State: Quacks in Kenya end 375,000 pregnancies annually

NAIROBI: Unsafe abortions are on the rise, with backstreet operators killing about 2,600 women annually, way above the number killed by cervical cancer last year.

The Ministry of Health says about half a million abortions are procured in Kenya annually, with an estimated 375,000 done in the back streets.

A team led by Joyce Mumah of the African Population and Health Research Centre (APHRC) says the backstreet operators not only kill 2,600 women and girls, but also maim thousands of others.

Last year, 2,451 women in the country died from cervical cancer according to the World Health Organisation’s Human Papilloma virus (HPV) Information Centre.

The demand for abortion, says Joachim Osur of Amref Health Africa, has given rise to a highly sophisticated network of illicit but life-taking abortion services.

The network, which Dr Osur details in a recent survey, is complete with an enviable referral system involving schoolgirls, their mothers and grandmothers, teachers, policemen, brokers, midwives, herbalists and health workers.

Osur was a key researcher in the 2012 national abortion survey, which revealed 464,690 abortions were procured in the country that year.

“The school system has been infiltrated by illegal abortion providers who have planted agents to direct pregnant girls to them,” Osur told The Standard in a recent interview.

Osur, whose findings are published in the current issue of the African Journal of Reproductive Health, says the networks advertise their services through word of mouth, with past clients referring new ones.

Schools, he says, are the most fertile grounds from where to recruit clients.

“My cousin, a student at a nearby school and a neighbour’s daughter in another school act as my agents, referring needy girls my way,” a quack told the researchers.

Explaining why so many want to abort, in her report, ‘Unintended Pregnancies in Kenya: A Country Profile’, Mumah says almost half, 43 per cent, of pregnant women today do not want pregnancy.

Of this, 14 per cent do not just hate pregnancy, but take measures to terminate it with most ending up at backstreet clinics.

Recently, APHRC researchers sought to establish why many women prefer backstreet clinics to formal hospitals even when the Constitution allows limited legal abortions to save the life of a mother by a qualified medical professional.

The APHRC team led by Chimaraoke Izugbra interrogated 50 women who were being treated in public hospitals for post-abortion complications.

The women had developed complications, most life-threatening, after their efforts to abort illicitly went wrong. Although they sought treatment in formal hospitals, all were in agreement that the institutions are unsympathetic to aborting women.

The women accused health workers in the institutions of gossiping about who had aborted and even revealing it to others.

The worst that can happen to women who have aborted, they told Izugbra, is for their friends, relatives or the public to know their secret.

“Workers in these formal facilities make women feel very bad. They even ask women: ‘When you were having sex, did you not know that you would get pregnant?’” said one woman.

Writing their findings in the next month’s issue of the Social Science & Medicine journal, the authors indicate a much misunderstood underground abortion network that is serving about 375,000 women annually.

But the pro-abortion groups defend the formal health workers, arguing that the Ministry of Health has been intimidating them and undermining the provisions of the Constitution.

They complain that withdrawal of the 2012 national abortion guidelines undermines the rights of women to procure safe abortions as enshrined in the Constitution.

In 2012, the Ministry of Health released the Standards and Guidelines for “Reducing morbidity and mortality from unsafe abortions”, only to withdraw them a year later.

While releasing the guidelines, the then Director for Medical Services Francis Kimani said the intention was to reduce deaths and illnesses associated with unsafe abortion.

However, in June this year, the Federation of Women Lawyers (FIDA) took the ministry to court over the withdrawal of the guidelines.

“Withdrawal of training puts women at greater risk of death from unsafe abortions by unskilled health workers, which violates women’s rights to access comprehensive and accurate health treatment,” Fida lawyer Harun Ndubi said.

The Director of Medical Services says the ministry decided to first develop the Health Bill 2015, now in Parliament, as the guiding framework under which other laws and guidelines would be anchored.

But even this bill has come under criticism from the civil society, which claims it will take away the right of women to safe abortion.

In May, Erick Yegon, of Ipas Africa Alliance and C Odula-Obonyo of COVAW-Kenya wrote to the National Assembly complaining that the Health Bill 2015 as drafted will deny women their constitutional right to safe abortion.

They are, for example, opposed to a clause that seems to suggest that for a health worker to perform an abortion they require a special licence.