Counting the cost of an illegal abortion 15 years later

Pascalinah Kabi

HER forced smile through the tears streaming down her cheeks is reminiscent of the rainbow that breaks through the clouds and presents a breathtaking kaleidoscope of colour.

But even though she smiles as she cries, the 33-year-old *Limakatso cannot shake off the feeling that her recent miscarriage was due to the unsafe abortion conducted on her then barely developed body 15 years ago.

Limakatso first fell pregnant in 2003 and her then boyfriend immediately left her high and dry. Scared of raising a child on her own and knowing that her family could not afford to feed an extra mouth, Limakatso battled with the thought of aborting for weeks.

“It must have been on the fifth week (of the pregnancy) when I decided that I wanted nothing to do with the baby,” Limakatso recalled in a recent interview with the Sunday Express.

“Together with my best friend, we went to Thaba-Bosiu for a backdoor abortion which wasn’t successful. Two weeks later, we heard of a lady in Lithabaneng and I went there in the morning.

“The backdoor abortionist injected a mixture of soup, water and spirit into my womb through the vagina. I was supposed to leave immediately after the operation but I failed to walk because of the labour pains. The abortion only succeeded in the wee hours of the next day,” Limakatso said.

She immediately left the abortionist’s house even though she was heavily bleeding and went to hide at her friend’s place. Three weeks later, Limakatso was admitted at St Joseph Hospital in Roma due to the complications from the unsafe abortion.

A dilation and curettage (D&C) — a procedure to among other things clear the uterine lining after a miscarriage or abortion — was carried out. Clinicians eventually stopped the heavy bleeding and immediately, Limakatso was back to her usual fit self.

But if the physical wounds quickly healed, the emotional and psychological wounds presented a totally different proposition. She was emotionally scared and struggled to be a role player in her family which had been humiliated by the news of her experience. Fifteen years later, Limakatso is still struggling to live with the consequences of that unsafe abortion.

“I have been struggling to carry a baby to full term and where I have succeeded, the child dies a few hours after birth. I can’t shake the feeling that the abortion I had 15 years ago has had serious medical complications and is the cause of my predicament,” Limakatso says with tearing eyes.

Meanwhile, the Ministry of Health’s Director General, Nyane Letsie, says abortion is the main cause of the high maternal mortalities in Lesotho’s only referral hospital — Queen ‘Mamohato Memorial Hospital — where up to 70 women were treated with abortion complications in September 2018.

“Abortion is first and foremost cause of maternal mortalities at QMMH. Some people don’t present complications from abortions on time and come with sceptic abortions. Secondly to deal with an abortion is more expensive and challenging to our health system. We continuously run short of blood as the patients only come having lost some units of blood,” Dr Letsie said.

She added: “It is also a challenge on the scarce human resources we have because daily we are talking about five to ten people that are presenting at Tšepong with similar conditions, yet there is no theatre to deal with abortions only. Now we don’t discharge the patient immediately, we need to make the patient sleep over for observations and we need equipment and other resources to do so. At the end of the day it is very costly for the nation. The absenteeism of patients from their work places is also costing the economy and companies a lot.”

Dr Letsie said the illegal abortion crisis was a result of unwanted pregnancies that could be avoided through primary prevention methods.

“The fact of the matter is that we now know the people faced with this challenge (of unwanted pregnancies) and we need to start asking questions like, ‘where do these people get family planning services’? This will help us target such places and strengthen family planning services so that the people can have access to them and prevent unwanted pregnancies.

Lesotho is however, not alone in this crisis and key stakeholders in the health sector recently met in New Delhi, India and reaffirmed their commitment to urgently and effectively act and ensure the attainment of universal health coverage across the globe.

The Partners Forum 2018, organised by the Partnership for Maternal, Newborn and Child Health in collaboration with the government of India, is committed to ensuring that people like Limakatso have access to comprehensive information and services on family planning and reproductive health issues.

The forum also wants to ensure that youth-led coalitions have the capacity to promote adolescent health and well-being from a rights-based perspective.

Addressing the forum, former African Youth and Adolescent Network on Population and Development (AfriYAN) president Tikhala Itaye said there was an urgent need to start talking about issues around women, children and adolescents.

“I come from the African continent where we believe the proverb that says if you want to go quickly, go alone but if you want to go far, go together. Here we are together from different countries, nations and regions; different races, ages, cultural and religious beliefs for a common vision and to truly change the lives of every woman, every child and adolescent.

“If we truly want to bring about that change, we need to work together because there is power in partnership. We need to start connecting the dots. Sometimes we do not talk to one another but we need to start talking to understand who our partners are, what are we doing, how are we doing it and how we can effectively work together,” Ms Itaye said.

On her part, Malawian legislator, Juliana Lunguzi, urged lawmakers around the world to start taking women, children and youth issues seriously. Addressing the forum on the role of parliaments in holding governments to account for commitments to achieve women, children and adolescents’ health, Ms Lunguzi said she was using her position to advocate universal access of health in Malawi.

“When the government wanted to change the location of Malawi’s National Cancer Centre from Lilongwe to Blantyre, I stood with others to protest that move. That was because I know how important it is to have the hospital at the central location where it will be easily accessible to all Malawians especially women because we have many cases of cervical cancer.”

Ms Lunguzi said it was important for lawmakers to not only discuss health issues but hold governments accountable because “if we cannot deliver for the women, communities will remain the same and will always have problems”.

The conference concluded by committing to place millions of women like Limakatso at the centre of their agenda.

“The global strategy is dedicated to realising the rights and protecting the health and well-being of every woman, every newborn, every child and every adolescent — everywhere, including in fragile states and settings of humanitarian crises.

“In order to achieve our aims, people’s needs must be understood and analysed and their voices must be heard — not only in articulating the problems to be addressed-but also in making decisions about priority financing,” part of the forum’s communique states.