海角大神

Dr. Cinthia G贸mez is on a mission to help victims of sexual assault.

It's a major undertaking in Honduras, where听domestic violence and murders targeting women听occur with impunity 鈥� and where half of听babies born to girls ages 15 to 19 are the result of rape.

鈥媁鈥媓en victims of sexual assault arrive at Tegucigalpa's largest public hospital, where Dr. G贸mez's program is based, they are met by both physicians and psychologists. They are tested and听given 鈥媘edication to help diminish their chances of contracting HIV or other sexually transmitted diseases.

But ever since 2009, doctors like G贸mez have lacked what many global experts say is a vital tool in treating female rape victims: emergency contraception.

The sources of such high rates of sexual abuse across the country and within families remain a complex problem, with officials pointing to factors including increased organized crime and violence,听sweeping poverty, low levels of education, blended families due to migration, and cultural taboos on talking about sex.

Even as many here try to raise awareness about reproductive health and sexual assault, however, they must work within a total ban on emergency contraception, which can prevent pregnancy if taken within 72 hours of sex. The six-year-old prohibition is rooted in a powerful religious lobby that views the intervention as a form of abortion, which is banned. Religion is 鈥渧ery important鈥� in Hondurans' lives, and 88 percent oppose abortion in all or most circumstances, according听.

But critics say the ban also sends a discouraging message about women's ability 鈥� and right 鈥� to deal with at least some of the effects of what is acknowledged as a widespread social problem.

鈥淭here was a parting of the waters,鈥� says Regina Fonseca, of the NGO Centro de Derechos de Mujeres (CDM), referring to Honduras' 2009 coup that saw economic woes, a sharp uptick in drug trafficking and violence, and setbacks for human rights. 鈥淚mprovements to women鈥檚 rights and gender equality seemed to evaporate overnight.鈥�

A red flag

At the hospital听where G贸mez and her team from Doctors Without Borders run their clinic, there's another clinic specifically for expectant teen mothers, decorated in shades of violet and bubble-gum pink. Girls with protruding bellies tap on their cellphones as they wait their turn to meet with Ana Raquel G贸mez de Ordo帽ez for a consultation.

Dr. G贸mez de Ordo帽ez asks the same questions of each girl who enters her office: How old are you? When was your last period? Is the father still in the picture?

One 14-year-old patient nails the first two questions; but the last one proves to be more difficult.听

She isn鈥檛 dating the baby鈥檚 father 鈥� they only saw each other once, maybe twice. She doesn鈥檛 know if he鈥檚 in school. She doesn鈥檛 know if he works. She doesn鈥檛 know his age, and can鈥檛 tell the doctor if he is 鈥渁 lot鈥� older.

With each response, G贸mez de Ordo帽ez sees more red flags.

As levels of violence extend across the country, so too do the stories of gang members 鈥渃laiming鈥� young girls, or threatening their families if their daughters resist unwanted advances.

There鈥檚 a link between the two, says Julio Zuniga, country director for PASMO, a reproductive health NGO. Girls become tools in hurting rival gangs, and as weapons spread in a community, domestic violence grows as well, Mr. Zuniga says.

鈥淎 family might report their daughter鈥檚 pregnancy as consensual, when in reality they are protecting their safety,鈥� he says

But sexual abuse within the family is all too common as well. An estimated 90 percent of all reported cases of abuse of minors involve sexual abuse by a family member, according to the public ministry. Hundreds of new cases are discovered each year.

This mounting evidence is why Honduras should allow for the use of emergency contraceptive, says G贸mez. Some 60 percent of the victims her team treats arrive within the first 72 hours after an assault, which in other countries would be in time to receive emergency contraception. Many come to the hospital specifically seeking emergency contraception, she says.听

鈥淭hey are incredibly vulnerable,鈥� G贸mez says. 鈥淚t鈥檚 not just the general risks of unprotected sex like HIV or STDS, but the mental health effects鈥� that come with being victimized, including the possibility that the rape could result in pregnancy.听

Many women who become pregnant from an assault tell G贸mez they plan to abandon their child after birth, or threaten to commit suicide. They're less likely to get their child vaccinated or attend follow-up medical appointments. This is on top of risks that already exist for teen mothers, such as higher infant and maternal mortality, or the increased likelihood of dropping out of school.

Close to 20 local NGOs, including CDM, have teamed up with Doctors Without Borders to advocate the legalization and sale of emergency contraceptive. They're pressing lawmakers and pursuing legal avenues for survivors of sexual violence, arguing that the ban means the state failing to protect women鈥檚 health. 听

Out of favor

In 2009, when then-President Zelaya was ousted in a coup, he had fallen out of favor with Honduras鈥� conservative elite by proposing policies seen as in line with the likes of Venezuela鈥檚 Hugo Ch谩vez. Among them was his veto of a congressional bill to criminalize emergency contraceptive as a form of abortion.

Soon after he was forcibly removed, the interim government of de facto President Roberto Micheletti issued an administrative ruling that effectively banned the so-called morning-after pill. 听听

For Martha Lorena Alvardo, who was a congresswoman during Zelaya and Micheletti鈥檚 governments, that was the right move. She runs Organizaci贸n Pro-Vida, a pro-life NGO, and says she couldn鈥檛 be happier with Honduras鈥� stance on abortion and emergency contraception.听

鈥淲hen emergency contraceptive was legal it was given out like candy,鈥� Ms. Alvardo asserts. 鈥淗onduras has very strong Catholic roots 鈥� abortion isn鈥檛 acceptable to us,鈥� she says, categorizing emergency contraception as abortion, a view that medical professionals reject.

Alvardo, whose family has run an influential law practice here for generations, acknowledges that Honduras has a crisis of teen pregnancy, sexual assault, and incest. But for her, a 10-year-old-girl who shows up at the hospital after being raped by her stepfather 鈥� a case G贸mez鈥檚 team recently dealt with 鈥� isn鈥檛 evidence of the need for emergency contraception. Instead, the unborn child 鈥渟hould be seen as the blessing that brought the abuse to light, saving鈥� the young girl鈥檚 life.

"You can鈥檛 solve personal, social, or economic problems by鈥� not having a baby, says Alvaro.

To an extent, Ms. Fonseca from CDM agrees that preventing a pregnancy through emergency contraception won't solve everything. Though she believes in a woman's right to choose if and when she wants to have a child, the root cause behind sexual abuse is still a burning issue.

"There's no silver bullet to dealing with high rates of sexual assault or teenage pregnancy," Fonseca says. But women have "so little say" over their reproductive health: "Allowing emergency contraception gives them that smallest bit of control."

鈥� Whitney Eulich reported from Honduras as a fellow with the听听