 Hello, everyone, and welcome to a new episode of People's Health Dispatch. Today, we are here to talk a bit more about the recently concluded International Day of Safe Abortion and to focus especially on Argentina. So in 2020, as many will know, the feminist movement in Argentina had a landmark victory because abortion was legalized by the National Congress then. And so thanks to this piece of legislation, hundreds of women in Argentina were granted access to safe care, which they didn't have before. And compared to decades when about half a million abortions were carried out in clandestine conditions per year. So today, we are joined by Pablo Ralf, who is a family physician at primary health care level. And we are going to talk to him a bit more about what the 2020 victory meant in practice and what lies ahead. So hi, Pablo, and welcome to People's Health Dispatch. Hi there, hi to everyone. So just to come back to go back a step, a couple of days ago, so on 28 of September, we marked the International Day of Safe Abortion. And so feminists in Argentina also took part in these global actions. Can you maybe tell me a bit more what happened around that day and especially why is participating in the global movement important for Argentinian feminists and health activists? Well, first of all, I have to clarify that I'll be speaking on behalf of health care workers. Obviously, I can't speak on behalf of the feminist movement. So I apologize for that. The 28th of September is an important day for Argentina. It has been so since the 1990s since it came about. It commemorates a very special date for both Latin America and Argentina. It's allowed civil society at large and the feminist movement as a flag bearer for the right for abortion to be able to try and put abortion on the public agenda, which it finally was able to do so. And ever since abortion's legalization, it serves as a date to it serves as a time reminder that even though abortion is legal, access to abortion is a different situation. The fact that it has been legalized doesn't necessarily mean that widespread access is available. So it serves as a date to be able to come up with a balance in terms of the goals that have been achieved and the challenges that lie ahead. And in that sense, both are very present in Argentina. A lot has been achieved since abortion has been legalized. Access has improved significantly in many provinces, but still there are many obstacles that lie ahead. A lot of challenges that still need to be addressed. So it serves in that sense. This year in particular, the 28th of September was also very important because it allowed the abortion movement at large to be able to celebrate that a doctor in the province of Salta, who had been legally processed for providing a legal abortion, was finally acquitted. Her case was dismissed in what was a clear case of persecution from conservative sectors from the judicial sector and the health sector. So that was a big victory for the abortion movement and for the feminist movement specifically. And in terms of how the 20th of September fits into the global context, I think Argentina's abortion movement and the feminist movement in the country has grown a lot thanks to the global abortion movement, the regional abortion movement. So it's always been an important source of inspiration, of information, of experiences, et cetera, for the feminist movement. And since Argentina has become one of the few countries in Latin America to fully legalize abortion, our experience has in turn helped to improve and to strengthen and to bolster the demand for legal abortion and the rest of the world. And of course, so you mentioned that you will be speaking as a health worker primarily. So I was wondering, we did receive the 2020 in Argentina as a very big victory for women and for the feminist movement. So I was wondering, from the perspective of physicians and of other health workers, what has changed since 2020? So what have been the biggest changes that you have seen in your work? And did it actually lead to an improvement in practice? To answer the question, we need to put things into context. I speak as a health worker in the city of Buenos Aires, which is the richest city in the country. I speak as a worker in the public health sector. And in terms of guaranteeing rights and in terms of challenging and trying to improve access barriers for patients in general and for women specifically, the public health sector in Argentina is a lot stronger than the other health sectors. So I'm very privileged in that sense. So whatever I can tell as my experience is not necessarily is definitely not the experience that someone in the province of Hukui could tell you about or the province of Andorza, for example, which are very conservative, Catholic provinces where all of these issues, religion, conservatism, et cetera intersect with the right to health and with the right to access to abortion practices and services. So in my day to day, what has changed is that not necessarily for myself, because I have been working towards guaranteeing abortion access before abortion was fully legalized. Abortion was legal in certain circumstances. And me and the team that I work with work to help women have access to abortion via those legal permissions. But on a day to day basis, it's become a lot more simple. A lot of women who previously hadn't approached the clinic for abortion services now do so because friends have told them about it because of word of the mouth to mouth, basically. And because women, thanks to social media and thanks to the campaigning of the abortion movement, have realized that the problem, which is an unwanted pregnancy, now has a solution. And it's their right to be able to solve it via the health sector. So that's improved drastically. I think a very important issue for Argentina was that, as I say, abortion wasn't fully illegal. There were a lot of not loopholes, but ways in which health care professionals could help women to access abortion services via a comprehensive understanding of the legal framework, which was restrictive, but which allowed women to access abortion. But it was very tiresome. It was very difficult. One had to spend a lot of time to be able to justify why a woman had a right to an abortion in that situation. And that's not the case anymore. The focus is now strictly on a woman's desire to solve a health issue irrespective of what's happening in her life. And it's no longer the onus isn't on us to be able to justify before the law where the woman has a right to access abortion or not. So that's changed a lot. Abortion becoming legal has improved access also because a lot of health care professionals who previously were reluctant to offer services because they were worried about the possible repercussions professionally and legally aren't worried about that anymore. So a lot of professionals have started offering services who previously weren't offering it. And a very important aspect of the law is that it applies to the entire health system. So a lot of women who didn't have access to the public health sector because they had other health coverages, women who speak to the majority of the population and more so in Buenos Aires, which is a rich city. So I would say around 60, 70% of the women in a reproductive period of their lives, if they had that problem, very few would access the public health sector and would generally access health care abortion but in a clandestine manner. And now the health insurance plans have the obligation to be able to offer other services. And that has been slow, but it's been progressive. And as far as we can see, it's definitely taking form. So that access that road towards abortion access is definitely material life, which is very interesting to see. But then on the other hand, it's probably not perfect. That's my educated guess. So can we maybe spend some time talking about the obstacles that are still in the way in which you face or that women can face when they try to access abortion? Argentina is a federal country. So much like, for example, the United States, a federal law isn't necessarily applicable in each state or province in the case of Argentina. We have 24 different provinces. And it's a very different scenario here in the city of Buenos Aires, which is a lot more progressive, cosmopolitan, which has a long tradition of health care workers fighting for the rights of patients and the feminist movement fighting for the right for abortion, compared to other provinces, which are more conservative, which have a much stronger Catholic population, which have a much weaker public health sector, and where all of those things intertwine and intersect, and they create a scenario where, even though you have a law which states that abortion is legal, that doesn't necessarily mean that a woman can easily access a primary care level or a professional or any health care worker who not only knows about the fact that abortion is now legal, but also knows how to offer that service, who has the medication available, who, if they have to refer women to the second or tertiary level, has those networks available. And this is talking about putting the focus on the health care system, obviously, from a cultural perspective. A lot more conservative societies in these provinces tend to make a general understanding of society that abortion is now legal, and producing those transformations in terms of how people perceive abortion as a right and no longer a very big social taboo are a lot slower than in the city of Buenos Aires or in other provinces, the province of Santa Fe or the province of Buenos Aires, which are, by and large, big urban provinces. So the big disparities in terms of access to abortion still, they are being addressed, but they still exist. And we can't talk about obstacles and challenges without talking about the counter movement, which, like in the rest of the world, is definitely present in Argentina. It's very strong. It lobbies in different sectors of society, in the judiciary, in the health sector, in the media, and its effects are there to see. The cultural debate is still well and alive. We have achieved a big victory in terms of the abortion movement, thanks to the feminist movement definitely, but the debate hasn't been closed. It's still there. And I would say that's the biggest issue, because that permeates towards how the judiciary reacts to abortion demands, that permeates towards how a nurse receives the demand for an abortion from someone in a small clinic in a conservative province. The day that changes, things are going to change, but that's still a big challenge. OK, and finally, of course, the success of the feminist movement in Argentina was quite an inspiration for many other movements in the world. And I was wondering from your point of view, what do you think is the biggest lesson or the takeaway that we can take from the experience of the struggle for abortion care in Argentina? I think that what the feminist movement has achieved here in Argentina, although it has become a progressively circular and more democratic society, is still a Catholic country and has deep rooted conservative beliefs in the majority of society. I would say that there are two things. One has been the way that the feminist movement has achieved converting a very specific demand, which originally was of the feminist movement, in a public demand, society at large demanding access to abortion as part of the democratic platform. If we consider ourselves to be a democratic society, a just society, then just like women should have access to divorce, men should have access to different rights, social and economic rights, then women should have access to decide over their own bodies, not from an individual perspective, but from a more collective perspective. I think that's definitely be put on the agenda by the feminist movement. And we've seen that transformation. I've seen it as a white male health care professional and hats off to the feminist movement for that. That's one of the main things that's happened in Argentina, which doesn't necessarily happen in other countries, so that's one of the takeaways. And then the other thing that has happened in Argentina, which has inspired many other countries in the region, and I would dare to say many other countries in the world, has been the way that the feminist movement has been able to not only foster, but also embrace a generational change. The new generations, which don't bring the same demands that second and third wave feminism had, but they bring new feminist demands. They incorporate sexual dissidences. They incorporate all sorts of other demands that weren't on the feminist agenda 10 or 15 years back. And the feminist movement has been able to transform itself. It has been able to refresh its agenda and be more in tune with what society needs. And that generational change, which are seen in the Nounamenos movement, which started in 2015, which was one of the main starting points for the turning points for when one can see when abortion finally got on the public agenda and when one could see that the tide had turned in terms of whether abortion was going to be legalized or not. That was definitely one of the turning points for Argentine society at large. And that was definitely thanks to the feminist movement. And I would say that's one of the most specific takeaways from Argentina. Thank you so much, Pablo. Thanks to you.