Despite being illegal, abortions are still available in Zambia's capital at very low fees through private medical practitioners – in particular, by Chinese doctors who remain poorly-regulated in the country.
By Frederick Mwansa, Lusaka
Global report warns: Back-street abortions on the rise
A long-term fall in the global abortion rate has tapered off and the number of unsafe pregnancy terminations is rising worryingly, according to a report published by The Lancet two weeks ago.
Between 1995 and 2003, the number of abortions around the world for every 1,000 women aged between 15 and 44 fell from 35 to 29.
But in 2008, the rate was almost unchanged, at 28 per 1,000, due to a surge in abortions in developing countries.
The Lancet report also highlighted a dramatic increase in the proportion of unsafe abortions.
This rose from 44 percent of the total in 1995 to nearly one in two -- 49 percent -- in 2008, inflicting a traumatic toll in death and injury.
The UN World Health Organisation (WHO) defines unsafe abortion as a pregnancy termination performed by an individual lacking the necessary skills, or in an environment that does not conform to minimal medical standards or both.
Around the world, unsafe abortions accounted for 220 deaths per 100,000 procedures in 2008 -- 35 times the rate for legal abortions in the United States -- and for nearly one in seven of all maternal deaths.
Each year, around 8.5 million women in developing countries encounter abortion complications that are so serious they need medical care.
source: AFP
My research revealed that both conventional medical practitioners and traditional healers clearly understand that providing such a “highly risky medical service” is a serious criminal act – the equivalent of murder under Zambian law – but they seem to remain largely unconcerned.
“Some pregnancies may endanger the lives of the mother. Other expectant mothers may not be in a position, financially, to provide proper care to their child when it’s born. So we try and help them,” said a Chinese doctor who did not want to be named. “It is not our wish for people to abort their pregnancies but we do it on request.”
Illegal abortions
At a popular Chinese clinic in Lusaka’s middle-class township of Kabwata, a Chinese doctor agreed to conduct an abortion for my partner without even questioning why she wanted it done. The doctor simply outlined the cost of 38 euros (around ZMK 250 000) and said she would perform the procedure as soon as she received the payment. We promised to return later.
At another three clinics (one Zambian and two Chinese), situated right in the heart of Lusaka town, the operators also agreed to carry out the operation but at a much lower fee of 20 euros. They promised quick and satisfactory results.
In an interview, Ministry of Health spokesperson, Dr Reuben Mbewe warned that the state would arrest and prosecute any private clinics found offering abortions because it was a criminal offence under Zambian law.
“Not criminals but life savers”
But according to Rodwell Vongo, head of the Traditional Healers and Practitioners Association of Zambia (THAPAZ) and himself a traditional healer, practitioners offering the service are “not criminals but professionals who are helping to save people’s lives.” Other practitioners backed Dr Vongo’s view.
Further interviews with several Zambian women indicated that as the HIV/AIDS pandemic becomes more prevalent and poverty levels grow, more women are approaching local private local clinics for assistance to abort their pregnancies and to avoid the high cost of looking after children.
Mary Kanchule (a pseudonym), 27, said she had an abortion at 16 because her pregnancy was “a mistake” and her boyfriend was unemployed and therefore unable to support the child if it was born. Her termination was carried out by a traditional healer who operates at her local market.
“I sometimes feel guilty about my decision to abort, but there was nothing I could do because I just had to do it,” she stated.
Risks and regrets
Shop assistant, Juliet Katebe, aged 23, has come to regret her decision to have an abortion. She got pregnant as a 15-year-old and it was decided to have an abortion at a private clinic.
“My parents made all the arrangements and paid for the operation because they felt I was too young to have a baby and they wanted me to continue with school,” Katebe said.
“It was a painful experience and I almost died. The doctor had to rupture my placenta in order to access the fetus,” she explained.
“I regret the whole process because now I am told I cannot bear children,” said Katebe. “I blame my parents for everything.”
Under Zambian law, people found conducting abortions are charged with murder because the act is still regarded as the deliberate termination of human life. Persons convicted of murder are sentenced to life in prison and or even death.





















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