‘They’ll be abandoned’ – a provider on the Global Gag Rule

Leave no one behind   |   19 January 2018   |   3 min read

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Annie Ramasy travels for up to six hours every day to provide family planning services to women in rural, isolated communities in Madagascar.


Annie Ramasy

Our teams in Madagascar work tirelessly to reach underserved and vulnerable populations, who would otherwise have no access to modern methods of contraception.

In Madagascar, a country with persistently low contraceptive rates and high unmet need among rural hard-to-reach communities, Annie’s tireless work has enabled her to reach the women that need her services the most. Women that have nowhere else to go.

By creating a safe space, Annie has built a relationship of trust with the women in her community, reaching more women every time she visits.

“When I started, we only had 10-15 people coming for services. Progressively I gained their trust by explaining how contraception works, and the number of clients have consistently increased… today there are up to 40 clients waiting for me when I arrive.”

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Following the re-imposition of the Global Gag Rule by the Trump administration, these life-changing and life-saving services are now at risk. A voucher programme that has delivered sexual and reproductive healthcare to thousands of the country’s poorest women has already been forced to close, and Annie’s outreach team is one of 22 at risk, leaving the future uncertain for the many women who rely on them. Annie recalls:

“When I heard that USAID had withdrawn their funding, I asked my clients how they would feel if we couldn’t come anymore. One of them screamed: De ahoana amin’izany? (so what now?)”

In Madagascar, the re-imposition of the Global Gag Rule leaves the futures of many women and girls dangerously uncertain. Lailana, 25, who first started using contraception five years ago, after the birth of her second child said:

“We made the decision not to have any more children to give our family the best future possible and contraception gives me the possibility to have control over this decision. Without the outreach team, I would be lost.”

“We made the decision not to have any more children to give our family the best future possible and contraception gives me the possibility to have control over this decision. Without the outreach team, I would be lost.”

Lalaina, 25 year old client

“I am not only a nurse to them, I am a confidant. If I were not able to reach them, I would feel like I abandoned and betrayed them.”

Being the only service provider the women know, Annie knows the important role she plays in the community.

“I am not only a nurse to them, I am a confidant. If I were not able to reach them, I would feel like I abandoned and betrayed them.”

“Contraception does not only prevent pregnancies, it gives you time to define what you want to do with your life. In a country like Madagascar, having a large family when you cannot afford it prevents thousands of people having the chance to get a better life. If you cannot move your family forward, how can you move your country forward?”


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