"We found Broomsticks in her intestines" - The case of backstreet abortions

Backstreet abortions are reaping from and ripping girls in the country. A majority of failed abortions and evacuations have rendered ladies barren, and are the heart of cases handled at Kenyatta National Hospital's gynaecology ward. Speaking to us, Head of Gynecology department at The Kenyatta National Hospital said cases of procured abortions gone bad were a norm. He said that the number of cases referred to the hospital were numerous, and that very few patients explored safer options. Of worrying cause however, the doctor said, were the procedures used in such abortions.

"Some patients tell us some of these people used crotchets to pierce their uterus. The piercings extend to the intestines and cause more life threatening cases," said Dr. Maranga.

He narrated to us a case of a woman who was found with broomsticks in her intestines, a case he says shocked him.

"A while ago, a lady with a swollen abdomen came to us. We suspected her large intestines had swollen or that she had an injury in her gut" said Dr. Maranga.

"We decided to operate her. With the first cut, we found three broomsticks in her, which we pulled out. But that was not the only problem, in her pierced intestines, there was pus," he added.

On further examination, they discovered that the piercing was coming from the uterus. Dr. Maranga said that they found out her uterus was rotten and had to remove it for her to survive.

"After the process, we asked her to be open with us. She told us that she had procured an abortion in some backstreet clinic where she was referred by her friend," said Dr. Maranga.

At the hospital's Acute Gynaecology Ward, Ward 1D, many of the cases they receive are those of abortions that went wrong. We spoke to the Ward's Senior Nursing Officer, Mirikau Wycliffe who is trained in post abortal care. He said what puzzles him more is the equipment used in such procedures by the backstreet guys. "Last month we had a 15 year old Maasai girl, she was discharged just last week. Her uterus had inverted, and even worse, she had been given traditional concoctions already, so we weren't sure how to start," said Mirikau.

According to him, most cases referred to them require repairing damage which he says is caused by wrong equipment. He showed us the proper evacuation set, a plastic syringe that sucks out, rather than the suspected metals and sharp devices used by backstreet guys. Within the past two weeks, Mirikau says they lost a 17 and 15 year old whose kidneys has shut down completely.

Earlier in January there was a case of a girl of 16 years, whose two kidneys had failed after she developed complications from an induced abortion. She lost so much blood that by the time she got to the local hospital in Kisii, she was anaemic and organ failure had set in. Her abortion was procured by her parents, who would later take her to Kenyatta after a  scan showed that the abortion procured earlier was incomplete; her uterus was perforated causing vaginal bleeding leading to anaemia and subsequent organ failure. "The common complications from these cases are excessive bleeding (anemia), infection (sepsis), uterine perforation and renal failure," he said.

Most of the cases that come to the hospital are not easily traceable. Save for the referred cases, many walk into the hospital without any notes. Mirikau told us that a majority of the patients were just told to go to Kenyatta Hospital in case of any complications.

"We try using tact to get this information because nobody commits themselves. A while back we tried to follow up on some notorious clinics. We had noted them down," he said.

"We just wanted to call them for free training, and show them the right method and equipment," said Mirikau.

He said that the notorious clinics were mostly from Waithaka, Kawangware and also Dandora. He said the methods they use to evacuate cases at the hospital are only for pregnancies that are up to a maximum of 12 weeks. Mirikau also said there was a pill called Cytotec that was being misused by abortionists. He told us that the pill, initially used to prevent stomach ulcers, was being used for abortion.

"Most people just google and use it as a homemade solution," said Mirikau.

Dr. Maranga said that a majority of the cases that came in were backstreet, and only happened because they ignored the law for money. "This is a moral thing and we cannot claim to have answers to it. The law says it is illegal, but it is still happening," said Dr. Maranga the gynecology department head.

CAMPUS STUDENTS ARE THE MOST CASES

According to Mirikau, the cases that come into the hospital are seasonal. Most of them, the majority are between the months of February-April. The register at the ward indicates that there were 74 cases in January, 75 in February, 82 in March, 69 in April and 73 in May.

"Most of these are campus students. A popular university in this city is the leading. Most of them conceive during December holidays," he said. "Most of them procured abortions not because their lives are in danger, but because these were unplanned pregnancies. They tell us here openly that they cannot use condoms and family planning," added Mirikau.

From the register, the age group was 15-35 years old, but a majority are between 18-25 years. A few of the cases are married women. Mirikau also blamed a number of the student cases on emergency pills, which he said are on a rampant use. Mirikau said that the pills cause ectopic pregnancies and tubal pregnancies which are popular amongst student cases. He told us that it was hard for the patients to tell when their safe days were because of a hormonal imbalance caused by the pills.

"There is a need to advocate for health and sex education in campuses," said Mirikau.

Dr. Maranga told us that most of the young cases were because of a lack of support systems like counselling. The ban on abortion, he said, puts the caregiver and the patient at an awkward place.

"Caught in between the law is usually the patient. There is the money bit, and that is where the quacks come in, because there is a lot of money in abortion," said Dr. Maranga.

Dr. Maranga said the Youth and Adolescents clinic at the hospital has counselling sessions on what can be done as an alternative to abortions.

"The baby can be adopted and we have support systems for that," said Dr. Maranga.