By Joelle Boxer
Late last year, Dr. Eunice Brookman-Amissah won the Right Livelihood Award, also known as the “Alternative Nobel Prize,” for her pioneering efforts to improve safe abortion access in sub-Saharan Africa.
According to Dr. Brookman-Amissah, of the 36,000 deaths that occur globally due to unsafe abortion, almost 24,000 are in sub-Saharan Africa. “That was a totally unacceptable state of affairs,” she said, “given the fact that nobody, absolutely no woman has to die from a totally treatable and manageable cause.” Her advocacy work is credited with contributing to a 40% reduction in deaths from unsafe abortion in the region since 2000.
From Physician to Minister
Dr. Brookman-Amissah was born in 1945 and trained to be a physician at the University of Ghana Medical School. Raised in a conservative household, she held anti-abortion views at the start of her career. Dr. Brookman-Amissah has often recounted a tragic, personal experience with a young patient that shifted her stance. In 1992, a distressed 14-year-old girl named Amina came to her clinic asking for help, explaining that a man “had given her money to give to a doctor to make her period come.” Dr. Brookman-Amissah, upset with a request she considered inappropriate, told Amina to bring her mother to the clinic. Unfortunately, Dr. Brookman-Amissah found out that Amina died the following weekend from an unsafe abortion. As she pondered in The Means of Reproduction: “Was Amina really a criminal? Maybe I’m the criminal. That man, that older man, is a criminal. The whole society is liable for the death of an innocent young girl who didn’t even know what was happening to her.”
Thus began a 30-year career in reproductive rights advocacy. Dr. Brookman-Amissah started working with Ipas, an international NGO committed to safe abortion access. She then served as Ghana’s Minister of Health from 1996 to 1998 and as Ghana’s Ambassador to the Netherlands from 1998 to 2001.
From Minister to Advocate
Dr. Brookman-Amissah returned to Ipas in 2001, where she served as Vice President for Africa until 2014. Recognizing that when she began her career, “abortion was not a word that you could mention in polite society,” her push to reform restrictive, colonial abortion laws was tireless.
She worked to educate and build consensus among diverse stakeholders, including the African Union; regional institutions like the African Commission on Human and Peoples Rights and the West Africa Health Organization; regional groups of Ministers of Health and Ministers of Women’s Affairs; governments; media, women’s rights, youth, and religious organizations; and organizations that train doctors and midwives. Her advocacy led to legal reform processes in Mozambique, Sierra Leone, Benin, Eswatini, and Kenya.
Mozambique’s 2015 reforms legalized abortion during the first 12 weeks of pregnancy for any reason and the first 16 weeks in cases of rape or incest. Sierra Leone’s parliament passed a bill in 2015 that would have also legalized abortion during the first 12 weeks of pregnancy; while the president blocked it at the time, reform is now back on the table. Benin’s parliament passed a bill in 2021 that legalized abortion during the first 12 weeks of pregnancy “in most circumstances.” Eswatini reduced restrictions on abortion through its 2005 constitution, broadening access in cases in which there is a danger to the mother’s life, a serious threat to the mother’s health, and on the grounds of rape, incest, or fetal impairment. Kenya also reduced restrictions through constitutional reform, mandating in its 2010 constitution that abortion be available as emergency treatment and when there is a danger to the mother’s life or health.
In addition to the passage of new laws, Dr. Brookman-Amissah’s efforts improved implementation of existing laws in countries including Ghana, Zambia, Malawi, Senegal, and Mauritius. She also helped disseminate the Maputo Protocol; convened the conference where the World Health Organization launched its first safe abortion guidance; and worked to make the International Confederation of Midwives a partner in safe abortion reform.
Reflections
Reviewing this reproductive rights icon’s accomplishments, I was struck by the following reflections.
- Reform can come with risk: Unfortunately, Dr. Brookman-Amissah was subject to death threats throughout her career, including from U.S.-based anti-abortion groups.
- Reform requires persistence: “Sometimes people avoided me when I attended meetings and conferences, but I went, time after time after time, and pushed on.”
- Reform requires more than legal change: “The issue of stigma is still there… changing the laws may provide the services, but it still takes some time for people to change their attitudes to something that they have been socialized all their lives to think is wrong.”
- Reform requires diverse coalition-building: “We’ve had some religious leaders who are very supportive of the issue. It is not impossible for that to happen.”
- Reform is impacted by foreign policy: “[The U.S.’s Helms Amendment and Gag Rule] have a chilling effect on Ministries of Health in the region. They are not willing to be seen as actively involved in the push toward access to safe abortion. It’s been a difficult issue for us. That’s one of the reasons it has taken us 30 years to get here.”