It is no secret that women and girls are undergoing unsafe abortion in Malawi, where abortion is illegal. Experts have argued that the situation costs government millions of kwachas, as it is more expensive to treat a post-abortion case than it is to prevent it.
During a debate by Coalition for Prevention of Unsafe Abortion (Copua) in Mzuzu last month, Dr Grace Chiudzu, an obstetrician/gynaecologist, confirmed this.
“Three women died of unsafe abortion complications at Kamuzu Central Hospital (KCH) last month. The reason was that they could not endure the shame of keeping the pregnancy,” said Chiudzu.
She said the first case delayed to report to the hospital which is a typical case of fear and shame for women who abort in clandestine environments often without the help of skilled health workers because the law bars them from seeking abortion.
“She was very sick. We tried to look for blood to save her life, but we couldn’t get any. It was sad seeing her die,” she further said.
She said the second was suffering from perforation of the uterus while the third died from heavy bleeding.
It is such loss of life that results from the fear and shame of raising a child without a father which, according to Chief Lukwa of Kasungu, justifies the need for introducing penalties for men who refuse to take responsibility for pregnancies.
Lukwa says when a man refuses to take responsibility for pregnancy, it is a form of gender-based violence (GBV); therefore, it should be punished.
This was discussed during a recent debate in Blantyre organised by Copua and the Malawi Human Rights Commission (MHRC) on whether Malawi should legalise abortion.
What baffles him most is what he calls the attitude of Malawians who hide behind religion and culture to disown pregnancies, leaving women helpless.
“The new Gender and Equality Act and President Joyce Banda’s Safe Motherhood Initiative will mean nothing if such men are not held accountable,” says Lukwa.
The chief says keeping a pregnancy whose father is not known is a taboo in most communities. Thus, when most women are raped or their partners deny responsibility of a pregnancy, they resort to unsafe abortion.
“Women and girls opt for unsafe abortions when their partners deny responsibility. This is what we have to deal with apart from legalising abortion,” says Lukwa.
Although abortion is illegal in Malawi, a 2010 study by the Ministry of Health with support from Ipas and the World Health Organisation (WHO) reveals that 70 000 Malawian women have abortions every year, out of which over 30 000 are treated for complications arising from unsafe abortion.
Ministry of Health spokesperson Henry Chimbali says it is estimated that around 17 percent of unsafe abortions contribute to maternal mortality in Malawi.
“Abortion is offered in very special circumstances as determined by a medical practitioner. As government, our priority is the provision of youth friendly services so that all youth have access to SRH care. We have also increased access to contraceptives so that women avoid unwanted pregnancies, Chimbali says.
If the UN estimates that 17 percent of maternal deaths are due to unsafe abortions, are anything to go by, then Malawi’s chances of attaining the MDG on maternal health are far-fetched.
The UN adds that many women get unwanted pregnancies because they cannot access contraceptives, among other factors.
According to government, deaths resulting from unsafe abortion are one of the primary causes of maternal mortality rate, which is currently at 675 deaths per 100 000 live births.
In addition, 30 percent of all admissions in gynaecological wards are due to unsafe abortions. Statistics from the biggest referral hospital in the Southern Region, Queen Elizabeth Central Hospital (QECH) in Blantyre, show that almost half of the women treated for post-abortion complications are younger than 25 years old.
Dr Phylos Bonongwe, a gynecologist at QECH, says there is need for updated laws, so as to criminalise irresponsible men and also legalising abortion.
He believes having enabling laws will prevent unnecessary deaths from unsafe abortions.
“It will also save government resources,” Bonongwe says.
According to a cost impact study which the Ministry of Health, public hospitals and health centres spend an estimated cost of K300 million ($494 000) annually to treat women with post-abortion complications. The study says rural women are estimated to spend double or triple to obtain an abortion compared to urban women.
The country’s Contraceptive Prevalence Rate (CPR) is at 42 percent, which means 58 percent of women do not use contraceptives although they need them, which results in unplanned pregnancies.
Lukwa, who is also member of Copua, insists that while legalising abortion would ensure good health for women and girls, there is need to punish men who deny responsibility.
“This is a good issue for debate because for a long time, we have used colonial laws which need to be changed,” says Lukwa.
Sun shines on forest women
Chintapakka Jambulamma, 34, looks admiringly at a solar dryer. It is the prized possession of the Advitalli Tribal Women’s Cooperative Society—a collective of women entrepreneurs that she leads.
She opens up a drawer in the dryer, scoops out a handful of the medicinal plant Kalmegh and exclaims: “Look, it’s drying so fast.”
“We work hard, gather good quality herbs and seeds. Our life depends on this money. Why should we settle for less?”
Around her, women from the cooperative break into laughter. The women are from the Koya and Konds tribes in the Eastern Ghat mountains of southern India. The forest has always been their home and their source of sustenance. Now, these women are tapping the sun that shines through it.
The solar dryer has four panels attached. It was installed two years ago by the Kovel Foundation—a non-profit group that helps forest tribes defend their rights and improve their livelihood.
The dryer—one of the two such machines installed by the foundation so far, cost about a million rupees ($17 000) says Krishna Rao, director of the foundation.
The investment has been worth it, he says, because the women are using it to run a business sustainably. “There are 2 500 women from 20 villages in the cooperative. None of them have studied beyond the junior school. Yet, they know how to run a business well,” Rao tells IPS.
“They are organised and work well as a team. Also, they are learning how to collect the roots, leaves and fruits without harming the mother plant, so that their resources don’t run dry.”
The forests of this region yield over 700 non-timber forest products that include leaves, edible herbs, medicinal plants, fungi, seeds and roots. Most popular among them are honey, gum, Amla (Indian gooseberry), Tendu leaves, Mahua flowers and soap nuts.
Koyas and Konds have made a living for centuries off such forest products. Penikala Ishwaramma, 23, is one of the herb gatherers. On a good day she gathers 20-25 kg of herbs. This year there is a bumper growth of the kalmegh herb in the forest, and Ishwaramma has gathered 116 kg of it.
“We work hard, gather good quality herbs and seeds,” says Ishwaramma. “Our life depends on this money. Why should we settle for less?”
Besides establishing a clientele, the women are planning to upgrade their technology. Krupa Shanti heads five forest villages in the area. Shanti says she is proud of the women’s cooperative and would like to see it grow bigger.
The government has installed a solar photo voltaic station at a nearby school that can convert and store solar power. Shanti is lobbying authorities to install one such station in her village.
“The government has so many welfare schemes. But for forest women like us, the best scheme is one that will help us become economically independent. If the government installs a solar charging station in each of our villages, we can expand this business and change our future.”—Ips