Not everything he does is bad.
'People will end up dying': Trump's cuts devastate clinics in Zambia
t is under-fives week at Zambia’s Nyangwena health centre and, outside in the morning sunshine, women are taking turns to weigh their babies. A noisy toddler wriggles as his mum places him into the harness of a set of scales. Measurements are taken and, afterwards, ice lollies handed out to children.
Reaching families in the surrounding rural communities is a major challenge for staff at the centre, and, after outreach services were stripped back, things are getting worse.
It is one year since devastating
cuts to family planning services, imposed by Donald Trump, took effect. Already, Esther Zulu, clinical officer at Nyangwena, worries staff are seeing more young mothers. The number of teenage pregnancies recorded at the centre has doubled, from eight in 2017 to 16 in 2018.
Meanwhile, the number of people taking tests for sexually transmitted infections and HIV has slumped. “People will only come if they are not feeling well,” says Zulu.
Until November 2017, a project run by Planned Parenthood Association of
Zambia (PPAZ) would offer HIV testing in homes, distribute condoms in the community, and give family planning information to teenagers in schools.
Such work was halted by the Mexico City policy, or
“global gag rule”, signed two years ago by Trump, which blocked US funds to any organisations involved in abortion advice and care overseas. The policy has been imposed by Republican presidents since Ronald Reagan in 1984, but Trump’s measure was more wide-reaching than ever before. Campaigners estimated that 15 times more funding would be affected. Women’s rights groups and health experts warned that progress on family planning, population growth and reproductive rights would be swept away.
Rural areas such as Nyangwena, which were once prioritised by US aid, are thought to have been hardest hit. Here in Rufunsa district, and across Chongwe and Livingstone, projects tackling teenage pregnancies and HIV, run by PPAZ, were all cut. The organisation, which is a member of the International Planned Parenthood Federation, lost almost half of its annual operating budget in 2017, with access to a $3.8m (£3m) fund cut off.
More than 70 community members – who, in exchange for a small monthly stipend, provided a range of outreach care – were let go. Seventeen staff members lost their jobs. Salome Sichali, programme office at PPAZ, cried when she told the community. “There were 70-plus people whose lives were shattered, and abruptly.”
Community leaders asked how people would be able to access services or condoms, which PPAZ had been making available at collection points in shops and near to bars. Today, the entire district of Rufunsa, home to 68,000 people, receives government packages of up to seven boxes, each containing 144 condoms every month. These are shared between 23 health facilities.
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