Nairobi — As the country waits with bated breath for a new coalition government after two months of post-election violence, focus is shifting towards an estimated 1,200 victims of sexual assault, who include women and men as well as girls and boys.

And the emerging debate revolves around the emotive question of whether or not women who become pregnant as a result of rape should be allowed to abort or endure carrying their unplanned and unwanted pregnancies to term.

In an International Women's Day media report, a family planning official is quoted lamenting that the Kenyan law on abortion does not address gender violence such as rape or incest.

"The law is not flexible," Sarah Onyango of the Planned Parenthood Federation of America - International is reported to have said.

African states

Data from the US-based Centre for Reproductive Rights indicates that only 16 out of 62 African countries allow abortion in cases of rape.

They are: Mali, Sudan, Benin, Burkina Faso, Cameroon, Eritrea, Ethiopia, Guinea, Togo, Zimbabwe, Botswana, Ghana, Liberia, Namibia, Seychelles, and Swaziland. An even smaller number - Mali, Benin, Burkina Faso, Eritrea, Ethiopia, Guinea, Togo and Zimbabwe - allow abortion in cases of incest.

While genuine queries arise as to why women who have been raped should not be allowed to abort, inquiries among the medical fraternity in the aftermath of post-election mayhem indicate that chances of becoming pregnant from mass rape are slim.

According to Dr Jean Kagia who is a founder member of the Institute of Family Medicine, chances of becoming pregnant from mass rape are less than one percent.

"Some of those women will already be pregnant; others will be too young to be pregnant; others will be too old to be pregnant, while others will be using a method of contraception."

And because of the trauma and shock of rape, she adds, the rapist hardly ejaculates into his victim.

"If you take specimens of people who have been raped, in very few of them will you find sperms."

According to the obstetrician and gynaecologist, psychological issues surrounding rape make victims less likely to conceive.

And, apart from the small pool of likely candidates for abortion, the procedures required to sustain a case of rape in defence of an abortion are so rigorous as to almost rule out such justification, according to the dean of the School of Medicine at the University of Nairobi, Prof Zipporah Ngumi.

"We don't give a prescription in mass rape; individual cases are treated differently."

According to a Nairobi consultant obstetrician and gynaecologist, Dr Stephen Njogu, any future prescription for abortion can only hold if rape was determined in the first instance.

"As a doctor, you get the history that she has been sexually assaulted. How she looks like, inthe first instance, is very important," Dr Njogu said.

The checklist, he said, includes the look of the victim's clothes.

Are they dirty? Are they torn? Bodily injuries, even before examining the victim's private parts, are also an important indicator of rape, he said.

"It's very important to take specimens of any semen that can be seen, and the earlier they are taken, the better," Dr Njogu said.

The doctor stresses the importance of taking specimens, saying: "These days there is even DNA testing, which can help nab the culprit."

The importance of a thorough examination is confirmed by medical literature.

According to Jantje Wilken and Jan Welch in a March 2003 article in the British Medical Journal, forensic examination is aimed at collecting evidence for use in criminal justice processes, including documenting injuries and samples for DNA and toxicology.

"It involves a "top to toe" survey as well as genital examination undertaken by a doctor or nurse with special training, such as a sexual offences examiner, whose sex is acceptable to the client," they say.

"Retrieval of DNA is maximised by conducting the examination as soon as feasible after the assault, and advising the client not to wash, drink, or eat (depending on the orifices involved) until samples have been taken.

"Police officers can collect urine samples and mouth swabs, thereby minimising the client's discomfort while waiting as well as increasing the chance of detecting drugs excreted in the urine.

"If more than seven days have elapsed since the assault sampling for DNA is unlikely to be productive, but documentation of injuries may still be relevant," Wilken and Welch say.

It is equally important to deal with the trauma arising from rape, including physical injuries in the private parts.

All the sources interviewed stressed the need to cover the victims with broad spectrum antibiotics, to ward off sexually transmitted infections; with antiretroviral drugs to prevent HIV infection; and with the morning after pill to prevent pregnancy.

During an interview with Ms Rahab Ngugi, the patient services manager at Nairobi Women's and Children's Hospital, she said that their gender violence recovery centre had handled 341 cases of post-election rape - more than a quarter of the 1,200 reported countrywide.

According to Ms Ngugi, 148 of the victims were below 18 years, and the adults above 18 years were 258.

"We saw children as young as one and a half years and women as old as 65 - 60 years who had been abused."

A later report from the same hospital put the number of violence survivors at 443, with rape victims accounting for 356 of who the youngest victim was nine months old.

Postinor-2 - a morning after pill - was administered to all raped women who reported to the hospital. The drug is readily available in pharmacies.

Handle cases

"It is a contraceptive that you give immediately within 72 hours (of rape) to help prevent conception," Ms Ngugi said.

So, what does the hospital plan to do with women who may have become pregnant from the mass rape?

While it would be assumed that the hospital that has distinguished itself for handling cases of gender-based violence would champion routine abortion of rape victims, the Nation established that it is run on pro-life norms.

Ms Ngugi explained: "We are anti-violence, and so we believe that terminating life - abortion as it were - is violence in itself. We can't say we are a gender violence recovery centre when we go into termination of life.

"However, we encourage people to make individual choices. So, if you came here and you felt that this (abortion) is the way for you to go, you will not be condemned. You will be referred; you will be supported for your decision, but as an organisation, we cannot carry out termination of a pregnancy

"Because of the nature of our work, we do not go that (abortion) route because we believe that the child has a right to live," she says.