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Planned Parenthood Global’s Move to Kenya–A She-Files Exclusive

NAIROBI—I first heard that Planned Parenthood Global— the international arm of the Planned Parenthood Federation of America–had moved their head office from New York to Nairobi during a girls’ power lunch in Johannesburg. One of the women, who is on Planned Parenthood’s executive board, mentioned that executive director of Planned Parenthood Global, Latanya Mapp Frett, had relocated to Kenya. The idea to move overseas was twofold—to both be closer to much of the on-the-ground work the organization supports in Africa (they also do work in Latin America) but also to get away from the noise and drama that was happening in the U.S. because of the new Trump administration.

One of the biggest concerns to global women’s reproductive health in 2017 has been over the signing of the Global Gag Rule (GGR), which applies to any organization that receives health funding from the United States, preventing them from not only providing abortion services, but also from referring, counseling or advocating for abortion access. While Ronald Reagan was the first U.S. president to sign this executive order back in 1984, Democrat presidents Bill Clinton and Barack Obama overturned the order when they took office (from George Bush and George W. Bush respectively). While in and of itself the GGR has long been a concern to health advocates, this order signed by Donald Trump went many steps further than previous GGR orders that had applied to international family planning programs, to now targeting international organizations who work on any U.S. funded global health program, including HIV/AIDS prevention and treatment, maternal and child health, and malaria programs

Ms. Frett, who previously worked for eight years as a human rights officer for UNICEF and a decade with the United States Agency for International Development (USAID), has seen under her stewardship PPGlobal quadruple the size of the program to become one of the most sustainable global health organizations in the field. An attorney, her first job was at the NAACP Legal Defense and Education Fund in Washington, D.C. and she is currently one of the board of directors for Oxfam America (the development organization also recently relocated their world headquarters to Nairobi) and she is an adjunct professor of population and family health at Columbia University’s Mailman School of Public Health. Ms. Frett is also a member of the Council on Foreign Relations. She sat down with she-files.com’s Ginanne Brownell Mitic in Nairobi to give an exclusive interview about relocating to the Kenyan capital and why this became an imperative under the Trump administration. EXCERPTS:

BROWNELL MITIC: Tell me a bit about the history of Planned Parenthood Global—I am not sure many people in the U.S. know there is an entire international arm of Planned Parenthood.

FRETT: About 45 years ago, we started working with USAID with their population program to build capacity of organizations in developing countries to do family planning. Back then it was nowhere near as it is now, as contentious, as sometimes downright impossible to work with the U.S. government. Back then, the government actually valued Planned Parenthood’s work because when [officials] thought about doing local capacity building for family planning, of course Planned Parenthood stood out because that is what we did in the U.S. We started doing that around the world. What we do want though is to foster a local movement around women’s health. We want advocacy work that protects both the laws and the environment for family planning and safe abortion. And that is our focus now.

Why did you make the decision to move the headquarters from New York to Nairobi?
We started thinking about contingency plans even before January, preparing for the strong probability that Trump would reinstate the Global Gag Rule. PPGlobal does not take U.S. foreign assistance to do its work overseas, so we knew we would not have an immediate loss of funds but that the environment in which we work would suffer greatly under the GGR. We wanted to make sure that we were in a position to support organizations who were going to face these immediate financial losses, who would lose commodity chains of contraception that USAID pays for, and we knew it would be very difficult to do that remotely from New York or Washington. Lots of organizations were feeling pressured to just give up parts of their programs because they were thinking they could not do certain things because of the policy. So we really needed to focus on how we could support that. The flip side of that is like anything else, when you lose something, you cope. So the innovations of how we adapt and cope under this new world order are going to come from here, are going to come from countries in which we work. We also had lots of assets on the ground, in terms of office space and we thought it makes sense to do it in Kenya. We will be closer to the field and we will be driven, not by ideological policies like GGR or funding appropriations on reproductive health, but driven by what our partners need and what they are doing.

You moved in August. How has it been so far?
We have an incredible team that sits with Planned Parenthood in Washington, D.C. and the great thing about them, while they both focus on what is happening in D.C. they also work with our advocacy groups around the world and what is happening in their countries. There is a natural connection that happens so we are really excited about them being in the field more because of me being here they come here a little bit more because they are forced to take direction from me [laughs] and I think that will make them more useful. One of my officers will be in Kenya for two months, so it opens up new opportunities for her to take what is happening in Washington and bring that to our partners here so they can kind of get some strategies going but also she takes that back the perspectives of our partners on the impact of new U.S. policy restrictions and funding cuts to inform the advocacy work happening in D.C.

Tell me a bit about the advocacy work that you do.
Since I have come on board we have focused a lot on marginalized populations so for us that means young people, with a particular emphasis on young adolescent girls and in very rural areas where women just don’t get access to information and services. So our service delivery really has this niche on modern technology that doesn’t reach the developing countries as fast, and to help those people and organizations to get that done. That is on the service side. On the advocacy side, we realize that you cannot deliver these services in a vacuum. So you really need a supportive community, you need supportive parents, you need supportive schools, and on a national level you need a supportive government. So all of our advocacy work is to bring together coalitions, provide voices and how you make that environment happen.

What has been the reaction to conversations around abortion in a place like Kenya? 
In Kenya, I think it is still relatively a personal thing and a decision that a woman would make herself. But the problem is that her access or her ability to actually carry out her decision is very limited. There are multiple hurdles in order to get to a trained provider. It is not stigmatized in the same way it is in the U.S., but the problem is that usually the person they went to get help from doesn’t know what the hell they are doing. Then the woman gets sick and she goes to the doctor and there is no support there and she does not get the care she needs then she dies. When we talk about stigma in the U.S. we are talking about “naming and shaming’ some woman who decided to do that or some anti-choice group harassing women outside of a health center. What we are talking about here in Kenya is also risking women’s lives – because of the unacceptably high rates of maternal mortality and unsafe abortion and lack of access to safe abortion services.

Is this something PP Global are very much trying to change in Kenya and across the continent and in other regions you work in?
We have to show these girls that there are alternatives where abortion is safe and legal. There are trained providers that will help you without you completely destroying your life or killing yourself. That is where we come in, supporting local organizations and communities who are already available and willing to provide these lifesaving services in the context of local law. So when we talk about safe abortions in these countries, we are really talking about saving lives here.

The GGR has been looming large this year over sexual reproductive health on a global level. What is different about what President Trump signed versus what his Republican predecessors had done?
Those of us, like Planned Parenthood whose core goal is to do this kind of education and advocacy work, have been affected by the Global Gag Rule in the past. What Trump did was broaden the scope of who would be affected. So it used to be just family planning organizations but now it is any foreign organization receiving U.S. global health assistance. So even if you work on infant mortality, maternal mortality, immunizations— you can go down the list— malaria, HIV/AIDS, any of these sectors, because these are sectors in our global assistance funds from the U.S., you still have to comply with the GGR or forfeit your U.S. funding. And signing on means that you have to say that, “I will not talk about, counsel or perform an abortion.” And not only do you have to sign it to keep your funding, but you can’t refer to someone else who will provide abortion services and you have to screen all potential subgrantees to make sure they will comply with too, which undermines effective partnership and cuts out some of the most skilled and trusted providers.

So a government-run hospital or clinic that gets funds from USAID for, say, maternal health cannot get any funds? So even if your clinic inside the hospital has nothing to do with abortions and you rely on U.S. funding, if the hospital that you are affiliated with counsels on termination, you too can lose funding?
Well, the GGR applies to foreign non-governmental organizations and does not apply to other country governments and government-run hospitals. But you’re right that it is a complete gag where even if you don’t provide abortions you can’t even talk to people about it as an option or refer them to a different clinic. And it’s really a challenge and conflict for providers, who have a duty to uphold the health rights of their patients. You’re going to see cases beyond people wanting counselling or referrals for abortion due to personal reasons and see extreme cases like fetal abnormalities. Under this rule, they cannot be supported. Even in cases of rape, a circumstance where there is technically an exception for the GGR, you see women and especially very young girls, being forced to carry pregnancies to term. We call it “stolen lives” where you force young people, particularly those who are victims of sexual violence, to have babies.

Can you give us an example?

We did a report on Ecuador and we had a doctor testify on this issue, with violence against girls being the theme of the day. She talked about delivering the baby of a 10-year-old child who had carried to term. And there are all sorts of bizarre rules on C-sections and you cannot use an epidural because of the age. And her telling the story about this girl’s pain and pulling a baby through this small cavity that was not fully formed to actually deliver a child, even now it gives me the chills. These girls are not ready for pregnancy and their bodies are not ready, the fistulas they cause, there is so much damage you do and we have stop being silent about that. With harmful cultural practices like early marriage, adolescent pregnancy is a very real challenge. And while advocates and communities work to eradicate those practices, you need to also introduce services like family planning because their families and their communities should know these girls are not ready to deliver children.


Photos: 1) Woman receiving counselling, (Mark Tuschman / Planned Parenthood Global); 2) Ms. Mapp Frett (Susana Raab); 3) Woman having baby’s checkup (Mark Tuschman / Planned Parenthood Global) ; 4)  In Gboko, Nigeria, a provider counsels a patient on the use of contraceptives (Mark Tuschman / Planned Parenthood Global)

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