s core values sensitizing staff at every level of the for as long as you live, much of implementation of abortion thus commitment to saving the lives of the millions support women with family planning facility— from the medical providers which may be tax-free. You get an increasing the chances that low- of women and children who die needlessly each decisions, which nurture the whole to the night watchmen—about the the need to address maternal immediate charitable deduction income and vulnerable women may year. And in September, another Millennium family. With more education about needs and rights of women seeking from income taxes. seek an unsafe termination alterna- Summit was called in New York to assess suc- family planning, there is a greater care. Dr. Gutiérrez played a key role mortality and morbidity, yet never tive. Using protocols developed by cesses to date. The campaigns, the press pieces, demand for contraception, which Compared to rates of return Pathfinder, Dr. Gutiérrez has worked the legislation, and the most recent Millennium provides women with a way to con- from CDs, stocks, or Treasury with health officials to implement even mention the word abortion. “Pathfinder takes abortion Summit, however, all fail to tackle a key aspect for trol their fertility and their future.” Bills, your annual income could the policies and to promote their straight on,” Cheryl Tomchin saving women’s lives: expanding access to safe be significantly higher. adoption so that abortions can be said. “Not only does Pathfinder do Having traveled extensively in less abortion. How can we claim to care about women’s provided at 14 hospitals. comprehensive abortion care and developed countries, Cheryl has lives, and not make explicit the critical role unsafe youth-friendly postabortion care, witnessed the powerful impact that gift of money As a result of advocacy efforts or securities abortion plays in maternal death? but Pathfinder also stands strong in Pathfinder’s work has on women’s Safe Abortion: urging the expansion of legal the face of legal challenges to abor- lives. “Rape and defilement, incest, criteria for abortion, including At Pathfinder we have consistently taken a stand tion through their advocacy work.” coerced sex, and lack of family Dr. Gutiérrez’s testimony before to make sure the subject of abortion is included in Defending Rights, gift Cheryl believes this work is critical planning are realities. Women donor annuity the National Congress, there are worldwide discussions about improving women’s because women facing a decision around the world need access to now a number of working com- remaining lives and health. In 1989, Pathfinder, in concert about an unplanned pregnancy reproductive health services. There Protecting Health, principal to missions addressing the barriers with a number of other NGOs, brought a lawsuit may not have had a choice leading is no simple solution to unwanted pathfinder to receiving an abortion in Peru. lifetime fixed against USAID over the (commonly referred to as the Global Gag Rule), which prohibited US govern- into that situation in the first place. pregnancy. Women risk their lives income and in changing providers’ attitudes Saving Lives charitable income about women who had urgent Recently, Dr. Gutiérrez received ment-funded NGOs from partnering with organizations that provided abortion-related services or information. During to have abortions— often in unsani- tax deduction health needs following an unsafe international recognition for his the years the policy was in effect, Pathfinder was one of the only recipients of USAID funding for contraceptive services Cheryl spent a couple of years in and tary conditions—and to have an termination. He wanted to ensure long-lasting commitment to inter- that simultaneously raised private funds for safe abortion services. around India during the 1960s. She organization like Pathfinder work that Peruvian women had access national reproductive health, as said, “I saw what women’s lives are to ensure that abortions can happen Sample Annuity Payments for a $10,000 Gift** We are committed to matching our advocacy actions with funding and programming in the countries where we work. to a range of services, including well as his efforts in making post- like when they have no choice about in legal, safe, and sanitary ways Age Rate Annuity Tax Deduction Only when abortion is provided legally and safely where it currently is not, will we finally make discernable progress the number of children they have— and that comprehensive postabor- treatment for incomplete and abortion care available in some of 60 5.2% $520 $1,979 unsafe abortions and contraceptive the most impoverished regions of to end women dying unnecessarily from unsafe abortion. Only then can our world leaders honestly say they are commit- or who they marry for that matter! tion care is also provided is why 70 5.8% $580 $3,503 counseling. The project began as Peru. At the annual meeting of ted to their promise to save women’s lives. The memories of the women I met The Tomchin Family Charitable a pilot in one hospital, and soon The Society of Obstetricians and remain with me today.” Cheryl was Foundation supports Pathfinder.” 80 7.2% $720 $4,843 expanded to 50 hospitals through- Gynaecologists of Canada, held in * Figures are for illustration purposes only. Minimum

June 2010, Dr. Gutiérrez received Sincerely, President Editor out Peru. This focus on improving 1

age is 60, and minimum gift is $10,000. Your rate

Linda Suttenfield 0 the distinguished Honorary Fellow- Daniel E. Pellegrom will be based on your age at the time of your gift. reproductive health services not 45 Associate Editor e 217 only contributed to a reduction ship award. Pathfinder’s Senior Board Chair ** The deduction is estimated and will change with Jaime-Alexis Fowler www.pathfind.org Cynthia A. Fields the monthly IRS discount rate in maternal mortality but also Vice President Caroline Crosbie said, 02472- Kristy Kade Contributors eet, Suit improved provider responses to “This award was truly an honor for A g

Rita Badiani, Kristy Kade, Ellen M

n

Advocacy Program Officer i r n, obstetric and neonatal emergencies. Dr. Gutierrez and highlighted the i Israel, John Lazame Tindanbil Contact the Pathfinder Development e w o t

e M Office at 617-924-7200, or via email The initiative is now being carried life-changing working that Pathfinder on the cover: Comprehensive safe abortion services are a hallmark of Pathfinder’s work. By integrating r o

PS– You can learn more about our recent advocacy work at www.pathfind.org/advocacy. e J t out at different levels of the health programs and staff have accom- safe abortion into existing health services, stigma is reduced and there is an opportunity to address a wide a at [email protected] for Nine Galen Str range of sexual and reproductive health needs including postabortion counseling about contraception to W system across Peru. plished under his leadership in Peru.” sign: a personalized example.

de avoid future unwanted pregnancies. photo: Amy Coughlin The young women had such promise. The three are among hundreds who abortion care in additional countries ception to avoid future unintended have accessed Pathfinder-supported In Africa, the World Health such as Angola, Egypt, Kenya, Peru, pregnancies. In South Africa, ork. p i safe abortion services for youth in and Yemen. The continuum begins contraceptive method acceptance Z

s w One was the first in her family to attend

South Africa and among thousands with access to contraception to prevent after abortions was nearly 100 percent. of any age who have reached out for Organization estimates that an unplanned pregnancy and covers all

university. Another was putting herself In each country, Pathfinder focuses s e l

sexual and reproductive health needs l

Pathfinder-supported safe abortion i G

on facilitating quality provider - athfinder’ services around the world. Without such as pregnancy counseling, screen- u

one in seven maternal deaths o

through secondary school while also g

training, improving access to client- i these critical services, Anna*, one of ing for and management of sexually s B s e

friendly counseling, creating compas- i r e n the young women said, “I don’t know transmitted infections (including HIV) t d o a I : h t taking care of her orphaned siblings. sionate environments for vulnerable P S what I would have done. I certainly is a result of unsafe abortion. and gender-based violence, screening o t es about P populations (including adolescents h wouldn’t be here right now.” for cervical cancer, and of course, safe p The third was running a small shop to abortion (or quality postabortion care and youth), mobilizing community Worldwide, unsafe abortion statistics Ghana where abortion is highly restricted). support through discussions with Innovations in care

: support her extended family. Three youth, make access to safe abortion a public complete and accurate information, Unsafe abortion remains a critical health concern in Ghana, where it is a leading In August, New York Times colum- on health imperative. In 2003, 19.7 million One of the strengths of Pathfinder’s and advocating with legislators and i Fulfilling t e email updat three different stories, one common abortions were performed under cause of maternal mortality. Misunderstanding of Ghanaian law, combined with stigma programs is that each approach is government officials for supportive nist Nicholas Kristof wrote about a

eiv 1 m unsafe conditions. Complications (especially towards youth), often leads women to seek unsafe alternatives to end an tailored to the needs and prevailing policies. Through these efforts in “Another Pill That Could Cause a ec or experience: each had faced a difficult due to unsafe abortion procedures unplanned pregnancy. Pathfinder has been working with facilities and communities conditions of the country and seeks 2009, Pathfinder supported more Revolution.” The pill is f o r Promises n account for an estimated 13 percent of in northern Ghana to increase access to and reduce stigma around safe abortion to engage the local community. than 61,000 women with safe abor- (also called Cytotek and commonly e t t i decision around an unplanned pregnancy. maternal deaths worldwide every year.2 services since 2006. In 2009, Pathfinder reached 3,521 women with comprehensive Pathfinder is committed to improv- tion services and treated more than used to prevent stomach ulcers). c a s

s ing access to quality services for 20,000 women suffering compli- s In Africa, the World Health Organization Misoprostol provides a safe, non- t

s abortion care services spanning across three regions. Working in partnership with e e r

r 5 d ould lik

d estimates that one in seven maternal postabortion or comprehensive cations of unsafe abortion.

d Ghana Health Services (GHS), Pathfinder is initiating sustainable approaches to surgical abortion option for women on d 3 t A I w l A e deaths is a result of unsafe abortion. abortion care within the legal limits, i e ensure that high-quality safe abortion services—that take into account local needs— around the world —at a much lower a y c y e

t Because of Pathfinder’s commit- r am i m t The difference between developing and as funding permits. Financial m E C N S n are provided in public facilities. In partnership with the GHS and Nurse Midwifery ment to improving services, each cost. Pathfinder’s work includes and developed countries is stark: in support for these interventions is Council, Pathfinder strengthened and supported the inclusion of youth-friendly of the three young women in South training providers in the use of developing countries, more than half Mozambique so limited that Pathfinder strives to comprehensive abortion care, postabortion family planning, values clarification, Africa will actually be able to fulfill “.” And in countries of abortions performed are unsafe achieve maximum benefit, sharing best Mozambican law criminalizes and restricts abortion services in many ways. These STI/HIV and gender-based violence screening, as well as adult learning techniques their promise. And Pathfinder is where women are now learning (55 percent), whereas in developed practices and lessons learned through- restrictions, combined with stigma and discrimination surrounding abortion and into the national comprehensive abortion care curriculum. Overall, Pathfinder committed to ensuring all women, about Misoprostol, Pathfinder . countries nearly all abortions per- out the countries where we work. e g p 4 postabortion care, myths and cultural beliefs, and gender inequities have created works to ensure that all abortions in northern Ghana are performed safely, and of all ages, of all nationalities, works with professional pharmacist o n

l formed are safe (92 percent). f e l v

vi “Successful interventions start with have that same opportunity. a in a supportive, risk-free environment by providers trained in modern methods. associations, training pharmacists

n significant barriers for women to receive care in Mozambique—and puts their lives i h e n r i G commitment to protecting women’s e Beyond the clear health implications,

to provide important information

d at risk. Through advocacy and sensitization meetings with provincial and district d

l n d

o “Women, from time immemorial, f e fi Pathfinder believes that access to safe health, upholding their choices, and e about appropriate drug dosage r h e health officials, athfinderP has clarified ambiguity around the national abortion policy t s

n have gone for abortions. They feel a o a

P defending their rights,” Ellen Israel e abortion is every woman’s right. “If we n l and procedures. They also learn

d and is now providing accessible abortion services at a key rural hospital (previously p a

e desperate—and each has her , l

d said. To that end, Pathfinder establish-

i say that women should have the right m e m to counsel women to seek safe r v P eady abortions were only offered at central hospitals). Pathfinder is also providing

. o o own reason,” Daniel Pellegrom, f r t to decide when to have children, that es common ground with government p g services and emergency care in case u n e postabortion care, often for women beginning a medical abortion with Misoprostol, i

d m Pathfinder’s President said. “It is h t o e alr

t and civil society partners and organizes

e must include access to abortion,” said n l v n

b of complications. “Word of mouth i p at 21 other project sites. Intense advocacy and mobilization with safe abortion

e our obligation to do as much as e a m a planned, local approach that takes

Ellen Israel, Pathfinder’s Senior Tech- c o

a about Misoprostol is empowering c l n messages in communities has lead to communal understanding that this is a public we can to ensure women don’t feel e s athfinder r p into account community needs, the e o nical Advisor and a nurse-midwife. d t i f

n women because it’s inexpensive t as health imperative. Community, religious, and health leaders have demonstrated desperate. That they have all the a A o P “In many areas where we work, women legislative and political environment, a e l and perceived as more private, t their full commitment to raise awareness and improve women’s access to care. In options they need and the services m funding sources, and strategic part-

e plans. don’t have the power to prevent preg- r , p ou that I ha they have a right to have. We are more natural, and less invasive,” o s two years of implementation, 10,400 women have received services and more than

f nerships. Trust and confidence among w I can join the nancy—because of limited influence e

n committed to that, period.” Ellen Israel said. i Y in their relationships, an unmet need 115,000 people have been reached through community meetings and home visits. government and stakeholder partners for contraceptives, gender inequity and and communities are paramount. violence, or social and religious pressures.”

y notifying So what does a Pathfinder safe abortion y will or estat As long as these disparities exist, abor- * Name changed to respect anonymity. 4 Sedgh G, Henshaw S, Singh S, Åhman E, program entail? First and foremost, y b Shah IH. Induced abortion: rates and trends tion services will be needed and women 1 World Health Organization (WHO) 2007. integration into existing services. worldwide. Lancet 2007; 370: 1338–45. must have the right to obtain them. Unsafe abortion: Global and regional estimates : of the incidence of unsafe abortion and associated 5 Pathfinder’s system of collecting global y making a planned gif ormation about ho This reduces stigma and indicates o mortality in 2003, 5th edition, Geneva, Switzerland. data for indicators common to many of

y b Currently Pathfinder provides safe abortion is another important repro- our projects is newly-established, and r e t

e 2 Singh S et al., Abortion Worldwide: A Decade of e inf l

acy Societ we are aware that reports from some k w i abortion services as part of a continuum ductive health service, not a hidden Uneven Process, New York: Guttmacher Institute, athfinder in m o projects are incomplete. Thus, what eg 2009. s F i of sexual and reproductive health care in act. Integrated services also offer we report is a conservative estimate of d l x e l e mor l 3 World Health Organization 2007. Unsafe abortion. Pathfinder’s accomplishments in 2009.

A the opportunity to address a wide u seven countries: Ethiopia, India, Ghana, - e eiv acy Societ o Anna and another Pathfinder client m

i Mozambique, South Africa, Uganda, and range of sexual and reproductive a ec eg in South Africa share a moment with J photos / center panels: top: Pathfinder Ghana; bottom, counter clockwise from left: : included P L i w R Join the L Viet Nam. And where abortion is more health concerns for clients including

two Pathfinder tafs f members at the Pathfinder India , Mary Burket, Pathfinder India, Jaime-Alexis Fowler, Pathfinder Ghana o t h n n youth clinic while relating their stories. p restricted, Pathfinder supports post- proper counseling about contra-