HEALTH-COTE D’IVOIRE: Abortion – Illegal, Sought After, Sometimes Fatal

By Aly Ouattara Reprint | | Print |

Aly Ouattara

SEGUELA, Côte d'Ivoire, Aug 23 2006 (IPS) - Poverty, civil war, fears of religious persecution: any one of these can push women to have abortions. In Côte d’Ivoire, however, all of these factors are present, leading to what some claim are substantial increases in the termination of pregnancies.

This is despite the fact that the procedure is illegal in this West African country. A 1981 law condemns those who carry out abortions and their assistants to five years imprisonment – and fines ranging from about 300 to 3,000 dollars.

Sixteen-year-old Korotoumou Bakayoko was just one victim of the perceived increase in abortions. The parents and friends of the former high school pupil gathered recently to bury her at the municipal cemetery of Séguéla – a town in the centre-west of Côte d’Ivoire.

“She died as the result of an abortion. She was three months pregnant, inconspicuously so, and had decided to end it without her parents knowing,” Massandjè Bakayoko, a cousin of the deceased, who was Muslim, told IPS.

The eldest daughter amongst five children, Bakayoko had feared her condition might bring shame on her family, as Islam frowns on pregnancy outside of marriage.

On the advice of friends, she attempted to abort her baby using tree bark, roots and pieces of glass ground into powder – but this only succeeded in making her bleed internally. Ultimately, she slipped into a coma.

The situation was worsened by the fact that the hospital in Séguéla was not able to provide her with proper care.

“She was already in a critical condition, and the hospital lacked the right medical equipment. We could not avoid the worst,” François Ignace Kobénan, a nurse who was amongst the first to treat Bakayoko, told IPS.

This absence of supplies, he added, was prompted by the years of uncertainty that followed an armed uprising of 2002 that divided the West African country into a rebel-held north and government-controlled south. The rebels took up arms to fight against the alleged exclusion of people living in the north.

“Clandestine abortions have attained dangerous levels in our hospitals during these four years of crisis, both on the rebel and government side,” says Dr Lassina Sanogo, a general practitioner at the central hospital in Bouaké, where rebels have their headquarters.

A study conducted in 2005 by a local non-governmental organisation (NGO), ‘Objectif santé’ (Goal: Health), showed that 34 percent of the 2,400 women interviewed for the survey had undergone at least one abortion.

In the north, it added, 70 percent of abortions were carried out under safe conditions on girls and women aged 13 to 24, with the agreement of their parents or partners.

“It must be noted that there are…forms of secret terminations of pregnancies which are safe, done by doctors, nurses and midwives in hospitals and maternity wards in our country and other West African countries – for big sums of money,” Zana Sanogo of the NGO ‘Programme de santé communautaire’ (Programme for Community Health), based in Korhogo in northern Côte d’Ivoire, told IPS.

Dr Logozeni Diabaté, who practices at a medical centre in the Séguéla region, estimates that the procedures can earn those who perform them between 50 and 100 dollars.

“All the world knows it, but no-one dares speak of it because Ivorian legislation – like legislation in other countries in the sub-region – bans abortion,” he noted. “It’s (just) when it goes badly that the world is informed.”

The remaining 30 percent of persons who sought abortion in the north, however, were obliged to have backstreet procedures that often led to complications, some of them fatal.

On average, three of every ten girls and women dealt with by the healers, medicine men and nurses operating as casual workers who are typically consulted in these cases died, or found themselves affected by sterility and other problems.

Aristide Kouamé Kobénan of the NGO ‘Santé pour tous’ (Health for All), based in Toumodi, a town on the edge of the buffer zone that separates rebels and government forces, highlights the role that poverty plays in abortion.

“A pregnant girl, rejected by her partner and parents, without psychological support, does not hesitate to have a clandestine abortion.”

Similar words come from Amadou Sidibé, assistant to the Ivorian minister of social affairs.

“In Abidjan (the economic capital) in the south of the country, new borns are currently found dead, wrapped in plastic and abandoned in public rubbish bins,” he told IPS.

Massive displacement of people from the north to the south of the country as a result of conflict has added to the number of clandestine abortions and abandonment of new-borns in bins and public places, say certain midwives.

“It would be better to legalise abortions, even if they are condemned by certain religions, so that they can take place under the required medical conditions, to avoid the death of young girls or women as a result of abortion – or sterility due to terminated pregnancies,” says Zana Sanogo.