Too many illegal abortions, too little contraception

Dubbed the “babies in bags” scandal, the discovery of 15 foetuses last year near a river in Nairobi horrified Kenya—and drew government assurances that illegal abortions would be brought to a halt.

A pregnancy can only be terminated in the East African country if it puts a woman’s life in danger. The foetuses, which had been placed in garbage bags in May, were alleged to have been illegally aborted at a private clinic operated by gynaecologist John Nyamu.

Several months later, however, authorities appear to be fighting as much of a losing battle against illegal abortion as they were last year.

“Their [abortionists’] operations have become highly secretive. These people have become very cautious because they are aware of the random checks by the Kenya Medical Practitioners and Dentists Board,” said Daniel Yumbya, CEO of the board—a government body that registers and regulates medical facilities in the country.

Following a tip-off earlier this year, the board raided two clinics in the Central and western Rift Valley provinces, but did not detain staff there, or anywhere else.

“What we are saying is that we know abortion is being conducted by unprofessional personnel, but we have not succeeded in arresting anyone,” Yumbya said.
Concerns have also been raised that government health institutions may be conducting illegal abortions, something officials have denied.

Nyamu was implicated in the “babies in bags” affair after records bearing his details were found with the foetuses. The two reproductive health clinics that he operated were closed, and he has since been charged with killing 13 of the 15 foetuses. Two of Nyamu’s nurses were also charged—but authorities have not been able to track down the mothers of the aborted babies.

Thousands of deaths

According to a 2004 report entitled A National Assessment of the Magnitude and Consequences of Unsafe Abortion in Kenya, about 300 000 abortions are carried out in the country each year, most of them under unsafe conditions. About 2 600 women die from abortion-related complications every year, while 20 000 are hospitalised.

The assessment was undertaken by health authorities, the Kenya Medical Association, the Kenyan chapter of the Federation of Women Lawyers—and International Projects Assistance Services, a global body that works to improve reproductive health care for women.

While abortion is denied to women in Kenya, the contraceptives that could help them avoid unwanted pregnancies are—all too often—also unavailable. Richard Muga, director of the National Coordinating Agency for Population and Development, penned a column earlier this month in which he noted that contraceptive use stood at just 39% among married women—a figure that had not risen since 1998.

Earlier this year, the government allocated $2,6-million for reproductive health services (previously, donors had provided about $13-million a year for contraceptives alone). Women’s rights activists doubtless find this allocation a little small when considering, say, the amounts of money allegedly lost to corruption.

In July last year, a former British envoy to Kenya, Edward Clay, claimed that graft had cost the country $187-million since President Maui Kibaki’s government came to power in December 2002.

‘Gag rule’

Furthermore, the United States’s reinstatement of the Mexico City policy is also reported to have taken a toll on family planning in Kenya.

US President George Bush reintroduced the policy when he was first sworn into office in 2001. It states that US funds cannot be given to foreign NGOs that use money from other donors to perform abortions or promote them in any way—or to give counselling and referrals for the procedure.

The policy, widely known as the “gag rule”, was first announced by former president Ronald Reagan at an international population conference held in Mexico City, Mexico, in 1984.

The Family Planning Association of Kenya (FPAK), an NGO that has been operating since independence in 1963, says it was obliged to close down eight of its 17 clinics around the country as a result of the gag rule.

“USAid—the United States Agency for International Development, which was our largest donor—gave us one condition: to stop collaborating with the IPPF [International Planned Parenthood Federation], who are liberal about abortion or they would stop funding us,” noted Joachim Osur, the FPAK’s director of delivery services, recently.

“But it was impossible for us to stop engaging with the federation, since it has also been supporting us from the beginning. As a result, USAid immediately stopped their funding support.”

Following the withdrawal of American funds, the FPAK’s Community-Based Distribution of Contraceptives initiative, which involved the community in handing out contraceptives in households, stopped.

“This initiative meant that women who could not come to our clinics to get contraceptives could easily access them through the distributors. After the initiative collapsed, many more women definitely ran out of birth-control mechanisms,” Osur noted.

The withdrawal of US funding cost the FPAK an estimated $276 000 a year.

Charge for services

The FPAK was also obliged to start charging a fee for its services, an amount of up to $10,50, depending on the contraceptive assistance provided.

With more than 56% of Kenyans living on less than $1 a day, the smallest charge can prove unaffordable for women in the country. Osur said there has been a significant reduction in the number of women visiting FPAK clinics: the organisation is now serving 82 000 women a year instead of about 130 000 as before.

“When you talk of a drop of about 50 000, you are talking of unwanted pregnancies and even deaths from abortion. This is a serious issue,” Osur noted.

Marie Stopes, an international organisation that provides reproductive health services and post-abortion care, was also hit by the gag rule.

“We had to close down two slum clinics. These were clinics in major slum areas in Nairobi and the number of women affected is quite significant,” said spokesperson Martha Waratho.

Kenyan authorities could not confirm the total amount of money the country has lost as a result of the reinstated Mexico City Policy. Repeated efforts to get comment on the effects of the gag rule from the US embassy in Kenya’s capital, Nairobi, were also unsuccessful.—IPS

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