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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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Health

[IN NUMBERS] Coronavirus Update: COVID-19 In Africa

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While most cases of the COVID-19 coronavirus have been reported in the U.S. , Europe, and China, the virus is spreading rapidly across the African continent.

The confirmed worldwide cases for the virus have surpassed four million with the current figure being at 5,557,310.

The increase in new reported cases around the world has led the World Health Organization (WHO) to declare the coronavirus a global pandemic.

The death toll has risen globally to a whopping 348,312.

The U.S. leads with 97,377 deaths. The U.K is second with 36,393. Italy is third with 32,616. Spain is fourth with 28,628, and France is fifth with 28,289.

China, where the virus originated from, maintains that its death toll is at 4,634.

The figure of the global recoveries stands at 2,333,215.

The African continent has 114,749 cases of Covid-19, while the death toll stands at 3,389. The continent has made 46,365 recoveries.

Here are the numbers in Africa:

Country Confirmed Cases Confirmed DeathsConfirmed Recoveries
Algeria7,9185824,256
Angola60317
Benin135361
Botswana29119
Burkina Faso81452672
Burundi42120
Cameroon4,4001591,822
Cabo Verde (Cape Verde)362395
Central African Republic (CAR)47918
Chad61158196
Comoros78118
Congo46916137
Cote d’Ivoire (Ivory Coast)2,301291,100
Democratic Republic of the Congo (DRC)1,94563312
Djibouti2,270101,064
Egypt15,7867074,374
Equatorial Guinea96011165
Eritrea3939
Eswatini (formerly Swaziland)2252119
Ethiopia4335128
Gabon1,56712365
Gambia25113
Ghana6,486311,951
Guinea3,067181,575
Guinea-Bissau1,109642
Kenya1,16150380
Lesotho2
Liberia24924136
Libya72338
Madagascar4482135
Malawi82328
Mali94760558
Mauritania20067
Mauritius33210322
Mayotte1,52119894
Morocco7,3321974,377
Mozambique16448
Namibia1914
Niger92460753
Nigeria7,0162111,907
Reunion4491411
Rwanda321222
Sao Tome and Principe25184
Senegal2,909331,311
Seychelles1111
Sierra Leone60638230
Somalia1,59461204
South Africa22,58342911,100
South Sudan56366
Sudan3,378137372
Tanzania50921183
Togo36312121
Tunisia1,04647883
Uganda16066
Western Sahara66
Zambia9207336
Zimbabwe51418

Note: The numbers will be updated as new information is available.

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NO WOMAN SHOULD EVER DIE GIVING LIFE

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By –Sheikha Hend Al Qassimi and Siddharth Chatterjee

Rafiullah Wardak looks upon his newborn daughter Amina, recovering after being wounded by gunmen who stormed a maternity award in Kabul on May 19, 2020. Mr. Wardak’s wife, Nazeya, was among at least 24 people killed in the attack, including women, nurses, and newborns. Photo – Courtesy of the Rafiullah Wardak family published @csmonitor

Consider this. 24 women, children and babies were murdered at a hospital in Kabul, the Afghan capital. Even by standards of a country as accustomed to bloodshed as Afghanistan, the May 12 attack on a Kabul maternity clinic was an event of unmitigated horror.  

That anyone could target women at their most vulnerable and infants in their first hours of life defies belief and makes one despair of the world that welcomed little Amina. Born just two hours before the attack that killed her mother, Amina’s leg was shattered by a bullet.

US Secretary of State Mike Pompeo said: “Any attack on innocents is unforgivable, but to attack infants and women in labour… is an act of sheer evil”.

The incident throws into relief the need to protect vulnerable populations even as the world struggles with the spread of the COVID-19 pandemic.  Health workers operating in difficult circumstances, such as the heroic Dr Najibullah Bina who led the team that conducted the first surgery on little Amina’s leg, continue to expose themselves and their families to the virus as well as to terror attacks.

The pandemic has an alarming potential to reverse hard-won socioeconomic gains inspired the March 2020 appeal by UN Secretary-General António Guterres for an immediate global ceasefire, which asked all warring parties to silence their guns to facilitate the delivery of aid and open up space for diplomacy.  

Women generally are at specific risk and disadvantage in Afghanistan, largely for reasons of culture. Their lives, quite separately from their deaths, are constrained in many ways that affect their health, education, nutrition and well-being. One of the most dangerous places in the world for a woman to give birth, Afghanistan is a microcosm of vulnerability for women and children, with a maternal mortality rate of around 638 maternal deaths per 100,000 live births and around two physicians for every 10,000 people.  

Afghanistan must figure out how to best support women and children when health efforts are under threat by both terrorists and a dangerous virus.

Around the globe, COVID-19 is worsening the situation for women already at risk, such as those in abusive relationships. Many millions are now required by emergency regulations to remain at home with their abusers, removed from the gaze of those who might otherwise see them and offer help. 

And with one in every three women globally experiencing physical or sexual violence from an intimate partner in their lifetime, the issue is startlingly grave.  

UNFPA, the UN’s Population Fund, says the COVID-19 lockdown is disproportionately affecting women and children. It is resulting in millions more cases of violence, child marriage, female genital mutilation and unintended pregnancy. “The new data shows the catastrophic impact that COVID-19 could soon have on women and girls globally,” said Dr. Natalia Kanem, UNFPA’s Executive Director.

Their well-being and economic resilience are threatened not only by the lockdown itself, but also by scaling down of health services and support such as hotlines, crisis centres, shelters, legal aid, protection, and counselling services.

The horror in Afghanistan further illustrates the urgency of the UN Secretary General’s clarion call for the peace-humanitarian action-development nexus to deal with      conflicts, violent extremism, and other forms of instability.  Now more than ever, there is a need for approaches that address social, economic, and political drivers of radicalisation.

There will be no one-size-fits-all model, and each country must continually assess which members of society are at the highest risk. If vulnerable groups are not properly identified and suitable responses developed, the consequences of this pandemic may be more devastating than we have dared to imagine.

Humanity has often been guilty of detachment regarding the plight of vulnerable populations.  The COVID-19 threat is an opportunity to change course.  While the virus does not discriminate, we must be careful lest our responses to it end up further entrenching current inequalities.

Images of two-hour-old Amina, swaddled in a blood-drenched blanket and with a bullet in her tiny bones must exponentially rouse our collective humanity and question the normalisation of indifference to the most vulnerable. 

About the Authors

Sheikha Hend Al-Qassemi

Sheikha Hend Al Qassimi, a multifaceted Emarati Princess, is an accomplished editor and writer, successful entrepreneur and architect and a committed philanthropist. She has a Masters in Marketing, Management & Communications from the Paris Sorbonne University. A Bachelor of Arts and Design with a double major (Architecture and Design Management) from the American University of Sharjah.  Follow her on twitter- @LadyVelvet_HFQ

Siddharth Chatterjee

Siddharth Chatterjee is the United Nations Resident Coordinator to Kenya. He has served in various parts of the world with UNFPA, UNICEF, UNDP, UNOPS, UN Peacekeeping and the Red Cross Movement. A decorated Special Forces veteran, he is an alumnus of Princeton University. Follow him on twitter-@sidchat1

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Beyoncé And Tina Knowles-Lawson Are Accelerating Coronavirus Testing In Underserved Communities—And Challenging Other Celebrities To Do The Same

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Last weekend, close to 1,000 residents flocked to two middle schools in predominantly black Houston communities, waiting patiently in their cars to receive free COVID-19 testing. 

Unlike many other cities nationwide, Houston has had free testing available to the public but “some people, definitely minorities because we are overlooked, just aren’t aware or aren’t taking it seriously,” Tina Knowles-Lawson, a Houston native herself, tells Forbes.

That lack of awareness in the community inspired Knowles-Lawson to create the #IDIDMYPART campaign. Launched in partnership with daughter Beyoncé and her BeyGOOD initiative, the campaign encourages black and brown residents—the demographic that’s dying at a faster rate than any other in the state—to seek free COVID-19 testing. The campaign ran two testing locations on May 8 and 9, 2020, with plans to recruit celebrities in other cities to continue the initiative in the weeks and months to come.

A #IDIDMYPART testing site. BEYGOOD/#IDIDMYPART

“It’s associated with Beyoncé, in some way, so it’s a cool thing, you know?” says Knowles-Lawson. “And it’s working, because people are still going to testing sites.”

The testing locations kept that cool factor in mind. As volunteer medical professionals from the United Memorial Medical Center administered tests (the hospital is following up with each individual attendee), DJs spun the latest hits from Beyoncé and other artists. And on their way out, attendees were given vouchers to two of Houston’s most popular restaurants: Frenchy’s and Burns Original BBQ. “You didn’t have to get in your head about the test; it wasn’t so sterile,” says Knowles-Lawson. “It was almost like a celebration of getting tested. We wanted to take away the stigma.”

Knowles-Lawson also wanted to stress health and wellness more holistically, so other products including vitamins, grooming supplies, toilet paper, gloves and masks were also handed out, thanks in part to the campaign’s partners including Procter & Gamble, Matthew 25 Ministries, supermarket chain H-E-B and TWC Logistics Trucking. 

Cars lined up at an #IDIDMYPART testing site. COURTESY OF BEYGOOD/#IDIDMYPART

“People are getting upset when they see people with no mask on, but a lot of people just don’t have them,” says Knowles-Lawson.

That the campaign took place on Mother’s Day weekend was just a coincidence, but was still a fitting time for the mother-daughter collaboration to launch. Knowles-Lawson, who grew up impoverished in Galveston, Texas, has always sought to instill the give-back mentality in her daughters, Beyoncé and Solange. “It was five kids at home, and my sister had eight children, and they were always at our house—our little two-bedroom house,” recounts Knowles-Lawson, with a laugh. “But my mom could stretch a piece of steak. She just shared all the time. I never forgot that.” Once they were old enough, Beyoncé and Solange were continuing the family’s acts of service, spending their Sundays feeding Texas’ homeless community after church. 

A sign at the #IDIDMYPART testing site. BEYGOOD/#IDIDMYPART

Beyoncé’s also teamed up with Twitter CEO Jack Dorsey to donate $6 million in support of mental health and wellness organizations in Houston, New York, New Orleans and Detroit.

And the #IDIDMYPART campaign isn’t limited to Houston. It’s challenging other celebrities to continue the initiative in other cities nationwide. Several have already answered the call. Tyler Perry has vowed to implement the initiative in Atlanta, Octavia Spencer aims to set up sites across Mississippi, and Cookie and Magic Johnson will lead the charge in Detroit.

“Nothing would make me happier than to see people use their platforms to get this information out,” says Knowles-Lawson. “People are getting testing who wouldn’t otherwise. We can keep the momentum going.”

Brianne Garrett, Forbes Staff, ForbesWomen

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