27 July 2012

Zambia: Public Fury Over Abortions Justified

ABORTION is an emotive issue the world over, but it is one topic that calls for a sober and rational analysis to ensure that appropriate medical interventions that are taken to deal with this problem are based on informed opinion and are devoid of irrationality.

Secondly, it is important for medical practitioners in any given environment to peruse appropriate statutes and ensure that their prescriptions are in conformity with the law.

Marie Stopes-Zambia, a branch of the United States-based non-governmental organisation, Marie Stopes International, has had its abortion 'mission' abruptly aborted by the Ministry of Health following a public furore over 490 abortions carried out in Northern and Muchinga provinces.

This development stems from failure by the NGO to contract the services of a qualified local consultant who could have conducted a comprehensive survey to delve into all the salient issues the NGO needed to know prior to commencement of its work.

Although the public is aware that illegal and unsafe abortions outnumber those that are carried out legally, flouting the law with impunity cannot go unpunished, and cannot be condoned by any country. The ban is, therefore, justified.

In Zambia, abortions are regulated under the Abortions Act of 1972 which stipulates that three medical doctors with the requisite expertise should authorise an abortion before it can be carried out. In the case at issue, only one doctor conducted the abortions.

One of the prerequisites that had to be satisfied before a legal abortion was carried out was that the life of either the mother or the unborn child could be in imminent danger if the pregnancy was not terminated. It is unclear if this factor was considered.

Sadly, most abortions in our country are deemed illegal because they are premised on economic factors-most women, particularly the young and vulnerable, claim to have no capacity to look after their unborn children, while other cite differences with their partners.

This is a serious moral issue which anti-abortionists often raise. Pro-life movements believe that life begins at conception, and they have consistently argued that abortion is no different from murder.

What is unsafe abortion? The World Health Organisation (WHO) defines unsafe abortion as "a procedure for terminating a pregnancy that is performed by an individual lacking the necessary skills, or in an environment that does not conform to minimal medical standards, or both."

Statistics speak volumes about the magnitude of this problem in Africa, and globally.

The overall abortion rate in Africa, where most abortions are illegal and unsafe, showed no signs of decline between 2003 and 2008 with WHO statistics indicating that there were 29 abortions per 1,000 women of child-bearing age.

WHO further notes that in 2008, 97 per cent of abortions in Africa were unsafe.

"In the United States, legal induced abortion results in 0.6 deaths per 100,000 procedures. Worldwide, unsafe abortion accounts for a death rate that is 350 times higher (220 per 100,000), and in Sub-Sahara Africa, the rate is 800 times higher at 460 per 100,000â-'

Unsafe abortion is cited by WHO as a significant cause of ill-health among women in the developing countries, with estimates for 2005 indicating that 8.5 million annually experience complications linked to unsafe abortion that require medical attention, and three million of the victims do not get the care they need.

Beyond the immediate health concerns affecting women who contract unsafe abortions, there are other complications that arise such as reducing women's productivity, causing long-term health problems such as infertility, unnecessary maternal deaths that leave children orphaned, and added financial burden on public health systems.

All considered, abortion is not an issue that can be wished away by simply banning Marie Stopes-Zambia. A comprehensive review of current practice in Zambia is desirable in the light of what transpired in Northern and Muchinga provinces.

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