Tag: abortion

Sex education: What Nollywood and sermons don’t teach

(Pic: Flickr / Nollywood Artist)
(Pic: Flickr / Nollywood Artist)

Positive parenting had began to gain popularity among parents and teachers in the small Nigerian town of Sapele where I grew up, and my school was not going to be left behind.

So, every Valentine’s Day saw us assembled in our school hall to be treated to a film screening. Somehow, my teachers always managed to find the same kind of Nollywood story: good girls who kept themselves pure in the midst of the moral morass of youth and married handsome, wealthy men who loved them dearly for their virtue and would do anything to have them.  In the late 1990s, the whole film show business seemed like such a big deal. But did it occur to anybody to question the choice of Nollywood as a viable Sex Ed aid? I I don’t think so.

Before the film played, it was mandatory that we live through 30 minutes or so of reorientation. The big colour television, placed at the centre of our school hall, would be on, the blue screen waiting, while a teacher – preferably the most religious or the most willing/concerned – talked to us about our changing bodies. By an unspoken consensus, on days like this – on other days too, but especially on days like this –  everybody tried to avoid the use of certain words. And, standing in line, my breath held, my self-comportment overstretched, it was easy to understand why.

Those words, in their raw carnal forms, had terrible pitfalls. We had seen it happen many times; girls we knew, swallowed whole by the scotching intimacy of carnal words. Girls who knew about breasts and hips. Girls who we could tell, just by looking at them, that they were doing ‘it’. Girls who became pregnant. The general impression being that good girls just did not notice their bodies.

For the same reason that these words could just not be said, these films we saw were less about whatever narratives they managed to have and more about the overarching message. That narrative was: Good girls wait and are rewarded, bad girls end up with babies on their backs walking the streets looking lost. Good boys graduate, get great lives and have beautiful families, bad boys end up unfinished and angry at the world.

Then one year, our ‘exposed’ Home Economics teacher brought back a new movie Yellow Card (Zimbabwean) from one of her trips to Lagos. That film represents for me, to this day, a kind of epiphany.  At school that day, I saw a story that was by miles different, unnerving even, but possible. I saw young people who were preoccupied with sex but also preoccupied with education and careers. It showed them making mistakes but also it showed them trying to make better choices. And for showing this, that sex was not so much the problem as much as poor sexual choices were, for attempting to move the frame of conflicts to a flexible one, the whole positive parenting film show thing became suspect.  Our teachers feared we would become confused. And so, the whole film-screening campaign with its preemptive concern for possible life-altering choices was quietly shelved.

If campaigns to improve sexual and reproductive health education has done anything well in the last couple of decades, it is that it has increased the willingness of parents, schools and religious bodies to talk to about sexual and reproductive health. In communities like the one where I grew up, and perhaps communities like it mirrored all through Africa, this is how you mostly learn sex education: from well-meaning people in churches and schools who would designate whole programs to “talk to the young people about sex”, but deliberately neuter or thwart the message in the “best interests” of young people.

Recently, I attended a church program where the guest speaker, a woman from a religious NGO, insisted that “the computer age” was directly responsible for the proliferation of abortions in young girls. And as I sat there listening to her say these things in her confident, measured voice, I was not worried by the certainty of her illogic. It was the readiness, gratitude almost, with which the audience swallowed this rare information that worried me. The nature of information that was disseminated is problematic, perhaps enough to be counter-productive?

The statistics around abortion appear conflicting. Certain research shows that this conservative approach to sex education led to better sexual behaviour. Other research shows that it did not reduce the abortion rate. And that worse still, the numbers of unsafe abortions in countries like Nigeria are as high as ever. While this says nothing definitive about the challenges that apply to the methods of Sex Education currently practiced in Nigeria and other African countries, enough information exists that draws attention to the inadequacies of the approach.

From school lessons in the 1990s to school lessons now, SEX = SIN is the form of sex education that young people are getting, instead of the more pertinent ‘there are safe ways to have sex’. This is mostly because Nigeria, like much of Africa, is a highly religious space, where your Sunday School teacher most likely doubles as your concerned/willing school teacher, so there is the unavoidable problem of an overlap of the same kinds of sermonised sex education everywhere.

The dangers of going out to seek or buy protection can still seem as big and as real as the dangers of reckless, unsafe sex in certain communities. And this sermonised form of Sex Education which very often equates the emphasising of condom and contraceptive use as promoting irresponsibility, if anything, contributes to the entrenchment of conservative ideas in communities that are already too conservative.

Sex education is everywhere; on billboards, on TV, in churches, in schools, but it is still a long way from being about the simple and most basic thing: the right to protect yourself. It is yet to transcend religion or what I am willing to telling you. It is yet to be about life, about safety, about options.

Kechi Nomu writes from Warri, Nigeria. Her poems have appeared in Saraba Magazine and Brittle Paper.

Ethiopia’s game-changing abortion law

(Pic: Flickr)
(Pic: Flickr)

After decades battling high maternal death rates – at least a third of which were due to botched abortions – Ethiopia took a stand: it prioritised newborn and maternal health, and in 2005 it relaxed its abortion law in an effort to save women’s lives.

Stopping short of legalising abortion, the new law decriminalised the act. It also allows women to terminate pregnancies that result from rape or incest, if the foetus has a severe defect, or if a girl is under the age of 18 and cannot care for the baby herself. Before 2005, a woman could only have an abortion if it was a matter of life or death.

“Anecdotally, I would say [the law] has had a huge impact on saving lives of girls and mothers,” said Addis Tamire Woldemariam, general director for the minister of health, but he said he did not have official numbers on the law’s impact. The latest statistics available are from 2008, which show that 27% of women who sought abortions in Ethiopia did so legally and safely. That still suggests more than 70% of abortions were done in unsafe conditions by untrained providers, but before 2005, that figure was much closer to 100%.

“Before, women would drink a tea made of plants to induce abortion,” said one health extension worker in the northern village of Mosebo. The women would then have extremely painful cramping followed by heavy bleeding – too heavy, she said. “It is much better now. We encourage them to go the health centres or clinics.”

Lack of access
But one major reason women are not getting safe abortions is that most Ethiopians live in places even less accessible than Mosebo, which is just off a bumpy gravel road that stretches 43km to the northern city of Bahir Dar. Getting to a health facility that provides abortion care is extremely difficult.

In Ethiopia’s capital Addis Ababa, Dawit Argaw owns a Blue Star Clinic – a private health facility partnered with Marie Stopes, a global provider of newborn and maternal care, contraception and safe abortions. He explained that if he did not perform the abortions women sought at his clinic, they would just end up choosing a dangerous option. “The main reason that we do this is that we have seen so many complications [from abortions performed illegally], by [untrained] persons,” Argaw said. It used to be common that women would come to his clinic with puncture wounds or severe infections from botched abortions. “But since 2009 [four years after the new law was implemented], we have seen this maybe two or three times.”

While the vast majority of women seeking abortions are still getting them through unsafe means, in large cities like Addis, women can get to clinics and doctors more easily.

But women’s health is also helped by increased access to contraceptives, and the number of women who have unwanted pregnancies is in decline as more women use birth control. “Ten years ago, contraceptive prevalence was 6%, and the most recent figures are at 40%,” Woldemariam said.

Grateful for the service 
At the Marie Stopes Clinic in Addis Ababa, a woman sits in a small room with a desk, a bed with stirrups attached and a thin curtain. Here, she receives contraceptive advice. “We consult with her and have her choose a family planning method before she receives the abortion care,” Sister Tihish, the nurse, explains. The patient, who withheld her name, also did not disclose how she got pregnant, “but many of the cases we receive are because of rape,” the nurse says.

In cases of rape or incest, women are not required to give proof. Woldemariam of the Ministry of Health said making a woman relive the psychological trauma of rape by asking for evidence would be “immoral” and “inhumane”, so many abortion-providers have adopted a “don’t ask” policy. For many, that leaves a gaping loophole in the law and gives women a way to get abortions for reasons beyond what is legally allowed.

Dr Seyoum Antonios vehemently opposes the abortion liberalisation. The general surgeon explains the requirements are far too lax. “You look at the books at these clinics and all of them say `rape, rape, rape’ with no proof,” he exclaims. “My country is being painted as a land of rapists.”

But for 29-year-old Khadija Ali, who asked that her real name not be used, access to an abortion was a matter of life or death. “I was working as a housekeeper in Bahrain when my employer raped me,” she explains, wringing her hands in pain from cramps as the abortion pills she took a few hours earlier took their toll. “I became pregnant, and immediately returned to Ethiopia because no one could know it happened, or else I would be seriously hurt or even killed.”

Her friend told her about the Marie Stopes Clinic, which provides abortion care and contraceptive counselling. “I am very glad,” she said, for the service. Still, Khadija says she will never tell anyone – including her husband – what happened, and definitely not about the abortion.

Social stigma reigns 
Khadija is not alone in keeping her silence. “This is something very sensitive in the community,” Woldemariam said. “I mean people practice it, but they do not want to talk about it,” which is fine, he said, as long as women are getting the care they need.

The vast majority of Ethiopians are socially and religiously conservative within their respective beliefs. Orthodox Christian leaders, who have the most followers in Ethiopia, are willing to privately consult families on family planning but would never discuss abortions. That is the case with almost all communities, Woldemariam explained.

A local priest in Mosebo village said that is how he advises families and what he practices in his own family. “Children are a gift from God, but having more children than you can feed is an even bigger sin,” he explained. Magadesa Mugeda, a resident of Mosebo pregnant with her second child, agrees. Her daughter was born five years ago, and she used an injectable contraceptive to plan her family. “With our land and our resources, we could not afford to have more kids,” right away, she said.

When asked about abortions, Mugeda immediately tensed up. “I do not know or care to discuss these things.”

Abebe Asrat, a no-nonsense midwife at the Marie Stopes clinic agrees with Mugeda. “Do not ask me what I think of government policy,” when it comes to abortions she said. “Almost everyone is against abortions… but we do what we have to,” she explained. There are alternatives, she insisted: women should be encouraged to use contraceptives and family planning methods to prevent the whole ordeal.

Argaw said if he did not see that safe abortions saved women’s lives, he would have a harder time accepting how his work was conflicting with his religion. “Religiously [abortion] may be forbidden. Even in my religion it is forbidden. But for me as a human being I accept it [is necessary],” he admits. “So that is why I do it.”

The tragedy we found in Tuesday’s trash

It’s another pretty day in Ngong with clear skies and chirping birds. Jackie, the newest member of my circle of parenthood help, has just returned home from fetching my son Shaka, who is three months away from turning five. As I open the gate, she says to me: “Mama Shaka, kitu kimefanyika!” Something has happened.

Tuesday is rubbish collection day in our town, which is located in the Great Rift Valley near Nairobi. My family has lived in Ngong for over 20 years, and no municipal or county rubbish removal initiatives have existed during this time. So local entrepreneurs came up with their own trash collection initiative, a service that we use at the moment. On this warm, summer’s day we put our trash out as usual for the truck to collect.

Jackie lives about 50 metres from my childhood home, and just 10 meters from the pile of trash at the end of our street. At 30 she is no shrinking violet, but she doesn’t say much. Today, however, she is more excited than usual. She tells me that a little baby boy has been found on top of the pile of rubbish. I don’t understand. Where is the child’s family, I ask? How do you tell a child to sit on a pile of rubbish? Jackie says she doesn’t know. No one knows. All they know is that the little baby was wrapped in a curtain and left there. A curtain. Now it makes sense. The little baby was aborted and dumped along with Tuesday’s trash.

While rummaging through the rubbish, a street child had found the aborted baby. It was a baby, not a foetus, because this abortion was carried out very late into the pregnancy. Jackie tells me that the child had all its parts – all it had to do was grow. She reckons it was five months or older. She laughs as she relates this to me, but her laughter is not out of malice or insensitivity. Like many others, she just didn’t know what else to say or do.

I ask Jackie why no one called the police. She says someone has to go to the police station and write a statement before they would come and collect the body. I want to do this – but with the law enforcement system here, there’s a chance that I would be questioned, and even suspected of the backstreet abortion. I’m a single mother, with no important surnames that can offer me any kind of protection, and no husband to come vouch for my moral worthiness. Saying the wrong thing at the wrong time to the wrong police officer would get me into trouble.

I go to cover the body. It is placed at the side of the road where children pass by on their way home from school. They do not need to see that. Worse still, they do not need to hear the conversations vilifying the woman or girl that had aborted the baby, and shaming the faceless and nameless doer of this ‘evil’. Someone ventures that they know whose curtain the baby is wrapped in – but fortunately a witch-hunt is not called for. In places like Ngong with slow justice systems and even slower delivery of public services like police protection, the people’s thirst for due process comes fast and furiously.

Abortions in Kenya
Kenya has one of the highest abortion rates in the world. Over 460 000 abortions were carried out in 2012 alone, according to research by the African Population and Health Research Centre (APHRC). The majority of these were due to unwanted pregnancies. Another survey revealed that more than 2 500 Kenyan women die annually from complications arising from unsafe abortions carried out by unqualified medical practitioners. Kenya relaxed its abortion laws in the new Constitution that passed in 2010. Before this, abortion was illegal unless except to save a woman’s life – and  in this case, three doctors would have to approve a woman’s request for one. The new Constitution gives healthcare practitioners more latitude to determine when an abortion can be carried out. But as you can imagine, if the decision to grant a woman or girl an abortion lies in the hands of a healthcare professional, this leaves a lot to chance. Many Kenyans are still largely conservative when it comes to discourses on abortion, and chances that a nurse in a rural village will grant a 15-year-old with an unplanned pregnancy a requested abortion are very slim.  Commenting on the APHRC report, researcher Dr Elizabeth Kimani said that there is still a lot of stigma in Kenya around access to abortion as a reproductive health right for women. The government is dragging its feet in upgrading not only the facilities to carry out abortions, but also initiatives to sensitise health care professionals on why there’s a critical need for conversations about abortion in the country.

(Pic: Flickr / Damien du Toit)
(Pic: Flickr / Damien du Toit)

Ten years ago, when I was in high school, I was subjected to a mandatory pregnancy test after what the school authorities found what they suspected was an aborted foetus  in one of the dormitory bathrooms. The test was not a pee-on-a-stick type test. The school nurse carried out a vaginal exam, pressed down on my abdomen, and squeezed my nipples – to check for milk production, I guess. It was humiliating to say the least, and all the girls – nearly 1000 of us – had to undergo this. I could not imagine how or with what a fellow student could have carried out that suspected abortion. According to 2012 report by Kenya’s human rights commission, women take overdoses of anti-malaria medication or insert sharp objects like knitting needles and sticks into their bodies.

Back in Ngong, I dared to think about the woman that had just aborted this baby. She wasn’t a statistic in a report far away – she lived in my neighbourhood, she was close enough for me to have maybe met her or even spoken to her. Was she okay? Was she alone? Did she have help? Was she slowly bleeding to death in a little flat somewhere? Had she been raped? Was it an unplanned pregnancy? Maybe it was a case of incest, or maybe it wasn’t. To attempt a backstreet abortion this far into a pregnancy was an act of despair and desperation. The young woman or girl who did this really had no other choice. She didn’t. The people gathered by the side of the road did not ask these questions – all they saw was an aborted child, dumped on top of Tuesday’s trash.

I am unapologetically pro-choice. Restrictive laws and harsh social systems leave women and girls with such few options and virtually no bodily autonomy. And this goes beyond just the right to have safe abortions – it begins with a woman’s or a girl’s right to decide what happens to her body. A lot of underage sex is coerced and transactional. Many unplanned pregnancies are unwanted, even in marriage and in situations of perceived social stability. There’s no safety anywhere as far as women’s and girl’s bodies are concerned.

While society, religious organisations and indeed governments attempt to put their best moral foot forward, the reproductive and health rights of women and girls continue to suffer. And this suffering is not left to the women and girls alone – society suffers too. Women, men and children had to see an aborted child dumped on the side of the road, and the traumatic effects that witnessing such a sight can have on them goes ignored. As a passionate advocate for the right of women to choose, it was a humbling moment when I realised that these ‘issues’ are not happening  ‘out there’ – they are happening right outside my front door, right on top of Tuesday’s trash.

*This post was edited to correct the number of abortions carried out in Kenya in 2012.

Sheena Gimase is a Kenyan-born and Africa-raised critical feminist writer, blogger, researcher and thought provocateur. She’s lived and loved in Kenya, Tanzania, ZimbabweZambia, South Africa, Botswana and Namibia. Sheena strongly believes in the power of the written word to transform people, cultures and communities. Read her blog and connect with her on Twitter.