Photographing the Global Gag Rule’s Effects in Ghana for Foreign Policy
June 1, 2017
On assignment, Nichole Sobecki documented women’s healthcare in Ghana and the possible effects of the “global gag rule,” which forbids overseas organizations that receive U.S. funding from discussing or providing abortions. Click to see more from her work for Foreign Policy.
At a clinic in Kumasi, a woman receives a contraceptive implant in her arm. Critics fear some organizations will stop providing family planning services entirely to ensure that their funding for other health services continues.
In a neighborhood in Accra, Sobecki followed a community health volunteer who educates residents on issues including sexual and reproductive health, ebola and cholera.
Three days after he was sworn in as president, Donald Trump reinstated a ban on U.S. aid to overseas organizations that provide or promote abortion. A day later, Nichole Sobecki was on her way to Ghana to document the ban’s potential effect.
The ban, called by its critics the “global gag rule,’’ has been imposed by every Republican president since Ronald Reagan, so Trump’s move was no surprise. Foreign Policy magazine, preparing to publish its first themed issue—focused on women—had assigned Sobecki and writer Jill Filipovic to cover the ban’s impact on African women before Trump’s inauguration. Their story appeared in the March-April issue of the magazine.
“It’s an issue that’s really important to me personally,’’ Sobecki says. “As an American living in Africa, a lot of the stories I’ve been doing have been on the impact of American policies in the region, from the refugee ban to the gag order. It’s really hard to ignore the impact.’’
The ban on U.S. funding of abortion overseas, formally known as the Mexico City policy, was established by Ronald Reagan in 1984. It was rescinded by the Clinton administration, reinstated by George W. Bush, then lifted by President Obama. But Trump’s iteration of the policy, signed January 23, could broaden the ban: It appears to cover all overseas health funding, not just family planning funds. And it no longer applies only to nongovernmental organizations—such as Planned Parenthood and Marie Stopes International—but potentially to national health systems as well.
“A lot of people we met were struggling to fully understand how this will play out, [partly] because the (Trump) administration has refused to give clarity on a number of issues,’’ Sobecki says. As a result, she says, some health organizations could abandon family planning altogether “just to ensure that the funding they need to do their work will continue to come in.’’
Sobecki spent a week in Ghana, traveling from the capital of Accra to towns and rural areas, photographing not only family planning clinics run by NGOs, but vibrant daily life. She captured women at work—selling plaintain chips and water to motorists—and at church. She shot high school students attending a sexual health information session. And she followed a midwife, Andrena Gryekye, as she took her toddler to daycare, cared for her pregnant patients at a clinic, and went door to door in her community to give women information about contraception, prenatal care and vaccinations for their children.
What made Ghana a critical location to tell the story about the gag rule is that since 2006, Ghana has made abortion and contraception more available. Part of the reason is because research shows that botched abortions—whether self-induced or back alley—is the second leading cause of maternal death for Ghanaian women. The re-imposition of the gag rule—in a broader form—could threaten the lives of many women.
Initially, Sobecki did not believe she would be able to photograph an actual abortion procedure. “So you have to think more broadly about how to approach the subject,” she says. Because the stigma of abortion is still great in Ghana, the issue is so personal, and women seeking contraception and abortions are vulnerable, the writer and photographer proceeded with care. “It was really important to me that the women understood who I was, how the photographs would be used, and also why we were taking them,’’ Sobecki says.
At clinics, she wanted to be sure that the women understood they would continue to be treated even if they declined to be photographed. She and Filipovic were not present when clinic staff approached patients about being photographed, lest any of them feel pressured by the journalists’ presence to say Yes.
Sobecki’s mission was also to photograph Ghanaian women outside of the clinics. “If you see a woman in a clinic, you’re seeing her as a patient seeking medical care or birth control. Whereas this woman has a full and rich life outside of that.’’ The other images in the essay “give you a sense of what women’s lives are like outside of their sexual and reproductive health. It humanizes them.‘’
Sobecki, 30, has lived in Nairobi, Kenya for the past five years. Formerly with AFP, she covered the 2013 terrorist attack at the Westgate Mall. She has photographed stories in Libya, Sudan and Afghanistan. She participates in the Instagram project Everyday Africa, which posts photographs designed to show the full spectrum of life on the continent, beyond the images of conflict, poverty and famine that make the news and enforce stereotypes.
Africa “is just such a diverse space to work in,’’ she says. “I try to operate from a place of having a tremendous amount of respect for my subjects, [whether it’s] someone you’re meeting on the street or someone you’re meeting in a clinic. Speaking a little bit of the language helps.’’
To Rebecca Frankel, Foreign Policy executive editor, Sobecki’s photographs from Ghana passed an important test. “Can I just look at the photos without reading the story and get a rich sense of what the story is about and who these people are?” Frankel says. “That’s what Nichole’s eye captured.’’
The ten-image photo essay appeared in FP’s print edition; the magazine’s digital site ran 17 images. Online analytics showed that visitors were spending time to read the story, “which for me is a sign of real success,” Frankel says.
What readers didn’t get to see was a photograph from the abortion procedure that Sobecki eventually got to witness. While everyone present gave permission, clinic management questioned whether access should have been allowed. In consultation with Filipovic and Sobecki, Frankel decided not to publish any of those photos.
The clinic “is doing really important work in an area that is being threatened and we didn’t want to affect that work, and we didn’t want to affect the ability of other journalists to report on this story by jeopardizing their access in the future,’’ Sobecki says. Clinic personnel also worried that photographing a procedure might deter women from seeking help because they might fear for their privacy.
“We wanted to make sure in doing this story we were not further compromising women’s access to health. If this would deter 100 women or even one woman, that isn’t a risk we wanted to take,’’ Sobecki says. But in addition, the image of a woman on an exam table, draped and with feet in stirrups, is not new, she says. “I didn’t think it was the most important image for people to see.’’
Frankel agreed. The first consideration was the clinic’s dismay. But the photos themselves “did not demand to be seen,” she says. “There was nothing revelatory about them, in part because Nichole had afforded a certain amount of privacy and discretion in the way she was shooting.’’
“Sometimes you see these images and you think ‘Yeah, this is important and there’s a reason people need to see this.’ And there wasn’t.’’