Overseas Aid: Charities and Faith-based Organisations — House of Lords, 2018-07-12
Topic: Health
Elizabeth Barker (Liberal Democrats, Centre to centre-left): My Lords, I thank the noble Baroness, Lady Stroud, for giving us the opportunity to discuss this topic today. I also congratulate the noble Lord, Lord McNicol, on an excellent maiden speech. I am intrigued to discover that he is a snowboarder because, to the best of my knowledge, he comes from the one part of Scotland where there is very little snow—that is why they built Prestwick Airport where they did. So he is clearly a man of great fortitude who works hard to achieve his goals I declare my interest as chair of the All-Party Parliamentary Group on Sexual and Reproductive Health, a member of the APPG on Population, Development and Reproductive Health and of the HIV/AIDS group, and a supporter of the NAZ project, a black and minority ethnic organisation dealing with HIV and AIDS, principally in this country but also in other parts of the world For those reasons, I listened to the speech of the noble Baroness, Lady Stroud, with great interest. Faith-based health providers are a major component of health service delivery in many developing countries, especially in sub-Saharan Africa. The WHO estimates that at least 40% of healthcare services in sub-Saharan Africa are provided by the faith-based sector, and that between 30% and 70% of health infrastructure in Africa is owned by faith-based organisations. So it is clear that faith-based organisations are going to be a very important part of the delivery of health. That is not surprising: Christian missionary hospitals and Islamic hospitals were often the first medical facilities throughout Africa. Because of their extensive infrastructure, they are a critical component; they exist where the government sector and the private sector are poorly developed. They are very active in public health initiatives, particularly around HIV and AIDS, tuberculosis and malaria. They can aid and augment the supply of materials and medicines. They are sometimes the only genuine NGOs, and they are very much trusted and influential in the communities in which they work At the same time, some faith-based providers of services have very narrow, conservative interpretations of their faith that can have a direct effect on very important matters such as access to family planning, contraception, abortion and HIV/AIDS treatment, particularly condom distribution and condom use. That has very obvious consequences for women and girls. It is therefore only right that we look at that issue in some detail today, because it is critical not only to the lives of the people but to government organisations that are trying to work in a complicated landscape of providers For many faith-based organisations, the provision of healthcare services is an important part of their mission, and those faiths live out their values within their service provision. That is absolutely understandable, but, within different religions and at different levels of religious organisations, there is often quite a variation in understanding of what their practice is and should be. At its heart, the Catholic Church has very clear policies, particularly about access to contraception and abortion. In other religions, it is less clear. For example, there is a debate raging about whether intrauterine devices are abortifacients. That can have a major impact on a population of women and girls It is an issue that people in the aid sector return to time and time again. Nobody doubts that religious organisations can be of major importance in the development of the health, wealth and economy of a nation, but, as public policy, and in particular local political public policy, is often heavily influenced by external religious funding sources, it can sometimes bring about a great change. It is interesting that we are discussing this today when the President of the United States of America is in town. His Government came in and reintroduced what is known as the global gag rule. If fact, they extended a previous US Government policy to deny funding to any organisation that they deemed to be a provider of abortion services. That is having a huge impact across the world. Not only does it affect those services that provide safe abortions, it has a direct impact on services that provide access to family planning and contraception, which may not necessarily provide abortion services but are caught under that rule. That in turn has a knock-on effect on the general health systems of, in particular, low-income and middle-income countries As ever, the Minister will not be surprised that I ask: how is DfID, as one of the leading providers of funding for contraceptive services and access to safe abortion—because our Government recognise that it is one of the key interventions that can be made to affect the economic outlook of not just women and girls but of the country—going to calibrate the distribution of moneys? DfID has not had a change in policy, but it now has to operate within a landscape in which other major funders, chiefly those of the United States, have changed Back in 2011, a report was produced by the All-Party Parliamentary Group on Population, Development and Reproductive Health. It was called, Sex, Ideology, Religion: 10 Myths about World Population Growth and produced by Richard Ottaway, the then Conservative MP, and was a riveting read for any of us interested in this field. He made the important point that most of the tenets of major religions were devised well before many of today’s issues, such as the changing technology of reproductive health and contraception, climate change and access to water and food, were the emergencies that they now are in certain parts of the world. Therefore, their consequences are somewhat different. He rightly says that all religions have a belief that family planning is a good thing and permissible. What is questionable, and where they differ, is on how that may be achieved. For some, we know that access to contraception remains a taboo: for others it is not When DfID is in the business of deciding which religious organisations will be part of its strategy for a country, will it ask about and take into account the policy that that religious group and its providers in the field will follow? That is not to weed people out or say that some people may never have any funding; it is about ensuring that the objectives of the programme that we set, which are laudable, for the at-risk populations in those countries are met I simply say this. There will always be funding for religious organisations; they will always have a legitimate part to play. But we need to have greater transparency about the nature of their funding alongside that of other people, so that we ensure that key vulnerable populations do not miss out completely on essential health services In the brief time available to me, I will mention another small but interesting issue that came to my attention during the Commonwealth Heads of Government Meeting. I listened to an Australian senator, Linda Reynolds, who was talking about orphanage tourism. It was a new issue to me, but one that I was interested to hear about. The Australian Government are about to change their laws on trafficking to include orphanages. They are doing that because considerable investigation, not least in places such as Cambodia, has revealed that so-called orphanages operate to standards which make one question them. Children are often there who have not been separated from their family but are there as part of a lure to tourists. It is a way in which desperate people attempt to gain an income The Australian Government are not only going to change their law to try to clamp down on orphanage tourism, they are promoting a smart volunteering scheme. It is often generous-hearted young people, often with the backing of their community here at home, who volunteer and form short-term attachments to children. We in the West now know that putting children in institutions is to condemn them to just about the most awful health and life outcomes and we tend not to do it. We tend as far as possible to support children in any setting other than an institution It is perhaps time that we began to look internationally at some of this. I am not suggesting that right at this moment we change our laws, but I ask the Minister whether he and his department might ask their counterparts in Australia what they are doing, why, and what we might learn from them Faith-based organisations have a very long tradition of helping some of the poorest and most desperate people in the world. In so far as they continue to do that, they deserve our backing, but we must ask increasingly that we have a debate with faith leaders about the exclusivity of some of the policies behind their engagement in this work.