In a landmark ruling of 2021; the Malawi High Court rested the matter of safe abortion!
In his ruling; Justice Mzonde Mvula guided that girls and women seeking to terminate a pregnancy in Malawi would need a medical approval upon review by a doctor.
It meant; girls and women seeking abortion, first needed medical-consent.
However, two years down the line, the reality remains almost unchanged; women and girls continue to shun medics on termination of unplanned pregnancies … and incidents of unsafe abortion continue to surge.
The same remains with the push to legalize abortion leading to post abortion complications across the country’s four administrative regions: North, East, Centre and South.
Not surprising; clinical service providers are worried over the high incidents of unsafe abortion.
MIJ Online understands the pattern is pilling pressure on health service delivery in hospitals spread across the northern region.
According to Dr. Dan Kwacha – chief dermatologist for the region; in three months alone; one district in Malawi’s Northern hemisphere can register an average of 344 cases of unsafe abortion.
“We are having to treat bad conditions. The situation doesn’t look good because more and more women especially girls are continuing to use unsafe means of pregnancy termination,” says Kwacha.
He adds; “in turn, this is straining the health service delivery system already crippled with post-natal expertise and also lack of medical resources, sadly it would seem many terminating pregnancies, aren’t consulting medics … complicating the picture even further,” he says.
767 kilometers away from Mzimba to Nsanje district; the picture isn’t good either.
This year alone, so far, over 700 women have terminated pregnancies and needing post abortion treatment and care in this border district with Mozambique.
However, Ednah Samate, post abortion care coordinator for the district says these figures are nothing to be scared about.
“This is what we’re registering in Nsanje from time-to-time. Its’ sad that women continue to terminate pregnancies by themselves through dangerous means and risking their lives,” observes Samate.
For the girls themselves; those with intent to terminate pregnancies continue to shun medical procedures for the hostility of medical personnel in health facilities.
Topezyani Ndamela a post abortion client in Makhanga, one semi-urban area in the district says she couldn’t seek medical procedure for the obvious.
“Our health centres aren’t friendly … I couldn’t seek their attention for termination of my pregnancy and then I couldn’t keep the pregnancy because I didn’t want to live with the trauma of a pregnancy of rape and then conceive a child of that circumstance.
“The best I could do was to terminate that pregnancy. Unfortunately, it hasn’t ended well, here I am struggling and my uterus, is in bad shape according to doctors,” says Ndamela.
On the other hand; Usizwe Ngwenyama in Edingeni, Mzimba, says she has been bleeding heavily since she terminated her pregnancy.
“My life has taken a down-turn since I plugged-off my pregnancy. For instance; I’ve been bleeding heavily, and am told my womb is damaged so much so that chances are narrower of carrying another pregnancy,” says Ngwenyama.
Commenting on the matter; a safe abortion campaigner Winnie Botha blames the situation on structure of the legal provisions on termination of pregnancy.
“One problem is the framing of the language, it makes it difficult for health professionals to provide the service to the needy; equally, it makes it difficult for those seeking the service to acquire it.
“It tells you we are ignoring a big problem, trying to bury it, when it’s with us, what’s being reported in the northern region is just a tip of the ice-berg … for the picture is bigger than what we are seeing,” Botha says.
Another an anti-abortion campaigner Kenneth Ntago says the status quo calls for urgency in addressing the problem, arguing; “a poor nation like Malawi cannot be wasting resources treating post abortion cases instead of finding solution”.
Currently, in the absence of legal provision to allow clinical termination of pregnancies, it remains a challenge to normalize the situation.