By Kelvin Mokaya
Globally, unsafe termination of pregnancy remains a major public health problem. According to the World Health Organization (WHO), annually an estimated 8.5 million women suffer from complications of unsafe abortions, resulting in 47,000 maternal deaths. The majority of unsafe pregnancy terminations occur in the developing countries with the most severe morbidity and mortality occurring in sub-Saharan Africa.
It is estimated that every year at least 2,600 women die from unsafe abortions in Kenya, while 21,000 more women are hospitalized annually due to complications arising from incomplete abortions whether spontaneous or induced. Despite these statistics, most healthcare providers in Kenya lack comprehensive knowledge on the laws that allow access to abortion care, and the skills to effectively assess, recommend and provide abortion care within the constitutional provision.
Quite alarming, right?
Because of the restrictive anti-abortion laws and limited access to quality health care, most induced abortions in the country are unsafe and contribute to the high morbidity and mortality burden. In Kenya, maternal mortality is high at about 6,000 deaths per year, 17% of them from complications of unsafe abortion. Unsafe abortion in Kenya is among the highest in Africa.
Do we remember the JMM’s story that led to a court case, the outcomes of which could bring about changes to support access to safe abortion within the law in Kenya? Try to jog your memory a little bit. It’s in 2015 that this story was published in a local daily newspaper.
JMM was just 14 years old and in her second year of Secondary School when she was sexually assaulted by an older man. When she missed her period twice she realized that she was pregnant. Being fearful of the pregnancy being discovered and not knowing what to do, she confided in her friend who told her that she knew someone who would take care of it. The practitioner was in their local town behind a shop labelled Chemist. He gave her some medicine, but nothing happened. She went back and this time he inserted some cold metal instruments, and when JMM went home she started bleeding heavily, vomiting and having a fever. When she was taken to a nearby hospital, her complications of excessive bleeding and sepsis were too severe to be treated there and she was referred to another hospital and admitted to the critical care unit. There, she was diagnosed with kidney failure requiring dialysis thus yet again referred, this time to the national referral hospital in Nairobi. She had surgery and was treated for chronic kidney disease. She remained in poor health until she died, in June, 2018.
It a pity that JMM’s story is not rare. The Kenyan Constitution was changed in 2010 to expand the situations under which abortion could be provided legally, including to situations of rape. However, the Standards and Guidelines for Reducing Morbidity and Mortality from Unsafe Abortion that were formulated in response to the changes in the law were withdrawn.
This meant that women and girls seeking to terminate pregnancies that should have been allowed under the law resorted to unsafe abortions, with disastrous results…DEATH!
Overtime, the situation hasn’t been any better as we’ve witnessed thousands of women dying every year in the country due to botched backstreet abortions.
In the week of 3rd to 7th July 2023, the Ministry of Health was set to release the Big Five Combipack guidelines on the provision of safe abortion that will realize a reduction in deaths associated with unsafe abortions, something that hasn’t happened yet because of one individual who is very much misinformed on this matter at hand.
Access to safe abortion is very critical for the health of our women and girls. Dr. Wahome Ngare cannot continue to hold the Ministry of Health hostage over false claims, misinformation and speculated fears that he has. Women in Kenya are dying in child labor due to infections, blood pressure and over-bleeding. Girls are dying from unsafe abortions on a daily basis, especially in the urban informal settlements. The Big Five Combipack guidelines must be released with IMMEDIATE effect. We do not have the liberty of waiting anymore! We cannot prioritize our selfish interests over lives. The Ministry of Health under the leadership of Hon. Susan Nakhumicha, should RELEASE the guidelines and set women free!
Under international human rights law, States are required to ensure that women do not have to resort to unsafe abortion. This is very clear.
Kelvin Mokaya is a Sexual And Reproductive Health And Rights Advocate at NAYA
