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Is lack of access to safe abortion clinics creating a market for dangerous alternatives?

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Clandestine clinics offering illegal abortions are one of the prime causes of unnecessary maternal deaths across Africa. The lack of facilities for safe procedures makes the statistics worse.


When the pain started, I called him. I begged him for help.I was bleeding so much. The pain became more and more severe. I could not sit,or stand or lie down. I could not move. He told me not to contact him again,that it was not his problem. He told me to go to hospital if I have problems. After that, I never got hold of him again.”

This is the story of Megan Naidoo (not real name), the survivor of an illegal backyard abortion procedure. Naidoo was seven weeks pregnant when her boyfriend forced her to have an abortion.

She lived with him and her father in a small two-bedroom flat on the outskirts of Kimberley in the Northern Cape province of South Africa. There are not many institutions providing safe abortions in Kimberley and Naidoo was afraid of shaming her Muslim father.

So, she took a bus to Johannesburg in search of a way out of her desperate situation. She had only about $144 for the trip. Her boyfriend gave it to her when he put her on the bus to Johannesburg and told her to return with a clean body.

As she walked through the city searching for someone to direct her to a designated facility, she came across a flyer, stuck to a lamppost. The flyer was advertising safe and painless abortions. At first, she did not realize what the flyer suggested. Then, she saw more flyers decorating electricity boxes, lamp posts, traffic lights and sidewalk walls; they were everywhere around her. “Safe 30-minute abortions, no pain guaranteed” the flyers beckoned her; “Phone ‘Dr Nick’ to make appointment”.

Although she was afraid of judgment, she managed to make the call. Back home in Kimberley, her family would have, in God’s name, stopped her from killing an innocent baby for selfish reasons. This is also what the nurse said to her when she first approached the local hospital in Kimberley for help.

But, this was not the reaction she got from the quack, ‘DrNick’, whose number was on the flyer. He told her there was nothing to be scared of and that he would make sure “everything is out” and she would have no pain at all.

She met Dr Nick in front of a dilapidated building entrance on Rissik Street, in Johannesburg’s gritty central business district. He told her to hand over the cash in an unnoticeable way.

Fortunately, she had set aside about $50 prior to their meeting. He handed her four tablets; two to put under her tongue, the third one was a suppository to be inserted immediately. He told her she would start to bleed after four hours and instructed her to then take the last tablet. She might experience a little pain, he advised, but nothing more than normal period pains. He told her to phone him if she needed him and then he left.

With nowhere else to go, she returned to the bus station. She took the tablets, and locked herself in the cubicle of a public toilet, near the station.

Four hours later, intense pain began. Six hours later, she started bleeding. The pain grew more intense with time. Naidoo phoned Dr Nick but he told her to go to hospital.

He also instructed her to tell the hospital staff that she had been to Marie Stopes, an international non-governmental organization (NGO) that provides safe abortion services. The third time she phoned, Dr Nick’s phone was switched off and he never answered again.

Naidoo had eventually bled out pieces of her uterus when she was found by the bathroom cleaners who assisted her, in the seventh hour of the severe pain.

They took her to a nearby clinic where health workers were unwilling to assist and reprimanded her that she deserved the pain because of what she had done. The cleaners then took her by taxi to the Charlotte Maxeke hospital nearby. A gynecologist  on duty said that Dr Nick’s tablets forced Naidoo into induced labor that eventually lasted 10 hours.

She is one of thousands of women across Africa who nearly died at the hands of illegal abortion providers.

In South Africa, reportedly, only 7% of the country’s health facilities provide abortions. This is due to the lack of trained staff and the conscience objection right given to all South Africans by the Constitution,which enshrines the freedom of conscience, belief and opinion.

Often times,women are chased away from hospitals due to hospital managers being against abortions. Access to safe abortions is hampered as often, there are fewer facilities that provide abortion services to women in their second trimester.

In Africa, only Cape Verde, South Africa and Tunisia permit abortions without restrictions as to reason.

As a result, the influx of pregnant women from across the continent seeking safe abortions, adds to the increased need for designated abortion facilities.

To top that, various African NGOs that have been providing the service were recently choked by American president Donald Trump’s implementation of the Global Gag rule.

This ruling caused all funding for safe abortion facilities, across the developing world, to dry up completely.Hundreds of NGOs and outreach programs providing services and information, in especially poor countries across Africa, had to close their doors and halt awareness campaigns. Also, any NGO receiving United States-aid and funding is not allowed to co-operate with an NGO if the latter is pro-abortion.

This means that pro-choice women in countries such as Malawi and Zimbabwe have nowhere to go to have safe abortions. In Zimbabwe, family planning clinics that provided various services including safe abortions, had to close down. Not only did this result in a lack of medical services in rural parts of Zimbabwe, women can no longer get their contraceptive medication from these clinics.

In Zimbabwe, Zambia, Botswana, Mauritius and Namibia,abortion is only available in certain circumstances. In Seychelles, Tanzania, eSwatini (formerly Swaziland), Malawi and DRC, abortion is only available in extremely limited circumstances. Abortion is totally outlawed in Lesotho, Angola and Madagascar.

By all estimates, the more African states fail female citizens, the more money is pocketed by fake doctors and other backyard abortion providers. The more money is spent in this underground market, the more backyard providers are attracted to the trade.

According to Whitney Chinogweny, Head of Communications and Public Relations at Marie Stopes Sandton in South Africa, 52% to 58% of abortions in Africa are performed by illegal abortion providers, contributing to 12% to 15% maternal deaths across the continent. Without sufficient funding, NGOs cannot create awareness around the dangers of illegal abortions.

Sometimes illegal providers overdose women, giving them mixtures of laxatives, aspirin and medication used for stomach ulcers. At times,backyard doctors remove the foetus using household equipment like wire hangers and fire tongs.

Once these con artists have taken their victim’s money, they usually disappear, never to be found again. They cannot be tracked or traced. They change phone numbers and change locations.

If African governments do not amend abortion policies and facilitate the establishment of designated institutions, NGOs will continue to be forced to deal with the challenges weighed down by limited resources. 

Anina Peens

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J&J Loses Bid to Have $4.7 Billion Talc Verdict Set Aside, Vows to Appeal

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Johnson & Johnson failed to persuade a Missouri trial judge to set aside a July verdict awarding a record $4.69 billion to 22 women who blamed their ovarian cancer on asbestos in the company’s Baby Powder and other talc products.

The healthcare company faces thousands of lawsuits over the safety of talc in its Baby Powder, a fixture of its consumer products division that has been core to J&J’s reputation as a family friendly company.

The trial was the first in which plaintiffs claimed that asbestos fibers in J&J’s talc caused ovarian cancer. It relied on unsealed internal company documents detailing J&J’s alleged knowledge of asbestos contamination since at least the 1970s.

The company, which says its Baby Powder does not contain asbestos and is safe, in a statement said the failed motion was merely a formal step required before appealing the verdict.

READ MORE| Johnson & Johnson Moves to Limit Impact of Report on Asbestos in Baby Powder

“The same judge has denied similar motions on prior verdicts in his court that were ultimately overturned by the appellate courts. We are confident this verdict will also be overturned on appeal,” J&J said.

Judge Rex Burlison in the ruling on Wednesday said the jury’s decision and the large award of punitive damages was justified based on J&J’s “particularly reprehensible conduct” as evidenced during trial. He denied the company’s request to overturn the verdict, saying the women had presented sufficient evidence to support the jury’s verdict.

A jury in July awarded $550 million in compensatory damages and $4.14 billion in punitive damages.

Reuters on Dec. 14 published a special report detailing the company documents that sent J&J shares tumbling. They have dropped more than 13 percent since Friday, wiping out more than $45 billion in the company’s market value.

Shares on Wednesday were off about 2 percent at $127.88.

Mark Lanier, the women’s lawyer during trial, in a statement said plaintiffs were pleased with Burlison’s decision.

DECADES-LONG USE

The women and their families said decades-long use of baby powder and other cosmetic talc products caused their illness. They allege the company knew its talc was contaminated with asbestos since at least the 1970s but failed to warn consumers about the risks.

While plaintiffs in the long-running litigation in the past had claimed talc itself causes ovarian cancer, plaintiff lawyers in recent months shifted their claims to allege asbestos in the talc causes mesothelioma, a cancer closely linked to asbestos exposure, and ovarian cancer.

J&J denies that its talc products ever contained asbestos and says decades of studies and regulatory assessments show its talc to be safe.

Missouri’s appeals court has overturned two prior ovarian cancer talc verdicts against J&J on technical legal grounds, saying the decisions could not stand following a 2017 U.S. Supreme Court decision limiting where companies can be sued for personal injuries.

S&P 500 ends flat in choppy trade

The company in its September motion made a similar argument, telling Burlison that the women, the majority of whom were from out-of-state, had no right to sue in Missouri.

J&J also said Lanier during the trial “substituted proof and evidence with misleading and inflammatory graphics,” including an image depicting J&J pushing a woman off a cliff into ovarian cancer.

But Burlison in his Wednesday ruling said the cases rightly belonged in Missouri court due to J&J’s connection to the state.

More than 9,700 talc lawsuits, the vast majority of those J&J faces, allege asbestos-laced cosmetic talc caused ovarian cancer, while a smaller number claim its use led to mesothelioma. -Reuters

  • Manas Mishra 

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Johnson & Johnson Moves to Limit Impact of Report on Asbestos in Baby Powder

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 Johnson & Johnson on Monday scrambled to contain fallout from a Reuters report that the healthcare conglomerate knew for decades that cancer-causing asbestos lurked in its Baby Powder, taking out full-page newspaper ads defending its product and practices, and readying its chief executive for his first television interview since investors erased tens of billions of dollars from the company’s market value.

J&J shares fell nearly 3 percent Monday, closing at $129.14 in New York Stock Exchange trading. That drop was on top of the 10 percent plunge that wiped out about $40 billion of the company’s market capitalization following the Reuters report Friday. J&J also announced Monday that it would be repurchasing up to $5 billion of its common stock.

Senator Edward Markey, a Massachusetts Democrat on the Environment and Public Works Committee, on Friday sent a letter to the head of the U.S. Food and Drug Administration calling on the agency to investigate the findings in the Reuters report to determine whether J&J misled regulators and whether its Baby Powder products threaten public health and safety.

J&J Chief Executive Alex Gorsky, in his first interview since the Reuters article was published, defended the company during an appearance on CNBC’s “Mad Money” with host Jim Cramer on Monday night. J&J knew for decades about the presence of small amounts of asbestos in its products dating back to as early as 1971, a Reuters examination of company memos, internal reports and other confidential documents showed. In response to the report, J&J said on Friday that “any suggestion that Johnson & Johnson knew or hid information about the safety of talc is false.”

A Monday full-page ad from J&J — headlined “Science. Not sensationalism.” — ran in newspapers including The New York Times and The Wall Street Journal. The ad asserted that J&J has scientific evidence its talc is safe and beneficial to use. “If we had any reasons to believe our talc was unsafe, it would be off our shelves,” the ad said.

J&J rebutted Reuters’ report in a lengthy written critique of the article and a video from Gorsky. In the written critique, posted on the company’s website, J&J said Reuters omitted information it supplied to the news organization that demonstrated the healthcare conglomerate’s Baby Powder is safe and does not cause cancer; that J&J’s baby powder has repeatedly been tested and found to be asbestos-free; and that the company has cooperated with the U.S. FDA and other regulators around the world to provide information requested over decades.

“Since tests for asbestos in talc were first developed, J&J’s Baby Powder has never contained asbestos,” Gorsky said in the video. He added that regulators “have always found our talc to be asbestos-free.”

A Reuters spokeswoman on Monday said the agency “stands by its reporting.”

Reuters’ investigation found that while most tests in past decades found no asbestos in J&J talc and talc products, tests on Baby Powder conducted by scientists at Mount Sinai Medical Center in 1971 and Rutgers University in 1991, as well as by labs for plaintiffs in cancer lawsuits, found small amounts of asbestos. In 1972, a University of Minnesota scientist found what he called “incontrovertible asbestos” in a sample of Shower to Shower. Other tests by J&J’s own contract labs and others periodically found small amounts of asbestos in talc from mines that supplied the mineral for Baby Powder and other cosmetic products into the early 2000s.

The company did not report to the FDA three tests by three different labs from 1972 to 1975 that found asbestos in the company’s talc.

The Reuters story drew no conclusions about whether talc itself causes ovarian cancer. Asbestos, however, is a carcinogen. The World Health Organization’s International Agency for Research on Cancer has listed asbestos-contaminated talc as a carcinogen since 1987. Reuters also found that J&J tested only a fraction of the talc powder it sold. The company never adopted a method for increasing the sensitivity of its tests that was recommended to the company by consultants in 1973 and in a published report in a peer-review scientific journal in 1991.

The ad J&J ran in newspapers Monday also pointed to an online talc fact page the company created with “independent studies from leading universities, research from medical journals and third-party opinions.”

That website has changed since early December, according to a Reuters review of online archives.

The website, for instance, no longer contains a section headlined “Conclusions from Global Authorities” that as recently as Dec. 5 listed organizations including the U.S. FDA, the European Union and Health Canada as among entities that have “reviewed and analyzed all available data and concluded that the evidence is insufficient to link talc use to cancer.”

On Dec. 14, the day Reuters published its report, that section of the website had been removed. It is not clear exactly when the online page changed.

The Canadian government released a draft report this month that found a “consistent and statistically significant positive association” between talc exposure and ovarian cancer. The draft report also said that talc meets criteria to be deemed toxic.

The draft report put forth proposed conclusions that are subject to a public comment period and confirmation in a so-called final screening assessment, Health Canada said.

If the conclusions are confirmed, Canadian officials will consider adding talc to a government list of toxic substances and implementing measures to prohibit or restrict use of talc in some cosmetics, non-prescription drugs and health products, Health Canada said.

A J&J spokeswoman said the company removed the website section after the Canadian government issued the draft report. “We chose to be conservative while that draft is under review,” the spokeswoman said.

While J&J has dominated the talc powder market for more than 100 years, the products contributed less than 0.5 percent of J&J’s $76.5 billion in revenue last year. – Reuters

  • Mike Spector, Lisa Girion and Ankur Banerjee 

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Burnout, stress lead more companies to try a four-day work week

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Work four days a week, but get paid for five?

It sounds too good to be true, but companies around the world that have cut their work week have found that it leads to higher productivity, more motivated staff and less burnout.

“It is much healthier and we do a better job if we’re not working crazy hours,” said Jan Schulz-Hofen, founder of Berlin-based project management software company Planio, who introduced a four-day week to the company’s 10-member staff earlier this year.

In New Zealand, insurance company Perpetual Guardian reported a fall in stress and a jump in staff engagement after it tested a 32-hour week earlier this year.

Even in Japan, the government is encouraging companies to allow Monday mornings off, although other schemes in the workaholic country to persuade employees to take it easy have had little effect.

Britain’s Trades Union Congress (TUC) is pushing for the whole country to move to a four-day week by the end of the century, a drive supported by the opposition Labour party.

The TUC argues that a shorter week is a way for workers to share in the wealth generated by new technologies like machine learning and robotics, just as they won the right to the weekend off during the industrial revolution.

“It would reduce the stress of juggling working and family life and could improve gender equality. Companies that have already tried it say it’s better for productivity and staff wellbeing,” said TUC economic head Kate Bell.

OVERWORKED

Lucie Greene, trends expert at consultancy J. Walter Thompson, said there was a growing backlash against overwork, underlined by a wave of criticism after Tesla (TSLA.O) boss Elon Musk tweeted that “nobody ever changed the world on 40 hours a week.”

“People are starting to take a step back from the 24-hour digital life we have now and realize the mental health issues from being constantly connected to work,” Greene said.

A recent survey of 3,000 employees in eight countries including the United States, Britain and Germany found that nearly half thought they could easily finish their tasks in five hours a day if they did not have interruptions, but many are exceeding 40 hours a week anyway – with the United States leading the way, where 49 percent said they worked overtime.

“There has been work creep. Because you always have the technology, you are always working, so people are getting burned out,” said Dan Schawbel, director of executive development firm Future Workplace, which conducted the survey.

Schulz-Hofen, a 36-year-old software engineer, tested the four-day week on himself after realizing he needed to slow down following a decade of intense work launching Planio, whose tools allowed him to track his time in detail.

“I didn’t get less work done in four days than in five because in five days, you think you have more time, you take longer, you allow yourself to have more interruptions, you have your coffee a bit longer or chat with colleagues,” Schulz-Hofen said.

“I realized with four days, I have to be quick, I have to be focused if I want to have my free Friday.”

Schulz-Hofen and his team discussed various options before settling on everybody working Monday to Thursday. They rejected the idea of flexible hours because it adds administrative complexity, and were against a five-day week with shorter hours as it is too easy for overwork to creep back in.

Clients who call on a Friday hear a recorded message explaining why nobody is at the office.

“We got an unexpected reaction from customers. Most of our clients did not complain. They were just jealous,” Schulz-Hofen said.

Grey New York, an ad agency owned by WPP (WPP.L), launched a program in April to allow staff to work a four-day week for 85 percent of their full-time salary.

Schawbel expects the idea to catch on in more companies and countries, but probably not his own: “I think America will be the last country to give us Monday mornings off because we’re so used to this way of working.” -Reuters

  • Emma Thomasson

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