More women are dying from unsafe abortions than ever before

In December last year, 88 women were rushed to Kenyatta National hospital for treatment due to abortion related complications.

In this group was a young patient, 15 year old Maria Kwamboka*, who was in need of urgent medical attention. The Form Two student was admitted to Kenyatta National Hospital from a hospital in Kisii unconscious.

Maria had procured an abortion on the advice of her friend. A procedure that not only left her anaemic but also saw her suffer kidney failure.

On the day of the interview, Kwamboka is on a wheelchair. A green hospital gown covers her frail body and stops just before her ankles.

On her right upper arm, a black stitch runs across a wound. Her short hair lies flat on her head. Seeing visitors, she runs her long fingers on her head, then on her knee and clumps them together on the table.

Her eyes flicker as she scans the room. She looks out of the window on the side and says a faint, “hello.”

She has been on Ward 1D for about a month. She has seen other women, over seventy of them, walk in and out of the hospital leaving her behind. The drip on her hand is fastened by a white bandage.

SIMILAR PROBLEM

She stutters, and speaks out softly.

“I went to my sister and told her that I had not had my monthly periods. She told me that I could be pregnant,” begins Kwamboka.

“I did not know what to do, but what I knew is I would not let my mother know about it. And a neighbour, a young woman, told me that I should not worry. It was something that would be solved in a few minutes.”

Kwamboka’s friend assured her that she would take her to a doctor who would make the pregnancy go away. She said, the doctor had helped her three times in the past with a similar problem.

“I asked her if it was painful, she said I would not feel a thing. She even said she would pay the required Sh1,500,” says Kwamboka.

They went to see the ‘doctor’, and Kwamboka was suprised to find that it he was not based in a hospital but rather in a chemist’s shop. Her friend insisted this was how it was done,  so she followed her into an inner section of the chemist and into rooms the chemist attendant said he rented for this purpose.

“I was not given an injection as they do in hospital but he said I lie on a dusty bed and lift my legs. Shortly after, I felt metal rods go inside me and after a few minutes, he stopped and said I could leave. He said in a few hours, the baby would come out,” recalls Kwamboka.

They went back home and Kwamboka’s friend assured her it would be okay.

But the next morning, she woke up with severe stomach pains and intense bleeding.

“I was rushed to hospital but I did not tell them what I had done. They tried to stop the bleeding and seeing that I would die if I did not tell them what happened, I confessed.

When the bleeding worsened, she was rushed to another hospital.

“I overheard the doctors say that due to the bleeding my body was in shock and it was not good,” she says.

FIRST TIME UNLUCKY

Though she had no idea what they meant, she felt the import of their words when her body began to swell and she was unable to go to the toilet. Her mother and uncle then made the decision to take her to Kenyatta National Hospital.

“I was rushed to the renal ward where I spent almost two weeks undergoing dialysis. This stitch here (points on her right upper hand to the shoulder) is where they inserted tube for my dialysis,” says Kwamboka.

She is sad and remorseful as she recounts her ordeal.

“I wish I had known that the Sh1,500 paid would cause me this misery. Not just to me but my family as well. Now I understand the cost of an unsafe abortion is: I may have to rely on dialysis for a very, very long time. It could have been worse.” says Kwamboka.

Though her boyfriend was ready to accept responsibility for the baby, Kwamboka says she feared the wrath of her mother more.

Kwamboka admits that she had some awareness about contraceptives and their use through counsellors who would visit their school from time to time to educate them

However, what she did not know was that she could fall pregnant at her age and that pregnancy could still happen even if it was her ‘first time’.

“I regret what happened but, I am angry because I know that there are other girls who will go to that same chemist and they might die,”

Maria stops and sighs. She fiddles her fingers, traces the edge of her nails and continues.

“Now I know that the procedure I went through is illegal. But, can the government do more to stop this... why aren’t there cells for the doctors, nurses and chemists who put women’s lives at risk?” she wonders.

“I want to heal and go back to school. I want to feel better. I am grateful that despite it all, my mother and family have accepted me back.”

She paused, sucked in some air and said:

“We need to talk about the risk of unsafe abortion. I have experienced the detrimental effects of abortion, stigma and misinformation about family planning and contraception.”

LUCKY TO BE ALIVE

Her guardian, a maternal uncle is glad his niece is alive. He said their family was overwhelmed by the botched abortion as they are torn over how to help her.

During the phone interview Kwamboka’s uncle remained hopeful.

“She is young and has a future ahead of her. We have sold everything to keep her in hospital and to nurse her. As a family, we have been awakened by this and we hope other parents will not be caught up like we were.”

He added that the family had  forgiven Kwamboka and still  accept her as their daughter. “

“We know she was under peer pressure but our prayer is that doctors help her to get better,” he says.

“But, we are pleading with the government to arrest the pharmacist he is wrecking the lives of other young girls’ lives in Kisii County,” He stated.

Currently, Kwamboka has been discharged but she is still at KNH as she is yet to clear her hospital bill. Her uncle explains that she is expected back on February 27 for a checkup that will then advise on when she will begin her dialysis sessions.

LEGAL ENVIRONMENT:

Under the 2010 Kenyan constitution, Article 26 states:

(1)Every person has a right to life.

(2)The life of a person begins at conception.

(3)A person shall not be deprived of life intentionally except to the extent authorized by the constitution and any other written law.

(4)Abortion is not permitted unless, in the opinion of a trained health professional, there is need for emergency treatment, or the life or health of the mother is in danger, or if permitted by any other written law.

In 2012 the former Director of Medical Services Dr Francis Kimani launched ‘The Standards and Guidelines for Reducing Mobility and Mortality from Unsafe Abortions in Kenya’.

The guideline provided the national guidelines on safe abortion with the intention was to reduce deaths and illnesses associated with unsafe abortion.

It also advised health workers on who, where, and how to perform an abortion, under what circumstances and to compel the workers to only offer the option to deserving cases as per the law.

However, it was withdrawn on December 3, 2013 by Dr Kimani arguing there was need for wider stakeholder consultation on the contents of the document.

Centre for Reproductive Rights Regional Director for Africa Evelyne Opondo said the lack of the guidelines “breeds the questions on how to safely terminate a pregnancy, who qualifies for safe termination, and thus women end up in the hands of quacks.”

 * names have been changed