Kenyan women risk with backstreet abortions

Published Apr 27, 2005

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By Katie Nguyen

Nairobi - It was futile to keep on wishing that the baby would disappear, so Anne decided to take fate into her own hands and a kitchen knife to her belly.

The teenage schoolgirl was rushed to a Kenyan hospital, her stomach a mess of stab wounds.

Surgeons struggled to patch up her shredded uterus and stem the bleeding, but Anne died on the operating table - another statistic in Kenya where up to 2 000 women die every year because of complications arising from botched abortions.

Doctors say Kenya's strict abortion laws have forced thousands of women and girls to the backstreets where charlatans use all manner of sharp instruments - metal wires, knitting needles, forceps - to penetrate the womb and kill the foetus.

"These deaths are really a tragic story because the knowledge and technology to prevent them is there - it's senseless," said Eunice Brookman-Amissah, vice-president of reproductive health organisation Ipas.

"This only happens to the poor, disenfranchised, faceless, voiceless women," she said.

The picture is amplified across sub-Saharan Africa where 30 000 women die each year from unsafe abortions, and millions more suffer life-long problems.

"Africa is only 10 percent of the world's population but it has 44 percent of its unsafe abortion deaths," said Fred Sai, a Ghanaian gynaecologist and consultant on reproductive health.

He attributed the rate of deaths to Africa's reluctance to change colonial-era abortion laws, and a poor record of healthcare on the continent.

Shrouded in shame and stigma in most societies, abortion in Kenya was pushed into the spotlight last year when street boys found 15 foetuses wrapped in black bin liners and dumped in a shallow river on the outskirts of Nairobi.

Catholic bishops, who hold moral sway in the predominantly Christian country, held a requiem mass to condemn "the terrible holocaust of abortion".

A police investigation later led to murder charges against a gynaecologist and two nurses.

"Abortion is not acceptable because it is against the law," Justice and Constitutional Affairs assistant minister Robinson Githae told local media recently.

"It is only God who can take away life," he said, ruling out any softening of the law.

Women's rights activists say the "babies-in-bag" case has stifled any debate on whether the Kenyan law, which allows termination only when the mother's life or health is in danger, should be changed.

Currently, a woman found guilty of having an abortion can be imprisoned for seven years, while anyone abetting an abortion could face a 14-year jail term.

But, the threat of jail time has done little to deter thousands of women.

At any one time, more than half the beds in the obstetrics and gynaecology ward of Nairobi's major state-funded Kenyatta hospital are occupied by women admitted with abortion-related complaints.

A room on the ward containing the sterilised cannula and forceps needed for safe terminations is under lock and key - in case medical staff are tempted to perform abortions on the side.

"If Kenyatta were to refer all these women to the police, the prisons would not have the space to contain them all," said obstetrics and gynaecology consultant Dr James Kiarie.

"You cannot condemn them to the backstreet forever."

Sometimes two to a bed, the patients lie listlessly in the gloomy, stuffy ward. Most look like the rural poor, scarves wrapped tightly around their heads, patterned cloth swathed across their hips.

Health workers say most women who end up here live below the poverty line - unable to feed another mouth and unable to afford an illicit abortion in a private clinic.

They flock to the hospital - bleeding, infected, their organs perforated - to be cleaned and sewn together again.

Ipas' Brookman-Amissah said it costs up to 100 times more to patch someone up than perform the abortion in first place.

For every death, 20-30 women suffer permanent damage to their uterus, cervix, fallopian tubes, intestines or bladder.

Kiarie talks of one 17-year-old patient whose intestines were pulled through her uterus and out the vagina during a backstreet abortion. She survived but will never conceive again.

The doctor wants the law changed.

"We cannot impose our morality on other people," Kiarie said. "What we are basically saying is that let these women die, they deserve it."

According to the United Nations Population Fund, about 530 000 women a year die in pregnancy or childbirth, nearly half of them - 247 000 - in sub-Saharan Africa.

Activists blame male leaders for inaction on a continent where women's rights are at best ignored, at worst, violated.

"The fact that women die from unsafe abortions I don't think impinges on the consciousness of the African male leadership," Ghana's Sai argued.

"There's the thinking that maternity requires deaths."

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