Questions and answers on International Women’s Day with LSRJ’s founding executive director, Cari Sietstra, JD, Stanford ’02.
What do you do?
Since leaving my post as the founding executive director at LSRJ – a great job, if ever there was one – I’ve been an “independent consultant specializing in reproductive health and justice.” Over time I’ve developed expertise in long-term conflict and crisis settings.
Wait, what does “consultant in reproductive health and justice” mean, exactly?
While it could mean a number of different things, for me it means that for the past six years I’ve pitched potential projects to donors and then partnered with non-profits so the donor’s money is tax deductible and my work is done under an institutional umbrella. I have a great deal of autonomy and flexibility. I am based in the US but spend time each year in Thailand and sometimes Burma.
Most of my projects are located on the Thai/Burma border and focus on refugees, undocumented migrants, or internally displaced persons. My colleagues and I are particularly interested in reducing harm from unsafe abortion, expanding access to emergency contraception and long acting reversible contraceptives like IUDS, and promoting adolescent reproductive health.
What does reproductive health look like where you work?
Basically, eastern Burma has been a conflict zone for more than sixty years. So reproductive health indicators and maternal mortality rates are by far the worst in Asia and among the worst anywhere in the world. Unsafe abortion and post-partum hemorrhage are the leading causes of maternal mortality. There are extensive barriers to achieving reproductive justice including lack of family planning supplies and education, legal barriers to safe abortion, a lack of trained medical providers, early marriage (sometimes coerced or forced), and lack of access to basic healthcare and adequate nutrition.
For an in-depth discussion of reproductive heath in this area of the world, please check out the report Separated by Borders: united in need that our team just published with Ibis Reproductive Health.
You mentioned a “team” – who do you work with?
I am lucky to work with a team of exceptional women who include a doctor-researcher, a nurse, and the wonderful Maggie Hobstetter, another LSRJ alum. Maggie first came out to the border as an international legal intern for LSRJ in 2007.
Maggie and I have led a safe referral pilot project to connect undocumented Burmese migrants in Thailand with a safe, legal abortion. (Abortion is legal in some cases in Thailand.)
Do you use your law degree in your work?
I do, especially on projects like the safe referral pilot, where we’ve trained Burmese and Thai health care providers on Thai law – what it is, how it’s interpreted and implemented, how to recognize women who qualify for legal abortions, etc.
But I don’t use most of the “hard” advocacy skills I practiced in law school. My colleagues and I try hard to avoid any direct advocacy or persuasion.
We don’t tell the Burmese medics we work with that they “should” support legal abortion or that they “should” give unmarried couples family planning. What we do is give them information that legal abortion is very safe (this is often absolutely new to them). We share human rights documents that uphold the rights of both married and unmarried people to access reproductive healthcare. But when folks say things like, “I think abortion is a sin,” or “unmarried couples should not have sex,” we don’t push back. As outsiders, that isn’t our role. Our role is facilitate difficult conversations about controversial issues in reproductive health and to empower local advocates with information and support.
Do you feel like that attitude reflects a reproductive justice framework?
I do. I think the best way I can do work in a long-term crisis setting as a well-educated foreigner is to respect the values and priorities of the people I work with while still offering up information on a full-range of reproductive health technologies and rights.
You can’t just walk into an isolated, conflict-affected area and be all, “Hi, I’d like to give you some EC, IUDs and safe abortions. And can I talk to your teenagers too?” People would be like, “Hi, crazy white lady. Thanks but no thanks.”
It’s taken years of work to build the strong trust we have with our local partners. And to do so we’ve tried to be clear that while we are very willing to push boundaries in terms of the work we do, we will always try to meet people where they are on these issues and respect profound differences of opinion. It’s been an amazing way to create what we hope will be lasting social change. Our motto is: “Baby steps. It’s all about baby steps.”
We understand that in a long-term conflict setting we will not be able to fix the overall health situation until the core issue of the conflict itself is resolved. But small interventions can make huge differences in the lives of women, families, and communities.