WUNRN
By Sally Chiwama
Selina’s gullet (were food passes) has constricted and is burning, a hole has been made on her stomach in an effort to feed her because food and water cannot pass through the gullet and she has had to undergo an operation to fix the burnt part of the gullet and another to take out her uterus as well as the foetus that has rotten in her womb.
At first glance it is not easy to get the connection between a woman’s gullet and a uterus, well this is what happened to 25 year old Selina Mwendakula in a bid to terminate her 4 months unwanted pregnancy. Selina is married with three other children but did not want the fourth child. She opted to terminate the pregnancy thus drinking the deadly battery acid and pushing a stick through her vagina only to perforate her uterus.
Selina is only one of hundreds of women that the University Teaching Hospital (UTH) gynecology department receives every day, in fact the figures are quite alarming , the department receives more than 200 cases of attempted abortions and that 30% to 50% bed occupancy in the gynae emergency ward are abortion related.
Speaking to Selina from her bedside, she wishes she had never attempted to have an abortion because in her mind, God had given her a second chance.
“ Mwandi mummy, I wish had never attempted, right now it would have been a different story, by this time you wouldn’t even have been talking to me, look at me, I have lost so much blood, elo ichi chapamukosi (gullet) kaya, my uterus has been removed, I have nothing left”, she said amid sobs.
Selina also told this author that, apart from the battery acid that she drank, she also used a sharp instrument that she pushed through her vagina thus perforating her uterus.
At
a workshop held at the Pamodzi Hotel recently, Director of Public Health and
Research in the Ministry of Health (MoH) Dr. Victor Mukonka said that abortion
was a significant contributor to high maternal mortality in Africa including
He said that the MoH was taking firm and steady action on maternal death and that they were optimistic that with time and the involvement of the private-public partnerships would yield positive results of elimination of the unnecessary deaths of women from unsafe abortion.
“It should be note that safeguarding the health of women in the reproductive health category is one of the key national health priorities which is receiving its due attention” said Dr. Mukonka.
Unsafe
abortion is one of the major causes of maternal mortality. The issues
surrounding abortion are not well known because of the stigma that is
associated with it. Many women in
Further more Dr. Mukonka also acknowledged that unsafe abortion in Zambia is said to contribute about 30% of maternal deaths according to a study that done at the UTH a few years ago an noted that it was imperative to address the scourge if the country was stop women dying unnecessarily and attain the millennium Development Goals (MDGs).
“ Abortion has always been an emotive issue, but it is important to remember that a lot of women are either dying or suffer complications of unsafe abortion, hence we cannot allow emotions to guide how abortion should be handled”, Dr. Mukonka said.
Vice President of IPAS Africa Ambassador Dr. Eunice Bookman Amiss in her opening speech at the workshop said that it was a well known fact that Africa region bears an unduly large burden of the worlds total burden of disease, but that it’s share reproductive health illness is even more disproportionate and abortion has been among the most neglected an challenging areas of reproduction health.
She noted that thousands of women die in African countries every year because they have no access to safe services and sighted the following as the reasons-lack of access to effective contraception, stigma around abortion, gender inequalities, primitive and archaic colonial laws and ignorance among policy makers, legislators, health professionals, communities and women themselves about national laws.
She stressed that “Access to safe abortion is essential to human rights and to the health and lives of women as well their full development”.
She told the participants that women of all nationalities and social standing, rich or poor, married or single, educated or uneducated, young and old, with or without children have abortions and have always had a need for terminating an unwanted pregnancy.
Very
few people are aware however that termination of pregnancy is provided for in
the laws if
Dr Kamanga told participants that termination of pregnancy is provided for in the laws of Zambia by the termination act of 1972 and is considered the most liberal abortion law in Africa yet the law comes with restrictions and these include risk to the life of the pregnant woman or risk of injury to the physical or mental health of the pregnant woman.
Despite all these restrictions Dr. Kamanga says that the “the public has to understand that even if Zambia was rich country and all was available unwanted pregnancies would always occur and when such a thing happens, a woman should be given a choice” .
He
further stressed that when a woman is given a choice and she chooses to
terminate, free and safe services are available and are provided for under the
laws of
“ It’s a pity that most of them come when almost too late when they have attempted to terminate on their own and the infections start to get septic and starts to affect other parts of the body and they die” said Dr. Kamanga.
However, reflecting limited knowledge of the law and inadequate access to legal abortion services.
In
1982 -83, fifteen (15) % of all maternal deaths at the UTH in
A trainee Gynecologist Dr. Stephen Mupeta says that a lot of women have died at the hands of self styled experts who perform abortions in the back streets. The self styled “experts” come in all forms, elderly women, clinical officers, an even doctors who are out to make a quick buck.
“We offer almost free services to access to safe abortion, but most people are unaware of this service” he said.
Dr.
Mupeta bemoaned the lack of respect for the law with these self styled experts
and stressed that Termination of pregnancy (TOP) was a specialized procedure
which was done by trained health care providers who were specifically trained
to carry out this procedure who include Doctors, mid-wives, clinical officers
or nurses. In
“I would like to emphasize that no matter who the health care provider is as long as they are not trained in termination of a pregnancy, they will not provide a safe abortion” said Dr. Mupeta.
He says that the department receives all sorts of cases such starting from women who have drank an over dose of chloroquine, herbs pushed in the vagina, hang wires and those that have drank dangerous stuff such as battery acid all in the name of acquiring an abortion. (Quote the figures in presentation) 30% bed occupancy in emergency gyn ward is abortion related the time they get here, it is almost too late. Some die in the process, while receiving medication”, said Dr. Mupeta.
He bemoaned the lack of trained providers and sighted it as a challenge to the UTH, he also warned people to be aware that they shouldn’t just go to anyone to get the service.
Dr. Mupeta strongly appealed to the authorities that more health care providers be trained in safe termination of pregnancies.
================================================================
To contact the list administrator, or to leave the list, send an email to:
wunrn_listserve-request@lists.wunrn.com. Thank you.