[NYTr] Pro-Choice Ugandans Steer a Gradual Course

[All the News That Doesn't Fit]

Womens eNews - Aug 27, 2007
http://www.womensenews.org


Pro-Choice Ugandans Steer a Gradual Course

By Rachel Scheier - WeNews correspondent

KAMPALA, Uganda (WOMENSENEWS)--Nulu Lwanga was barely managing to feed
her four children selling banana juice from a roadside shack when she
learned she was pregnant again.

Abortion is illegal in Uganda. It is also widely practiced, as Lwanga
well knew. A woman in her neighborhood had recently bled to death at
the hands of a traditional healer who had unsuccessfully tried to end
her pregnancy with poisonous herbs.

Asked if she told her husband about her predicament, Lwanga just
laughed. "These African men, they just want to have babies, babies,"
she explained through a translator. "They don't want to be responsible
for them."

Abortion--which is banned, except in special circumstances, in most
African countries--is a leading cause of the continent's very high
maternal mortality rates. According to the World Health Organization,
about 4.2 million unsafe abortions occur each year in Africa, resulting
in about 30,000 deaths, nearly half of the total number of women who
die from abortion complications worldwide.

But abortion has long been a no-go topic for local politicians, who
typically walk a tightrope between the arguments of health workers and
influential Christian leaders by saying as little about the issue as
possible.

That may be changing.

Liberalizing Moves in Africa

Lawmakers in Mozambique, under pressure from the health ministry there,
are expected this fall to end--or liberalize--the country's more than
century-old prohibition on the procedure, joining the handful of
African countries, mostly in Francophone West Africa, where abortion is
legal. And an increasing number of high profile Kenyan leaders have
been calling for "an open debate" on the issue. Among the latest is
Vice President Moody Awori, a practicing Catholic.

In Uganda, the controversy that bubbles up on newspaper editorial pages
and radio talk shows every time the abortion question is raised here
has become familiar. A few months ago, the well respected leader of the
country's Human Rights Commission, Margaret Ssekagya, provoked anger
from the country's powerful religious establishment when she declared
that "we should promote safe abortion instead of running away from the
reality."

That reality is particularly grim here.

A study last year by the Guttmacher Institute in New York and doctors
at Kampala's Makerere University found that a staggering 85,000 Ugandan
women are treated for abortion-related health complications each year.
Unsafe abortion is the country's leading cause of maternal death. At
current rates, the study found, half of all Ugandan women would require
treatment for complications related to abortion sometime in their lives.

"You don't need a microscope to see that this is going on; most of
these women are being treated in public health facilities," said Elly
Mugumya, executive director of the Family Planning Association of
Uganda. Based in Kampala, it is one of the country's oldest
reproductive health organizations. "Government is not keen to enforce
this law. The fact is that abortion is an unavoidable reality. How many
prisons could you build?"

Lobbying for Gradual Change

No one thinks, however, that legalization is on its way anytime soon.
Even contraception--forbidden in the 1970s, under former dictator Idi
Amin--is only relatively recently widely available in Uganda. Mugumya
argues that a more practical strategy for those who would like to see
the law changed is lobbying for liberalizing the legislation gradually.

"Our job as health advocates is to encourage the debate and soften the
stance; and it has worked," said Mugumya. "Now you see arguments for
and against legalizing abortion, which is healthy."

That is relatively new. Uganda, which has long been home to an
influential Christian majority, is currently in the midst of a
fundamentalist revival. Sylvia Namabidde Ssinabulya, a member of
Parliament who lobbies for women's reproductive rights, believes that
many lawmakers favor at least a liberalization of the abortion ban. But
in a country where the first lady, Janet Museveni, opposes the
promotion of condoms, even touching the topic is politically
treacherous.

"It has not been something that is talked about here, and now when it
is, it is only brought as a moral issue rather than a health one," said
Ssinabulya.

It is common for poor women in villages to resort to desperate methods
ranging from poisonous remedies from traditional healers to drinking
detergents or inserting sharp sticks into their vaginas.

"Post-abortion care" is one of the main services provided by the
Kampala-based Uganda Private Midwives Association.

Clinicians Ask No Questions

One of the contradictions in abortion law here is that while it makes
the procedure illegal--except in very specific instances where the
woman's life is in danger--clinics and hospitals that treat women
suffering from bleeding, infections or other complications following
abortion or miscarriage are forbidden from interrogating her or calling
the authorities.

Sakina Kiggundu, who heads the group, says that while Ugandan women are
aware of modern birth-control methods, they often don't use them
because of widespread myths about contraception; that it will lead to
birth defects or infertility, for example. Studies have shown that
nearly half of all babies born in the country are the result of
accidental pregnancies.

But Kiggundu says that even health workers such as herself are hesitant
to lobby publicly in favor of changing the abortion law in Uganda.
Those who are particularly reluctant often receive funding from the
U.S. government, which thanks to the so-called global gag rule of
current administration, are forbidden to use the funds to provide
abortions, inform their patients about the availability of abortion or
to lobby for change in their nation's abortion laws.

"Many people here would like to see (abortion) legalized, but those who
are opposed are much stronger," says Ssinabulya.

One of the things that rarely gets mentioned by either side is that a
relatively safe abortion is available in Uganda, for those fortunate
enough to have the means and knowledge to obtain one.

The campus of Kampala's Makerere University--where "abstinence rallies"
are now regularly held on Friday nights--is one well-known place where
a young woman can ask around for the names of reputable nearby clinics
that quietly provide the service. The price is negotiable.

Nulu Lwanga didn't know any of this, but she was lucky: A sympathetic
neighbor happened to work for a nongovernmental organization that
provides health services to women.

Terrified, and yet more frightened of the prospect of giving birth to a
child she didn't have the means to feed, she scraped together 30,000
Uganda shillings (about $18) and went to a clinic recommended by her
neighbor. The procedure went smoothly. She never told anyone.

[Rachel Scheier is a freelance writer based in Kampala.]


For more information:

HIV-Positive Women Talk It Over in 'Mama's Club': -
http://womensenews.org/article.cfm/dyn/aid/2835/

Soldier Verdict Spotlights Rape in Ugandan Camps: -
http://womensenews.org/article.cfm/dyn/aid/2756/

'Carpet Grades' Are Target of Ugandan Bias Policy: -
http://womensenews.org/article.cfm/dyn/aid/2722/

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