The Foreign Service Journal, May 2022

THE FOREIGN SERVICE JOURNAL | MAY 2022 21 Editor’s Note: We have invited MED leadership to respond in the June FSJ . Speaking Out is the Journal ’s opinion forum, a place for lively discussion of issues affecting the U.S. Foreign Service and American diplomacy. The views expressed are those of the author; their publication here does not imply endorsement by the American Foreign Service Association. Responses are welcome; send them to journal@afsa.org. The Foreign Affairs Manual states: “Where local medical facilities are inad- equate to provide required services, travel to locations where such services can be obtained may be authorized.” In none of these cases did MED authorize necessary interventions. Lifesaving medical evacu- ations for reproductive care are routinely shouldered by female diplomats after the State Department refuses to assist. Health care should always be impar- tial and nonjudgmental. Further, medical professionals should know that each indi- vidual and the country in which they are serving is unique; every situation must be carefully evaluated, without comparison to other individuals or posts. We are immensely grateful to those who came forward to share these pro- foundly personal stories. They have done so to help bring to light the mistreatment and negligence that has occurred at far too many posts and health units around the world. As their experiences underline, the State Department has a long way to go to achieve health care equity for all who serve in its ranks. Demanding Change: In Practice and In Writing We ask that the Department of State effectuate the Biden administration’s commitment to women and girls’ sexual and reproductive health in the United States and globally, and provide access to the same reproductive rights we have in our own country when we serve overseas. These rights should be guaranteed in the Foreign Affairs Manual, including: ■ Allow medevac prior to 12 weeks of gestation for access to reproductive health services. ■ Require the State Department Bureau of Medical Services to include emergency contraception medication, mifepristone and misoprostol, and rape kits at each overseas U.S. government health unit. ■ Allow medevac to access other related reproductive health services, such as endocrinological testing, perimeno- pausal and menopausal counseling and screenings. ■ Require all health units to develop contacts with and maintain access to local, high-quality obstetric and gyne- cological medical professionals or offer medevac for high-quality care if it is unavailable locally. ■ Require all health units and their staff to provide respectful, impartial care that is free of judgment to any diplomat, regardless of their reproductive choices. ■ Require the Bureau of Medical Ser- vices to instate leadership that is repre- sentative of its constituents. In just 15 days, we secured hundreds of signatures from U.S. diplomats, both men and women, in support of these demands. As we note in the letter: “Diplomats representing America in countries across the world are denied access to the same services that are legal and readily avail- able in the country we represent and are told, You are on your own .” We will no longer stand for this. We have united to demand access to repro- ductive health care equal to what we are afforded in the country we represent abroad.