Phoebe Gates on the Global Stakes of the End of Roe v. Wade

I was with her on Friday when the Supreme Court’s decision came down, and I told her about my revelation with the Rwandan teen moms. But she didn’t find it quite as insightful as I did. “I don’t think this is a communication or compassion problem,” she said. “More people agree with Roe than they did 50 years ago. Women won the argument, but we still lost the policy battle.”

She was right—as moms are, annoyingly, most of the time. Did I really believe that putting Clarence Thomas in a room with 52 Rwandan teen moms would suddenly make him vote like Elena Kagan?

The problem was never that we didn’t share enough compelling stories or appalling statistics. One more viral Gloria Steinem or RBG quote wouldn’t have saved Roe. This wasn’t about persuasion at all. It was about power. The wrong six people were in positions of authority. And they are why women lost the right to choose.

When I started college last year, I wanted to become an advocate, like my mom. So I tried to learn as much as I could about making policy, finding the best data, gathering the best ideas, and educating the right people. But now I realize I was blind.

There was a fundamental flaw in my thinking. Public health—especially women’s health—requires learning about power, and how to wield it. It’s not just about what to do, but also about how to get it done.

They understand this intuitively in places where women’s health is not guaranteed by the law. In Rwanda, my heroes are people like Dr. Florence Akiiki Bitalabeho, head of the community health department for the University of Global Health Equity; Raissa Umutesi, an oncology nurse; and Mariella Munyuzangabo, the associate director of maternal health for PIH Rwanda, where I’m interning this month.

Dr. Bitalabeho, who is also a professor, uses community engagement to make sure that PIH programs are both sustainable and driven by what the community asks for. Umutesi is not just a nurse; she also runs an entire support program for girls like the teen moms I met. Munyuzangabo helps maintain PIH’s vast maternal health program by constantly surveying female patients and training doctors around the clock. They’re almost more like revolutionaries than medical professionals. Yes, they treat patients. But they are activists too.

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