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HEALTH-NAMIBIA: Illegal Abortions Common Despite Risks

Patience Nyangove

WINDHOEK, Oct 7 2009 (IPS) - Ten years ago, a move to legalise abortion in Namibia failed. The number of unwanted pregnancies remains high, with many people unwilling or unable to use contraception. Despite the risks, illegal abortions remain common.

Misoprostol – a drug used to control ulcers, more usually known by the brand name Cytotec – has become a favoured method for inducing abortion.

The drug costs around $14 U.S. dollars per tablet from a pharmacist and is readily available on the streets of Windhoek. Medical doctors who conduct abortions illegally using the drug charge between 140 and 200 U.S. dollars.

Twenty-two year-old Monisha (not her real name), a student at University of Namibia, decided to have an abortion because her boyfriend is a married man and hence could not marry her.

"My parents would have killed me if they had found out that I was made pregnant by a married man, who can't marry me," she says. "I am also not ready to be a mother, I am still a student."

She was two months into the pregnancy when, with the help of a friend, she bought five Cytotec pills from a drug peddler in Windhoek's Khomasdal suburb.

Monisha says she was charged $113 for the pills, and instructed by the drug peddler to insert three of the tablets into her vagina and swallow two. He told her that if developed any complications during the abortion, she should not seek treatment at health institution but rather come back to him for help.

Fortunately Monisha's pregnancy was successfully terminated without any complications. "It was like a bad period. Off course I felt some pain but I took some pain killers," she says.

Cytotec is classified as a controlled drug and by law should only be sold to people with a medical doctor’s prescription, however errant pharmacists are selling it to anyone who asks for it.

Merja (not her real name either) a pharmacist in Independence Avenue in Windhoek says she only sells Cytotec pills to people referred to her by friends.

"You can't just sell to anyone because you don't know who is a police officer or not. It's quite a risky business but what can we do? We need the extra money and at the same time we are providing a service to our fellow desperate women need.

"It's not like we are killing babies, I only sell Cytotec tablets to those whose pregnancy is less than three months to minimise the risk of fatal complications," she says.

According to Merja she buys a packet of Cytotec tablets containing 56 pills for the equivalent of U.S. $50 and sells each tablet for $14, making a cool profit of 740 U.S. dollars per packet.

Merja says most of her clients are students from the university and the Polytechnic of Namibia.

Monisha's termination went smoothly but large numbers of women end up with a host of complications that include haemorrhaging when due to a torn cervix or punctured uterus says a medical doctor at Katutura State Hospital. (Doctors in the public health service are not permitted to speak to the press, so he spoke to IPS anonymously.)

The doctor says one of the most common complications that they deal with at the hospital include infections that develop when foetal parts are left inside the uterus.

"A pelvic infection may lead to persistent fever over several days and extended hospitalisation. It can also cause scarring of the pelvic organs," he says. The doctor says in severe cases some women have died because of back street abortions after excessive bleeding.

Minister of Health and Social Services, Dr Richard Kamwi said illegal abortions remain a serious health problem in Namibia with abortion-related deaths much more common among young women.

"It was also found that about one third of the deaths were due to septic and illegally-induced abortion most likely unsafely performed somewhere.

"Fifty-nine percent of the women dying of abortion related complications were under the age of 25. This is consistent with other reports that increasingly young people resort to unsafe abortion or even commit suicide because of unwanted pregnancy," Kamwi says.

Sam Ntelamo, director of the Namibia Planned Parenthood Association says baby dumping and infanticide is now an issue of concern in Namibia, although without comprehensive data, it is impossible to estimate the true extent of unsafe abortion as many cases are believed to go unreported.

"Even police statistics and anecdotal information suggest that the problem is a significant one," Ntelamo said. "We quite often hear of bodies of newborn babies retrieved at water works sites around Windhoek and outside. These are shocking revelations"

Ntelamo blames the surge in the number of abortion cases to a great number of youth failing to access reproductive health services.

In 1999, the Namibian government tried to legalise abortion, however it claims it was forced to abandon the law after the public opposed it. Government at the time said wide-ranging consultations with communities that included churches; radio phone-ins and letters indicated 99 percent of Namibians did not want abortion to be legalised.

Anti-abortion sentiment remains high. One Namibian interviewed by IPS feels that if government legalises abortion, this will fuel immorality.

"Abortion must never be legalised in Namibia, women will just wily nilly commit murder. Innocent babies will be killed, if our mothers had been given that opportunity to choose whether we should have lived or died then a lot of us would not be here. It's also so un-African," says Ndawana Hausiku.

Under Namibian law a woman can only have an abortion in cases of incest, rape or when the pregnancy is deemed a health risk to the life of the mother.

The director of Sister Namibia, a non-governmental organisation that deals with women's rights, Liz Frank told IPS that Namibia urgently needed to reform its law on abortion.

"That draft bill which was declined by the public a few years ago needs to be dusted off and retabled. There is need to embark on a campaign to educate the public on the advantages of legalising abortion in the country," she said.

"Currently the health ministry is spending huge amounts of money in cleaning up botched abortions, while so many women are dying or having life threatening injuries after undergoing backstreet abortions. Women should have access to safe abortion."

Presently only four African countries permit abortion on demand during the first trimester, South Africa, Guinea-Bissau, Cape Verde and Tunisia.

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