Many pregnant women in distress who don’t meet these requirements will attempt to seek out other routes in order to recieve the abortion they desire. However, most of these other routes are unsafe and pose significant health risks as well as potential prosecution. In some countries, namely Morocco, it is estimated that as many as 800 illegal and unsafe abortions are performed daily. Worldwide, 13 per cent of pregnancy-related deaths are related to botched abortions, according to the World Health Organization. Unfortunately, given their unregulated and unsanitary nature, they often end in death or other permanent health complications.

In an attempt to raise awareness for the high toll of these abortions, Dutch physician Dr. Rebecca Gomperts founded the nonprofit pro-choice organization Women on Waves in 1999. The aim of the organization is to provide women who live in countries bound by restrictive abortion laws with the reproductive health services that they need, especially in the form of non-invasive and non-surgical abortion services. Since its inception, Women on Waves has also provided assistance in the forms of contraceptives, counselling, education, and hotlines where women can call to learn about all matters of women’s health.

By circumventing repressive abortion laws through providing medical care on international waters, Women on Waves aims to “prevent unsafe abortions and empower women to exercise their human rights to physical and mental autonomy.” Upon the founding of the organization, Dr. Gomperts designed  a portable gynaecology unit named “A-Portable” with the Dutch design company Atelier Van Lieshout. A-Portable operates as a mobile clinic and can be easily installed onto ships made for international travel. Every ship carries a minimum of one specialized abortion doctor, one gynaecologist, and one specialized nurse, in addition to other trained personnel. According to the organization, the standards under which each ship operates exceed the requirements set forth by Dutch law and other EU regulations.

In 2001, Women on Waves made its maiden voyage onboard The Aurora  to Ireland, where abortion is illegal. Since then, the organization has travelled to Poland in 2003, Portugal in 2004, and Spain in 2008. As a reflection on the influential work of Women on Waves, an official poll in Poland found a 12 per cent increase in support of legalized abortion.

Women on Waves’ most recent journey to Morocco this past Thursday, October 4, was somewhat unsuccessful. The Moroccan Health Ministry intercepted the ship as it tried to dock in Smir, and naval forces were deployed, while authorities on land shut down the harbour and restricted access for both journalists and women seeking aid. As it was evident that the Moroccan government was not going to budge, Women on Waves launched what it called its “Trojan Horse.”

As the ship remained at sea, it revealed its Moroccan hotline number women can call for information on receiving a safe, Dutch government-sanctioned medical abortion through the use of the drug misoprostol, which is on the World Health Organization’s (WHO) List of Essential Medicines. Arthrotec, the brand name of misoprostol available in Morocco, can be used until the 12th week of pregnancy.

Legally, ships equipped with A-Portable are able to provide safe, surgical abortions up to the end of the first trimester, or 13 weeks, as governed by Dutch law. When on international waters, Women on Waves is only subject to the regulations of its origin country, the Netherlands, and thus can perform abortions as regulated by the Dutch Ministry of Health, Welfare, and Sport.

Women on Waves has not always had such liberal reign. In 2004, the Dutch health minister ruled that each boat must be within 25 kilometers of the Slotevaart hospital when performing an abortion, should the crew encounter an emergency. Fortunately, this decision was then overturned by the Law Court of Amsterdam in 2008, and Women on Waves was restored to its original legal status in providing abortions anytime during the first trimester.

It has been shown through polls done by Women on Waves that after each visit of their boat, the general opinion toward legalizing abortions takes a turn for the positive. This is especially beneficial to women of lower socio-economic status as they are the most likely to use unsafe methods resulting in severe complications. As such, considering the lives of women with unwanted pregnancies, one cannot deny that access to safe abortions is one of the most fundamental issues of social justice.

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Leaving for the trip, I didn’t know what to expect. I jumped from one scenario to the next, trying to envision how each clinic would look like or what I would be tasked with.

The setup of the clinics was simple enough. All of the students were split into three groups, and each day, we would load and board the buses by 7 a.m. One group would be taken to the development project ( such as building a bathroom for an elementary school in the small community of Ccaccaccollo), while the other two would each run a clinic in nearby mountainous communities, where access to medical care is not readily available. It took two hours to drive up treacherous dirt paths barely wide enough for a single bus. One could only imagine how long the people of the villages would have to walk just to get basic medical care.

At the dental stations in each community, I didn’t see a single person with less than ten cavities, and the number of children with cavities so large that the tooth was practically gone was heartbreaking. In assisting the dentist, I was able to witness seven complete tooth extractions under barely any anaesthesia. While the lidocaine was always injected generously, it was impossible not to notice the tears building up in the eyes of children hardly over the age of ten, as the dentist jammed a root elevator into their gums, loosening teeth that were still intact. The patients never made a sound, even when the dentist moved on to forceps and with pure force, pulled the tooth out. Many times, the teeth were rotten to their core and simply cracked in half when the dentist applied force. The dentist had to go in a second time and attempt another extraction in hopes that they would not further break into smaller pieces. Watching the blood flow freely from such an open wound was both mesmerizing and repulsing. I remember wanting to look away or cringe, but I was frozen in place by the unbelievable surgery in front of me. I kept trying to imagine my own trips to the dentist, but my experiences paled in comparison, and the most that I could do was to keep a solemn expression. The dentist would smile with words of encouragement to the patient, admire his own handiwork, and wave the next patient over.

Aside from dentistry, there were also doctor and OB/GYN stations at each clinic. Patients came through the door with varied ailments, and even with the language barrier between English and Spanish or Quechua (a native South American language), the doctors tried their best to explain every patient’s problems to the students. There were simple coughs, to full-body dermatitis caused by scabies, to various fungal infections, to parasitic worms. With every patient, the doctor would write a script for whatever medication they needed, and they would be able to pick it up at the pharmacy station.

While the patients waited to see a doctor or the dentist, they could sit in the education station and watch videos, which gave information on a wide range of health issues such as breast exams, further dental precautions, and general hygiene care.

As a developing country, Peru has faced political unrest and fiscal crises since gaining independence in 1821. Although the country is still classified as a less-developed country due to its Human Development Index, living standards, and undeveloped industrial base, there have still been periods of stability and strong economic upswing. One of the most telltale signs of a developing country that I noticed was that there was a big gap between the wealthy and the poor in Peru. It was almost as if the middle class did not exist. Peruvians seem to be either extremely affluent or impoverished, with the latter group left without access to basic healthcare. Unequal distribution of income is one of the main roadblocks in Peru’s current system, as it produces a large gap in education, which has proven to result in many other problems.

Because of this lack of quality education, poorer communities are not well-equipped with knowledge regarding preventative health practices such as tooth brushing and frequent mammary examinations. Unaware of health-related warning signs or symptoms, people will usually ignore minor problems until they become extremely serious, as was seen in the full-body scabies cases. Many of the patients I saw had issues that were either easily preventable or could have been easily cured when the early onset of symptoms were noticed.

An uneven income distribution also results in a lack of proper infrastructure, including roads, sanitation, and stairs for the mountainous communities. This means that they will not have easy access to hospitals until the city expands towards them. Without these fundamental backbones of development, the children of those communities will not have access to quality education and thus the cycle will continue.

In its focus on information, MEDLIFE is ensuring that, in addition to free and immediate medical aid, the rural communities are also aided through education and development so that, over time, these communities will gain access to a gamut of services and be able to thrive on their own.

Immediate care is important for any emerging community, but without a change in the structural causes of poverty and a development of infrastructure, health outcomes in the area are not likely to improve.

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