How the health department has failed SA’s women

South Africa’s Health Department has “failed women” by not making it easy to access contraception, said Dr Eddie Mhlanga, the department’s head of Maternal Child and Women’s Health.

He was speaking in Parktown, Johannesburg, on Thursday evening on why South Africa was not on course to meet the United Nations Millennium Development Goals to reduce maternal mortality rates by three-quarters and provide universal reproductive healthcare to women by 2015.

No country in Sub-Saharan Africa was on course to meet the goal of reducing the maternal mortality, according to the United Nations website.

Mhlanga said that maternal mortality rates were increasing in South Africa when they should be declining. He added that “2 000 pregnant women died each year in South Africa from a range of causes, some preventable and some not”.

The United Nations factsheet on maternal deaths says that 80% of all maternal deaths should be preventable. A women’s risk of dying while pregnant was one in 30 in Sub-Saharan Africa, and only one in 5 600 in developed nations.

As a result of increasing maternal deaths, “the National Committee for Confidential Enquiries into Maternal Deaths (NCCMB) that reviews the causes of all maternal deaths in South Africa had recommended that contraceptives be made more easily available to women. But this recommendation had not been taken into account,” said Mhlanga.

The Health Department has “failed”
Mhlanga said the health department had “failed to provide contraception where women could access it,” while sexual violence against South African women led to many unwanted pregnancies.

“I used to say the word ‘no’ was the best form of contraception, but that’s not true in South Africa where there are high rates of violence against women” said Mhlanga.

He said the latest figures from the NCCMB showed that from the period 2004 to 2007, a total 136 women had died from botched abortions.

“It is a whole societal problem” he said. The doctor slammed the fact that in many communities sexuality was not talked about. “We speak in parables. We don’t want to say the words ‘sex’ and ‘intercourse’.”

Mhlanga said young women did not feel comfortable obtaining contraception because healthcare providers did not always have the right attitude to dispensing it. He felt less judgment and more support of women was needed. He said young girls didn’t want to obtain contraception from “aunties” or people over 40 but that younger people did not always have the skills to provide it.

Members of the audience suggested that contraception be made available in schools and factories. Mhlanga said younger people needed to be trained to offer contraceptives to their peers. “We are a messed-up society” he said, arguing that women “should not have to go to healthcare providers to get hold of the contraceptive pill as some were reasonably safe”.

“It should be available in taverns” he added.

Media silences rural and poor women
Political analyst Christi van der Westhuizen said “there should be widespread social outrage” over increasing maternal mortality rates in South Africa.

Van der Westhuizen said the media continued to stereotype women and add to the stigma when they tried to access termination of pregnancy services. She said the media always argued they had a right to freedom of expression, but “who is that freedom of expression for?”

She said the voices of poor women and those from rural areas were never reflected in the media, and therefore ordinary people did not benefit from the media’s so-called right to freedom of expression.

“We must actively pursue this for South Africans and stop silencing voices. The fact that the voices of black poor women and rural women are being excluded is an indictment of the media.”

Van der Westhuizen said media were primary producers of meaning in society, but they stereotyped women. “Baby-dumping stories are sensationalised but the social context does not feature in stories”.

“Sexual coercion and violence against women” continued to be a problem in South Africa, she said.

Van der Westhuizen also criticised media reports saying that abortion was being used as a contraceptive, which she said “flew in the face of available evidence”.

“Media stigmatise women either as becoming pregnant and abusing the state system for social grants or abusing state services to use abortion as a contraceptive”. Van der Westhuizen argued the media should examine the reasons why women fell pregnant when they didn’t plan to.

She said the stigma women felt when choosing the right to terminate their pregnancy could lead to their deaths, if they felt forced to use backstreet abortion services.

Mhlanga said the stigma associated with accessing reproductive healthcare services led to preventable deaths. He told how his cousin’s wife had experienced a miscarriage and died as a result of not seeking medical help soon enough. He said women felt stigmatised about miscarriages even though up to 40% of pregnancies ended in miscarriage.

Advertising ‘death’
Organiser Karen Trueman said she was disappointed that only two representatives of the media attended the event.

Newspapers were slammed for accepting adverts that promoted unsafe abortions.

“The adverts advertised death to desperate people”, said Mhlanga, who spoke about his horror when he witnessed women dying from badly-administered or self-induced abortions.

Mhlanga said the NCCMD had recommended hospitals advertise their services for safe abortions, but this had not happened.

He said municipalities had to be approached to stop the advertising of unsafe abortions on walls in the inner-city, streetlight poles and at taxi ranks.

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