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16 Feb 2004 16:12
Health workers in Burkina Faso have called for a more open discussion of issues related to sexuality and abortion. This follows the release of a report by the Demographic Research and Study Unit, which found that up to 8 000 illegal abortions take place each year in the country’s capital, Ouagadougou.
“We need to go out into the communities and talk about abortions to increase awareness,” says Jean Lankoande, a gynaecologist at the Yalgado Ouedraogo hospital in Ouagadougou.
“Each time there’s an induced abortion, it’s a family planning failure,” he adds.
While family planning was introduced in Burkina Faso in 1986 along with a national population policy, only 27% of women in Ouagadougou use contraception.
“The sex education issue remains totally unresolved. At the family level, parents have problems talking about sex with their daughters who, when they become women, have the same problems talking about sex to their own children,” observes Lea Zongo, president of Pugsada, a group that helps girls who become pregnant.
She says those who approach Pugsada are often high school students who hesitate to use contraceptives or insist that their partners put on a condom. This reluctance can sometimes be ascribed to poverty; in other instances, the girls believe that willingness to have sex without a condom illustrates love for their partners.
Pugsada also assists girls who fall pregnant by married men who are unwilling to acknowledge paternity, and who press the girls to go for abortions.
“In our chats, we realise that many of these girls do not go to family planning clinics because they’re afraid of meeting a relative there. But it’s a necessary evil if you factor in how their parents will behave,” Zongo explains.
Her words are echoed by Georges Guiella, a researcher at the Demographic Research and Study Unit (Uerd): “Sex remains a taboo subject in the home, and when this age bracket goes seeking birth control they are viewed with great disapproval.”
The Uerd found that 61% of illegal abortions are performed by health workers, and 13% are carried out by traditional healers. The remaining 26% of abortions are induced by the women themselves.
Abortion is currently illegal in Burkina Faso, although it may be permitted in instances where a woman’s life would be threatened if the pregnancy continued—or where conception resulted from rape or incest. Abnormalities in the foetus are also grounds for abortion.
“The Uerd, as a national research institution, is seeking to contribute to the establishment of effective national health policy by taking on [this] delicate and taboo topic,” says Guiella.
The Uerd study, issued towards the end of last month, said that almost two-thirds of illegal abortions resulted in complications. Thirty-three percent of the women involved had to go to hospital—and about 5% of these cases died.
Statistics from the Burkinabe Ministry of Health show that the deaths of 24% to 28% of pregnant women are linked to abortion. (These figures relate to hospital fatalities.)
Lankoande says illegal abortions frequently lead to internal bleeding, the main cause of death in such cases. Substances used to induce abortion sometimes lead to kidney and liver problems—while menstrual irregularities, fertility problems and infections have also been reported.
“Induced abortion is, oddly, both greatly decried and very common in Ouagadougou right now,” says the Uerd report. About 60% of women who attempt abortion are between 15 and 19 years of age.
For the past five years, the government has sponsored a pilot programme for abortion aftercare at the Ouedraogo Yalgado hospital. Women who enter the programme receive counselling in reproductive health by trained workers from maternity wards.
The project has helped reduce the severity of abortion-related complications for many women, and authorities now plan to make it a standard feature of the national health care programme.
Concerns about abortion do not only relate to the physical problems resulting from the illegal procedure, however. As unwanted pregnancies are caused by unprotected sex, which allows the spread of HIV, officials fear they may also signal a resurgence of HIV/Aids.
According to the World Health Organisation, HIV prevalence in Burkina Faso dropped to 6,5% in 2003 from 7,19% in 1997. This decrease may yet be jeopardised by the national reticence towards discussions about sexuality.—IPS
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