21 November 2012

Uganda: For Only Sh10,000 One Can Have an Abortion!

Photo: Newvision
Uganda spends an estimated U.S. $14 million on unsafe abortions every year, according to research. (file photo).

No clinic turned me away:

Sunday Vision-In Kampala abortion has become as simple as having lunch. Though illegal, the practice has become so rampant that most clinics no longer feel guilty about it. To prove just how easy it is, our under-cover reporter went to various city clinics feigning a pregnancy and virtually all of them were keen to perform an abortion for between sh10,000 and sh200,000. Here is her experience

At a clinic on Kiira Road, I paid sh15,000 for consultation before I could see a gynaecologist. When I told the medical specialist that I was three months pregnant and wanted to do away with the unborn baby.

"My boyfriend is not ready to father a kid," I said.

He answered: "My daughter, abortion is equivalent to murder. What if it is the only child God gives you?"

Despite sounding like a preacher, he accepted to do the abortion. He, however, said he had once faced a problem when he helped a woman to abort without her husband's knowledge. So, he really wanted to be sure that the father would not raise hell.

I asked him what kind of method he would use if my boyfriend allowed. "We have different methods. Since that baby is old, we would use a machine to open the cervix and pull out the foetus." He warned that the procedure might cause nausea, dizziness, vaginal bleeding and abdominal cramps for a few days.

At a clinic in Kalerwe on Gayaza Road, I told a nurse I was two months pregnant and wanted to abort because I was still a student. She asked me to pay sh60,000, adding that we would use pills. She sent her assistant to a pharmacy to buy some pills. She asked me to place three tablets under my tongue and undress so that she inserts a fourth one into my private parts.

"Does it have side effects?" I asked. She answered: "As soon as I finish inserting the tablet, you are going to pad yourself. After four hours, you will be bleeding as if and will experience some pain."

I told her I had to go for classes and could not wait for her to do the insertion. So I picked the three tablets and told her I would come back later.

I headed to Mpererwe where the medic blamed me for being irresponsible. I had told him I was a student of Makerere University.

"Since you are a university student, you can study with the pregnancy," he said.

Eventually, with more cajoling, he accepted to carry out the abortion on condition that I pay sh100,000. I told him I did not have that much.

"I am putting my job at risk because abortion is illegal and the pills are expensive."

I left.

In Bugolobi, when I told the doctor I was four months pregnant, he demanded to know who had directed me to him. "Why did you not use condoms? Why do you want to abort?" he fired at me.

He then told me that my pregnancy was too advanced for pills, so he would use a surgical method. He then gave me a brief lecture on the law on abortion: "Doctors are allowed to carry out abortions on women if they think their physical or mental health would be at risk if they went on to give birth. However, aborting just because you want to do away with the pregnancy is illegal."

He told me he would carry out the abortion at sh250,000. After a hard bargain, he said he would not take anything lower than sh200,000. He argued that due to his experience, I would not feel any pain or bleeding.

In Kavule, after paying sh10,000 for consultation, I waited for 30 minutes before the gynaecologist arrived for duty. Ironically, there were some Catholic magazines and books in the waiting area for patients to read and a picture of the Virgin Mary on the wall.

A rather short, light-skinned, male doctor walked in and found five of us waiting for him. In the doctor's room, I told him I was three months pregnant and I wanted to terminate it. Without further questions, he started explaining to me the kind of methods they use.

"We give out pills and for some women who do not want to bleed for so long, we take them to the theatre." He advised me to opt for the method of sucking out the foetus with a pump because I would go back to work the following day normally and nobody would notice. He told me that pills would make me bleed for long and it might turn out to be dangerous.

"Madam, our policy here is that we have to do a test to confirm the pregnancy," he said, adding that I would have to pay sh150,000.

Important to note:

Each year, an estimated 775,000 women in Uganda have unintended pregnancies. Over 50% are teenagers

About 300,000 abortions are carried out every year which translates to an annual abortion rate of 54 per 1,000 women aged 15-49.

16 women in Uganda die every day due to pregnancy-related complications, including crude abortion

Uganda spends sh7.5b every year treating post-abortion complications due to crude methods used


Girls more afraid of pregnancy than HIV

By Carol Natukunda

Many young Uganda women do not seem to worry too much about catching HIV or sexually transmitted diseases.

"With HIV, you swallow ARVs and nobody will know," says Claire, 16, "but pregnancy, the whole world will judge you. My parents would kill me! I would drop out of school!"

As such, it is not uncommon these days to find young women carrying the morning after pill in their bag.

On the other hand, the majority are not sophisticated enough to prevent a pregnancy, so they take chances and when the pregnancy comes, they go for an abortion.

According to a report issued by the US-based Guttmacher Institute in 2009, nearly 300,000 abortions are carried out in Uganda annually. To put it in perspective, the report states that out of every 19 Ugandan females aged 15-19, at least one will carry out an abortion in a year.

Unfortunately, most of these are girls in their teens and early 20s - about 54% of the unintended pregnancies are in this age group. A 2010 study, conducted by the Makerere University School of Public Health, among students from S.3 to S.6 in Kampala schools found that about one fifth of the girls - 21% - had ever aborted. The researchers sampled 54 mixed schools from all denominations, including private and government-owned.

This is not surprising because unprotected sex is common among Ugandan girls. The Uganda AIDS Indicator Survey 2011 report also shows that three quarters of Ugandan teenagers aged between 15 and 19 years are engaging in sex without condoms.

This means about 2.6 million teenagers are having unprotected sex. A total of 2,458 female teenagers aged 15-19 were interviewed as part of a broader survey covering 12,153 females and 9,588 males across the country.

Nearly half the teenagers (or 47.3%) disclosed that they had started having sex. Of the teenagers who were sexually active, 5% had more than one sexual partner. Surprisingly, according to the survey, teenage girls are having more multiple sexual partners than older females in their 20s, 30s and 40s, which probably explains why most of the abortions are among teenagers.

Molly Businge, who heads Kawaala Health Centre III in Rubaga division, reveals that seven to 10 out of 10 adolescents who visit the clinic have a sexually transmitted disease.

Regina Ssali-Mugabi, the nurse in charge of the HIV clinic at Kisugu Health Centre III in Makindye, blames it on pornography.

"After watching the movies, they want to try it out," Mugabi explains.

Many experts also blame parents for neglecting their role of teaching children about HIV.

"There is silence on sex both at home and school. Because we do not give information, doesn't mean that the youth do not have sex," says UNFPA's country director Janet Jackson.

Charles Zirarema, the director of Population Secretariat also agrees: "We assume that our children are young. But they are having sex."

Possible complications of abortion


Excessive bleeding

Failure to conceive again

Miscarriage at subsequent pregnancy

Psychological disturbance and flashbacks

Bacterial infections

Chronic abdominal pain

Embolism (blood clot in veins)

Torn uterus

Injury to the cervix

Reduced pleasure in sex

Sleep disorders

Memory loss

Difficulty in sustaining love relationships

Difficulty in bonding with children

Suicidal feelings

Indulgence in drugs and alcohol


Uganda an abortion battleground

By Carol Natukunda

Abortion remains contentious because it is illegal in Uganda. According to sections 136 to 138, 205 and 207 of the penal Code, any person, who with intent to procure the miscarriage of a woman, unlawfully administers any noxious thing, or uses any other means is subject to imprisonment for 14 years.

A pregnant woman who undertakes the same act, or consents to its performance is subject to a seven-year imprisonment. Any person who unlawfully supplies means to procure an abortion knowing that it is unlawfully intended for that purpose is subject to a three-year imprisonment.

Yet Section 217 of the same code says a person is not criminally responsible for performing an abortion in good faith and with reasonable care and skill for the preservation of the mother's life.

In addition, Section 205 of the code provides that no person shall be guilty of the offence of causing by willful act a child to die before it has an independent existence from its mother if the act was carried out in good faith for the purpose of preserving the mother's life.

Pro-abortion groups advocate for the right for a woman to abort. One of the groups, the Center for Reproductive Rights & Development, advocates for the right of women to abort in instances of rape, incest and when a woman's life is at risk.

The American-based Center for Reproductive Rights (CRR) recently came to Uganda to train reproductive health advocates on how to campaign for abortion within the existing legal framework. The training was preceded by a detailed study of Ugandan laws and policies regarding abortion.

The organisation advances the argument that abortion is legal in Uganda except that most people are not aware. The organisation advances the argument that "preservation of the mother's life" does not simply mean preventing the mother from dying instantly.

Rather, they argue, it includes protecting the mother from the physical, emotional and material distress that they would go through by carrying the pregnancy and delivering the child under difficult circumstances.

The CRR experts advised Ugandan pro-abortion advocates to use terms like "pregnant women" instead of "mother" and "foetus" instead of "unborn baby" to make their arguments more acceptable.

This broadened definition of "preservation of the mother's life" has not yet been tested in the Ugandan courts of law, but it is bound to attract much public debate. Anti-abortion groups won't take it lying down because they equate abortion to murder.

Speaking at the third anniversary of the Catholic Church-founded Pro-Life Movement recently, the Archbishop of Kampala, Dr. Cyprian Kizito Lwanga recently said: "The time is now for school girls to stop practising abortion, since life begins at conception. Aborting is the act of taking human life that has been conceived in a woman's womb, so it is akin to murder."

Anti-abortion groups cite scientific researches proving that the foetus is able to hear, have feelings and respond to stimuli. That explains why children grow up to like the music that their mother played most during pregnancy.

On the other hand, supporters of abortion argue that as long people think the practice is illegal, they will continue to do it in hiding and end up dying needlessly.

The Government spends sh7.5b every year to treat complications resulting from unsafe abortions. In addition, about 16 women die every day due to maternal health-related problems, including abortion.

If a woman wants to have an abortion, it does not matter what the law says. She'll have it anyway," Joy Asasira, a lawyer at the Centre for Women's Rights and Development told a conference of gynaecologists and obstetricians recently.

Asasira further argues that rights begin at birth, therefore a foetus has no rights. "I am a woman and I love babies, but there are some issues beyond the woman."

Asasira's argument is unpalatable to some people. "The best thing is preventing pregnancy itself. You cannot start solving a problem from the bottom. Even if you legalised safe abortion, women will decide to use it as a family planning method," argues Prof. Donald Amoko, the former senior don at Gulu University medical school.

Dr. James Batwala, a senior consultant obstetrician and gynaecologist, says: "When you think about it, a woman has a right (to abort). Doesn't the child have right to life? We need to draw the line. What is more important right now is that abortion is a killer."

With Uganda rapidly becoming one of the hottest battle grounds for abortion debates, these arguments are not likely to persist for years. Even in the US where the battle has been raging for much longer, the issues are not yet resolved.

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