Christine Carcano joined the Peace Corps in 2011, two months after graduating from college, because she wanted to travel the world and promote public health. But she had only served four of her expected 27 months in a rural town in Peru when she says a local man from her community raped her.
"I didn't tell anyone in my town," she told The Huffington Post in an interview. "I was in denial. I thought if I didn't talk about it and didn't think about it, it would go away on its own."
Weeks later, when Carcano developed pelvic inflammatory disease as a result of the rape, she had to travel to Lima, Peru, for medical treatment. She finally admitted to the Peace Corps' medical providers what had happened to her. "It was the first time I could say it out loud," she said. "It felt like a huge burden had been lifted."
Because she had been assaulted, Carcano was required by the Peace Corps to have several blood tests done before she could return to her community. Her medical officer came into her hotel room the next day and asked her to sit down on the bed.
"She said, 'You got some blood tests back,' and I said, right away, 'I'm pregnant,'" Carcano recalled. "And she said, 'Yes.'"
The medical officer then informed Carcano of her options: She could continue her pregnancy and leave the Peace Corps, or the government could fly her to Washington, D.C. for an abortion. But the Corps could not cover the $500 procedure as it had covered all the rest of her medical care.
"It felt like a betrayal," she said. "The Peace Corps staff had been amazing, but when it came to my biggest hour of need, their hands were tied."
Carcano was 24 years old at the time, and living on her Peace Corps stipend of about $300 a month, an amount that only just covered rent, food and transportation. Carcano had no money to pay for an abortion, and if she chose to continue the pregnancy, she would have no job, no partner and no savings to help her care for a baby.
She also did not want to ask her parents for money for an abortion, because she didn't want to tell them she'd been raped and was now pregnant. "I felt very defeated," she said.
Carcano ended up borrowing money for the procedure from the mother of a fellow Peace Corps volunteer, who mailed a $500 check to Carcano's brother in the United States. Carcano had to call around to different clinics in the D.C. area, compare prices and set up her own abortion.
By the time she flew into D.C. and arrived at the clinic, she was two months pregnant. The doctor gave her three anesthesia options: light, medium and heavy, depending on what she could afford. She only had enough money for local anesthetic, the lightest option, so she remained awake throughout the procedure.
"I swear, I could feel everything," she said. "It was an incredibly painful experience, physically, mentally. The pain sort of lives with you. It's hard to think about the fact that I was financially restricted to a pain threshold."
Since 1979, the federal appropriations provision that funds the Peace Corps has contained a rider which prohibits funding for abortion, even in cases of rape, incest or when the mother's life is in danger. The policy is out of step with the rest of federal law, which allows abortion coverage in those special circumstances for nearly all other women who receive health coverage through federal streams, including Medicaid recipients, federal employees, residents of the District of Columbia and even women in federal prisons.
But Peace Corps volunteers often serve in countries with no legal abortion access and face a much higher risk of sexual assault than federal employees working in the United States. In a study distributed Tuesday by the Center for Reproductive Rights, researchers interviewed 433 returned Peace Corps volunteers, including 362 women, and found that nearly 10 percent of them had been sexually assaulted during their service, while a third of them knew another volunteer who was sexually assaulted. Five percent of the women surveyed reported having a personal abortion experience, either in the United States or in the country where they were serving.
The study, conducted by researchers with the University of Ottawa, Cambridge Reproductive Health Consultants and the Office of Population Research at Princeton University, found that all of the women who had been sexually assaulted in the Peace Corps described the ban on abortion coverage for rape survivors as "unfair, punitive, and reflective of a broader culture of victim-blaming."
Since 2011, Democratic members of Congress have been trying to bring abortion coverage for Peace Corps volunteers in line with the coverage other federal health care recipients receive. Last year, the Senate included the provision in its 2013 appropriations bill, but the House version left it out, and the provision was ultimately dropped after the two chambers conferenced on the federal budget.
This year, President Barack Obama has included abortion coverage equity for Peace Corps volunteers in his budget proposal for 2015, and Sen. Jeanne Shaheen (D-N.H.) and Rep. Nita Lowey (D-N.Y.) intend to introduce standalone bills that would permanently codify the provision.
"It is absolutely unconscionable that female Peace Corps volunteers who are victims of sexual assault, or whose pregnancies endanger their lives, are not afforded the same health care access as virtually all other women with federal health coverage," Lowey told The Huffington Post in an email. "They deserve our steadfast support, and I am working hard to ensure our volunteers get the health care coverage they need to continue serving our country.”
Carcano and Mary Kate Shannon, another returned Peace Corps volunteer who was raped twice during her service, are meeting with members of Congress from both parties this week to urge them to pass the Peace Corps Equity Act and to support Obama's budget provision. Shannon, who says she was first raped by a taxi driver on her way to lunch in her Peru community, told HuffPost she is trying to protect future volunteers from feeling abandoned by the organization charged with caring for them for 27 months.
"Abortion is a choice no Peace Corps volunteer wants to have to make, but what we do want is fair treatment," she said. "I don't want another volunteer to feel as lonely and distraught and helpless as I felt."