NAIROBI (TrustLaw) – As new guidelines are being drawn up to make abortion more easily available in Kenya following the liberalisation of the law, the police continue to harass medics providing the service lawfully.
At least 2,600 Kenyan women die in public hospitals each year as a result of botched backstreet abortions. Many more die at home without seeking medical care. And another 21,000 are admitted for treatment of abortion-related complications.
The expansion of abortion rights was one of the most controversial clauses in Kenya’s new constitution, which was approved by two-thirds of voters in a 2010 referendum.
Influential Christian leaders wanted the constitution to prohibit abortion under all circumstances.
However, the final document, under Article 26 (4), allows abortion in order to safeguard a woman’s life, or physical or mental health, or if there is need for emergency treatment.
“We are currently developing clinical guidelines to implement Article 26 (4),” said Joseph Karanja, an obstetrician-gynaecologist at Kenyatta National Hospital, Kenya’s largest public facility.
“We have held a series of meetings. Doctors, nurses, clinical officers, people representing the churches. It is as many stakeholders as possible.”
REDUCING MATERNAL DEATHS
The new guidelines are a critical step towards ensuring that the government fulfills its obligations to provide abortion services. They will detail who can carry out an abortion and the kind of facilities and equipment required.
“The lack of clarity around these issues has been a huge barrier to the provision of services in the past,” said Alisha Bjerregaard, a lawyer with the Center for Reproductive Rights advocacy group based in Nairobi.
Experts hope that increased access to safe abortions provision will cut Kenya’s maternal death rate. Unsafe abortions account for 35 percent of maternal deaths in Kenya, far higher than the global average of 13 percent.
“Once there are national guidelines, then people will know what to do, instead of doing things clandestinely and endangering the lives of women,” said Karanja.
Most Kenyans believe that abortion is entirely illegal as the penal code says that women who abort illegally can be jailed for seven years. Those who carry out illegal terminations face a 14-year sentence.
However, the new constitution clearly states that it is legal to terminate a pregnancy when a woman’s life or health is at risk.
Rich and educated women have always been able to procure safe abortions in top private hospitals; it is the poor who have been denied access to these services.
Medical practitioners in public hospitals have been reluctant to carry out abortions because of the legal ambiguities.
This drives poor women to backstreet quacks who insert knitting needles, sticks and pens into the women’s vaginas. Other women drink poisons like bleach or detergent in the hope of causing a miscarriage.
The government estimates that 800 unsafe abortions are performed every day.
“It is only in the public hospitals where ordinary people go that (there is) a problem,” said Karanja.
“If I want to terminate a pregnancy in Nairobi Hospital tomorrow… the case will be put on the list like any other.”
WOMEN STILL RISK THEIR LIVES
Once the new guidelines have been approved, the government needs to provide medical staff working in its facilities with the training and equipment to carry out abortions.
The public and medical staff also need to be educated about the change in the law.
“So far, they have done none of these things and, for all intents and purposes, it appears that, practically, things remain the same as they were prior to the new constitution,” said Bjerregaard.
“Many women who would qualify for safe services continue to resort to unsafe abortion, suffering complications and risking their lives.”
It is clear that the police have not been trained on the new law as they continue to harass medical staff who provide legal abortions, Bjerregaard said.
“In July, the police set up a sting operation where they sent in a client who required an abortion and then, once the procedure had been completed, the police rushed in and demanded a 200,000 Kenya shilling ($2,000) bribe to not bring her down to the police station,” said Bjerregaard.
“The provider met with the (officer commanding the station) after this incident and he indicated that they were planning on doing more of these sting operations in the future.”
In Kenya, 43 percent of pregnancies are unwanted due to high rates of sexual violence, limited access to family planning and poverty.
(Editing by Rebekah Curtis)
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