Thursday, November 15, 2007

Rebecca Gomperts, the abortion ship's doctor


Dutch doctor Rebecca Gomperts has caused huge controversy by providing abortions for women in countries where the procedure is illegal - by treating them on a ship anchored in international waters.

Wednesday November 14, 2007
The Guardian

Rebecca Gomperts, abortion doctor and activist, arrives straight from Heathrow, dressed in a smart suit, a big smile lighting up her girlish face. She is stopping off briefly en route to another engagement - a special screening of the film Vera Drake. She isn't keen. "I've seen it lots of times," she sighs, adding mischievously: "I'm going to try to get out of it."

The event has been organised to tie in with the 40th anniversary of the 1967 abortion act, which is also the reason Gomperts, 41, is in Britain. She is the founder of Women on Waves (WoW), a radical Dutch organisation that sails an "abortion ship" to countries where the procedure is illegal, before taking women out to the safety of international waters to provide terminations.

Gomperts' reluctance to see the Mike Leigh film is not because she is uninterested in the subject matter then. Her passion is evident, but after eight years of being involved in the fray over the abortion debate, she is keen to focus solely on her next voyage. Her goal, she states firmly, is to "get out of Europe".

"So far we have sailed to Ireland, Poland and Portugal, all when abortion was illegal, with varying degrees of success, but we are looking to visit either South America or Africa next summer," she says. "Wherever we go there is a lot of press attention and opposition from anti-abortion groups but it is in developing countries that women really suffer because of unsafe and illegal abortions. That is why it is important for us to go there and raise awareness, however difficult it may be."

An article published in the Lancet medical journal earlier this year backs up her view that the burden of unsafe abortion is borne disproportionately by the poor, the disadvantaged and the young. There are an estimated 210m pregnancies worldwide each year, of which one in five ends in an abortion. An estimated 20m unsafe abortions are carried out each year, 97% of them in developing countries. According to the International Planned Parenthood Federation (IPPF), complications from unsafe abortions account for 70,000 deaths annually, as well as countless injuries.

"It's such a waste of life," says Gomperts. "As a doctor, I look at the abortion issue from a health perspective and the fact is that an early abortion is safer than giving birth. That is not meant to promote abortion because if women want to have children it is a risk they are naturally willing to take. However, if they don't want them they should never be forced to take that risk."

It was a stint as resident doctor aboard Greenpeace's Rainbow Warrior II boat that inspired Gomperts to set up WoW. She was shocked by the number of women who were either suffering from botched back street abortions, or struggling to cope with several mouths to feed, in countries where the procedure is illegal or severely restricted. She became determined to find a way to help them. "I remember meeting an 18-year-old girl in South America who was desperately trying to take care of her three younger brothers and sisters. She had recently lost her mother because of a backstreet abortion. Her mother had been pregnant for a fifth time and couldn't support another child so she had gone down the illegal route. I thought, how is it possible that a whole family has lost their mother just because she couldn't get a safe and legal abortion?

"I went back to the Rainbow Warrior and told the crew the story and how I wanted to help and they said that if you had a Dutch-registered ship it would be subject to Dutch law and so it would be legal to provide abortions in international waters. It seemed like the perfect solution. Of course, I had no idea at the time what I was taking on."

Gomperts' plan was to raise enough money to buy her own ship, which would be properly equipped with the necessary medical equipment and treatment rooms, but it quickly became clear that this wouldn't be possible. Pro-choice groups don't attract the level of donor support often enjoyed by pro-life organisations, so Gomperts turned to Plan B: finding funds for a mobile clinic that could be transferred to a hired ship for each voyage.

By 2001 everything was in place for WoW's first trip. For practical reasons as much as need - proximity to the Netherlands and the lack of a language barrier - the destination was Dublin harbour. So with a cargo consisting of condoms, IUDs, the "morning after" pill and the abortion pill RU-486, a crew of six women and two men set sail.

"I was very naive when we went to Ireland," Gomperts says. "I think you have to have a certain amount of naivety to do something like that because if you knew what was ahead of you, you probably wouldn't do it. I had made good links with local abortion rights groups and they were very keen for us to come and raise awareness but initially they didn't want us to offer abortions. I always said that if we couldn't do abortions the whole trip was pointless, so we left it that we would offer medical abortions with the abortion pill." (Medical abortions involve taking pills that induce an early miscarriage, while surgical abortion - which the ship doesn't offer - is performed under local or general anaesthetic.)

However, it became clear when Gomperts arrived in Ireland in the full glare of the world's media that she had underestimated how controversial the trip would be. While the ship was en route, conservative members of the Dutch parliament had announced that WoW was not licensed to offer the pill legally. It was made clear to Gomperts that she could face imprisonment if she continued with her project. "It was a complete nightmare. We had such high hopes when we set off from the Netherlands, only for them to come crashing down when we hit port. The legal issues were cleared up a year later but there were so many obstacles that it was impossible to solve them in a few days."

It was a major setback and press coverage was mainly negative. Headlines included "Dutch activists renege on abortions promise" and "Abortion boat admits Dublin voyage was a publicity sham". In the end, the ship distributed all its contraceptives and "morning after" pills and received more than 200 calls from women requesting abortions they couldn't provide.

"I was surprised by how much impact the trip had politically," Gomperts says. "I think abortion is one of those issues within the EU where countries don't want to interfere with each other's policies. This was a very visual challenge to Ireland's policy and, being a Dutch ship, it made some people nervous. There are other organisations in the Netherlands that work for abortion rights but they just use advocacy and not loopholes in the law. We use these loopholes but I don't see it as any different from women travelling to England to have abortions, which happens all the time. The difference is, the ship is a symbol of freedom of choice."

Indeed Gomperts' methods are deliberately confrontational. She uses direct action, which is more associated with the anti-abortion movement, and seems unconcerned at being such a figurehead for her cause. Given the lengths that some groups will go to prevent abortions, isn't she ever afraid?

"No," she says. "I have never worried about my safety - other people do, but I don't. People are very passionate about this issue and I recognise and respect that. The most aggressive crowd I have seen was in Poland when we visited in 2003. We had to have a lot of security because the anti-abortion protesters were throwing eggs and red paint and it got quite unpleasant. However, when you are in the middle of a campaign there is so much to think about that fear is not an emotion you feel. You just have to get on with it."

There have been some successes. In 2004 when Women on Waves sailed to Portugal they were blockaded by two war ships, which refused to let them enter Portuguese waters. Gomperts says this "disproportionate response" by the government caused such a furore in the country that it ensured abortion was a key issue in the 2005 election, which ended with the ruling party being replaced by the Socialist party. In February this year, Portugal held a national referendum on abortion and in April, President Cavaco Silva ratified a law allowing women to obtain abortions until the 10th week of pregnancy.

It is this kind of success that propels Gomperts forward, she says. She has recently been battling with the Dutch government for permission to provide abortions on the ship until the 12th week of pregnancy, instead of the seven weeks that the organisation's licence currently covers.

"There is a very small window in which we can help women at the moment. I would like that extended because it is still safe under the conditions we provide.

"We would never provide surgical abortions purely for practical reasons. You need at least 20 minutes for each woman so we would have to stay out in international waters for a lot longer. We also know that the services we provide will never be able to meet the demand. It is a symbolic gesture. We know we won't solve the problem."

Gomperts was born in Suriname (her father is from the former Dutch colony) before moving at the age of three to the Netherlands, her mother's country. Most of her formative years were spent in the port of Vlissingen before she moved to Amsterdam to study art and medicine. She wanted to be an artist but says she wasn't "good enough". After various medical internships, she stumbled across abortion as a specialty.

"It is a profession where you can really help somebody in a very complete way. You need a lot of psychological and surgical expertise, so even though it is a very small field there is a lot of variety. It is also one of those issues that the more you know, the more the injustice gets to you. Now my aim is to take this whole debate outside the high ground of morality because it doesn't have anything to do with morality. Many women who I have helped have said they are generally against abortion but that their situation is 'different'.

"Even if you are against abortion you might face a moment where your situation is 'different'. My work is about ensuring there is a fundamental respect that a woman can make that decision for herself at that point in her life."

During her time as director of WoW, Gomperts has had two children; one is two, the other 14 months. Has motherhood changed her perspective? "Of course having children has changed me as person, but it hasn't changed the way I feel about abortion. If anything, it has become even clearer to me how important it is that [having children] is something you really want. I enjoy it tremendously but it is so demanding that it must be a voluntary decision."

Gomperts has been called many names since setting up her organisation, one of which - "pirate" - elicits raised eyebrows and a resigned shake of the head when I mention it. But how would she describe herself?

"That's too difficult," she replies. "I guess one of my strengths has been to make the impossible possible. When people say you can't do it I become determined to make it happen. If I don't, who else will?"

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