Inside the Fight to Legalize Emergency Contraception in Honduras and the “Hablemos lo que es” Campaign
There is a tragic irony for girls and women in Honduras. It's population of 9.3 million has one of the highest rates of sexual violence in the world, yet not only are abortions banned in all cases, but emergency contraception, such as the so-called morning after pill, is outlawed as well. Top that off with a lack of sexual education in schools and the result is a huge number of unwanted pregnancies and a massive obstacle to women's autonomy.
“Altogether, these extreme policies have created a country of women and girls whose freewill and dreams are stymied at every turn,” says Paula Avila Guillen, director of Latin America Initiatives at the Women's Equality Center in New York, whose focus has been Honduras and El Salvador for the last six years.
To combat the 10-year-old ban, Guillen, Honduran reproductive rights and anti–sexual violence activists and groups officially launched a sizable and coordinated campaign on April 25, “Hablemos lo que es,” to counteract the widespread misinformation around PAE — especially the myth that it induces an abortion. The awareness project was created to open up a dialogue about how the PAE ban harms women and girls and press President Juan Orlando's government to repeal its ban on a safe form of emergency contraception.
The powerful Catholic Church and conservative political-cultural groups in the country, one of the poorest in Latin America, are not about to allow legalized abortion. And while many are working to improve access to sex ed in schools, it is a slow-moving, generational effort that has formidable opponents. Notes Honduran activist and educator Ana Falope, who is working with the Ministry of Health to spread information on sex and contraception beyond the cities: “The teachers don't have the sexual education to teach the kids.” Another discouraging sign: According to reproductive rights–focused Guttmacher Institute, in Honduras in 2014, “only about half (52 percent) of girls attend secondary school.”
That leaves emergency contraception as the only immediate stop-gap for reducing unwanted pregnancies, which make up 45 percent of pregnancies for women under 20. But the emergency contraception pill, called PAE (píldoras anticonceptivas de emergencia), is illegal in Honduras — and nowhere else in the world! At the same time, one case of sexual violence was reported every three minutes in the year 2016, and UN Women estimates that only 11 percent of incidents are actually reported. This disconnect is as staggering as the practical result is simple. When victims of sexual violence go to the hospital for treatment, they are not offered the emergency contraception pill; the policy exacerbates trauma and allows for unwanted pregnancy.
Guillen, for one, is frustrated that this issue hasn't been a front-and-center issue across the Americas. She notes that Honduras is only a five-hour trip from New York, and that there is such as large population of Hondurans and Salvadorans in the United States. “We are so close and so connected. And I cannot believe that we don't talk enough about what is happening.”
Ana Falope says the disturbing situation has been the impetus for her activism and awareness work: “Getting to know women who have been raped and knowing that their main concern is not getting pregnant impels me not to be quiet and to be able to speak for those who cannot.”
Why is it banned?
Ten years ago April, the parliament in Tegucigalpa passed a bill “prohibiting the promotion, commercialization, free distribution and use of [emergency contraception] pills.” The female legislators who submitted the law claimed the pill causes an abortion to occur, and was therefore illegal (Honduras has a total ban on abortions). The pharmacies “are offering to our youth an abortive medicine, because it is made to be used after sexual relations, so it is not a normal contraceptive but an overdose of hormones, whose effects were analyzed by the Colegio Médico de Honduras [Medical College of Honduras] and declared as an abortive pill,” member Marta Lorena Alvarado said to a local news outlet at the time. The punishment for using the pill is the same as for a woman having an abortion, 3 to 6 years in prison.
Then-president José Manuel Zelaya vetoed the ban in May 2009, which sent the final decision to Honduras's Supreme Court. That June, Zelaya was ousted in a military coup and that October, the acting minister of health issued a regulation banning emergency contraception, despite not yet having a ruling from the Supreme Court. Within a year of PAE being banned, births in Honduras went up nearly 20 percent between 2009 and 2010. In 2012, the Supreme Court upheld the ban, saying it was constitutional.
Despite being used after sex, PAE, aka the morning-after pill, is not abortive — would the five other Latin American countries with abortion bans allow it if it were? The pill prevents the egg from being fertilized if used within 72 hours. This preventive quality is not up for debate.
Regular contraception, such as the birth control pill, is legal and not a controversy in Honduras. Thus, says Guillen, “there needs to be an understanding that emergency contraception is just concentrated amounts of the same ingredients.”
Again in 2016, after local and international nongovernmental organizations (NGOs) put together a protocol outlining comprehensive care for survivors of sexual violence to be presented to the government, Ministry of Health officials struck emergency conception from the document before neglecting to publish it. (As a psychologist and volunteer assisting survivors of sexual violence, Ana Falope was the youngest member of the committee to draft the document.)
Organized religion has also played a role in the emergency contraception ban, particularly regarding the Church's influence outside the cities. Says human rights lawyer Guillen, “I think the misinformation about PAE has played really well with some of the religious beliefs. It is connected to abortion, and abortion is still a very controversial religious issue. It becomes part of the same controversy.” Falope told the Guardian that “the biggest obstacles to change are the ongoing interference of churches, and the politicization of emergency contraception.” A machismo culture of gender prejudice doesn't help.
Other myths undergirding the ban are that the pill has been linked to cancer and infertility. In reality, both the World Health Organization and Pan-American Health Organization have concluded, based on medical studies, that the pill is mostly harmless with minor side effects. Health professionals in general and groups such as Doctors Without Borders advocate its use. There's also no shortage of international NGOs, such as Amnesty International, that have condemned Honduras's ban on emergency contraception as a fundamental human rights violation.
The good news
“Hablemos lo que es” is the first coordinated, large-scale campaign dealing with women's issues in Honduras, and includes events in Tegucigalpa, billboards and radio ads in addition to a sophisticated website, featuring videos and graphics, as well as a social media presence and press outreach. Ana Falope and Julissa Rivas, members of the Emergency Contraception Pill Strategic Group (Gepae), are the lead organizers of “Hablemos lo que es.”
Says Rivas, “PAE is fundamental for all women, but it is especially important for those who have been victims of sexual violence. We should unmask the myths and unite so that the Ministry of Health revokes the agreement that prohibits the trade of the PAE in our country, so that it guarantees the reproductive rights of all women in Honduras and protects them from preventable traumas as victims of a rape.”
An activist's inspiration
Paula Avila Guillen, director of Latin American Initiatives at the Women's Equality Center, has also been instrumental to the campaign. “The idea is to spark a conversation about these issues” with discussion forums at every level of Honduran society, she says.
Guillen, who grew up witnessing firsthand the consequences of armed conflict in her hometown in Colombia, knew early on that she wanted to be a human rights lawyer. “But I also saw how in the middle of all the human rights work, women's issues were always at the bottom of the list.” Twelve years ago she moved to the United States, and her work has been focused on Central America for the last six years. But the repression of reproductive rights is not just a south-of-the-border problem. In the United States right now, some states have created practical bans on abortions. “We are going backward. And it still is not top in the headlines, still not the top of the agenda. It shows how much work we need to do.”
CHICA asked her to share what motivates her activism. She gave us a quick but passion-filled glimpse into the heroes and heartbreaking cases that keep her fighting:
“Seeing the stories of the girls and women whose rights all the time had been violated and erased is what really inspired me to do this work. I have met some of the most amazing and extraordinary women…. Some of the greatest activists, like Regina Fonseca in Honduras and Morena Herrera in El Salvador, they are my inspiration to see that even in the most difficult circumstances, you can still stand up and do what is right even when you are risking prosecution for what you're thinking and what you're talking about. Even when risking harassment by the opposition, you still are doing it because you believe it's right.
But also, some of the women we have helped over the years. The 11-year-old girl, that unfortunately is not the only one but many who are pregnant, who was raped and who is forced to continue her pregnancy. From all the women who are wrongfully imprisoned in El Salvador, Guadalupe [Vasquez], Maria Teresa [Rivera], who are now freed, are part of my inspiration. Imelda Cortez is part of my inspiration. Women who suffered, who spent 10 years in prison wrongfully accused of having had an abortion in El Salvador. The women in Honduras I've met that are really trying to have a dream, to be able to have agency and able to have control over their lives. They just want basic healthcare. And hearing their stories and realizing that maybe they don't have the ability to tell them — that I have the ability to tell them. I have vowed to all of them, to every single one that I've met whose rights have been violated, that I would always do everything I can in my power, or to use whatever platform, big or small, to tell their stories to elevate their rights and to fight until justice is done.”