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

Published 3 years ago
By Forbes Africa

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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Related Topics: #abortion, #Featured, #illegal abortion.