By Halima Gongo
Kilifi County, Kenya: In Kilifi County, Kenya, the issue of unsafe abortions is not just a medical concern but a societal challenge. Many women and girls face struggles due to fear of hospitals and stigma from their communities. Despite efforts by local activists to educate and empower women, the impact of unsafe abortions remains pervasive, contributing to alarming statistics of maternal mortality in the region.
Kilifi County has a high rate of adolescent pregnancy and unsafe abortion.
I met Dena Kadzo (not her real name)at her home in Kilifi County Kenya, preparing breakfast. Kadzo risked her life for an unsafe abortion. She says she became pregnant when she was still in secondary school. Her boyfriend refused to support her and her parents were so strict, that she had no other option except to undergo an abortion without the help of a medical expert.
“I couldn’t do it at home, I already know parents are strict. I traveled to Mombasa and I never used anything from the hospital, I used the traditional method, and I made a concoction of soda and local herbs. when I drank it, It caused bleeding, after a while some discharge came out but not everything came out, I had to go to the hospital.”
Kadzo kept her struggle hidden, afraid not of unsafe abortions but of hospitals and stigma from her family and community.
“Hospitals scare me. if you want to abort they might insert equipment that won’t clean you well.You might end up having discharge that smells bad, unlike when we use our concoctions I never experienced that.”
Kache Kazungu, also underwent a painful abortion, influenced by her boyfriend who bought her some medicine. She was four months pregnant and never questioned anything. but now she knows better thanks to the Youth Voices and Action initiative a community-based organization in Kilifi County that advocates for reproductive health.
I really don’t know, he is the one who brought me the medicine he is the one who knows. When you take the medicine it takes like 5 to 6 hours until they start working, it is very painful, and it hurts.
Health practitioners like Mwanakarama Athman Mohamed say Kadzo and Kazungu are
lucky. Not all the women who perform unsafe abortions make it to the hospital.
“Sometimes the medicine they take can make the uterus rot, and you can get a condition called septicemia. It is a very severe state of sepsis and most of the time when it goes to the bloodstream, it goes all through the body to the brain. Now here, we get mortality.”
At just 27 years old Leila Abdul Khair is saving the lives of teenage girls and women here in Kilifi. She is a reproductive health champion fighting against unsafe abortion among girls. She organizes reproductive health events where she meets girls and women in villages and empowers them about the dangers of unsafe abortion. Through her initiative, Youth Voices and Action, over 400 girls learned about the risks of unsafe abortions, and they are sensitizing others.
Leila Abdul Khair, Director of Youth Voices and Action Initiative says that most women and girls don’t have information about reproductive health so when we go to the field we provide information. Mainly we look at the reproductive health concern, them having the information they know about their body and how it responds. We also provide information about the abortion complications the postal abortion care and the issue of the patient’s rights, like their rights.
Leila works closely with the community, She says there are too many stories like Katana’s and Kaches and says her group wants to help young women dealing with unplanned pregnancies to make better decisions. So far she has helped more than 600 girls in Kilifi County.
Emily Nasubo, a cleaner at Kilifi Referral Hospital and a skilled hair braider embodies Leila’s empowerment. What drives Nasubo is the heartbreaking stories of girls going through painful abortions she hears. She is motivated to support them. Through Leila’s initiative, Nasubo provides guidance and mentorship to the girls.
“In a span of six months this year Kilifi Referral Hospital has recorded at least 500 cases of post-abortion treatment. Kennedy Miriti the Reproductive Maternal Child and Adolescent Health Program Coordinator says most abortion cases are never reported. Girls often experienced post-abortion complications, however, their fear of stigma and interpretations of the complications prevented or delayed them from seeking care. Miriti confirms that Misoprostol is the most misused drug in Kilifi County for abortion.”Nasubo.
Kennedy Miriti, Coordinator of the Reproductive Maternal Child and Adolescent Health Program confirms how there is high maternal mortality in Kilifi.”We have a very high maternal mortality ratio as per the Kenya National Bureau of Statistics 2019 but if you look at the number of women that are delivering in our facilities it is around 89 percent so, a maternal mortality ratio of 532 per 100,000 live birds tells you that there must be somewhere where women die before they come to the health facilities and actually before they are known they are pregnant because they come from the community we are also exploring these maternal mortalities that we have not identified that are causing all those mortalities and definitely abortion is one of them.”
Abortion is restricted by Section 26(4) of the Kenyan Constitution, which states, that Abortion is not permitted except in the opinion of a health professional trained for that purpose, in case of emergency, or when the life or health of the mother is in danger, or as otherwise allowed by any other law in writing. Doctors estimate that nearly half a million abortions each year take place in Kenya, the majority of them unsafe.
In Islam abortion has always been a sensitive topic, the issue of abortion is more of a moral issue, something that Leila says is the number one reason why parents in Kilifi County never communicate sexual and reproductive health matters to their children.
According to the international human rights organization, the Center for Reproductive Rights, nearly seven women and girls die every day in Kenya due to unsafe abortion. Thousands more are hospitalized. Globally, over 60% of pregnancies end in abortion, with 45% being unsafe, leading to maternal deaths.
“This story was made possible with the support of the UZIMA-DS project, funded by the National Institutes of Health (NIH).
