March 2014

Page 1

Population Connection Volume 46, Issue 1 March 2014

The Plight of Syria’s Refugee and Internally Displaced Women

President’s Note


ecently one of our members sent me a small booklet entitled “Debate on Birth Control.” It’s a spirited 1921 exchange between Margaret Sanger, the pioneering force behind modern birth control, and an odd duck with the catchy name of Winter Russell.

U.S. Rep. Bob Goodlatte (R-VA): “… having a growing population and having new children brought into the world … promotes job creation.” Goodlatte chairs the House Judiciary Committee, which oversees federal courts, civil liberties, and constitutional amendments.

Sanger declaimed against the “poverty, misery, disease, overcrowding, congestion, child labor, infant mortality, maternal mortality, all the evils which today are grouped in the crowd where there are large families of unwanted and undesired children.”

From yesteryear’s Russell to Goodlatte and Limbaugh stretches a long line of those yearning to turn back the clock—and not just by a few decades. They long for a distant past, albeit one that never really existed.

Russell castigated birth control as providing people with “a certificate for an endless playground for the rest of their lives.” Sanger said she was “speaking for the millions of women who are crushed with over child-bearing, whose lives are broken, and who have become drudges in the family today.” Russell fumed: “These mothers think they are entitled to the whole world.” That was almost a century ago. Have times changed? Consider this: Winter Russell: “America is dying today.” Rush Limbaugh: “We are living in a dying country.” Winter Russell: “As a matter of fact, a large family is still the hope of the world … Why we have ample resources … We haven’t begun to touch the resources.”

Are our opponents fanatics? Winston Churchill opined that, “A fanatic is one who can’t change his mind and won’t change the subject.” Consider for a moment the strange fixation many of our foes have with the heretofore unknown field of rape philosophy, to borrow from James Wolcott. They seem willfully unaware of basic reproductive physiology. Small wonder the Tea Partiers showered accolades on former Governor and presidential candidate Mike Huckabee’s recent creepy comments about “Uncle Sugar” and women’s libido. Every week, it seems someone of his ilk spouts off some new inanity. But there is nothing funny about the plans they have for all of us. We’re still fighting some of the same battles of a century ago. One thing has changed though. Since that 1921 debate, world population has nearly quadrupled.

John Seager

Meet our new sister organization, Population Connection Action Fund Population Connection, a 501(c)(3) organization, now has a sister organization to serve as our political arm on Capitol Hill. As a 501(c)(4) organization, Population Connection Action Fund is permitted to engage in partisan political activity—which Population Connection cannot do. Unlike gifts to Population Connection, contributions to Population Connection Action Fund are not tax deductible. Population Connection — March 2014

Population Connection Volume 46, Issue 1 March 2014

Board Chair J. Joseph Speidel, MD, MPH President and CEO John Seager Editor and Designer Marian Starkey Proofreader Skye Adams Contributors Rebecca Dodelin, Amanda Claire Frank, Phoebe Greenwood, Rebecca Harrington, Cecily Hilleary, IRIN, Stacie Murphy, Shauna Scherer, John Seager, Marian Starkey Population Connection is the national grassroots population organization that educates young people and advocates progressive action to stabilize world population at a level that can be sustained by earth’s resources. Annual membership ($25) includes a one-year subscription to Population Connection magazine. All contributions, bequests, and gifts are fully tax deductible in accordance with current laws. Population Connection (ISSN 2331-0529) Population Connection 2120 L Street, NW, Suite 500 Washington, DC 20037 (202) 332-2200 (800) 767-1956 (202) 332-2302 fax


Exploit or Be Exploited: Survival Sex Among Syria’s Refugee Women By Cecily Hilleary

14 Rape and Domestic Violence Follow Syrian Women into Refugee Camps

By Phoebe Greenwood


Born into Crisis: Unwanted Pregnancies in Syria


Editor’s Note


Letters to the Editor


Pop Facts


In the News


The President’s Circle


Washington View


Field & Outreach


30 PopEd 32 Cartoon 33

Editorial Excerpts

Cover Photo

A young Syrian refugee of Kurdish descent at a camp in Erbil, Iraq. Photo: Eric Lafforgue

March 2014 — Population Connection


Editor’s Note


he New Year is a great time to make changes, big or small, as John Seager discusses in his January Huffington Post column (which can be found at In that vein, we at Population Connection decided that it was time to make a change to the name of our quarterly publication, formerly The Reporter. Our magazine is now called, simply, Population Connection. Here’s to turning over a new leaf in the New Year! This issue focuses on the assaults on the sexual and reproductive rights of refugees and internally displaced people (IDPs). This is not a cheerful topic, but it’s one that can’t be overlooked in the midst of the civil war in Syria, now entering its third year. Nearly 40,000 women—almost certainly just a portion of those who have been victimized—asked UNFPA for help after facing sexual assault or other gender-based violence in Syria and in refugee settings in 2013. Syrians are about to pass Afghans as the world’s biggest refugee population—they made up 80 percent of the global refugee count for the first half of 2013 (the latest period for which data are available). More than 500,000 were women of reproductive age and 50,000 of them were pregnant. Another 1.6 million Syrian women of reproductive age are internally displaced within Syria. Many Syrians claim that they fled their homes because of the threat or experience of gender-based violence by pro-government forces. In this issue, however, we focus on the harrowing experience of women after fleeing. Although all of the photos and articles in this issue come from Syria, that country is by no means the only one experiencing such horrors as child marriage, rape, and the delivery of babies 2

Population Connection — March 2014

(often unintended) in abysmal conditions due to displacement. According to the UN High Commissioner for Refugees (UNHCR), there are currently nearly 40 million people around the world who are living as IDPs, refugees, asylum-seekers, and stateless persons.1 Many women in disrupted situations want access to long-term family planning options to get them through the period of upset, until they are back at home or resettled somewhere more permanently. Emily Slocum, a midwife with Doctors Without Borders, recalls, “Some of the women [in the Democratic Republic of the Congo] said, ‘I’m going to be fleeing in the bush at a moment’s notice and so if you can give me something that will help me for three months, a year, three years, then I feel more protected.’” And, contrary to what Rep. Trent Franks (R-AZ) might think (and, shockingly, say out loud2) about pregnancy and rape, approximately 20,000 children were born from rape during the Rwandan genocide in the mid-1990s. Rape is, indeed, a very real cause of unwanted pregnancy. Preventing conflicts that force people to flee their homes may not always be possible, but responding humanely is entirely within the international community’s ability. Women who have fled their homes need access to the full array of reproductive health services, including family planning. Without it, they are homeless and powerless.

Marian Starkey Refugees are people who have fled to neighboring countries; IDPs are those who have left their homes but remain within their home countries. 2 “The incidence of rape resulting in pregnancy are very low.” – Rep. Trent Franks (R-AZ), June 12, 2013 1

Letters to the Editor

Thank you for your well-written and informative editor’s note in the September issue. I enjoyed very much the report card on Congress’s voting records. As a naturalized citizen of this great country I never understood why “free speech” would not give Americans protection against verbal insults at the same level as we are protected against physical violence. I was aware of abortion restrictions in some individual states but had no idea it seems to be what all the Republican lead states do these days. It is hard to believe that this was the platform they gained majority on. Polls still show that most Americans favor legal abortion. What is so ironic to me is that these legislators are the same who are against helping mothers with various welfare and early education programs resulting in just another generation of life in poverty and misery. Compassion seems not to be in their vocabulary. Lennart Elmlund New Haven, Connecticut The comparison of South Korean and Ethiopian population growth statistics on pages four and five of the December issue was interesting. I think many readers, in addition to myself, would have found it helpful to have U.S. statistics included for comparison to where most of us live. The Boots/Abortion article was very good—I am even filing/ saving it. However, the analogy has to do with waiting periods, and while we like that analogy regarding women’s rights issues,

Send correspo

ndence to marian@popc Letters are also accepted via postal mail. Le tters may be edited for clar ity and length .

Attn: Marian St Population Co


nnection 2120 L St., NW , Ste. 500 Washington, D C 20037

most of us probably support a waiting period for purchases of guns. Of course, the issues are different, since guns pose dangers to others whereas control of one’s body, involving future responsibility for another potential human being, is another matter altogether. Nevertheless, we don’t want to get bogged down in the potential discussion of waiting periods for various actions. It’s problematic. Population Connection has many helpful and informative articles. Thanks for a job well done. Wanda Shirk Genesee, Pennsylvania For the past several years I have wondered why the name of the organization was changed from ZPG to Population Connection. It doesn’t seem to be a strong indicator of what the organization advocates or does. Has anybody thought about a name change? Population Goals? Maybe that is not the strongest idea but there must be others out there with ideas that more clearly convey what you do. Lorraine Schwartz El Prado, New Mexico

Correction: In the last issue, we mistakenly stated that TLC’s Duggar family (stars of the show 19 Kids and Counting) lives in Tennessee. They actually live in Arkansas, where, according to a member of our staff who’s from that state, community lore pegged the size of their brood as the cause of local restaurants ending their “kids eat free” deals. They were just too expensive for restaurants to accommodate! March 2014 — Population Connection


UNHCR Mid-Year Trends 2013 The first half of 2013 saw a collective mass outflow of more than 1.5 million refugees. These new refugees joined the close to 2 million individuals who became refugees during 2011-12. Annual records show that the first half of 2013 saw the largest number of new arrivals since 1999.

Persons of Concern to UNHCR at Mid-2013

Main Source Countries of Refugee Outflows

38.7 million


11.1 million refugees




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Photo credit: Dona Bozzi

987,500 asylum-seekers 189,300 refugees who repatriated during the first half of 2013 20.8 million IDPs protected/assisted by UNHCR 688,200 IDPs who returned to their place of origin during the first half of 2013 3.5 million stateless persons 1.4 million others of concern

UNHCR figures at mid-2013 included IDP populations in a total of 25 countries. (IDPs: Internally Displaced Persons) Photo credit: Sadik Gulec

Photo credit: Dona Bozzi


Population Connection — March 2014

Countries That Host the Majority of Persons Under UNHCR’s Mandate or Care





Photo credit: Dona Bozzi


250,000 women in Syria and refugee settings will become pregnant this year.




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Newly Displaced People During the First Half of 2013






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Photo credit: Sadik Gulec

Source: United Nations High Commissioner for Refugees, 2013 Design by Rebecca Dodelin

March 2014 — Population Connection





New Data on Women Without Children About 15 percent of American women ages 40-44 don’t have biological children, according to recent figures from the National Survey of Family Growth (NSFG). Most women who don’t end up having children—either intentionally or due to circumstances beyond their control—are unmarried. The proportion of those who are childless/childfree is much lower among married women. However, the trend of saying “I do” and then skipping motherhood is on the rise, according to a new analysis of figures from the NSFG, conducted by the National Center for Family and Marriage Research at Bowling Green State University. They found that the proportion of married women ages 40-44 who had no biological children and no other kids in the household, such as adopted children or stepchildren, reached 6 percent during the study period of 2006-2010. That’s up from 4.5 percent in 1988. Polls have shown that couples and individuals are placing less emphasis on the necessity of child rearing for their happiness and personal fulfillment. Likewise, Americans are currently less inclined than they were in years past to respond that the primary purpose for marriage is to raise children. Despite the assessments above, a recent Gallup poll found that 90 percent of 6

Population Connection — March 2014

Americans either have children already or want to have them in the future.

Continuing Challenges to the Contraceptive Mandate Four New York organizations—Catholic Healthcare System, Catholic Health Services of Long Island, Cardinal Spellman High School, and Monsignor Farrell High School—along with the Archdiocese of New York, sued for a permanent injunction to the contraceptive mandate of the Affordable Care Act. The four organizations insure some 30,000 individuals of all faiths. Judge Brian Cogan of the U.S. District Court in Brooklyn ruled that the organizations are exempt from complying. The federal government can appeal the ruling, but has not yet done so. In a new ruling announced in February, employers with 50-99 workers will have until 2016 to implement the contraceptive mandate. The rule was originally supposed to go into effect on January 1, 2014. Companies with over 100 employees need now only provide contraceptive coverage to 70 percent of full-time employees (the original mandate was 95 percent).

about 30 homes across the country for low-income elderly people. Each home employs about 50 people who are not affiliated with the Catholic Church. The Obama administration told Little Sisters it could opt out of the contraceptive coverage requirement by completing a “self-certification form” and providing it to the entity that administers their health benefits. The nuns argue that even this requirement is too egregious because it shifts the provision of services they oppose onto another entity (the insurance company). Supreme Court Justice Sonia Sotomayor temporarily blocked the birth control benefit from going into effect for religiously-affiliated groups. The full Supreme Court upheld her ruling in January, keeping the injunction in place until the case is heard.

China Eases One-Child Policy

Nuns Sue Over Contraceptive Mandate

Until recently, China’s one-child policy required that both parents in a couple be only children in order to qualify to have a second child themselves. Now, due to a recent change in the rules, couples in which just one parent is an only child may have two children.

A group of nuns who run a home for elderly people outside Baltimore sued the federal government over the contraceptive mandate. St. Martin’s Home, where the nuns work, is a branch of The Little Sisters of the Poor, which operates

The Standing Committee of the National People’s Congress passed the resolution in late December. It will go into effect early this year, but only in some regions of the country. Many parents in China say that they wouldn’t have a second

child even if permitted, due to the high cost of child rearing.

U.S. Population Growth Rate Lower Than in Past Seven Decades According to the Census Bureau, the United States population grew only 0.72 percent last year to 316,128,839 (in July 2013). The population growth rate has not been so low since 1937. The country added 2,255,154 people between July 2012 and July 2013.

The Supreme Court has refused to consider cases that outlaw abortion before viability, typically considered 24 weeks. A new law regarding medication abortion will go into effect on April 1 in Arizona. It requires that both doses of the medication be given at a clinic (normally, women can take the second dose at home) and that it can only be used up to seven weeks of pregnancy (the drug manufacturers say it’s safe and effective up to nine weeks).

The population grew fastest in North Dakota, where the oil and gas industry is drawing workers from around the country. Maine and West Virginia lost population, as did Puerto Rico.

Abortion doctors will also be required to have admitting privileges at a hospital within 30 miles of their clinics.

During the 1990s, the population grew at over 1 percent a year, dropping to 0.8-0.9 percent during the past decade. The rate declined further at the onset of the recession and has not returned to its boom-time levels.

The U.S. abortion rate is at the lowest level it’s been in the four decades since abortion was legalized in 1973. In 2011, there were 16.9 abortions per 1,000 women ages 15-44 (a total of 1.1 million abortions were reported). The abortion rate declined by 13 percent from 2008 to 2011.

Supreme Court Rejects Arizona Abortion Case The U.S. Supreme Court declined to review a case against a federal appeals court ruling that Arizona’s 20-week abortion ban is unconstitutional. Under the law that the appeals court rejected, abortion after 20 weeks would only be permissible to “avert death or serious health risks to the mother.” Governor Jan Brewer signed the law in 2012. Doctors who performed abortions after 20 weeks could have been sent to jail.

Abortion Rate Lowest in Four Decades

The pregnancy rate is the lowest it’s been in 12 years, so analysts believe the abortion rate is declining mostly due to a decrease in unintended pregnancy (not because of measures restricting abortion that have been passed at the state level during the past couple of years). In another development, an estimated 239,400 medication abortions were performed in 2011—20 percent more than

in 2008. Medication abortions must occur within the first nine weeks of pregnancy. Although they are counted along with the total abortion rate, it is notable that of those abortions being performed, a larger share are done earlier and non-surgically, reducing barriers for women who would otherwise be unable to obtain abortions.

American Men Have Little Knowledge About Plan B Researchers surveyed 101 males and 97 females ages 18-25 during 2008 and 2009, all of whom were patients at a free clinic in Los Angeles or had received physicals for the Los Angeles Job Corps. About one-third of sexually active women in the study had used emergency contraception, while fewer than onefifth of the partners of the sexually active males had used it (to their knowledge). Half of the women and one-third of the men knew that they could purchase emergency contraception at pharmacies without a prescription. Only 18 percent of the women and 8 percent of the men, however, knew that the pills were available to women under the age of 18. The researchers conclude that greater educational outreach is needed, especially in low-income settings.

To read the original articles from which these summaries were taken, see March 2014 — Population Connection


The Population Connection President’s Circle

Recognizing Donors for Their Generous Contributions of $1,000 or More By Shauna Scherer


avid Vernier, Founder and CEO of Vernier Software and Technology, didn’t set out more than three decades ago to become a leading provider of science sensors and software for the classroom. He simply wanted to engage his high school physics students by helping them to interpret the results of their experiments in real time. One summer, he created graphing software that spared his students the time it usually took to graph their results by hand. “Students could do an experiment and it could take a half hour for them to make a graph.” His software sped up the process—immediately graphing results so his students could make a better


Population Connection — March 2014

association between the graph and what it all meant. Computers have come a long way from the original Apple II desktop models Vernier still keeps in the archives on the second floor of their LEED-certified facility. “Remember,” Vernier says of the company’s early years, “computers were just becoming available for normal people. It was obvious to me that when normal people could get their hands on a computer it could be a useful thing. This software helped me, and I thought it could help other people, too. It was a nobrainer. There wasn’t any great plan—it just seemed like common sense.”

This humble beginning changed the course of his life, as well as that of his wife and co-founder, Christine. (Mr. and Mrs. Vernier met at The Ohio State University; he fondly describes her as “a very smart, take-charge person.”) The Verniers started their company as a part-time venture. “It was the opposite of a dot-com,” he said. “It was very gradual … Life is what happens when you’re busy making other plans.” They both eventually quit their day jobs—he as a teacher, she as a social worker—and dedicated themselves full time to the company 33 years ago.

Population Connection’s commitment to transparency, accountability, and sound fiscal practices has earned us a four-star rating with Charity Navigator, an independent charity evaluator. “Population Connection’s coveted four-star rating puts it in a very select group of high-performing charities,” said Ken Berger, President and CEO of Charity Navigator. “Out of the thousands of nonprofits Charity Navigator evaluates, only one out of four earns four stars.” “We are very pleased by Charity Navigator’s positive review,” said John Seager, President of Population Connection.” Our supporters should feel confident that we’re using their dollars efficiently and effectively as we pursue our highest priorities—educating three million children a year about the impacts of population growth and advocating in Congress for much-needed increases in U.S. funding for family planning programs here at home and abroad.” Check out our detailed rating at

Vernier Software and Technology has since grown into one of Portland, Oregon’s top employers. They now distribute science interfaces, sensors, and graphing analysis software to over 130 countries, and their products are used by educators and students from elementary to university level. In a testament to the Verniers’ social and environmental values, their company has received numerous awards for being one of Oregon’s top 100 best companies to work for—as well as one of the best green companies, one of the healthiest employers, and one of the most philanthropic. They support multiple local causes, from the Oregon Museum of Science and Industry to the local Humane Society. They encourage their employees to volunteer locally by

reimbursing them each month for a half day of volunteerism. Vernier prefers to direct his philanthropy toward local causes, but he makes an exception when it comes to population issues. “There are lots of local environmental, political, and educational groups,” he said. “There isn’t a local equivalent for population.” He first became a member of Population Connection, then ZPG, in 1992. “I’d always been sort of an environmentalist. Way back [in 1990] I actually published a graph of the world population on our software and said that this might be the most important graph we’ve ever published.” “Most of the world’s problems are tied to population on some level, and we can’t

pretend they aren’t,” he said. “I suspect there’s going to be a time when food riots and desperation about overpopulation will be the norm. Why can’t we deal with it now and try to minimize the problems a little bit? Christine and I are just trying to do our part to spread the word.” We at Population Connection are grateful to the Verniers for their commitment to protecting the environment and for their participation in our leadership society, the President’s Circle.

If you would like to become a member of the Population Connection President’s Circle with a gift of $1,000 or more, please contact Shauna Scherer, Director of Marketing and Development, at or (202) 974-7730. March 2014 — Population Connection


Exploit or Be Exploited: By Cecily Hilleary, reprinted with permission from Voice of America (VOA) News


ach day, hundreds of Syrian women straggle into Jordan, Egypt, and other countries in the region in search of security and a better life for themselves and their children. But because many of them have left their husbands behind in Syria, they are vulnerable to sexual violence and sexual exploitation. Humanitarian groups are working to tackle the problem, but complain that a lack of money to fund the effort prevents them from doing more to help these women and girls. Asmaa Donahue, an advisor with the International Rescue Committee (IRC),

10 Population Connection — March 2014

describes the challenges refugee women face once they cross the border: “While the lack of security in camps makes them less safe for women, at least things like food and some supplies and services are available,” Donahue said. “A much larger proportion of refugees in this crisis are actually living outside camps in towns and villages, and don’t have access to many services at all.” “Many are struggling to make ends meet, barely able to scrape together the monthly rent for overcrowded apartments, or squatting in abandoned buildings or makeshift camps. Many are not able to work legally and have no steady source of income,” Donahue said.

As a result, women resort to risky survival strategies such as early or forced marriage or exchanging sex for food and a place to live.

Exploit—or Be Exploited

The Zaatari refugee camp in northwestern Jordan has, by all reports, become a hub for quick marriages between Syrian women and men from other countries, particularly the Gulf area. Hamida Ghafour, a foreign affairs reporter for the Toronto Star, recently spent time at the camp for a report on the subject and describes it as “a buyer’s market.” “If you are a groom and you are looking for a bride, preying on Syrian women is easier because they are in a position of not

Left: A young Syrian refugee holds her baby brother in front of their tent in Domiz refugee camp, northern Iraq. Photo: UNHCR / B. Sokol / November 2012. This page: Harmanli [refugee camp in Bulgaria] has a shortage of facilities like bathrooms, which must be shared. This situation is uncomfortable for many Syrians, especially women. Photo: UNHCR / D. Kashavelov / November 2013

Survival Sex Among Syria’s Refugee Women having any bargaining rights in getting a mahr, a sort of dowry,” she said. (Note: In Islamic law, mahr, a requirement of marriage, is paid to the bride and is hers to spend or save as she wants. However, in some countries, it is paid to her family.) “A lot of these women don’t know what else to do with their daughters, because they don’t have a tradition like you see elsewhere in the Arab world. Girls don’t go out and live on their own, go to university, or live a single life,” Ghafour said, “so they have to get married, settle down.” Some men go to Jordan with the best of intentions, either out of a sense of

religious duty or in search of a good wife, but because there is no way to investigate the backgrounds of prospective grooms and their families, families cannot be certain that their daughters will be treated well. The phenomenon has created new business opportunities; Ghafour relates the story of “Um Majid,” a 28-year-old refugee from Homs who works as a marriage broker: It began when a local aid organization approached her to ask if she knew any “pretty girls,” Um Majid said. Most of her business is conducted through word of mouth. Sometimes, she admits, she goes into the Zaatari camp posing as an aid

worker to scout potential brides for her clients. She expresses shame, but says life is all about survival—you either exploit or be exploited.

Underage Marriages

Dominique Hyde, the United Nations Children’s Fund representative in Jordan, says that while no official statistics are available, she confirms that UNICEF has seen an increase in early marriages to Jordanian and Gulf men. While early marriage—at the ages of 15 or 16—are not unusual in Arab society, particularly in rural areas, some refugee girls are being married off as early as 12 or 13. “Child brides are at risk of violence, abuse, and exploitation, and child marriage often March 2014 — Population Connection 11

results in separation from family and friends and lack of freedom to participate in community activities, which can have major consequences on girls’ mental and physical well-being,” Hyde said. UNICEF is working with other UN partners in Jordan to explain to Syrian families the challenges of early marriages. “Obviously,” Hyde said, “we can advocate with parents, but the reality is that when they have no more resources, they sometimes see marriage as the only solution for their daughters.”

Marriage “Lite”

Ostensibly designed as a way to get around the high price of marriage and avoid the sin of adultery, the misyar— or temporary—marriage, legal only in Saudi Arabia and Egypt, allows a man and woman to have sexual relations even though they don’t live in the same home. Newspaper accounts back up statements by aid workers that traditionally, some wealthy Gulf men vacation in poorer countries such as Jordan or Syria, where they enter into misyar contracts for the duration of their holiday then abandon their “wives” when they return home. Refugee parents are approving such unions in the hopes that these temporary unions may someday lead to normal marriages. In reality, the endings are not so happy. “The girl goes off with the husband, and after a few weeks or a few months, the husband gets tired of his young bride and sends her back to her family,” Ghafour told VOA. “And there is nothing anyone can do about this, because the marriage is not legally registered with the Jordanian 12 Population Connection — March 2014

government, and so the girls, the families, don’t have any legal recourse.” Those who are abandoned by their misyar husbands return in disgrace and may be forced to turn to prostitution in order to survive.


Because of the special stigma attached to prostitution in the Middle East, it is difficult to get information about its prevalence in refugee communities. Humanitarian workers appear reluctant

to admit that it takes place under their care. What can safely be said is that prostitution is a desperate measure taken by women who have no other means of support. The Toronto Star’s Ghafour encountered a young woman who admitted to working as a prostitute. “She was 15, actually, and she had gone through a misyar marriage. Essentially, that’s prostitution, isn’t it? She was too afraid to actually sit down and be interviewed, for natural reasons. She was worried for her life.”

Syrian sisters prepare the evening meal in an informal settlement in Lebanon. Their family was forced to flee Syria in 2011. Photo: UNHCR / S. Baldwin

THOSE WHO ARE ABANDONED BY THEIR MISYAR HUSBANDS RETURN IN DISGRACE AND MAY BE FORCED TO TURN TO PROSTITUTION IN ORDER TO SURVIVE. Ghafour says that local community-based organizations are very wary of helping women who work as prostitutes. “They don’t see it as a priority because there are so many negative connotations about it,” Ghafour said.

Insufficient Funds

Aid groups say they are struggling to keep up with rapidly increasing demands for services. “The international donors and donor governments have only met a quarter of their

funding commitments to this humanitarian crisis, and that commitment is already based on refugee estimates that were lower than what we’re currently seeing,” IRC’s Donahue said. According to UNICEF, nearly a quarter of a million of Syrian child refugees currently reside in Jordan. More than 2,000 refugees have streamed across the borders every day, and Hyde says she expects these numbers to more than double by July and triple by December.

“The humanitarian community was extremely generous to UNICEF Jordan in 2012,” Hyde said. “But this year only 19 percent or about $12 million of the $57 million appeal for Jordan has been confirmed.” Both groups say that unless they receive significant new funding, they will be forced to scale back on services drastically in the coming months.

March 2014 — Population Connection 13

A young mother crosses the border from Syria and becomes a refugee. In her arms she carries her onemonth-old son, Hamid. “Since he was born there has been non-stop bombing every day.� Photo: UNHCR / S. Rich / April 2013

Rape and Domestic Violence Follow Syrian Women into Refugee Camps By Phoebe Greenwood in Jordan, The Guardian, reprinted with permission

March 2014 — Population Connection 15


Children have witnessed massacres, mothers seen their sons killed, families watched their homes looted and burned. But there is one act of violence that refugees from the Syrian crisis will not discuss. The conflict has been distinguished by a brutal targeting of women. The United Nations has gathered evidence of systematic sexual assault of women and girls by combatants in Syria, and describes rape as “a weapon of war.” Outside the conflict, in sprawling camps and overloaded host communities, aid workers report a soaring number of incidents of domestic violence and rampant sexual exploitation. But this is a deeply conservative society. The endemic violence suffered by Syrian women and girls is hidden under a cultural blanket of fear, shame, and silence that even international aid workers are loath to lift. Dr. Manal Tahtamouni is the director of the Institute for Family Health, a local NGO funded by the European commission that was among the first to open a women’s clinic in the Zaatari refugee camp. When asked, she says, most women will not admit to being raped. They will say they have seen others being raped. “This is a conservative area. If you have been raped, you wouldn’t talk openly about it because you would be stigmatized for your entire life. The phenomenon is massively under-reported,” Tahtamouni says. Only after a long process of building trust through one-on-one counseling sessions might a rape survivor talk. Of the 300 to 400 cases her clinics receive in a day, 100 are female victims of violence, mostly domestic. In the day, the camp bristles with the 16 Population Connection — March 2014

economic and social buzz of a resilient society attempting to reclaim normality. Under the broad blue skies of the Jordanian desert, groups of women in full black veils peaked with sun visors shop in a makeshift high street of UN tents. At night, when gun battles raging at home can be heard across the border, the atmosphere darkens. Even Abu Hussein, a local boss of Zaatari’s brothel and bar district, has requested that UN officials launch patrols to control gangs of young men wreaking havoc in the camp and harassing women. Groping and lewd name-calling during food distributions and in the public latrines are common. Rapes have been reported. “There is a tendency to think that once [women] have crossed the border, they are safe,” says Melanie Megevand, a specialist in gender-based violence at International Rescue Committee charity. “But they just face a different violence once they become refugees.” In a reversal of the cultural norm, many families here are headed by women. Fathers and husbands have either been killed or gone to fight. At least threequarters of these families don’t live in the Zaatari camp but in nearby towns, where they quickly disappear beyond the reach of aid workers and their resources. With no means to support themselves, they are vulnerable. Um Firas has lived in Mafraq, near Zaatari, for more than a year since escaping Homs. She rarely leaves her home. Her husband disappeared years before the war so she is alone, accumulating an enormous debt to cover her rent. She still believes her family is better off in debt than inside the camp. She is particularly concerned for her

“There is a tendency to think that once [women] have crossed the border, they are safe. But they just face a different violence once they become refugees.”

teenage daughter, who took to sunbathing until her skin burned in Syria. “She told me, ‘If I turn black, the Shabiha [pro-government militia] might not want to rape me,” she says. “They were targeting women. Iranian and Hezbollah fighters came into our neighborhood with their swords drawn. The women they found, they raped. They burned our homes,” she adds, too exhausted by grief to stop crying. “I saw maybe 100 women stripped naked and used as human shields, forced to walk on all sides of the army tanks during the fighting. When their tanks rolled back into the Alawite neighborhood, the women disappeared with them.” In Mafraq, her landlord wants to evict her. He had offered to let the family stay only if Um Firas allowed his 28-year-old son to marry her 16-year-old daughter. Beautiful young Syrian women are in high demand. She refused. The Rev. Nour Sahawneh leads the community effort to help refugee families

Evening falls and temperatures drop in the Zaatari refugee camp. Photo: UNHCR/B. Sokol

in Mafraq. He has noticed with alarm a growing number of men flying in from the Gulf states to take Syrian girls from their desperate families. “Their pale skin, the way they talk, cook—it’s a fantasy for them, even if she is only 14,” Sahawneh says. “Yesterday I heard a man I know accepted 9,000 dinars [$12,720] from a Saudi guy for his 15-year-old daughter. He will take his ‘wife’ to a flat and stay with her for a few months then go home without her. It’s illegal to marry women under 18 in Jordan. Saudi men cannot marry non-Saudis without permission. She is not a wife but for sex only.” In the past three months, a bridal

boutique has sprung up in a small tent in what residents ironically call Zaatari’s Champs Élysées. It offers a choice of six elaborate, bedazzled bridal gowns to rent for 2,500 Syrian pounds [$17]. The average age of the wearer is 15. Rihab, 19, is marrying her 27-year-old camp neighbor tomorrow. Five months ago she met his sister, who made the match. Surrounded by the groom’s female relatives and shaking with nervy excitement, Rihab strips out of her niqab to try on the strappy dress only her husband will see her in. Her family had refused the marriage initially, the boutique owner explains under her breath. It’s going ahead now only because the groom’s family has

arranged for the new couple to be “bailed out” of Zaatari to start a new life in Jordan. Jamilla, Rihab’s future motherin-law, looks on, pleased. She married her 15-year-old daughter to a man in Amman last year and already has a oneyear-old grandchild. “Isn’t it better that they are married, that she is protected by her husband? I am marrying off my daughters as quickly as I can. They are young. They don’t know any better,” she says with a laugh. There is no time to ask how the bride is feeling. The dress has been bagged and she is being hurried out into the bustle of the camp. As her veil falls back over her face it covers a startled, wide-eyed expression of excitement—or fear. March 2014 — Population Connection 17

Born into Crisis Unwanted Pregnancies in Syria Reprinted from The Integrated Regional Information Networks (IRIN), the humanitarian news and analysis service of the United Nations Office for the Coordination of Humanitarian Affairs

This baby was born in Jordan. Her father hopes that she will be able to see her homeland, and that the family’s home will still be standing. Photo: UNHCR: December 1, 2012


hen aid workers with the UN Population Fund (UNFPA) speak to women inside Syria—many of them displaced from their homes and living in cramped collective shelters—they say they would rather do anything than get pregnant. “No one wants to be pregnant in the shelters … That’s universal wherever we go,” said Laila Baker, UNFPA representative in Syria. “There is no place to take care of the baby and it’s another mouth to feed.” In addition, they fear the delivery process will face complications, as access to antenatal care and safe delivery services, including emergency obstetrics, is now extremely limited in the country. Yet, UNFPA estimates that some 250,000 women in Syria and in refugee settings will become pregnant by the end of 2013. After more than two years of conflict, Syria’s healthcare system has broken down, hospitals have been destroyed, medical personnel have fled the country, supply routes have been disrupted, and in many places, family planning tools are not readily available. Fadia Salameh found out she was pregnant after arriving in the Zaatari camp for Syrian refugees in northern Jordan. The medical center in her home town in the suburbs of Hama, “which witnessed heavy shelling,” had no more contraceptives in stock, so she stopped taking birth control pills. “Our village ran out of everything—food, bread, and medicine,” she told IRIN from the camp, where she sought help from a UNFPA clinic. In 2012, UNFPA in Syria distributed nearly 1.5 million family planning pills, 40,000 injectables, 45,000 intrauterine devices (IUDs), and 21,000 condoms in governorates affected by the conflict. But the shipments are irregular and do not meet the high level of need. Mobile UNFPA teams also visit shelters, providing women’s health care and distributing vouchers that women can use to get free maternal health and emergency obstetric services at a clinic of their choice.

The Syrian Ministry of Health has remained active throughout the crisis, and some maternity wards and teaching hospitals are still offering obstetric or maternal health care.

“Conjugal room”

Internally displaced persons (IDPs) face additional challenges related to family planning and unsafe sex as a result of the crowded living conditions, especially in common shelters. UNFPA estimates there will be 1.65 million women of reproductive age living as IDPs by the end of 2013. While they may not want to have children, displaced married couples do still want to have sex, even requesting that aid agencies set up what they called a “conjugal room” in one shelter in Rural Damascus for privacy. UNFPA has not yet been able to conduct a survey to establish the scale of the problem, but at least in the capital Damascus, a growing number of sexually transmitted infections (STIs) have been detected in routine visits to clinics, Baker said. “We are really concerned that unwanted pregnancies and STIs may become an issue where they were not in Syria,” she told IRIN. “And when you do have an unwanted pregnancy or an STI, you do not [necessarily] have access [in Syria] to the care you need.”

Maternal and infant mortality

Before the conflict, 96 percent of deliveries in Syria (whether at home or at the hospital) were assisted by a skilled birth attendant, but previously strong registration systems have since broken down. As such, figures are not available, but Baker suspects maternal and neonatal deaths are also on the rise. Partners told Baker of two women in the central city of Homs who died in recent months after giving birth without anesthesia. The drugs had run out and could not be replaced because it proved too hard to get them across frontlines. Doctors operated on one woman post-mortem to save her baby girl. She is now four months old and being raised by her grandmother. The fate of the second baby is unknown.

March 2014 — Population Connection 19

a in ys as st da S. Baldw r fi r / e h R e C r viv : UNH ill su o rn w at. Phot o b new ing he r e h r ther e swelte whe h rries lter in t o w e r othe th no sh m i A ee w refug

Births by Caesarean section are 3-5 times higher than in normal conditions, Baker said. Women schedule them in advance to try to avoid having to rush to hospital in unpredictable and often dangerous circumstances. In one hospital in Homs, 75 percent of all babies are delivered using the surgical procedure. Women often have to walk or take the bus home within hours of the operation, because of general insecurity and fear of not being able to get home. Their husbands usually do not accompany them for fear of arrest while in hospital. But even with the advance planning, they can run into problems. On May 5, mortar shells reportedly hit the main referral hospital for maternal health in Syria, located in Damascus, seriously damaging it, just as one woman was lying on an operating table, prepared for a C-section.

As recounted to IRIN by Elizabeth Hoff, representative of the World Health Organization (WHO) in Syria who visited the hospital shortly after the shelling, the woman panicked, pulled out her catheter tube and I.V. fluid therapy, and ran. Two other women aborted in shock. Women are admitted to the hospital for no more than eight hours because of the increasing number of patients and insufficient beds, Hoff said. Late last year, WHO said doctors had been reporting a rise in “incomplete abortions.” Abortion is illegal in Syria, so instead women take pills that do not always work. “They don’t see how they are going to face a pregnancy because of all the difficulties, and another child to cater for when they can hardly cater for those they have,” Hoff told IRIN at the time.

A nurse holds a newborn Syrian refugee at the Mahmoud Charity Hospital in Cairo. The boy’s 25-year-old mother arrived in Egypt after fleeing Syria following a bombing attack that destroyed her home and killed her neighbors. Photo: UNHCR / S. Baldwin / May 2013

22 Population Connection — March 2014

“Compensating lives”

But just across the border, in the dusty, burgeoning Zaatari camp for Syrian refugees in Jordan, birth trends are quite different. Many women say the camp conditions are “not suitable” to have children; an online campaign by the Syrian women’s group Refugees not Captives calls on refugee women to postpone pregnancies until they return to Syria. But others want to “compensate lives” lost in the conflict. “We are not going to stop having children because of [the conflict],” said Um Ahmad, a mother of seven, while waiting in a queue to be seen by a doctor. Two of her brothers were killed, she said, “and that is why I want to stop using the IUD to give birth again …” “If Syrians stop having children while [so many are being killed], the nation will vanish,” she told IRIN. Every day, a crowd of Syrian women and girls forms outside a UNFPA-supported reproductive health clinic, seeking advice on family planning and fertility, as well as pregnancy tests and health checkups. “We are recording high rates of pregnancies daily,” said midwife Munira Shaban. “[We do have] clients come to seek help as they want to become pregnant. The numbers increase as the camp grows bigger.” The clinic sees about 90 women a day, and one third of them come with pregnancy-related inquiries, whether they be tests or treatment, according to gynecologist Reema Dyab. All forms of family planning are available in the clinic, Dyab said, but “the demand for this service is low … Most of our patients have asked for help in treating problems preventing pregnancies, and the majority indicated they wanted to stop using contraceptives,” she told IRIN. Some women said they were pressured by their in-laws to have more children. “They expect me to have more babies now, because my husband lost two of his brothers in the war,” said Um Khaled1. “I am expected to give them back all males that were lost.”


not a real name

Newly born babies often carry names of relatives who died in the conflict, refugees said. Many pregnancies at the Zaatari camp also involve child mothers, Dyab warned. The clinic, run by the Jordan Health Aid Society, registered 58 pregnancies involving mothers below the age of 18 during the last week of February alone. (Before the uprising in Syria, 11.6 percent of girls aged 15-19 were married.)

“They don’t see how they are going to face a pregnancy because of all the difficulties, and another child to cater for when they can hardly cater for those they have.” Raising awareness

STIs have not broken out in the camp, but the chances that people are having unsafe sex are “high,” Dyab said. “Women tell us that their husbands refuse to use condoms, which is very common in this cultural context. Even if some people take condoms, it does not mean they are used correctly.” Heather Lorenzen, a reproductive health officer at UNFPA in Jordan, said although it is challenging to tackle issues of sexual and reproductive health in the camp due to cultural sensitivities, aid agencies are trying to raise awareness. For example, UNFPA holds seminars about early marriage and family planning methods in the camp. “This is an opportunity for women to learn about services available and decide what is suitable for them,” she told IRIN. She said it is important to compare the current situation with reproductive health norms in Syria before the conflict erupted. “If we look back, birth rates have been high over the past years in Syria. Early marriages have been high in Syria, so it is difficult to see if pregnancy rates increased as a result of the war or if early marriages have become a coping mechanism.”

March 2014 — Population Connection 23

Book Review: Gender Equality and Inequality in Rural India: Blessed with a Son By Carol Ann Kell, Population Connection Board of Directors Note: Carol Vlassoff, the book’s author, is a member of Population Connection’s Board of Directors


amily planning, especially sterilization, has taken firm hold in rural Indian society. No matter how poor or uneducated, rural women are opting for sterilization, even after only one or two children. But only on one condition: that they have at least one son. That’s a main finding of demographer and women’s health specialist Carol Vlassoff in a new book, Gender Equality and Inequality in Rural India: Blessed with a Son, published by Palgrave Macmillan. Vlassoff ’s study of Gove, a village in Maharashtra, looks at changes in women’s social and economic status as well as changes in their contraceptive and fertility behavior over three decades. Her study was unusual in its approach in that she went back to the same village to record and measure the changes she observed at three different periods: 1975, 1987, and 2008. Her unique dataset allowed her to trace many of the same families and their descendents for more than three generations.

24 Population Connection — March 2014

Changes in Family Planning

Over the years, couples in Gove increasingly adopted modern family planning as a result of a long-standing campaign of the Indian government, focusing mainly on sterilization. In 1975, during the Emergency Period imposed by Prime Minister Indira Gandhi, India’s sterilization campaign was scaled up to address the country’s burgeoning population problem and to promote better health for mothers and children. Atrocities were recounted throughout the country, and in Gove, some already-sterilized men were reportedly rounded up for a second operation so that the family planning workers could meet their numerical targets. Nonetheless, for many Gove families, sterilization provided a welcome solution for couples who wanted to terminate childbearing. By 2008, young married couples were choosing to use family planning after having only one or two children. Although a wider range of contraceptive choices is now available, sterilization is by far the most popular method, and

women are being sterilized at increasingly younger ages. In 1975, the average age of sterilized married women was 24. In 1987, it was 23 and in 2008, it was only 22.

Impact of Population Growth

The population of Gove grew from 2,096 in 1975 to 3,250 in 2008. This 55-percent increase contributed to environmental problems, such as air pollution from smoking fires and motor vehicles, and noise pollution from motorcycles, jeeps, and buses plying village roads. The growing population also meant a heightened demand for land and housing, and a rapid erosion of farm size, as farms were subdivided among generations of sons. The proportion of landless households grew over the study period from 15 percent in 1975 to 23 percent in 2008. Farmers consulted in the study said it was no longer viable to depend on agriculture alone for survival, and that they and their brothers and sons had to find outside jobs to supplement farm incomes.

Woman and grandson in poor scheduled caste community

Son Preference

In 1987 Vlassoff was able to trace 94 women from her group of 1975 respondents, and in 2008 she followed up with 71 of her 1987 respondents, in order to see how closely these women came to having the number of children they said they wanted during their first interviews. She found that, in both years, their actual fertility was lower than their previously desired fertility. Those women who came closest to having their desired family size had exactly, or close to, the number of sons they wanted. Those women who had more children than desired had more daughters and fewer sons. In both years, Vlassoff found, “an excess of daughters, rather than sons, appeared to have led women to have more children than intended.” Thus, irrespective of the ideals women expressed, sons, not daughters, determined how many children they actually had.

parents after marriage, girls go to live in the households of their husbands, usually in other villages. Girls also portend expensive marriages. Although the practice of paying a dowry has been legally abolished in India, brides’ parents are expected to offer lavish gifts to grooms and their families. So, observes Vlassoff, “for poor families, having daughters could mean economic disaster.” Because of the expenses associated with daughters, sex discriminative abortion is widely utilized. It is a thinly disguised practice in Gove, with one full room of a small local clinic dedicated to the “medical termination of pregnancy.”

Changes Needed

Vlassoff argues that far more can be done to promote gender equality in India’s rural areas. She recommends that the Indian government and development agencies provide positive incentives for having girl children and disincentives for discriminating against them. She also asks for the expansion of policies to encourage couples to delay their

first child in order to increase the time between generations, and to promote spacing methods of contraception and less reliance on sterilization as a “once and for all” solution. “India … has shown that sustained efforts toward its goals can produce impressive results,” the book concludes. “The success and persistence of its family planning campaign is an example. If similar energy and commitment can be devoted to the development and implementation of public policies, legislation, and supporting actions to eliminate son preference, huge returns could be anticipated. These include enhanced reproductive health and female empowerment, as well as more rapid social and economic development, especially in rural areas. While this challenge may seem daunting, many progressive couples in urban India have found ways to rationalize and accept having only one or two female children. Building on the affection that parents already feel for their daughters, and even recognizing, as did many Gove women, that girls are often more caring and helpful than boys, may be a first step in making this a reality.”

Girls a Financial Burden

Vlassoff observed that most rural families expressed great fondness for their daughters, saying that girls were more loving and caring than boys. But while boys are expected to stay with their

Dr. Vlassoff (second from right) with part of her research team

March 2014 — Population Connection 25

Washington View

A Busy Start to 2014 By Stacie Murphy


he year is off to an eventful start, with lots of news (both good and bad) coming from all directions. Congress, the Supreme Court, and President Obama all made headlines, and all three have implications for family planning.

House Passes Ridiculous AntiChoice Bill … Again After returning from their December break, the House of Representatives immediately got back to work, passing a wide array of efforts, including a package to help the long-term unemployed … Wait. No. Never mind. That’s not what they actually did. What they actually did was immediately vote on more anti-Obamacare legislation and then vote 227-188 to pass H.R. 7, the dubiously-named “No Taxpayer Funding for Abortion Act.” That bill, in addition to permanently codifying the Hyde Amendment, would impose tax penalties on individuals and businesses that purchase insurance that includes abortion coverage, prohibit some insurance plans from offering abortion coverage at all, and ban the District of Columbia from using its own funds to offer Medicaid coverage for abortion. 26 Population Connection — March 2014

“This has been the problem for a long time—men in blue suits and red ties determining what women can and should do when it comes to their own health.” – Rep. Louise Slaughter (D-NY), speaking on the House floor in opposition to H.R. 7

This is the same bill that, in its 2011 incarnation, triggered massive outcry due to the inclusion of a rape exception that only covered instances of “forcible rape.” The bill’s sponsors avoided that particular linguistic minefield this time around, but the bill itself hasn’t been improved. Fortunately, there is little to no chance the Senate will even agree to hold a vote on the measure, and President Obama has stated that he would veto the legislation if it reached his desk. The House vote, however, is just one more sign that opponents of reproductive rights are determined to keep trying to chip away at our hard-won progress.

The 2014 Budget Battle Comes to a Close … In mid-January, after months of negotiation by representatives from both the

House and Senate, Congress voted to approve the final version of the Fiscal Year 2014 Omnibus Appropriations bill. The measure included the State Department/ Foreign Operations Appropriations bill, which is the source of funding for U.S. bilateral and multilateral international family planning programs. The overall funding for international family planning was held constant at $610 million. Of that number, $35 million was designated as a contribution to the United Nations Population Fund (UNFPA). The provisions of the bill had been previously agreed to, so the process for passage was very tightly managed and left no opportunity for amendments. Because of this restriction, the bill neither reinstates the Global Gag Rule (which the original House bill did), nor prevents a future president from doing so (as did the bill coming out of the Senate). The omnibus bill does, unfortunately, preserve the current restrictions on U.S. contributions to UNFPA. After minimal debate, both chambers of Congress passed the bill with bipartisan majorities, and President Obama signed it on January 17.

… And the 2015 Battle Begins

Planning for the FY 2015 budget process began before the 2014 process had even concluded. In December, Rep. Louise

Slaughter (D-NY) sponsored a sign-on letter to the Obama administration calling for both $1 billion for international family planning and robust increases to the domestic family planning budget. Population Connection was part of the effort to gather signatures for the letter, which was ultimately signed by 120 House members, all Democrats. Such a strong show of support for both domestic and international family planning is important as the administration prepares to release its proposed budget for 2015 some time in the next few weeks.

Give America a Raise

The country’s budget isn’t the only one that matters when it comes to family planning and decisions about childbearing. While the United States has seen progress in reducing rates of unintended pregnancy—especially among teens— the fact remains that nearly half of all pregnancies in this country are unintended, unwanted, or mistimed. Recent research by the Guttmacher Institute has found that unintended pregnancy remains a serious challenge— and one that disproportionately affects lower-income Americans. In fact, they found that women living below the poverty level were five times more likely to experience an unintended pregnancy

than women with incomes greater than 200 percent of the poverty line. President Obama called for a nationwide increase in the minimum wage during his State of the Union address—and he announced an increase for federal contractors. Several states have also begun working on the problem. It’s a good start, but it’s not enough. Too many people— mostly women—are working full time but are unable to escape poverty because they’re paid too little. And that leads to a host of negative consequences for all of us—unintended pregnancy among them. We believe that the birth control benefit included in the Affordable Care Act will help make contraceptives more affordable for more women and families. An increase in the minimum wage—and the resulting decrease in poverty—would be an important complement to that.

Affordable Birth Control in Court In the last Washington View (December 2013) I reported that the Supreme Court had agreed to hear the suit brought by several businesses, including Hobby Lobby, contesting the requirement that corporations offer insurance that covers birth control under the Affordable Care

Act. The justices will hear the case in March, and are expected to issue a ruling in June. While there are not yet any updates on the progress of the case itself, there is one bit of news that is worthy of mention: the list of groups who have filed amicus briefs in the case. The list on the side of the Obama administration is truly impressive: not only women’s groups, but also business groups—including the U.S. Women’s Chamber of Commerce, and corporate law experts. The list also contains a large number of religious groups, which argue that rather than enhancing religious liberty, a decision in favor of Hobby Lobby would actually undermine religious freedom in the United States.

Looking Ahead

With a budget fight all but guaranteed, a House of Representatives whose leadership is still willing to push bills like H.R. 7, and a potentially historic Supreme Court decision looming, 2014 is shaping up to be a critical year for family planning, both here in the United States and around the world. Protecting and expanding access to reproductive health care and family planning is going to take real commitment—from all of us. March 2014 — Population Connection 27

Field & Outreach

Alena Yarmosky: Former Fellow Fights On By Rebecca Harrington


lena Yarmosky remembers holding Clinton campaign signs as a young girl with her parents and sisters in rural Massachusetts. She also recalls describing someone as “pro-life” and her mother saying, “no, no, the term is anti-choice.” This progressive and politically active home would lay the foundation for her future advocacy work.

orphanage, and the second half teaching at a night school. The kids she worked with were living in extreme poverty, so when a fellow teacher told Alena that in two years, all of the girls would be pregnant, she was stunned. The depth of their poverty was already so great that the thought of them having children to support was incomprehensible to her.

While she always cared about progressive politics, her adult activism was born when she became involved in the first Obama campaign as an undergraduate at the University of Maryland. As a member of the student organization “Terps for Obama,” Alena participated in canvassing and phone banking on campus. The weekend prior to President Obama’s 2008 election, she and other members of the group traveled to Richmond, Virginia, to campaign. She was excited to hit the ground in such a crucial swing state, after feeling voiceless during her childhood and teenage years when George W. Bush had occupied the White House.

Alena’s experience in Peru was transformative, sparking an interest in global reproductive rights. She became convinced that family planning is an essential tool for keeping girls in school and for increasing their odds of escaping poverty.

The year after Obama’s successful campaign—with her political consciousness energized, but without a passion for a specific issue or cause—Alena traveled to Peru to volunteer for ten weeks. She spent the first half of her time at an 28 Population Connection — March 2014

Following her graduation from college, Alena worked as an intern in the office of Massachusetts Governor Deval Patrick. While doing legislative research and outreach for the state, Alena looked for a job to follow her internship that would allow her to focus on women’s empowerment and reproductive rights. That’s when she discovered Population Connection. She was drawn to our global focus on access to family planning, and believed that our Grassroots Fellowship, which is supported by a generous grant from the Mary Wohlford Foundation, would be a perfect fit for her skills and interests. Once at Population Connection, she hit

the ground running, assisting with our Capitol Hill Days advocacy weekend, conducting outreach to key congressional districts, and supporting our volunteers with their ongoing population awareness efforts. Her endless energy and enthusiasm allowed her to easily connect with our volunteers and supporters. Alena says that her time as a Mary Wohlford Fellow provided her with a “sense of global reproductive rights and its interconnectedness with other issues—economic and developmental— that allowed [her] to see reproductive rights as an overarching issue.” Before she worked for Population Connection, she “naively” thought that reproductive rights were “settled” here in the United States. While at Population Connection, however, she gained full awareness of the intensifying battle against reproductive rights in this country—122 anti-reproductive health care provisions were enacted in 2012—and began to develop an interest in the issue at the domestic level. In August of 2012, after her extended fellowship with us came to an end, Alena took a job as the Advocacy and Communications Manager at NARAL Pro-Choice Virginia, where she continues

to work diligently to protect reproductive rights for the women of Virginia.

Rallying for the Affordable Care Act outside the Supreme Court. Alena is on the far left.

The outreach skills she honed during her time at Population Connection serve as the foundation of her work at NARAL, where she is responsible for the coordination of the organization’s electioneering, as well as their reproductive choice communications efforts. During the 2013 Virginia state elections, Alena was responsible for coordinating the day-to-day activities of NARAL’s campaign volunteers while also “jumping to produce a response whenever Ken Cuccinelli said something crazy.” She is encouraged by the results of Virginia’s fall elections, in which multiple pro-choice candidates were elected to office. She notes that advocacy is a lot of work, and that the election results are “encouraging steps, but these positive steps might not translate into ideal policy, which is frustrating. Every little step matters, but we’re not going to see results immediately, because reproductive politics are fought on such a grand playing field, and this work is such a long term effort.” Of her advocacy work in Virginia, Alena says that she “really likes the fact that [she] can make a difference—there is so much work to be done in Virginia on the policy, advocacy, and messaging

sides.” She loves working with NARAL Pro-Choice Virginia’s “legislative rapid response team,” which helps the organization track and respond to legislation in the state legislature. She says that the battle for reproductive rights has become “hyperlocal” and that many legislative decisions are quietly made in state capitals. Therefore, it’s especially important for pro-choice activists to be “vigilant” in their attempts to “illuminate this process.” On her development as an advocate, Alena reflects that she has gained a greater respect for the political process

and has become more involved in state and local politics. While she’s become “much more of a realist about the possibility of Roe vs. Wade being overturned,” she is also encouraged by the pro-choice candidates recently elected in Virginia, and thinks that it’s “really great to see women and voters engaged in this issue.” The childhood version of Alena, who first held campaign signs at age seven, would be proud of the advocate she has grown up to be. We’re proud that working at Population Connection was an early stop on her professional journey and look forward to watching her future accomplishments. March 2014 — Population Connection 29

Why Environmental Literacy Plans Need PopEd PopEd

By Amanda Claire Frank, Senior Education Fellow


ontemporary environmental issues are vastly complex and full of dilemmas: How do we weigh the importance of preserving natural habitats with the need to increase food production? Is it only fair that developing countries embrace fossil fuels in order to spark economic growth, despite the environmental damage it will cause? With environmental issues becoming the subject of more and more political and economic debates, it is essential that young people develop the knowledge and critical thinking skills to navigate these difficult questions. That is why a growing number of states are considering making “environmental literacy” a graduation requirement.

No Child Left Inside

Teachers are increasingly recognizing the importance of environmental education, but pressures to meet content standards leave little room to squeeze another class into the school day. What is needed, therefore, is a curriculum that incorporates vital environmental concepts into core subject areas like math, science, and social studies. This is the approach of the No Child Left Inside Act of 2011, which would provide funding and guidance to states to develop Environmental Literacy Plans (ELPs).

30 Population Connection — March 2014

An ELP sets goals and provides assessment on students’ knowledge of environmental issues. While states have flexibility in designing their ELPs, one common requirement is for environmental education to be integrated across core subjects, thus ensuring that content standards are met.

standards in 2009 and released an ELP in 2011. Maryland enacted legislation requiring all high school students to complete an environmental literacy program, which is locally designed and approved by the State Superintendent of Schools. Most states, however, are still in the early stages of developing ELPs.

The ultimate goal of an ELP is to ensure that every student graduates high school with a working level of environmental literacy. Environmental literacy involves three skill areas: knowledge (being informed about environmental issues and their social/political implications), competencies (the ability to identify and analyze environmental problems), and dispositions (feeling a sense of personal responsibility towards the environment). According to the North American Association for Environmental Education, development of these three skill areas leads to environmentally responsible behavior, “the ultimate expression of environmental literacy.”

The Role of PopEd

While No Child Left Inside has yet to pass the House or Senate, a few states have taken it upon themselves to develop and implement ELPs or similar environmental education plans. Washington State adopted environmental learning

Here’s where PopEd can play a role: Our activities provide opportunities for environmental education and help students develop the three skills essential to environmental literacy. Many of our lesson plans explore real-world environmental issues, from carrying capacity to land use to air and water pollution. Our lessons help students recognize the social and political contexts in which environmental problems occur. Moreover, PopEd materials help students gain a sense of shared responsibility for environmental problems and challenge them to adopt environmentally responsible behavior. Finally, our materials address the population component of environmentalism, making the connection between human numbers and activities and the health of the natural world. Simply put, PopEd materials increase students’ abilities to articulate environmental issues and find creative solutions.

And since PopEd activities are crosscurricular and matched to national and state content standards, they are easily incorporated into the classroom. We are using this opportunity to reach out to school districts in states that have adopted ELPs to demonstrate how our materials can help them achieve their goals. As a provider of professional development workshops, PopEd can do more than just deliver useful lessons. We can serve as an excellent resource for the professional-development-in-environment requirement under No Child Left Inside. We are beginning our outreach in North Carolina, as the state writes its final draft ELP. We already have a strong presence there as an approved resource for the N.C. Environmental Education Certification Program, and having presented at many teacher conferences over the years. Environmentalism is no longer a niche field, but is connected to every professional and civic role that a student will assume, from business to politics to public health. It is our responsibility to ensure that our young people are prepared for the multifaceted challenges environmental issues present, and to make informed choices that benefit our world and our human community.

Mining for Chocolate This upper-elementary/middle school activity introduces students to the environmental damages caused by mineral extraction, while demonstrating how economics and consumption habits fuel mining in the first place. This hands-on activity has students use toothpicks to “mine” chocolate chips out of a cookie in order to simulate the effects of mining on the natural environment. Students recognize that mining impacts the land and learn that damages go far beyond the mining site, polluting water sources and damaging animal habitat. They analyze the opportunity cost of mining and discuss what environmental services are lost due to extraction. Finally, using a worksheet that matches everyday objects with their mineral components, students learn how population pressures will continue to produce the demand for mineral extraction. Photo: PopEd Teacher Trainers at last year’s Leadership Institute practice facilitating Mining for Chocolate

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32 Population Connection — March 2014

Editorial Excerpts

New York , New York

Los Angeles, California

In a disappointing order on Friday, the Supreme Court extended a temporary injunction barring the Obama administration from enforcing paperwork rules against a Colorado nuns’ group in connection with a federal law that requires employer health plans to cover birth control without a co-payment.

The Little Sisters of the Poor, an organization of Roman Catholic nuns that runs nursing homes around the country, is testing the contraceptive coverage mandate of the Affordable Care Act.

In its order, the justices required the Little Sisters of the Poor, which operates nursing homes, to file a written notice of its religious objection with the Health and Human Services Department. But they did not require the group to send a copy to its insurance administrator or to sign the normal government certification form that the nuns say would make them complicit in providing birth control and infringe on religious freedom in violation of the Religious Freedom Restoration Act. Religiously affiliated organizations like Little Sisters are exempt from having to provide contraceptive coverage if they offer a health insurance plan to their employees. The minor paperwork requirement frees them from having to “contract, arrange, pay or refer for contraceptive coverage.” The notion that it substantially burdens religious liberty is ridiculous. It is especially ridiculous in this instance, since contraceptive coverage will not be made available to the group’s employees even if the group ultimately loses its case. Its insurance plan is a selfinsured “church plan,” which the government concedes does not have to provide birth control coverage. – January 27, 2014

Under the law, most employers are required to provide their employees with health insurance that covers birth control. But the Obama Administration agreed to a compromise for nonprofit religious groups that object to contraception, exempting them from paying for such coverage. Instead, insurers agreed to absorb the cost. All the religious organization has to do is fill out a simple form attesting to its situation. Unfortunately, even that was too much for the Little Sisters of the Poor. The form couldn’t be easier or shorter. It takes five minutes to fill out and sign. One disconcerting possibility is that religiously-affiliated nonprofits might circumvent the intent of the mandate by expanding the role of nonprofit religious insurance organizations like the one the Little Sisters uses. That would be an extreme measure to avoid an aspect of healthcare reform that is meant to allow employees to make their own medical decisions. – January 7, 2014

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Your legacy...people and the planet in balance Have you considered leaving a legacy gift ensuring that your commitment to zero population growth continues well into the future? By remembering Population Connection in your will or estate plan, you can make a meaningful contribution to stabilizing population and improving the quality of life for everyone, everywhere. We also offer charitable gift annuities, which provide guaranteed life income and significant tax advantages. We are proud to honor our legacy donors as members of The ZPG Society. For more information, please contact Shauna Scherer, Director of Marketing and Development, at or (202) 974-7730.

Population Connection members Katharine and Julian Donahue, visiting Iguazu Falls in Brazil.

If you’ve already included Zero Population Growth (ZPG) in your estate plans, there is no need to change any language. We proudly maintain the name and the mission. 34 Population Connection — March 2014

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