Letters to the Editor
A Mixed Bag
In your last issue of Conscience, a particularly intriguing article was “The Biobag.” Sheila Briggs and Stuart Derbyshire raise plenty of issues and tradeoffs.
So, future generations could be the fruit of a plastic womb? The process depends, among other things, on heparin, a drug with current dire shortages that has had periodic shortages for many decades.
Until now, the fetus has lived in a dark environment until seeking light at birth. In the Biobag, apparently the fetus would have continuous visual access, providing monitoring and a show of its development. Is this good for the developing fetus? What might be the effect on immunity? Then there are financial, legal and even environmental questions: Could the procedure ever be mandatory? After the child is born, what becomes of these plastic Biobags— potentially a few billion bags? Technology providing freedom has mixed results at best in other realms. The Biobag appears to be at a more premature level of development than the premature fetuses it purports to save.
ROSE-ELLEN HOPE
Silverton, Oregon
Social Studies
AS NOTED IN YOUR LAST ISSUE (Ella Whelan, “The More Things Change (the More They Stay the Same)”), social media is undoubtedly essential for young people worldwide. Young people are browsing through Facebook, Twitter, Instagram and other platforms to interact, learn and share everything they are going through in their lives.
Seizing this opportunity, Reach A Hand Uganda (RAHU) has, since its inception in 2011, aggressively used social media as a tool for digital mobilization and as an information vessel to provide all forms of sexual reproductive health and rights (SRHR) to young people in Uganda and beyond.
RAHU is accomplished through SAUTIplus, an ecosystem RAHU designed to embrace the growing and innovative technologies in social media, radio and TV, mobile phones and print and digital media. The platform addresses sexual reproductive health and rights issues that affect young people in and out of school, ranging from HIV & AIDS, relationships, life skills, teenage pregnancy, child marriages and sexuality, among others.
Providing SRHR information and referrals via social media creates a positive output of information dissemination in every aspect of life for young people, including health. For example, young people actively engage with the SAUTI Senga (an online SRHR counsellor). Their questions about SRHR are answered, and they get referrals to a nearby health center to get services. They also may read articles on access to SRHR information in a funky language they understand and relate to.
To add to this, we have a vibrant social media community on the SAUTIplus Facebook and Twitter pages, where we interact daily with young people. We plunge into social media trends to spark conversations with them, and always link back to the SAUTIplus website and the app for more information.
Make no mistake, even with internet penetration growing every other day, many young people are not on social media. To mitigate this, RAHU always conducts integrated community activations and dialogues, as well as school outreaches and table talks to bridge this gap. We use these avenues to communicate with young people, teach them about SRHR, listen to their concerns and challenges and aid them in making informed choices. Even more, we use our cultural icons who have clout and influence to talk to young people and inspire them to be the best versions of themselves.
Reach A Hand Uganda Team
Don’t Be Anti-social
THANK YOU FOR YOUR article on social media and abortion activism (Whelan, “The More Things Change”). The stigma surrounding sexual health has made access to friendly, discreet sexual health information a key challenge, especially in developing countries. Many, especially young people, have no other option than to go and search for the information on their own.
In the digital era, when more than two billion people worldwide use social media to educate themselves and others, it represents a great opportunity to disseminate information on sexual health and to promote the availability of health services. Digital health platforms proliferate, providing internet-based sexual health services with enhanced confidentiality and convenience.
Healthcare services have lagged behind other fields in embracing the revolutionary potential of social media, but it’s time we take full advantage of the opportunity to promote sexual health services and access people virtually in the comfort of their homes, while ensuring their confidentiality and autonomy. At the same time, we remain aware that information can be twisted and wrongly interpreted, especially on social media, so clarity and consistency are key!
NATACHA MUGENI
Health Coordinator at
Kasha-Rwanda
Barrier Resilience
PHILLIP DARNEY PROVIDES valuable insights about abortion accessibility in his article “Un-Doctored: Abortion without Physicians.”
I wholly concur with Dr. Darney that political interference is a significant barrier to abortion access. Global Doctors for Choice (GDC) has also learned from our frontline work around the world that women want access to high-quality, safe and legal abortion care, and that they want health professionals to provide that care.
Indeed, doctors around the world play a central role in advancing the best interests of their patients through clinical care while also contributing the voice of medicine and science, a commitment to their patients’ well-being, familiarity with health systems and firsthand experience with the devastating consequences of unsafe abortion and lack of access to care. They are indispensable in upholding established protections on abortion, and essential in ensuring that reproductive rights are recognized as fundamental human rights.
Doctors can be most effective when they collaborate with other players— women’s groups and other civil society organizations, health ministries and human rights advocates. Over the past decade, GDC has worked collaboratively with these to tackle many of the obstacles women and girls face in trying to access reproductive healthcare, including abortion. We have worked to support the expansion of interpretations of laws on abortion, advised on the regulation of conscientious refusals of care, built the capacity of medical professionals to provide abortions and focused on equipping the next generation of doctors with the tools they need to provide safe reproductive care to women and girls.
Together, inch by inch, we will dismantle these political barriers.
LILIAN SEPÚLVEDA
Executive Director, Global Doctors for Choice
Proscribed Prescribers
IMAGINE, YOU WALK INTO THE office of your healthcare provider and leave with the birth control of your choice and a prescription for abortion pills—mifepristone and misoprostol—in case you have an unintended pregnancy. It really could be that simple.
We know that medication abortion is safe and effective, and the option of choice for a growing number of people in the US and around the world. Abortions by medication now account for 39 percent of all reported abortions in the US. But in our country, the pills are not available by prescription and are instead provided primarily in specialized clinics. Lack of access to these clinics, and in turn, to the medication, has been well documented. It is no wonder that people are seeking out abortion pills on their own, as “D.I.Y.: Self-Managed Abortion” clearly explains.
The Federal Drug Administration’s (FDA) over-regulation of mifepristone prevents it from being available by prescription, for both abortion and miscarriage care. The FDA’s refusal to make mifepristone more accessible is a political decision that is not grounded in science.
Healthcare providers should support easy access and safe use of abortion pills. Primary care providers, in particular, should be able to write a simple prescription for mifepristone. This would go a long way towards ensuring that everyone is able to access the care they need in a way that respects their privacy and dignity.
LISA MALDONADO, MA, MPH
Reproductive Health Access Project
