AS South Africa sits on the edge of disaster resulting from the effects of unsafe abortions, communities and health experts have said what was devastating was the reality that not only were women and young girls endangering their lives by going the illegal route, but the real tragedy was the involvement of state officials, who supplied those who performed terminations and made millions from the illegal procedures.
This despite the country having put into place the Choice on Termination of Pregnancy Act in 1996, which allows women the right to safe abortions in hospitals and doctors’ rooms, up to 20 weeks of pregnancy to ensure safety and in keeping with the World Health Organisation’s prescripts.
Leading termination of pregnancy clinic, Marie Stopes, says even though legal abortions are enshrined in law, unsafe and illegal abortions kill and maim thousands of women every year.
Leading a campaign called #TearItDown, the clinic, which has facilities across the country and which is accessible in all communities, wants anyone who knows of the illegal service providers reported and jailed.
Urging everyone to contact their nearest police station or speak to the Department of Health, they said: “We at Marie Stopes South Africa are also actively notifying the authorities of illegal abortion providers,” and in a form circulated online they asked society to sign and join them in ousting the backroom terminators so that women were directed to authentic facilities.
But the reality was that many women in desperate times would run for what appeared to be quicker and faster, and often times cheaper, local experts have said.
The lure of posters plastered all over and ‘in-your-face’ was enough to convince even those who could afford the time and money to have their unwanted pregnancies terminated at legally registered facilities and doctors, Pretoria obstetrician Dr Gwen Mbelu said.
The health care sector very often dealt with women, young and old, who came in with the severe effects of going rogue.
“They sometimes come heavily haemorrhaging, sometimes with the foetus still inside; damaged uterus; and sometimes they present much later if they did not heal. But we also have women who come in when they want to have children, only to find that they were so damaged they can no longer sustain conception.
“What is sad is, this affects not only the person who had the termination, but family, the father, and even a whole community of people, depending on their circumstances,” Mbelu said.
The WHO said the deaths were so many that they formed part of a global pandemic, of no less than 10 million women who were rushed to hospitals for treatment annually for unsafe abortion-related complications.
“Heavy bleeding (haemorrhage) and sepsis, and unsafe abortion related deaths leave 220 000 children motherless,” they said, and, said the National Institutes of Health, “Incomplete abortions and, in particular, unsafe abortions, are an important cause of mortality and morbidity in South Africa.”
High priority should be given to the prevention of unsafe abortion.
But Mbelu said it did not start or end there: “The industry is heavily funded by legitimate and high-ranking officials who have keys to the national pharmaceutical storage.”
The backstreet service providers used mifepristone-misoprostol, the legal drugs used in state facilities, which was accessible to only a few.
A state gynaecologist and obstetrician, who asked not to be named as she is not authorised to speak to the media, said millions went down the drain because state resources were being plundered.
Investigations had been conducted over the years, which uncovered a network of officials and non-health staff getting their hands on and supplying back-street abortion rooms with resources.
In a country where little attention was paid to detail, this underground industry thrived. “At a national colloquium held in Pretoria in 2020, it was revealed that the money lost to this unsafe abortion industry ran into the millions if not more. The failure to curb it at source was identified, but nothing has come from recommendations made.”
Young girls, married women, single mothers, mothers who felt they could not have more children for one reason or the other, paid anything from R200 to R2 000 to people who freely advertised their services, in a network which, reports said, involved men and women who took an oath to serve and protect, to uphold life and the laws of the country.
The fact that the adverts could be placed anywhere and everywhere, with numbers emblazoned all over, for law enforcement to act, was at the heart of corruption, some said.
“When the numbers are called it is down a rabbit hole which links them all to a network of government employees, who keep track of the numbers of women who go through this, but to actually pinpoint who they are is difficult as they are careful in how they dispense the drugs.
“Law enforcement needs to be at the forefront, to work closely with legitimate drug store gatekeepers if lives and money is to be saved. There are so many rotten apples, but if concerted effort is made to hammer away at the corruption which allows the leaking of drugs and equipment, the numbers of affected would greatly go down,” the government health worker said.