NYT:The Dawn of Post-Clinic Abortion -Dr. works to bring Medical Abortion to Women around the Globe.
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Gomperts is a general-practice physician and activist. She first assisted with an abortion 20 years ago on a trip to Guinea, just before she finished medical school in Amsterdam. Three years later, Gomperts went to work as a ship’s doctor on a Greenpeace vessel. Landing in Mexico, she met a girl who was raising her younger siblings because her mother had died during a botched illegal abortion. When the ship traveled to Costa Rica and Panama, women told her about hardships they suffered because they didn’t have access to the procedure. “It was not part of my medical training to talk about illegal abortion and the public-health impact it has,” Gomperts told me this summer. “In those intense discussions with women, it really hit me.”
Almost 40 percent of the world’s population lives in countries, primarily in Latin America, Africa, Asia and the Persian Gulf, where abortion is either banned or severely restricted. The World Health Organization estimated in 2008 that 21.6 million unsafe abortions took place that year worldwide, leading to about 47,000 deaths. To reduce that number, W.H.O. put mifepristone and misoprostol on its Essential Medicines list. The cost of the combination dose used to end a pregnancy varies from less than $5 in India to about $120 in Europe. (Misoprostol is also used during labor and delivery to prevent postpartum hemorrhage, and global health groups have focused on making it more available in countries with high rates of maternal mortality, including Kenya, Tanzania, India, Nepal, Cambodia, and South Africa.) Gomperts told me that Women on Web receives 2,000 queries each month from women asking for help with medical abortions. (The drugs are widely advertised on the Internet, but it is difficult to tell which sites are scams.)
When I spoke to him over Skype last month, Kale told me that his company, Kale Impex, supplies 1,500 drug compounds, including mifepristone and misoprostol, and has $4.5 million in annual revenue. He said he understood why it was important to Gomperts to partner with a drug exporter. “It’s a simple pill and still not freely available,” he told me. At one point over Skype, he asked me to turn on my camera. “Can you see this?” he said, holding up a sheaf of papers that Gomperts gave him. “These are notes from women we sent the packages to.” I asked him to read one, and he chose a message from Malaysia. “Me and my boyfriend are not really fluent in English, but you guys at Women on Web really did a great job,” it read. “We are grateful for the help and support and thank you for all that you do.” I had seen other notes like this in Gomperts’s office. One message from Kenya read: “I retrieved the medicine from the post in Nairobi yesterday. I kissed the pills when they fell into my hand.” Another from Northern Ireland read: “I used your service a few months ago. Today I finally found out I was back to normal, whatever that really means, seems strange to say really, but I wanted to say a HUGE thank you.” Kale paged through more notes, reading off a list of the places they came from: Costa Rica, Malta, Pakistan, New Zealand, Chile, India, Uganda, Ireland, Brazil, South Korea, Saudi Arabia, the United Arab Emirates, Poland, Algeria. “So many countries,” he said, with a note of awe.
Of the thousands of emails that come to Women on Web, 40 to 60 a month now originate in the United States, Gomperts said, double the number from two years ago. On the first day I was in the office, she showed me a recent email from Florida. “Please tell me where I can get miso without a prescription,” the email read. “I live in the United States and have no health insurance. I have two children and I am currently out of work, there’s no way I can afford another child. Please help. I’m desperate.”
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