美国国家公共电台 NPR U.S. Slashes Funds For Family Planning In Madagascar

 

SCOTT SIMON, HOST:

A number of countries have felt the effects of an executive order signed by President Trump¹ soon after he entered office. The administration reinstated and expanded a policy that bars international aid groups from getting U.S. funding if they perform or actively² support abortion³ anywhere in the world. In Madagascar, that's meant significant cutbacks as the largest provider of long-term contraception in the country. NPR's Jason Beaubien takes us there.

UNIDENTIFIED MAN #1: (Foreign language spoken).

JASON BEAUBIAN, BYLINE⁴: Nurses from the British nonprofit Marie Stopes International run family planning clinics in some of the most remote parts of this island nation off Africa's southeast coast. This team of two nurses and three outreach workers is currently plying⁵ the Canal des Pangalanes, a 400-mile-long inland waterway in eastern Madagascar. They move from village to village in a narrow, 45-foot long boat powered by an old truck engine.

On this day, the boat is tied up in the village of Ambohitsara. Dugout canoes loaded with green bananas, fish and sacks of rice are lined up next to them. The crew from Marie Stopes has set up a mobile contraception clinic in the village's three-room health center. The team was expecting to see 40 to 50 women on this day. But more than a hundred turned up before the event even started. One of the nurses, Olivia Haingoniaina, is holding up a blue plastic replica⁶ of a penis and demonstrating how to use a condom.

(LAUGHTER)

BEAUBIAN: The crowd erupts in laughter when she jokes about how they're much easier to take off than put on. Haingoniaina and her fellow nurse explain various ways to prevent pregnancy⁷, including the rhythm method. Birth control pills and condoms are widely available in Madagascar. But long-term methods like implants⁸ or IUDs aren't. And that's what the Marie Stopes team is offering on this day.

(SOUNDBITE OF TAKING BLOOD PRESSURE)

BEAUBIAN: In one room of the clinic, the first nurse screens the women, checks their blood pressure, weight, temperature. Then next door, Olivia Haingoniaina inserts the implant⁹ or IUD. One of the women who's come to this clinic is a 33-year-old single mother named Bacquerette. She walked more than four miles to get here. Bacquerette uses just one name, which is common in this part of Madagascar.

BACQUERETTE: (Foreign language spoken).

BEAUBIAN: She says she wants an IUD for peace of mind. She already has one child. She's not married. And she says having more children right now would make her life very difficult. A chief from an adjacent village, Nirivelo, has also come to the contraception clinic. He's there to make sure that several teenage students from his village get contraceptive implants.

NIRIVELO: (Foreign language spoken).

BEAUBIAN: He explains that one of the girls from his village got pregnant, and it's been a big problem. Her parents are upset. The boy's parents can't afford to pay a dowry. It's caused a little war in his village, he says. So to avoid these troubles, he's telling the other students to come to this contraception clinic. These clinics have been funded by the U.S. Agency for International Development, but that funding is being suspended by the Trump administration.

To public health experts, family planning is the foundation for maternal¹⁰ and child health not just in poor countries but in any country. If a woman can control when and how frequently she's pregnant, her health and the health of her children improve dramatically. Madagascar has made strides in these areas. The fertility rate has dropped from seven births per woman 30 years ago to just over 4 per woman now. But the country still has a long way to go.

Childhood mortality rates in Madagascar are worse than in Bangladesh. And Malagasy women are about as likely to die in childbirth as mothers in Haiti. And now Lalaina Razafinasoa, the country director for Marie Stopes Madagascar, says her group is losing millions of dollars in USAID funding.

LALAINA RAZAFINASOA: It's really unbelievable to have this happen.

BEAUBIAN: Madagascar had been trying to reach an ambitious goal of boosting its rate of contraception use from 30 percent to 50 percent. But with U.S. funding drying up, she says that probably isn't achievable anytime soon. The ironic¹¹ thing is that Marie Stopes is losing U.S. funding as part of a policy shift related to abortion. Yet the organization isn't involved with abortion services here because the procedure is illegal in Madagascar. The funding cut is because Marie Stopes's parent organization in London refuses to renounce¹² abortion as a family planning method. It does provide abortion services in other parts of the world. The loss of U.S. funding, Razafinasoa says, means that hundreds of thousands of women in Madagascar will lose access to reproductive health services.

RAZAFINASOA: So it would be a disaster.

BEAUBIAN: And this policy isn't just going into effect in Madagascar. It's affecting billions of dollars in U.S. global health grants in some of the poorest countries on Earth.

UNIDENTIFIED MAN #2: (Foreign language spoken).

BEAUBIAN: Back in Ambohitsara at the Marie Stopes contraception clinic, the staff called in woman after woman from 8 in the morning until just after sundown. The nurses held 135 personal consultations¹³ over the course of the day. Fifty-five women got new implants. Twelve got IUDs. Some just had questions. Some were follow-up visits. Haingoniaina, the nurse, says the large turnout at this clinic is similar to what they've been seeing recently up and down the 400-mile waterway. Everywhere they go, she says, she hears from women that they want smaller families.

HAINGONIAINA: (Through interpreter) In their minds, it's easier to do their everyday work if they don't have so many children. It's difficult to go fishing with a child. It's difficult to work their land with children. Life is simpler if they have fewer children.

BEAUBIAN: She says that her work is more than just a job. In a way, it's patriotic¹⁴, the 27-year-old says. It's about improving her country.

HAINGONIAINA: (Through interpreter) It's very important for Madagascar because, currently, there are families that have eight or nine children. The kids don't have enough to eat. They don't go to school. They're very, very poor. So it's not good for Madagascar.

BEAUBIAN: But unless Marie Stopes finds new money to replace the funding that's being suspended by the Trump administration, Haingoniaina could soon be forced to look for a new line of work. Jason Beaubien, NPR News, Ambohitsara, Madagascar.

1 trump   

n.王牌，法宝；v.打出王牌，吹喇叭

参考例句：

• He was never able to trump up the courage to have a showdown.他始终鼓不起勇气摊牌。
• The coach saved his star player for a trump card.教练保留他的明星选手，作为他的王牌。

2 actively   

adv.积极地，勤奋地

参考例句：

• During this period all the students were actively participating.在这节课中所有的学生都积极参加。
• We are actively intervening to settle a quarrel.我们正在积极调解争执。

3 abortion   

n.流产，堕胎

参考例句：

• She had an abortion at the women's health clinic.她在妇女保健医院做了流产手术。
• A number of considerations have led her to have a wilful abortion.多种考虑使她执意堕胎。

4 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

5 plying   

v.使用（工具）( ply的现在分词 )；经常供应（食物、饮料）；固定往来；经营生意

参考例句：

• All manner of hawkers and street sellers were plying their trade. 形形色色的沿街小贩都在做着自己的买卖。 来自《简明英汉词典》
• It was rather Mrs. Wang who led the conversation, plying Miss Liu with questions. 倒是汪太太谈锋甚健，向刘小姐问长问短。 来自汉英文学 - 围城

6 replica   

n.复制品

参考例句：

• The original conservatory has been rebuilt in replica.温室已按原样重建。
• The young artist made a replica of the famous painting.这位年轻的画家临摹了这幅著名的作品。

7 pregnancy   

n.怀孕，怀孕期

参考例句：

• Early pregnancy is often accompanied by nausea.怀孕早期常有恶心的现象。
• Smoking during pregnancy increases the risk of miscarriage.怀孕期吸烟会增加流产的危险。

8 implants   

n.（植入身体中的）移植物( implant的名词复数 )

参考例句：

• Hormone implants are used as growth boosters. 激素植入物被用作生长辅助剂。 来自《简明英汉词典》
• Perhaps the most far-reaching project is an initiative called Living Implants From Engineering (LIFE). 也许最具深远意义的项目，是刚刚启动的建造活体移植工程 (LIFE)。 来自英汉非文学 - 生命科学 - 医学的第四次革命

9 implant   

vt.注入，植入，灌输

参考例句：

• A good teacher should implant high ideals in children.好教师应该把高尚理想灌输给孩子们。
• The operation to implant the artificial heart took two hours.人工心脏植入手术花费了两小时。

10 maternal   

adj.母亲的，母亲般的，母系的，母方的

参考例句：

• He is my maternal uncle.他是我舅舅。
• The sight of the hopeless little boy aroused her maternal instincts.那个绝望的小男孩的模样唤起了她的母性。

11 ironic   

adj.讽刺的，有讽刺意味的，出乎意料的

参考例句：

• That is a summary and ironic end.那是一个具有概括性和讽刺意味的结局。
• People used to call me Mr Popularity at high school,but they were being ironic.人们中学时常把我称作“万人迷先生”，但他们是在挖苦我。

12 renounce   

v.放弃；拒绝承认，宣布与…断绝关系

参考例句：

• She decided to renounce the world and enter a convent.她决定弃绝尘世去当修女。
• It was painful for him to renounce his son.宣布与儿子脱离关系对他来说是很痛苦的。

13 consultations   

n.磋商（会议）( consultation的名词复数 )；商讨会；协商会；查找

参考例句：

• Consultations can be arranged at other times by appointment. 磋商可以通过预约安排在其他时间。 来自《现代汉英综合大词典》
• Consultations are under way. 正在进行磋商。 来自《现代汉英综合大词典》

14 patriotic   

adj.爱国的，有爱国心的

参考例句：

• His speech was full of patriotic sentiments.他的演说充满了爱国之情。
• The old man is a patriotic overseas Chinese.这位老人是一位爱国华侨。