Our ugly secret: abortion in Zimbabwe, illegal but thriving

"Today you're going to cry." The doctor, prodding Grace roughly with his nicotine-stained fingers, is matter-of-fact, there's no malice in his voice. And, afterwards, when she begs him not to let her see the foetus, he's considerate enough to cover it with a paper towel as it lies in a bloody puddle at the end of the examination table, before helping her to her feet. When he returns to the leather armchair in his consulting room, she notices that he doesn't bother to wash his hands before lighting a cigarette, blowing smoke in her direction as she leans over the desk to hand him his money.

"Be careful not to tell anyone about this," he says as she turns to leave, his eyes slits through the blue blur of cigarette smoke, "the jails are full of women like you."

He was right. That day she did cry. And for many days afterwards. There was clotting and cramps that had her balled up in pain in a corner of the sofa for the next two days, but, mostly, she cried because of the agony of an infection which festered where the doctor's unsterilised equipment had torn at her private parts.

The series of events that led to Grace finding herself in the deserted surgery that late Saturday afternoon once all the regular patients had gone home is irrelevant. She could have been a teenager who fell pregnant the first time she had sex with her boyfriend. But, as it turned out, she was a mature single mother unable to face the birth of a third child she had no means of supporting. Whatever her circumstances, Grace, like many other Zimbabwean women, found herself risking her life and her freedom to terminate a pregnancy she believed impossible to sustain.

She is hardly an isolated statistic. According to a report by the UN Children's Fund, Unicef, more than 70 000 illegal abortions are carried out in the country every year, with Zimbabwean women running a 200 times greater risk of dying of abortion complications than their counterparts in South Africa, where the procedure is legal.

Grace was one of the lucky ones. The infection cleared after a series of antibiotics, followed by a D&C. The doctor who treated her for the infection was discreet and, for her, luckily so. A hospital or doctor which treats a woman for complications which have evidently arisen from an abortion, are obliged to report the patient to the police. Both the woman, and the doctor who performed the procedure, can be arrested and sentenced to a minimum of five years imprisonment.

A largely Catholic society, abortion in Zimbabwe is condemned by both the church and the state:

"As a Christian, there's no grey area: abortion is murder," said a local priest. "The foetus, from conception, has a life, a soul, and we, as human beings, have no right to kill it."

Neither does the law allow for any ambiguity. The termination of a pregnancy, according to the current constitution, is a criminal act, and is dealt with as such. But there are those who believe the law is out-dated and no longer relevant to Zimbabwe's modern society.

"If society is to condemn mother/child care, where does it begin to pass judgment?," asked a local advocate for legalising abortion in Zimbabwe. "Does it begin with the woman who aborts a foetus within the "safe" period of 12 weeks; or with the mother who gives birth and dumps the new-born in the cistern of a railway station toilet? Or, perhaps it should begin with a health care programme that does not offer women free access to contraception and sexual education."

"How can the pro-lifers boast that we are protecting the rights of the child, when the newspapers are full of horrendous stories of infanticide and baby dumping? It's obvious there's something very, very wrong," she said.

Norma and Themba are testimony to the resilience of the human body. Early one winter morning, when the babies were around two months old, their mothers – presumably sisters, possibly prostitutes – decided to pack up and leave their squalid one-bedroom shack and seek new opportunities. The babies did not feature in their plans. So, without a word to anyone, the women left them in the apartment, already cleared of all its contents, locked the door behind them, and disappeared. Some time later, neighbours grew concerned by the endless crying coming from the house, and the fact that the women had not been seen going in or coming out for at least two days.

They broke into the house and found the pair, smeared in their own feces and close to starvation. By the time they reached them, little Themba was too tired and weak to cry anymore and was lying completely motionless. The neighbours alerted social welfare which placed the babies in a city orphanage. Today, aged around one year old, the children are doing well. Norma has just taken her first steps, toddling unsteadily along in her baby-grow, arms outstretched to anyone who passes. When you reach down to lift her, she clings to you like she'll never let go. Themba is more reserved, less trusting, but his big, bright eyes follow you wherever you go.

While tragic, the cousins' story is hardly the worst that Mary, who runs the orphanage, has heard. There are, of course, the ones who don't make it, who are dead before they can be rescued, drowned in pit latrines, left to starve in city dustbins. Others who come to the home so emaciated and near to death their abdomens are hollowed out like a kettle drum, their ribs sharp spears protruding from their pathetic chests, eyes too big for their skeletal faces. They've been either abused, neglected or abandoned to within an inch of their lives.

Mary points to the wall, to a "before" and "after" picture of a little boy called Daniel, three years old when he came to them, and weighing just five kilogrammes.

And, as the economic conditions in Zimbabwe worsen, so does the desperation that provides the fuel for these and countless stories like them.

Orphanages in the country, overseen by a struggling social welfare system, are full of children like Daniel, with little or no means to support them.

"With no money available locally, we seek most of our funding from outside the country," says Mary, whose institution offers shelter to teenage girls who fall pregnant, largely through incest and rape, and takes in their babies if they feel unable to do so.

"While, in the case of rape and incest, we would not stand in their way if they wanted to terminate the pregnancy, the girls who come to us have all chosen to give birth to their babies, not a single one has chosen to have an abortion. A large number of the girls choose to care for their babies themselves, sometimes not immediately, but after a year or two, when they feel ready, they come back and get them."

Women who do choose the abortion route say that although a "safe" legal abortion is exorbitant – around $350 – it's still a lot cheaper than the cost of giving birth to a child in a city hospital. And the birth is only the start of the expenses that begin to mount when a baby is born.

There are those who can not afford the "safe" option and resort, instead, to consulting traditional healers.

A concoction of pungent herbs sold by traditional healers plying their wares from a seedy-looking market in one of Zimbabwe's major cities, sells for around US$40 a dose.

A woman posing as a potential customer, was initially told the "medication" would cost her $100 to abort her pregnancy. When she quibbled over the price, the traditional healer she consulted immediately dropped the price to $50, promising "instant, safe results".

When the Termination of Pregnancy Act, in what was then Rhodesia, was amended in 1977, it was, compared to its predecessor, considered positively revolutionary.

The archaic Roman-Dutch common law permitted an abortion to be performed solely to save the life of the pregnant woman. The new law extended the grounds under which a legal abortion could be obtained, permitting the performance of an abortion if its continuation so endangered the life of the woman, or posed a serious threat or permanent impairment to her physical health.

In addition, the grounds covered pregnancies in which there was a serious risk that, if the child was born, it would suffer from a physical or mental defect of such a nature as to be severely handicapped, as well as pregnancies in which there was a reasonable possibility that the fetus had been conceived as a result of unlawful intercourse, including rape, incest or intercourse with a mentally handicapped woman.

But the question which begs answering in all of this is what do women in Zimbabwe want? It's a question legislators and human rights advocates have been grappling with for many years.

The problem, explains a lawyer who specialises in women's issues, is that women aren't speaking up:

"Traditionally, in Zimbabwe, women have not been called on to voice their opinions, so the concept of saying what they want is foreign to them," she said. "Human rights organisations will advocate for women's issues, such as the legalisation of abortion, and the government will say, let's ask the women what they want. And, of course, no-one will say a word."

The issue, she continued, presented a three-pronged dilemma: moral, human right and societal. Few women were going to be brave enough to stand up and be the isolated voice that went against the moral and societal foundations on which the country had been established:

"It would be suicide. Instead they choose to stay silent…and then risk a back-street abortion."

Her viewpoint is backed by a survey on the constitution, carried out recently by an advocacy group.

The results show a very small majority of those interviewed (40 percent) are in favour of the constitution preserving full rights for women to have an abortion, while a few less (39 percent) believe it should be preserved only in certain instances, which must be clearly stated by law. Only 19 percent, however, were completely opposed to the constitution preserving any rights for a woman to have an abortion.

Most telling of all, however, was the fact that, when separated into gender groups, more men than women were in favour of full rights for women to seek an abortion, 46 percent as opposed to 39 percent.

But even those who support the legalisation of abortion in Zimbabwe, are watching the situation across the border, in South Africa, very carefully.

The Choice on Termination of Pregnancy Act in South Africa was changed in 1997, providing abortion on demand to any woman of any age if she was less than 20 weeks pregnant, with no reasons required. Women were encouraged, but not obliged, to seek pre-abortion counseling, while those under 18 years of age or in a committed relationship were, once again, advised to seek parental consent or consult with their partner, but not obliged to do so.

The result is a woman like Thandi, who has already had three abortions…and is only 17 years old.

The government, which says it is aware of the rampant practice of illegal abortions, claims the only solution is the promotion of safe sex, but a spokesman for the Ministry of Health and Child Welfare admitted this was a huge challenge due to the unavailability of – and cultural resistance to – contraceptives.

Said a local medical practitioner: "In a country where safe, effective and affordable sex education and contraception are not widely-available, we can not suddenly start offering abortions to anyone who wants one, or we run the very real risk of it becoming the birth control method of choice. And that's not something any right-minded person would support," he said.

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