For three months, Sunday Ehigiator, who went undercover to unravel the allegation of multiple and underage abortions levelled against Marie Stopes Clinic, a United Kingdom NGO based in Lagos, by Project for Human Development, a pro-life NGO also in Lagos, writes that it is a well-oiled operation shrouded in secrecy
It started with a scoop in the early hours of May 21, 2019. THISDAY was tipped off that there was a concluded investigation on the Marie Stopes Clinic, a United Kingdom NGO based in Lagos by Project for Human Development (PHD), a pro-life NGO, also based in Lagos, and subsidiary of the Foundation for African Cultural Heritage (FACH). The tip off was that police detectives attached to Zone 2, Onikan, Lagos, would invade the clinic by mid-day. The raid was successful. Armed with that information, THISDAY swung into action with series of investigations.
Speaking with THISDAY on condition of anonymity, a staff of the NGO said, "The Marie Stopes abortion Clinic, strategically located at No 105, Itire Road, off Lawanson, a very densely populated area of Lagos was abruptly shut down yesterday May 21, 2019.
"Acting on a petition lodged with them by our NGO based in Lagos, a combined team of police detectives from the Nigeria police, Zone 2, Onikan swooped on the clinic. In order to provide evidence to the police that abortion is being carried out at the Marie Stopes Clinic, the pro-life NGO had previously sent its staff that pretended that she was pregnant to the Clinic. On getting there, she met Dr. Bernard and Miss Jadesola.
"She inquired from them whether they perform abortion because she was pregnant and needed abortion. They told her that they do abortion for N30,000. On returning to our office, we instructed her to enter into WhatsApp conversation with Marie Stopes through their Whatsapp number.
"In the conversation between her and Marie Stopes the latter clearly admitted that it performs abortion at the clinic. Armed with this evidence, we petitioned the police headquarters. Our petition was approved. Consequently, on May 21, 2019 we accompanied the police to the clinic together with our staff that pretended she was pregnant.
"When we got close to the clinic, the police woman in plain clothes, pretended as if she was the mother of our 'pregnant' staff. She took our staff by the hand and entered the abortion clinic while we all hid inside the two cars we came with. On entering the abortion clinic, she told Dr. Bernard that the girl was her pregnant daughter and that she wanted the clinic to abort the baby. Dr. Bernard agreed and demanded for the N30,000.
"At this juncture, the police woman blew the whistle and we all jumped out of the cars and entered the clinic. As soon we entered the clinic, the police immediately handcuffed Dr Bernard. All the nurses were in panic. The police spent two hours in the clinic opening all lockers and drawers. We entered a room called 'Procedure Room', where abortions are done.
"We met a girl of about 15 years old there. When the police asked her what she had come to do, she said she came to receive her injection, meaning abortifacient injection. The police arrested her as she wept. Later the police released her. The police saw many abortion files, manual aspirators, cartons of abortion pills donated to Marie Stopes by UNFPA, abortion injections and abortion bills.
"While the search was going on, Dr Bernard in police handcuff kept saying that Marie Stopes does family planning not abortion. The nurses also said that what they do is family planning. But the abortion files showed the names of girls including minors who had come to do abortion at the clinic. At the end of the search, the police took all the evidence to their station and granted Dr. Bernard bail."
After the arrest came interrogation. On this the source said, "The next day, we were invited to the police station. When we got there we met three country representatives of Marie Stopes in Nigeria. We all appeared before the police boss. We presented the case of our NGO against Marie Stopes. When we finished, Marie Stopes spoke up. They said that what they do in Nigeria is family planning and post-abortion care not abortion, that they are pro-lifers as well because they are saving women from dying, that many women die because they receive abortion from quacks.
"The police boss caught in and said to them, 'So you do abortion then'. In response, they said, 'no, we do family planning'. Then the police investigator queried, 'How can minors be doing family planning'. Then he showed the police boss the abortion files containing names of minors who had done abortion by Marie Stopes. He told his boss that the painful aspect is that the consent forms inside the files were never filled, meaning that the abortions were done on the minors without parental consent.
"At the end of the hearing, the police boss announced that the police should be given time to conclude investigation against Marie Stopes in Nigeria. When Marie Stopes demanded for the abortion files, the police refused to hand over the files to them. The police told them that they were evidence against them."
Prompted by this, THISDAY put a call through to the Lagos state police Public Relations Officer, Bala Elkana, a Deputy Superintendent of Police, to confirm the story. However, DSP Elkana said he wasn't aware of the operation as at when we mentioned it to him, but promised to get back after he might have contacted the station in charge (Nigeria police, Zone 2, Onikan-Lagos).
He did called back afterwards to say the police station claimed not to be aware of such operation. This aroused this reporter's suspicions to continue to dig further.
We were able to obtain contact of one of the officers that joined in the raiding of the hospital (name undisclosed). He disclosed to us that police actually raided the clinic; having received a petition from an NGO.
According to him, "on our arrival, we took possession of documented evidences of abortion being carried out on minors in the clinic, and some other instruments and injectables believed to be used in carrying out the act.
"It is a long list of details of all the girls they have had course to evacuate or perform abortion for. It has all their information.
"But we need more than that to be able to win the case in court. We need testimonies from victims; at least two or one of the underage girls. We have started reaching out to few of them we believe stays closer but they are all scared as it is obvious that most of them did it without the consent of their parents of guardian."
"The clinic is claiming that they don't perform abortion in Nigeria that they only give contraceptives and perform post abortion services. It is just an ambiguity to cover up their tracks.
"We all know that, there is no clear difference between abortion and post abortion treatment. But only a medical expert can really speak on that. But from the record we have of the purpose some of the victims visited, they clearly stated that they were there for abortion."
Mirabel Centre's Stance
Moreover, on May 22, 2019, THISDAY obtained a statement from Mirabel centre's Instagram page (@mirabelcentreng), which condemned the action of the police on the clinic, confirming the raid by the police to be true.
According to the post, "On Tuesday, May 21, 2019, police officers raided a Marie Stopes Clinic in Lagos. Harassed the health workers and patients and took away confidential client information.
"Marie Stopes offers free and affordable family planning services to women and men, pregnancy tests, pre and post-natal care, treatment and services for sexually transmitted infections (STI), HIV testing and ultrasound and laboratory services. They have trained staff who offers counseling and treatment especially to those who cannot afford the costs at private hospitals.
"To raid a centre that provides such services is sending a message to women and girls as well as men and boys that they are not safe in health centers and that they don't deserve access to quality health services without fear or judgment, why the attack?"
Efforts to Reach the Clinic
We likewise contacted Dr. Bernard a day after the raid to hear the hospital's side of the story, but he never picked his calls nor returned the call afterwards, hence we decided to go undercover to unravel facts about the case.
After the initial undercover attempt to infiltrate the clinic a week after the incident proved abortive, as staff weren't willing to give out any information on the abortion processes, and the clinic security monitoring every moves, we decided to give it a space of time; in this case three months, before returning.
This was done to enable them lower their guards in time, and reduce any suspicion. Months went by, and we returned. This time, their guards were indeed lowered. Unlike our initial visit, the security guards remained in their security house by the outside gate, without bothering to escort us in.
This reporter, in the company of a female colleague, Chiamaka Ozulumba, disguised as lovers, with a false intention to get rid of a two- months-old pregnancy visited the clinic on August 26, 2019 at about 3pm. They likewise changed their names to Raphael Mathias and Lilian Ezeobi respectively.
With our recorders discretely active, we went into the building. Upon entering, to the wall at our right, was a fee for all of the services they render from which the number nine tagged, "Abortion Advance Care", was pegged at N30,000.
Other items on the list includes, Long Active Reversible Contraceptives (LARC)-IUCD and Implants, Levonorgestrel (ESG-IUS), IUD Removal, Implant Removal, Injectables, Oral Pills, Male and Female Condom, Permanent Method, Visual Inspection With Acetic Acid (VIA), Cryotherapy, at N3,600, N7,200, N2,400, N2,400, N360, N250, N120, N3,600 and N14,000 respectively.
We were attended to by Miss. Jadesola at the reception. We requested to see the doctor. She informed us that consultation fee was N2,400 and we must register at N1,200 before we can see the doctor. In total, we paid N3,600 to the clinic's FCMB account via POS, for consultation and general registration before we were allowed access to the doctor l.
Before making payment, we took turns to question Miss. Jadesola on the safety of the abortion procedures, under the guise of being nervous about the process, and she took her time to make us believe we were in safe hands.
According to her, "She is in safe and in perfect hands. This is an NGO, it is international. We have not had any complications before. Since it is still within two months it is very safe. Because once it is 13 weeks, we won't do it. That is when it is no longer safe. As long is it is below 13 weeks, it is very safe. The procedure is N30,000. It won't take time. Once you pay the money, in less than five minutes, she is through. We would even have to place her on contraceptives after the process. It is one of our conditions.
"We have different types. The one we would place under your skin. And we do long term contraceptive-five years and above. The only side effect is that, it could alterate your menstrual circle. We also have IUD, that one is for 10 years. But anytime, you take any of those out, you can get pregnant at any point in time."
On the procedures the clinic uses in aborting unwanted pregnancies, she said, "She needs to condition her mind that nothing would happen to her. We use two methods-the surgical and injectables. If it is the surgical, we just evacuate the fetus from her womb. She won't feel any pain. We would take it out from her uterus. Of course, we would inject her so she doesn't feel pain. And she would come out like nothing happened afterwards.
"If she is using drugs, she would experience something similar to a serious menstrual pain for at most seven days. It is 98 per cent success. There is no side effect whatsoever for either of the processes. The people that came here for this process last two months for instance, they have come again for another abortion this month. They would do so again, the next month they are here again. That is why we insisted that they must do family planning, because we saw that they are now turning it to pure water. So we now say okay, if you must do it, we must place you on contraceptives.
Asked how long she has been with the clinic to know that the processes were safe, she said, "This is an NGO, it is International. The process is safe. If it weren't people, would have raised alarm. They are no quacks here. This place is International and it is registered. First and foremost, nobody has ever died here. This place isn't a quack centre, you can look it up. Our head office is in London.
"Again, once it's more than 13 weeks, that is the when there is danger. And the people that are going to do it for you are trained. So you need to first of all condition your mind that you will not die. Nobody has ever died here, and you will not die here please. Please I am begging you. So it is not an issue at all. And you are not going to have issues with child bearing in future. There are some people that would come here now for it, in the next two months they are here again. When we saw that this one would turn to something else, that was why we imposed them on contraceptives.
"So you must take a form of contraceptive so that you wouldn't come back here again. It was because of the instances I gave, because people have now turned it to normal thing. See, there are two more things. You can decide to take drugs. If you take drugs, that one is a normal process. But if you do the surgical, we would give you an injection that would kill the pain, then after that, you would come out like nothing ever happened.
"Nobody that sees you going will ever know that anything happened to you. I am assuring you, and you have my words. But I need you to first and foremost take out the fact that you will die. You will not die, you cannot die, me I don't want somebody to die on my neck o. So you will not die.
"I have been here since Marie Stopes moved here last year. I used to work with another hospital before I moved here. Once you are done, please you should be coming for checkup. You are not paying for it. If you come back for checkup, they would scan you to ascertain that you are okay, so your checkup is very important. A quack cannot own this place. We are not running this place based on what we get from it, we are running it with donations. So it is an NGO."
Consultation with Dr. Fatoye
We finally got to meet the doctor on duty, Dr. Fatoye and the first question posed towards us was if this was our first time of vising the clinic. We answered in the affirmative. Thereafter, we noticed a change in his countenance. His conversation with us became more abrupt as he was probably conscious of the fact that we might be an unwanted guest. He began to code the word 'abortion' with 'procedure' (an ambiguous medical terminology).
We managed to convince him that we were referred by a friend who had performed abortion in the clinic before, before we began to talk. "Let me face her she is the client," the doctor said after we exchanged pleasantries.
He continued, "you look tensed, you are worried. I don't want you to jump into conclusions, let us talk. What exactly is the issue? When was the last time you saw your period? I need the particular date of your last menstrual cycle. Because if it's beyond the two months timeline, the procedure gets very risky and we decline carrying out the procedure."
In response, we explained to that its less than two months, and she was supposed to see her period first week of every month, which she didn't see the first month, prompting us to do a urine test.
He continued, "So, at what point did you do a test and found out you were pregnant? Have you done a scan? Have you been pregnant before, do have you kids? We responded that we did the self urine test few days prior to coming to the clinic, and the result was positive. And responded 'no' to the questions on if she has been pregnant before or done any scan.
He continued, "You have never been pregnant, it's all right. For us in Maria Stopes, what we don't want or what we are working against is this kind of situation. Our mission is that, we want it to be that any time a woman is pregnant in this world, let it be that the conception was planned and the only way that is possible is through the promotion on the use of contraception.
"Like I usually tell people if for instance, I met Lilian or someone from Maria Stopes met Lilian a couple of months before or a year ago, they would probably have talked to her, like 'madam why don't you come and try this contraceptive' or try this one, and this child wouldn't have happened'.
"So of course this happens and we might have to help sometimes but what we are concerned about when this happens, is how it happens. So we use this as an opportunity to introduce contraceptives and counsel her. But first things first, we need to do a scan, we need to do an examination to decide on exactly the status and how we go ahead. But on getting to that point the cost is N30,000."
We asked what he meant by 'getting to that point', and he said, "Get to that point actually (like we should already understand in code) and you decide that okay, if we are going ahead, the cost is N30,000."
At this point we decided to call it a day, having realised he was being very careful of his language, hence we replied that we won't be able to go on with it right now, as she was too tensed at the moment, hence we would return the next day.
As we were leaving the clinic premises, we couldn't help but notice the disgusting looks on the faces of neighbors trading or living around the neighbourhood where the clinic was located, after seeing us coming out of the premises.
It was such look of condemnation, as though we had just killed a life. We were prompted to ask the motorcyclist that picked us from the frontage of the hospital why they were looking at us with such disgust? He replied that the look was because they thought we had truly gone in to abort our supposed pregnancy.
Position of the Law
In Nigeria, abortion is illegal and carries a stiff jail sentence, up to 14 years, unless done to save the life of the pregnant woman. Abortion legislation in Nigeria and court decisions on the subject were examined for this report.
Abortion in Nigeria is governed by two laws that differ depending on geographical location. Northern Nigeria is governed by the Penal Code and Southern Nigeria is governed by the Criminal Code. The only legal way to have an abortion in Nigeria is if having the child is going to put the mother's life in danger.
The abortion laws of the Criminal Code enforced by southern states, are expressed within sections 228, 229, and 230 with varied punishments stipulated. While section 228 states that "Any person providing a miscarriage to a woman is guilty of a felony and up to 14 years of imprisonment", section 229 states that "Any woman obtaining a miscarriage is guilty of a felony and up to imprisonment for seven years", and section 230 states that "Anyone supplying anything intended for a woman's miscarriage is also guilty of a felony and up to three years of imprisonment."
The Penal Code on the other hand operates in northern states, with abortion laws contained in sections 232, 233, and 234. The sections of the penal code parallel the criminal code, besides the exception for abortion with the purpose of saving the life of the mother.
The Penal Code's punishments include imprisonment, fine, or both. The offenses of these codes are punishable regardless of whether the miscarriage was successful. Meanwhile, no provisions have been made to the Criminal Code making exceptions for the preservation of the mother's life.
Nigeria's abortion laws makes it one of the most restrictive countries regarding abortion.
Since abortion is illegal in Nigeria, many women resort to unsafe abortion methods, leading to abortion-related complications and increasing mortality and morbidity rates in the country. According to research done by the Guttmacher Institute, an estimated 456,000 unsafe abortions are done in Nigeria every year.
Also, in a joint study carried out by the Society of Gynecologists and Obstetricians of Nigeria and Nigeria's Ministry of Health, estimates of women who engage in unsafe abortion were put at about 20,000 each year.
Research has revealed that only 40 per cent of abortions are performed by physicians with improved health facilities while the remaining percentage are performed by non-physicians.
Abortion accounts for 40 per cent of maternal deaths in Nigeria, making it the second leading cause of maternal mortality in the country.
Marie Stopes Operations in Nigeria
According to a statement on the clinic's website, "Marie Stopes Nigeria opened its first clinic in 2009, becoming one of the few providers of long-acting and permanent contraception in the country."
However, a scroll down the page, the clinic issued a statistics that it prevented 1,401,151 unintended pregnancies in 2018, and prevented 710,313 unsafe abortions in same year; which might loosely mean that they must have conducted, or intervened in those numbers of 'illegal' abortion cases, that could have turned out unsafe.
When the clinic's activities were initially clamped down by the police, THISDAY had engaged the Investigating Police Officer (IPO), Inspector Felix, in a phone conversation where he confirmed that he was part of the police team that went on the operation on the said date. He also confirmed that incriminating exhibits were recovered during the raid. He however, expressed his frustration in charging the case to court.
According to him, "the current position is to bring in witnesses that can confirm that they carried out abortion there. As at now, what we have is just the materials and the files we retrieved from there. And those things alone cannot work assuming we are charging them to court. We need someone who can testify that I was there on so so date, and this was what they did to me. So that we can win the case. We cannot just charge the case, if not, we will not win.
"The problem we are having is this. The language on the document, if you are not a professional, you can't explain it in correct terms. And that is where they trick you. The documents we have, what I saw there is evacuation and contraceptives which the doctor said anybody can have evacuation or contraceptives but the treatment that follows after, is what determines what type of contraceptive or evacuation. So that is the issue.
"As a lay man, we know it as abortion but they will tell you that when they went into the uterus of the person, that they discovered that she needed evacuation not abortion, and that it is the lay man that doesn't know what he is saying. They would say they are not the one that mentioned the word, but the patient who came. But because as a professional, I know that what I am treating isn't abortion, but evacuation or contraceptive, the only concrete way is through invitation of victims. We are trying to invite two underage girls from the list we recovered from the clinic. They are the ones closest to us here.
"One of them has relocated outside Lagos while the other is still in Lagos. But it is like they are scared. So we are looking out at how to persuade them. The others on the list are very far away, and it would cost a lot to bring them over. But we would do our best."
While the police carry on with their investigation, the onus however lies on the court to determine whether the activities of Marie Stopes are illegal or not, especially when it comes to minors.
Marie Stopes' Reaction
When THISDAY contacted Dr Bernard for his reaction he said: "All I can say is that, it is false, but I think you should speak to the head office in Abuja. I can't give you any details. So just confirm from them, and do your own research. There is a website, you can get the details.
"I'm not saying I'm not authorised to talk but I'll advise you to speak to people that are superior. Speak with Abuja. You can't be talking to me and want to report that. You understand? This is an international organisation, it wouldn't make sense. So it is better you speak with someone superior."
THISDAY called the Abuja office and was engaged by one Uche who debunked the report. On their stand on abortion she said: "It is wrong. Abortion is legally restricted in Nigeria, and here at Marie Stopes, we work strictly in line with that restriction. We only offer post abortion care, which is the care given to someone who has had a miscarriage, and that miscarriage was not properly treated; maybe the tissues are still there, that is the only care that we offer here."
THISDAY went a step further to contact the clinic via Whatsapp. Using my supposed girlfriend's pseudo name, Lilian Ezeobi, I claimed that when I carried out the act in their clinic, there was complications and needed to speak with the doctor. At no point did they deny ever carrying out abortion. Our conversation went thus:
Reporter: Good morning. Please I need Dr. Fatoye's Number.
Marie Stopes: Welcome to the Marie Stopes Nigeria (@MarieStopesNG) Contact Centre. We are here for you. Are you interested in talking about sex, painful periods, pregnancy, Infections, pregnancy prevention, or family planning? Please be rest assured that our conversation is strictly confidential, please feel free to talk to me. Why do you need Doctor Fatoye's number?
Reporter: Alright thanks. But may I know who I'm speaking with first. Is it Jadesola (the receptionist at the Lawanson clinic that attended to us)?
Marie Stopes: This number belongs to Marie Stopes Nigeria contact center.
Reporter: I'm aware from seeing this. (referring to the auto response message). I'll really love to speak with Dr. Fatoye because he gave me this number, and I had thought he would be the one I'm chatting with.
Marie Stopes: We do not give out our doctors numbers, If I may ask which hospital and location does Doctor Fatoye work?
Reporter: Surulere, Lagos. Lawanson.
Please go ahead and tell me what the problem is, I will be able to help you.
Reporter: Okay, hope this is very confidential.
Marie Stopes: I want to assure you that this conversation is strictly confidential, please feel free to talk to me.
Reporter: Hmm. Aiit. I was there last week for an abortion. Reason why I left Lagos after the procedure. Cause I don't want anyone around me to know what's going on. But I'm still bleeding. Kind of scared. He told me it should take 4 days, but it has gone beyond it.
Marie Stopes: May I know your name please.
Okay. I will forward his number to you right away.