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UCHD 2023
Posted on Categories News

350,000 abortions in Uganda are induced – experts

Article by Catherine Mwesigwa Kizza ( New Vision)

Infanticide, child abandonment and abuse — the Ugandan media is full of the stories. The missing story though is that the abused and murdered children are most probably survivors of induced abortion.

“There are over two million conceptions in Uganda every year. 200,000 to 300,000 of these miscarry or abort spontaneously but 350,000 abortions in Uganda are induced,” said Dr. Charles Kiggundu an obstetrician and gynecologist at a breakfast meeting convened by the Center for Reproductive Rights and Centre for Human Rights and Development in Kampala Wednesday, to discuss the laws and policies on abortion in Uganda.

“90,000 of the induced abortions end up with severe complications but only a half of them access post abortion services,” he added.

“Only half of the women with complications seek medical care. A few survive but many others die,” he added.

Joy Asaasira of CEHURD said of the 20 women in Uganda who die due to pregnancy and childbirth-related complications every day, four to five of these are due to induced abortion.

Dr. Kiggundu says these are needless deaths. The policy environment allows women to receive healthcare for post- abortion complications, however, studies have shown that when they seek care, it takes about 44 hours for them to get attention compared to 35 to 45 minutes other women spend in hospital before getting a service.

“Health workers do not want to treat women with abortion complications because they do not want to be seen to be accomplices to the termination of pregnancy,” he said.

He also pointed out that phrases on hospital documents like “Police notify” worry health workers and are a deterrent to provision of care for women.

‘Health workers do not want to get involved with police. They want to do their work unencumbered,” he said.

Women induce abortions due to unwanted pregnancies due to wrong timing of pregnancy or economic and social hardships.

“Some men tell their wives to abort because ‘they stopped having children’ and yet did nothing about it,” Dr. Kiggundu said.

Those who survive death end up with chronic pain, anemia, and infertility among other complications.

He said safe abortion services were available but hidden to the poor.

“You must be connected and well-oiled to access the services. Some women fly to South Africa to terminate pregnancies and return,” he revealed.

The consequences for the majority who go to quacks or unskilled medical workers working undercover are dire.

“We recover forks, pens, knitting needles, bed springs, sticks, herbs from women who run to us with botched abortions. Some of these things kill the woman before they even kill the foetus,” he said.

Treatment for those who survive death is expensive. According to CEHURD, sh17.6bn is spent on treating abortion complications.

Not only can this money be saved and spent on worthwhile health causes but women’s lives can be saved as well.

According to Dr. Kiggundu, the Ministry of Health’s comprehensive abortion care includes sexuality education to promote safe sex practices, family planning use including access to emergency contraception, reducing fertility, providing safe abortion services and quality post-abortion care.

Government is also training nurses and giving them skills to perform manual evacuation procedures to attend to women with incomplete abortions.

“There are still many gaps,” said Dr. Kiggundu. “Uganda still produces health workers for export and retains only a few.”

He revealed that only 30% of the vacancies for skilled health personnel required to provide safe motherhood are filled.

It is no wonder that despite government commitments, advocacy efforts, plans and policies to reduce maternal deaths in the country, there has been no progress in this indicator in the past five years.

New data from the Uganda Demographic Health Survey report of 2011 show that the maternal mortality ratio increased from 435 deaths per 100,000 live births in 2006 to 438 deaths, though other international studies show a decline to 310 deaths per 100,000 live births.

“26% of these deaths are due to unsafe abortion,” said Elisa Slattery the Regional Director, Africa Program Center for Reproductive Rights.

Once addressed, reduction in unsafe abortion contributes to reduction in maternal death.

Slattery said studies on the law on abortion in Uganda have found that “abortion is permitted where a mother has severe illnesses threatening her health like cardiac disease, renal disease, eclampsia.”

The Centre for Reproductive Rights study also found that healthcare providers are not required under the Uganda law to consult one or more providers to get their consent before terminating pregnancy as has been previously believed.

The organization is calling on government to broaden access of information among healthcare professionals and the public as a means of stopping the tragedy.

source:http://www.newvision.co.ug/news/634689-350-000-abortions-in-Uganda-are-induced—experts.html

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Maternal Deaths Against Constitutional Rights

When Valente Inziku’s wife, Jennifer Anguko, went into labour they had decided she would go to the local referral hospital just to ensure a safe delivery.
But Anguko bled to death because nurses and doctors could not be bothered to treat her. Her unborn child died as well.
“We attended antenatal clinics and each time they advised us to be near the health center when the delivery time comes. We did just as we were told and when we arrived the services were not provided,” Inziku said.
He had arrived at the hospital after his wife did and found her bleeding. “All the nurses were telling me was I had to clean the blood myself. I had my sister so we cleaned the blood,” said Inziku. “It was purely negligence of the nurses I kept calling them and they would tell us it is not yet the time for her to deliver the baby.”
So Inziku and his sister literally sat down holding his wife as she bled to death. “She died in my arms. She told me: ‘We have children, we have love but all this seems nothing if we have no help.’” Inziku said.
Inziku says the only doctor appeared 12 hours after his wife was admitted. “When the doctor finally arrived he told me it was too late and he asked why the nurses had called him,” Inziku said.
Inziku, a primary school teacher, is now left to look after their three children, all under the age of 10, alone.
Inziku is part of a group that has petitioned the Uganda Constitution Court to pronounce the escalating maternal deaths in Uganda violates the Constitutional rights of Ugandans.
The case was brought to court in March by the Centre for Health, Human Rights and Development together with three individuals: Professor Ben Twinomugisha, a lecturer at Makerere University; and two health activists, Rodah Kukkiriza and Inziku.
They want government to address maternal mortality and compensate the families that have lost mothers to negligence or poor services.
In the petition, the activists argue that by not providing the essential services for pregnant women, and many others, the government of Uganda is in violation of the fundamental obligation of the country to uphold the Constitution and defend, protect and promote the right to health and the right to life.
“I am here today because I want the court to know there’s an injustice going on. I have pain in my heart,” said Inziku.
The court was scheduled to hear the petition on Jul. 7 but the case was postponed because they did not have the required quorum of five judges.
Noor Nakibuuka Musisi, the programme coordinator at Centre for Health Human Rights and Development said securing a court declaration would be a great start in getting government to act.
“We want a declaration that the non-provision of essential services in the government facilities is a violation of the right to life,” she said. “The reason many women die is because there are no maternal kits, there’s no blood in hospitals and we have poorly paid health workers not behaving in the most ethical way.”
In June the Ugandan government announced an increase in the health budget for the 2011/12 financial year. It increased from 270 million dollars to 412 million this year.
However, Francis Runumi, the commissioner of health services and planning at the ministry of health said most of the budget was going to infrastructure and would not address the human resource crisis that has contributed to maternal mortality figures.
Still activists question the political commitment and health sector accountability. Recently government spent 760 million dollars on fighter jets and other defense equipment, which many question as a priority for Ugandans.
Robinah Kaitiritimba, the executive director of the Uganda National Health Consumers Organisation, part of the coalition that brought the case to court, said Ugandans must fight for their rights.
“There are no rights which are given on a silver platter, we must continue to fight and ensure our government responds to the cries of mothers and families.”
Maternal death in Uganda has remained high over years, every day at least 16 women die in childbirth. Uganda’s maternal mortality figures are at 435 deaths of every 100,000 live births, which translate to 6,000 deaths annually. Also child mortality remains high with infant mortality rate at 78 per 1000 births.
Most of the maternal deaths in Uganda are preventable and mainly caused by the massive shortage of trained and motivated professional health workers to attend births, lack of access to emergency obstetric care for responding to emergencies, lack of access to quality antenatal care, and lack of access to family planning services.
The gap in access to life-saving HIV treatment and malaria prevention and treatment are also major causes of maternal deaths.

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