Thursday, June 11, 2009

Kenya: Abortion: The Bitter Truth

Abortion: The bitter truth
The Standard, Nairobi, Kenya.

Published on 04/06/2009

By Dann Okoth

Unsafe abortions are taking a heavy toll on women and the heath care system with three of 10 pregnancy related deaths arising from botched attempts to end pregnancies, a Government survey reveals.

As young people continue to rely on sex myths, the Church adamantly against lifting the ban on abortion, courts dodging the matter and pro-abortion activists in no mood to compromise, the situation is bound to get worse. According to the survey, unsafe abortions account for a staggering 35 per cent of all maternal deaths with public hospitals spending over Sh18 million on treatment of related complications.

The survey conducted by the Ministry of Public Health and Sanitation and Ipas, an international NGO that works around the world to increase women’s ability to exercise their sexual and reproductive rights, finds that there are 380,000 unsafe abortions annually. This amounts to an incredible 800 unsafe abortions a day up from 700 cases 2002.

"A whopping Sh18 million of taxpayer’s money goes to mitigate the effects of the botched abortions," says Dr B Kigen the Deputy Head of the Division of Reproductive Health in the ministry.

Teenagers represent nearly 16 per cent of failed abortion cases that end up in public hospitals.

The survey whose findings have been collected and collated since 2004 reveals that for every 100,000 births there are 414 stillbirths directly associated with unsafe abortions.

The figure is double the amount set aside for the ministry in this financial year’s supplementary estimates for basic wages for temporary employees which stands at Sh12 million.

Tip of the iceberg

The figure could be a tip of the iceberg. "The numbers could be much higher and cost to the economy much bigger especially considering that the survey only captures cases that report to public health institutions for treatment," Kigen says.

The financial cost is not fully reflected in the figures because treatment in public hospitals is subsidized. For instance, Kenyatta National Hospital only charges Sh300 for cleaning the womb and associated treatment for each botched abortion. A similar service could cost upwards of Sh150,000 in a private hospital in Nairobi. "In private hospitals such cases are considered surgical where the requirement is that a patient deposits Sh100,000 . Ultimately, the cost of such operations run into several hundred thousand shillings depending on the gravity of the condition," says a lead surgeon in one of the leading private hospitals in Nairobi.

It is not yet clear how many cases end up in ragtag health outlets scattered across the country.

A recent case where a self-professed gynaecologist in Nairobi was hauled to court accused of illegally carrying out abortion and foetuses found dumped along the roadside in the city points to a growing problem. Indeed the fact that many young girls who procure such abortions never come out from these insidious health joints alive is a wake up call for the authorities to act.

But just to give a glimpse of what burden unsafe abortion has become, Kigen says that now such cases take up 50 per cent occupancy in gynaecological beds in public hospitals.

This essentially points to the fact that a huge chunk of the health ministry budget goes to take care of such cases.

"One per cent of women admitted to public hospitals with abortion complications die," Kigen says.

Incredibly, 16 per cent of the cases are girls under 19 while 70 per cent are women aged between 20-34 years.

The shocking revelations come a few months after doctors petitioned the Government to lift prohibitive laws on abortion with the view to saving lives of women who seek the service illegally.

Under the auspices of the Kenya Obstetrical and Gynaecology Society the doctors said the State should address abortion more objectively to improve the maternal mortality. While addressing a members’ gathering in Mombasa in February the Society chairman Dr Omondi Ogutu said maternal deaths could now be standing at double the official ratio of 141:100,000 yet most countries were now targeting a single digit ratio.

Reproductive Health

They called for the fast tracking of the Reproductive Health and Rights Bill which they say would address the abortion issue and cater for a wide range of issues including family planning and men’s reproductive rights .

To counter the increasing number of botched abortion Kigen says the Government has embarked on a programme to train staff on proper abortion care.

"The programme aims to address among other things post abortion care, strengthen family planning programmes especially targeting adolescent people in the reproductive age," he says.

The World Health Organisation, United Nations Population Fund, KWF and United States Agency for International Development, he says, support the effort.

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