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‘If you love or are a woman, don’t go to Malta,’ say couple in abortion drama | Reproductive rights

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When Andrea Prudente was sitting in a Maltese hospital waiting for her foetus’s heart to stop beating, she was offered grief counselling. Prudente, an American photographer, began to miscarry her pregnancy at 16 weeks during a holiday with her partner on the Mediterranean island, and had been told there was no hope for it.

But because of the heartbeat – and despite Prudente’s own life-threatening risk of haemorrhage and infection – doctors at the Mater Dei hospital in Msida would not intervene to end her very wanted pregnancy. Malta’s ban on abortion in all circumstances – the only EU country to do so – prevented it.

Prudente sent the grief counsellor away. “It’s like sending in a PTSD counsellor when the battle is still going on,” she says.

It took a widely publicised medical evacuation by air ambulance to the Spanish island of Mallorca to bring Prudente’s two-week ordeal to an end, and for her and her partner, Jay Weeldreyer, to begin to truly grieve for their loss.

Only in Spain were they able to deliver their daughter, hold her and say goodbye. Staff gave the couple a blanket for the body, and a star to hang on a tree alongside those representing all the other births that had taken place at the hospital.

As soon as she arrived at the hospital in Mallorca, Prudente was approached by a sympathetic staff member. “She said, ‘I saw you on the news.’ And she hugged me,” Prudente says.

She was discharged this weekend and is recuperating before the long journey back to Seattle. She says she feels weak but is slowly recovering.

It was only thanks to their travel insurance that the couple was able to get out of Malta at all: the insurer considered Prudente’s risk to be significant enough to send a private jet with a surgeon on board from Belgium to transfer her safely to Mallorca.

“We were extraordinarily privileged to be American citizens who had the ability to purchase that kind of insurance, because absent a third-party insurance company, and absent us being foreigners, there’s no way we were getting off that island,” says Weeldreyer.

He says he is staggered by the lengths they had to go for what could have been a straightforward, if distressing, procedure.

The couple were contacted by anti-abortion activists on social media, who urged them not to intervene to complete the miscarriage and telling them miracles could happen.

“We have a relationship with medicine, not with miracles,” says Weeldreyer.

A happy couple take a selfie at sunset
Jay Weeldreyer and Andrea Prudente in Malta before she began to miscarry. Photograph: Handout

Prof Isabel Stabile, a gynaecologist with Doctors for Choice Malta, has seen two other cases like Prudente’s so far this year. But for those local women, waiting for the heartbeat to stop was the only option.

“Luckily, in those cases, the women were fine physically,” she says, adding however that they were “mentally distraught”.

On Monday, Doctors for Choice submitted a “judicial protest”, a legal petition to Malta’s civil courts signed by 135 doctors demanding a review of the abortion ban. The doctors say the law ties their hands in cases such as Prudente’s, where medical professionals must weigh the care they provide to a patient against the risk of being prosecuted for terminating a pregnancy.

Under Malta’s abortion law, which dates from the 1850s, women who have abortions face up to three years in prison, and doctors who perform them can be imprisoned for up to four years, as well as losing their medical licence.

“The current law does not protect them when they try to protect the lives of women,” says Stabile.

She says many of the signatories would not consider themselves pro-choice, but simply want to put an end to the threat of losing their medical licence for providing care to their pregnant patients. A 2019 study found that more than 60% of doctors in Malta supported legalising abortion in cases of risk to the patient’s life and foetal non-viability.

Anti-abortion groups point to Malta’s low maternal mortality rate as evidence that the abortion ban does not put patients at risk, and say doctors will intervene in cases of risk to life.

But Stabile says maternal mortality is “a very, very low bar to set” for measuring whether medical care is adequate.

Weeldreyer and Prudente say that as they were preparing to leave Malta, a doctor at Mater Dei who also practised in London told them that if Prudente had been in the UK, he would have intervened as soon as he saw her ultrasound results.

Mater Dei hospital has been approached for comment.

In a dark irony, Prudente’s nightmare is likely to become a reality for many women back home in the US. On the day she was evacuated from Malta to Mallorca, the US supreme court removed the right for women in the US to terminate a pregnancy, leading to a swathe of states enacting outright bans on abortion with no exceptions for rape, incest or to save the life of the patient.

“The timing is nuts,” Prudente says of the ruling overturning Roe v Wade, noting that women in her position will soon have to travel between US states for the care they need. “It’s so regressive.”

She is now preparing to get home and sort through the “emotional wreckage” of a holiday that began as a “babymoon” but became a medical emergency, and then an international incident.

But she wants to use her experience to continue to advocate against abortion bans around the world. “We see ourselves as accidentally in this position to influence – just by being honest and sharing our story.”

In the meantime, Weeldreyer has a warning: “If you know a woman, if you love a woman, if you ever plan on knowing or loving a woman, or if you are a woman – don’t go to Malta.”

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‘There are snakes – but we attack the fires’: refugees fight flames in the Sahara | Global development

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Ahmedou Ould Boukhary knows he can get the call at any time, day or night from the local authorities in Bassikounou, a town in the south-east of Mauritania. Someone has spotted a fire in one of the villages perched on the edge of the Sahara. How soon can he and his men be there?

Boukhary leads the Brigade Anti-Feu – the Anti-Fire Brigade – a volunteer force of about 500 Malian refugees living in M’bera camp, towards the border with Mali, 11 miles (18km) from the town. When the call comes, teams of between 50 and 70 men pack themselves into the backs of pickup trucks and zoom out of the camp to deal with the blaze. Sometimes they travel up to 20 miles to put out fires.

A view from a plane of the vast expanse of Sahara close to Bassikonou and M’bera Camp where bush fires rage after the rainy season under the immense heat of the sun and the gusts of wind that spread the burning.
Malian refugees queue outside a distribution centre in M’bera camp for their allocation of food and feminine hygiene products
Two Malian refugee herdsmen watch their cattle next to a water trough in M’bera camp.
Members of the M’bera camp Brigade Anti-Feu drive to their training exercise. Before the rainy season, wildfires become a risk

With little more than axes and tree branches, the brigade helped to put out 36 fires in and around the camp since October, during the most recent dry season, which runs until June. The fires typically come after the rains, when scrubland, full of green plant life, slowly becomes a tinderbox.

Ahmedou Ould Boukhary, a founder of the 200-strong Anti-Fire Brigade who organises training for its members, at a tree nursery in the camp. A key method by which the community prevent bushfires is the creation of fire-breaks cleared of plant debris and other vegetation.

  • Ahmedou Ould Boukhary, a founder of the Anti-Fire Brigade, at a tree nursery in the camp.The brigade plants trees to replace those used for building and cooking

During a recent practice run, the trucks race into the desert. When they halt, the men jump out and start hacking at a small tree, passing its wispy branches around to use as makeshift brooms. They form a line, and start sweeping at the ground just as they would if putting out a real fire. Dust and sand billows into the hot air, which fills with the sound of excited shouts. The equipment may be modest, but branches used well are enough to stamp out many scrubland fires.

Brigade members arrive for a training exercise

“It’s a little tiring, it’s a little risky,” says Mine Hamada, one of the brigade leaders. “We have the courage to not be afraid. We’re brave – we go at midnight, we go at 1am, we go at whatever hour. We go into the bush. There are snakes, there’s everything – but we attack the wildfires.”

An influx of thousands of refugees escaping an upsurge in violence and rising insecurity in Mali since March has reduced the number of callouts this year. The hungry livestock they brought with them ate many of the shrubs and trees that would have posed a fire risk. Between October 2020 and June 2021, the teams extinguished 58 fires.

A man swings an axe cutting branchs from one of the many shrubs that litter the Sahelian landscape.
Brigade members practise a variety of different fire-fighting techniques. Some sweep, some swing and some hitting the ground aggressively with branches. In the background, a younger boy also practises. The Anti-Fire Brigade has acquired a heroic cachet. Teenagers can join once they are 18.
Members of BAF stand listening to a debrief from leader Ahmedou Ould Boukhary after the training session while dressed in long tunics and tagelmusts head scarves.
As ordered by their leader Boukhary, men walk in a diagonal line across the desert whooping and yelling as they practise a variety of fire-fighting formations

  • Clockwise from top left: a man chops long, bushy branches from a shrub – highly effective for beating back low-level fires; brigade members practise fire-fighting techniques. A younger boy also practises: the brigade has acquired a heroic cachet, and teenagers can join at 18; men practise and listen to a debriefing from Boukhary.

Founded in 2013 as an initiative between the Mauritanian NGO SOS Desert, the local authorities and the UN high commissioner for refugees, the brigade is among a number of volunteer groups that have sprung up in M’bera since the camp was established 10 years ago. The camp is home to about 80,000 Malians.

As well as putting out fires, the refugee fire brigade attempts to mitigate the risk of blazes by cutting down trees and shrubs to create firebreaks between patches of vegetation. The brigades also plant trees to replace those cut down to make homes in the camp and for cooking. These efforts are contributing towards the Great Green Wall – a massive reforestation project that aims to grow an 4,350-mile-long barrier to combat environmental degradation in the Sahel.

The men walk in a diagonal formation during their firefighting practice session, whooping and yelling

Miraculously, the brigade has only incurred one injury over the past nine years, Hamada says. Amid high winds, a man tripped and fell into a fire he was battling. His fellow firefighters were able to pull him to safety before he could be seriously hurt.

The volunteers say they take on the dangerous work, which often has them out in the field for hours at a time, because they want to protect the area in which they live. But they also do it out of gratitude – to pay back their Mauritanian hosts for the years they have spent as refugees.

“We must help les adoptants,” says Boukhary, referring to the local Mauritanians who, by accepting the Malians into their country, he suggests have “adopted” them. “We intervene to help them. Because we’re refugees on their territory. No one asked us to ‘Do this, do that’ – it’s our initiative.”

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Kiev Selling Off Country, Prioritizing Poland in This ‘Business Project’ – Russian Foreign Intel

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Previously, Russian Foreign Intelligence Service chief Sergey Naryshkin said that Warsaw and Washington were plotting to “reunite” Poland with western Ukraine, with the statement branded “false” by the Polish secret service.

The Kiev regime has, essentially, already started selling off the country, giving priority in this “business project” to Polish neighbors, the Foreign Intelligence Service of the Russian Federation stated on its website.

Poland’s aspirations are being facilitated by newly-adopted legislation in Ukraine.

“The new legal framework adopted by the Rada at the end of July offers special guarantees for Polish citizens and allows the sale of Ukraine’s industrial enterprises at a 50% discount, according to the SVR website.

Ukrainian flag and Polish Eagle on the building of the Polish Embassy in Kiev. File photo. - Sputnik International, 1920, 04.05.2022

Poland Plans to Annex Western Ukraine, Former Lawmaker Claims



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The repeal of abortion in the United States leaves doctors in legal limbo | International

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On June 29, five days after the US Supreme Court struck down federal protection of abortion rights, Emily Diament, pregnant with her second daughter, was due for her 20th week checkup. Everything was going well in a pregnancy that “could not be more desired.” She will always remember it: it was Wednesday, at two o’clock in the afternoon, when the doctor told them that the fetus’s heart had stopped beating. “It was terrible. At that time, Ram [her husband] and I had to think: Where does the Supreme Court ruling leave us now? “All of this was new”, adds this 33-year-old public relations officer in an email: “a panorama full of unknowns and fears”.

The gynecologist explained the alternatives. The first, “induction,” was the least safe. It essentially means giving birth to the stillborn baby. The second, more reliable and less onerous for her, was to undergo a D&E operation, an acronym for “dilation and evacuation”. “The process is also faster,” explains Diament. The couple opted for the latter.

The couple live in New Orleans, “the best city in the world”, as Diament likes to define it. The Supreme Court ruling, which overturned the half-century precedent of 1973 by the ruling Roe v. Wade, gave power to regulate women’s reproductive health back to the States. Diament’s legislators in Louisiana, anxiously awaited the moment of a “trigger law”, ready to take effect since 2006. Three days after the ruling, a judge blocked the activation of that rule, one of the most restrictive in the country. But it was just a mirage: on July 8 abortion was outlawed in Louisiana even for rape and incest. And so it goes: after several comings and goings in the courts, the ban holds up, pending new legal battles.

Among the restrictions contemplated by the law is the veto on D&E unless the mother’s life is in danger, or the baby has already died. Diament’s case fell into the permitted categories, but her ordeal compelled her to tell her story. “After going through that process and talking to several doctors about their concerns,” she explains, “I know this happened to me at this exact time for a reason.”

Bhavik Kumar is one of those nervous doctors, pushed into legal limbo by the new rules. He is a consultant in the largest provider of abortions in the United States, Planned Parenthood, in Houston, Texas, another of the epicenters of the restrictive tsunami that hits the United States. He explains that an “induction” can last “from one to 12 or 24 hours”, carries more risks (“the same as childbirth”) and generates more hospital expenses, causing serious debt among less well-off patients. Some, however, prefer it, because “the baby comes out intact, and they can bond with it,” adds Kumar. With D&E, which uses forceps, mothers do not see the dead body.

Conversation between doctor and patient

And that is all that Kumar asks: that the matter be resolved in a conversation between doctor and patient, “without political interference.” “Since the law came into force [in Texas], the only cases in which we are allowed to intervene after six weeks is if the life of the person is in danger, or if there is no doubt that the pregnancy is not viable.”, he warns.

Kumar, like many of his colleagues, has doubts around the idea of “life in danger”. “It’s not exactly a scientific concept,” he clarifies. “Every doctor, every ER, every clinic, and every hospital may have their own theory of what that means. Now, instead of looking at the data and talking to patients to decide what’s best, doctors, hospitals and clinics have to consult with lawyers, ethics committees or administrators about what they can and can’t do. Meanwhile, they also remain in limbo. The precautions seem justified: both Texas and Louisiana threaten prison sentences of between 10 and 15 years to those who perform abortions outside the supposedly permitted limits.

A gynecologist thus defined the new dilemmas of her practice during an interview with EL PAÍS held at a reproductive health center in Des Moines (Iowa): “It’s terrible,” lamented the doctor, who asked to speak anonymously. “They make us choose between the Hippocratic Oath [the famous “Do no harm”] and the penal code.”

This week, Attorney General Merrick Garland decided to take matters into his own hands with a Justice Department lawsuit challenging a new Idaho law that, when it takes effect at the end of the month, will allow prosecutors to “indict, arrest and prosecute a doctor merely by showing that an abortion has been performed, regardless of the circumstances.” The rule thus endorses the burden of proof on doctors (that is, to prove whether the woman’s life was in danger or not, for example, or if there was incest or rape, in cases where the law contemplates those exceptions). According to Garland, who warned that it would be the first in a series of legal actions by the Biden Administration to mitigate the effects of the new state laws, that provision conflicts with a federal regulation, The Emergency Medical Treatment and Labor Act (EMTALA).

“D&E requires training that many physicians lack,” explains Diament. “With the new laws, it is likely that there will be doctors who prefer not to learn the technique to avoid its possible consequences. It’s not that we don’t have autonomy over our bodies, it’s that doctors can’t watch over our health either. This is not protecting life, quite the contrary. It’s completely surreal.”

“We must not forget that we are facing cases in which pregnancies are absolutely desired. First they have to accept terrible news, and then they are forced to go through a process that is very traumatic for many, and after that, a few weeks later, they have to relive the experience when the hospital bill arrives”, argues Gabriela Benazar Acosta, spokesperson from Planned Parenthood Latino, New York.

Kumar warns, for his part, that “medicine is a science with vast gray areas, no matter how hard these legislators insist on the contrary. No one better than doctors, in an empathetic dialogue with patients and their families, can know in each specific case what is the best way to act.”

These days, stories like Diament’s are emerging in the United States (“there have always existed,” says Kumar, “but now the spotlight is on them”). Stories of women who are sent home by hospitals with instructions to return when they get worse and are “really” bleeding (“And that, even when it is clear that there is no turning back,” warns the doctor). A patient in Texas whose water broke at week 18 and was advised to stay in the hospital until week 24 to keep her pregnant until then, which is when “viability” outside the womb is set to begin. Maybe then, the baby might survive (the chances, Alan Peaceman, a professor of maternal-fetal medicine at Northwestern University Feinberg School of Medicine in Chicago, told NPR that the chances are “as close to zero as far as medicine is concerned”).

“All this means that some have to travel to other states because they do not want to wait to get even more sick,” adds Kumar. Since the Supreme Court toppled Roe, class and race are two factors that have surfaced in the debate on reproductive health in the United States. With this regressive wave, which comes after half a century in which women took for granted a protection that they are now denied, began an exodus of patients from their places of origin to States in which abortions can be performed. This has created yet another gap, between those who can afford to take vacation days, often unpaid, from their jobs and pay for the trip and the intervention, and those who simply cannot afford it. In the case of miscarriages, inevitable in between 10% and 20% of pregnancies, this different position in the wheel of social fortune can become, if things get complicated, deadly.

Translated by Xanthe Holloway.

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