Give women options in reproduction

Njoki Ndung’u

This week I had the privilege of sharing a platform with eminent UN and local gender specialists to discuss the challenges of gender equality with particular regard to the Millennium Development Goals.

Like other signatory countries to the MDGs, Kenya is obligated to set up policies and mechanisms that will ensure the attainment of the specified development targets by 2015.

Of these, the MDG3 and MDG5 are of particular interest to me. The former is concerned with the attainment of gender equality that is measured by the key indicators of gender parity in accessing education, increasing the share of women in wage employment in the non-agricultural sector and an equitable proportion of representation in national parliaments.

This particular goal further targets the elimination of violence, harmful traditional practices and discrimination that leaves women with little autonomy and control over their own lives. These current limitations must be urgently redressed to achieve MDG3. Yet with just about six years to go to 2015, it will be a race against time to ensure that these targets are realistically met.

The MDG5 aims to improve maternal health. The indicator for this is spelt out as the reduction of maternal mortality by three quarters by 2015. I had a particularly heart-warming moment occasioned by a visit to the Jamaa Mission Hospital in Jericho, Nairobi. The hospital, run by the Sisters of our Lady of Charity, has a programme supported by the Freedom from Fistula Foundation, which is partly funded by the Safaricom Foundation. It provides medical repair for patients suffering from obstetric fistula, a condition that causes both physical and mental anguish.

The disease is a fairly widespread condition countrywide, especially among malnourished women. Despite this prevalence, there are hardly enough specialised doctors for its therapy. In fact, there are only four trained surgeons in the country who can perform this delicate operation! This training is not even available in our local medical schools.

Examples like this cast well-founded doubts on the Government’s commitment to MDG5. While it offers plenty of lip service on achieving the same, there is no coherent policy or budgetary follow-ups to realise the same.

For instance, it is common knowledge that safe motherhood must logically include the easy availability of contraceptives and other measures to prevent unwanted pregnancies, particularly for poor women. Yet, the good Professor Anyang’ Nyong’o, Minister of Medical Services, admits that access to contraceptives is low due to Government funding. This year, Treasury only allocated Sh500 million to family planning.

Inaccessibility of safe and affordable family planning services has left women dangling between a rock and a hard place. They are forced to turn to illegal and unsafe abortions when they are confronted with unplanned and unwanted pregnancies. They account for 30 per cent of maternal deaths, while others are left nursing lifelong injuries. It is understandable for the minister to plead with our development partners for funds to remedy this unfortunate situation. Indeed, I hope the Obama administration will choose to invest in maternal health and family in Africa. But foreign help should only be complementary to our own efforts. The ultimate responsibility for planned parenthood lies with our Government.

If it cannot address the demand for reproductive specific healthcare for more than 50 per cent of its population, who will?

Unfortunately, this particular responsibility appears lost to the Government. Instead, what is manifest is its uncanny knack for punishing victims of its own neglect. For example, last week a woman from a poor rural area was convicted for procuring an abortion. At the time of conviction, she was pregnant with her sixth child. Imprisonment in such a case is of little effect. It is actually counter-productive and guaranteed to cause more problems to the convict, the family of five — now motherless children — and society at large.

Besides, considering all the circumstances, the jail term on its own is unlikely to be a sufficient deterrent as expected. In the very likely event that she gets pregnant again, and through no real fault of her own, it is probable she will repeat the same again.

But who can cast the first stone at her? To my thinking, the real criminal here is the Government; it is guilty of wilful neglect. It is unable and unwilling to provide her and many such indigent women with contraceptives. Perhaps the money spent on prosecuting, convicting and imprisoning women for performing illegal abortions should instead go into preventive contraception and all attendant medical and social services. The biggest crime committed here, however is the silence that emanates from quarters that should ideally be raising their voices of anger at such situations.

Since August 1998, we have been holding annual remembrance for the bomb blast that decimated nearly 300 lives. We understand the enormity of such numbers of deaths. However, when the total number of maternal deaths globally per annum is the equivalent of four jumbo jets crashing without survivors everyday, we do not even blink. In Kenya alone there are 590 maternal deaths to 100,000 live births. These are poor, rural, or slum mothers to be, most of them adolescents.

But I don’t see the national flag at half-mast for them!

The writer is an advocate of the High Court of Kenya

ndungunjoki@yahoo.com