LONDON — Britain’s second-largest abortion provider is accused of being a tax-funded backstreet abortionist to women in the developing world. A former manager of a Marie Stopes International (MSI) family-planning clinic, operating in Uganda, has alleged women and girls underwent painful illegal abortions by non-medical practitioners using handheld vacuum aspirators.

In a YouTube video released by a British organization called Culture of Life Africa, Desire Kirabo — a woman identified as a former manager in a MSI clinic in Hoima, Uganda, where abortion is illegal — claimed abortions were the mainstay of services offered at the busy facility, funded by American and British humanitarian aid agencies.

Kirabo said the procedures were performed sometimes on minors and sometimes on unborn babies in the second trimester of pregnancy by a “manual vacuum aspirator” — a tool approved by the World Health Organization for abortions of babies up to 12 weeks of age.

“It’s a very painful procedure, by the way,” Kirabo told the interviewer, Nigerian-born British pro-life activist Obianuju Ekeocha. “They cry. They scream out loud.”

According to Ekeocha, Kirabo is a nurse who was hired by MSI in 2011, believing the facility was a family-planning clinic.

But she was asked to do abortions and refused, eventually being fired from the clinic in 2013.

Kirabo said clients were taken into an “abortion room,” where a staff member called a “clinic officer” or a “medical assistant,” who was not a doctor, would perform the procedure, while a nurse would speak to the patient to distract her from pain as a loud radio played in the background. “As the girl continues to cry and shout, the radio is increased so it distracts the outside from the inside.”

Asked what was done with the fetal remains, Kirabo said, “They’re disposed of. Before 14 weeks: flushed in toilet. After 14 weeks: pit latrine.”

She added that sometimes abortions were done as late as five and six months into pregnancy.

 

Global Tax Funding

As the second-largest abortion provider in Britain, Marie Stopes performs more than 70,000 abortions each year in the United Kingdom.

According to the organization’s website, it works in 37 countries, providing “high-quality, affordable contraception and safe abortion services.” It receives hundreds of millions of dollars in annual funding from governments and lists among its “partners”  the World Bank, UNFPA, UNICEF, U.S. Agency for International Development (USAID), the U.K.’s Department for International Development (DFID), which oversees UKAID, and foreign aid agencies from other developed-world countries, including Canada, Australia, France and Denmark.

Kirabo said staff at Marie Stopes were directed to hide abortion equipment whenever there were regional meetings and when donors from USAID would be inspecting the clinic.

 

Denials

USAID issued a statement to the Register saying USAID “fully abides by U.S. law, including the Helms Amendment, which precludes the use of foreign assistance funds to pay for the performance of abortion as a method of family planning or to motivate or coerce any person to practice abortions.” It added that it takes legislative and policy requirements governing its programs “very seriously” and works to ensure compliance.

USAID did not provide total numbers for funding the agency gives to MSI, but one USAID review document describes a “$40-million ceiling” on a five-year project with Marie Stopes between 2010 and 2015 having “nearly been attained” by 2013.

Kirabo said she recalls hearing that, with “every abortion we made, DFID paid money for that abortion. That is what I was being told. I don’t know how true that was.”

In a statement to the Register, MSI said the abortion agency “respects and complies with national laws and regulations governing abortion” wherever it works.

“We categorically reject the claims made in this video, which is a poorly researched assortment of factual errors, misrepresentations and outright lies. The most basic facts, from the name of our founder to the claim we use DFID or USAID funding to support anything other than family planning in Uganda, are wrong. This is deliberate misinformation pretending to be journalism.”

Contacted by the Register, a DFID spokesman dismissed the Culture of Life Africa allegations as “categorically untrue and misleading — no DFID funding is used to support abortion in Uganda.”

DFID spends about a half-billion dollars each year on population, reproductive health and family planning measures under bilateral aid alone, however.

 

Stopes’ Mission

Marie Stopes is one of the primary beneficiaries of its largesse and received at least £25 million (more than $30 million) in funding in a single partnership program.

Among MSI’s charitable donors are the Ford Foundation and the Bill and Melinda Gates Foundation, which has given more than $60 million to MSI for family planning and cervical cancer vaccine delivery since 2012. A $2.8-million grant awarded by the Gateses to MSI last year was to “expand family-planning choice” in countries in Africa, not including Uganda.

Footage in the Culture of Life Africa video also shows Paul Cornellison, Marie Stopes’ program director for South Africa, at a 2007 London conference saying, to laughter in the audience, “We do illegal abortions all over the world. We can help people, you know. … There are various things we can do if we can just get a foot in the door.”

In 2012, Zambia evicted Marie Stopes from the country when it discovered it was performing illegal abortions there.

 

Health Risks

Manual vacuum aspirators, or MVAs, resemble a large oral syringe in which cannula (medical tubes) are inserted.

It has become a tool of choice for abortion advocates in the developing world, though it is rarely used in Western hospitals for abortion.

A Biomed Central study of the repercussions of “clandestine” abortions in Cameroon, in Central Africa, found that MVA was the leading tool used in 44% of the procedures, which were largely done by nurses, and resulting complications included severe anemia, incomplete abortion, infection, hypovolemic shock (a life-threatening major hemorrhage) and perforations of the uterus.

Kirabo said she entered MSI thinking it was a family-planning organization, but learned, “through the [initiation], it becomes different, and it’s all about abortion.” Asked if other options, including adoption or any other help, were discussed with clients, she said, “There was no help. The service was an abortion. I think, at Marie Stopes, you would rather lose a family-planning client than lose an abortion client.”

“Abortion is the core business; it’s more important to them than ... family planning,” Kirabo added.

“At the end of the month, there was a projection for how many abortions the center has done. So the client has to be convinced.”

Earlier this year in the United Kingdom, the Care Quality Commission reported more than 2,600 serious safety violations by Marie Stopes International clinics operating in Britain.

After visiting 12 of its 70 British clinics between April and August, investigators issued a damning report that forced MSI to temporarily halt providing some abortions. Infractions cited included nurses failing to give information sufficient for consent, doctors “bulk signing” consent forms — in one case, 26 in under two minutes — and vulnerable patients failing to understand what they were undertaking before the procedure.

In addition, the clinics were cited for equipment failures, insufficient training and staff blunders, as well as for dumping fetal remains in ordinary medical garbage.

 

Lavish Salaries

More controversy plagued Marie Stopes when it was reported in 2014 that its chief executive from 2007, American Dana Hovig, was paid between £290,001 and £300,000 (about $350,000 to $360,000) in 2012 until he left to join the Bill and Melinda Gates Foundation in 2013.

In December 2016, it was reported that, although MSI receives £46.3 million in government and private donations as a charity, new chief executive Simon Cooke was paid a £251,831 ($303,508) bonus last year on top of his £168,924 ($203,584) basic salary.

David Paton, a professor of industrial economics at Nottingham University Business School, told Ekeocha that taxpayers need to be informed about how government money is being spent on MSI and to “put pressure on members of the House of Lords to change its priorities.”

President Donald Trump vowed on the campaign trail to cut millions from the foreign aid budget, and family planning is a recognized target. Considering its own trouble at home, MSI could be one of the first agencies to meet the chopping block.

To help persuade political leaders, Culture of Life Africa’s Ekeocha recently launched a CitizenGo campaign to defund Marie Stopes International; the campaign garnered nearly 18,000 signatures from people around the world in its first week.

Cardinal Wilfrid Napier of Durban, South Africa, tweeted his support for the defunding petition Jan. 17: “Tell @USAIDAfrica, @DFID_UK & others to stop #KillingAfrica! Sign @COLAfrica’s #prolife petition here.”

Celeste McGovern

writes from Scotland.