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Meet the rural champions helping women combat unsafe abortion

 Mamulusi CBO group outside their offices at Nambacha on September 30, 2023. [Benjamin Sakwa, Standard]

Angela (real name withheld) got married at 19 after sitting her Kenya Certificate of Secondary Education (KCSE) examination in Navakholo, Kakamega County.

A few months later, her husband secured a job in Nairobi, and for five years he never returned home.

“I became lonely and got another man who impregnated me after six months of dating,” said Angela.

For the sake of her marriage, Angela sought the services of an elderly midwife to terminate the two-month pregnancy.

“I did not have the Sh10,000 she asked for and I had to sell at least 10 bags of maize to raise the money,” she told The Standard.

She was given concoctions that did not terminate the pregnancy as expected, instead the herbs caused her to bleed.

“I was rescued by a woman from Bumulusi Community Based Organisation who took me to hospital for emergency post-abortion care,” she says.

Bumulusi CBO promotes access to safe reproductive health (SRH) services and fighting gender-based violence in the Navakholo sub-county.

Angela, now 26, would later be introduced to family planning. She is now a mother of two.

Eunice Owano, 35, also from Navakholo was still breastfeeding when she discovered she was pregnant again.

“I was weak and my baby was also sickly. I wasn’t ready for another child so I went to the local “doctor” who gave me a concoction to terminate the pregnancy,” she says.

Her condition worsened after she took the concoction. “The kienyeji (herbal) medicine almost sent me to an early grave. I bled excessively, and was persistently dizzy, with a foul body odour emanating from a mixture of pus and blood,” says Owano.

She was also rescued by a member of Bumulusi CBO who took her to a hospital where she was given emergency post-abortion care. When she recovered she was introduced to family planning, and today Owano is happy that she is empowered and can choose when to have another child.

“Bumulusi CBO saved my life and also opened my eyes. So many women and girls are risking their lives through unsafe abortions, yet this is a situation that can be managed with more information on safe sex and also how to access reproductive health services,” she says.

The CBO, which has 45 members, has greatly improved access to sexual and reproductive health services in Navakholo sub-county.

Pamela Wambongo, the CBO’s chairperson, says they were trained by Ipas Africa Alliance - a non-governmental organisation working to promote access to reproductive health services.

“We educate communities on sexual reproductive health, access to family planning services, gender-based violence, HIV/Aids prevention and good nutrition. At first, it was difficult for the community to believe us,” says Ms Wambongo

She went on: “Women used to die while procuring unsafe abortion but our intervention has helped reduce the cases by providing accurate and timely information to stop desperate women and girls from going to quacks to terminate unwanted pregnancies.”

Wambongo says the CBO does not promote abortion and neither do they procure abortion but “we only refer cases of unsafe abortion to health facilities for specialised medical attention.

“We hold intergenerational meetings, attend self-help group meetings, and go to churches and barazas to sensitise communities on sexual reproductive health. Their reception has been positive,” says Wambongo.

She says cases of teenage pregnancy have reduced and the community no longer buries victims of unsafe abortion. “We distribute condoms and advocate uptake of contraceptives to prevent unwanted pregnancies that lead to unsafe abortion and sexually transmitted diseases.”

The group has also helped end stigma associated with the use of contraceptives with many men and women freely picking up condoms from the organisation’s offices located at Nambacha trading centre.

Stella Wekesa from Namakoye in Navakholo says: “We don’t tell girls to abort but we talk to them about responsible sexual behaviour and where to seek professional help in case of unwanted pregnancy.”

Ipas Africa Alliance Community Engagement Manager Mori Ogambi said they were working with grassroots organisations to strengthen their capacity to engage with community stakeholders in shifting norms and enhancing social protection and accountability that support women and girls' sexual reproductive health rights and gender equality.

“In collaboration with CBO partners like Bumulusi, we have established a network of community stakeholders who are active and committed to women and girls' SRH rights. This work has resulted in an improved referral system and enhanced social support for girls and women seeking safe abortion services,” said Mr Ogambi

He added: “Families have been restored and working with local administration, teachers and religious leaders have been instrumental in initiating conversations around normalising abortion in the community.”

Ogambi said community dialogues have normalised and opened discussions around abortion as well as increased knowledge on sexual and reproductive health and services.

Consequently, this has led to improved attitudes and behaviour and reduced abortion-related deaths and stigma among girls and women in Kakamega.

According to the Kenya Demographic Health Survey (KDHS) 2022 report, Kakamega reports approximately 12,900 teenage pregnancies annually. Of these, one in five of those aged between 15 and 19 now give birth. The youngest girl to give birth in Kakamega County in 2022 was aged 13.

In 2021, some 558 young girls aged between 10 and 13 got pregnant in Kakamega County. The Kenya Health Information System (KHIS) 2022/23 report puts the number of women of reproductive age receiving family planning commodities in Kakamega at 57.7 per cent.

Adolescent girls aged between 10 and 14 and receiving family planning services were 219, while those aged 15 to 19 were 23,829. Women aged 20 to 24 who received contraceptives were 63,155. Those who received male condoms were 18, 298, female condoms 714, and those who were counselled on natural family planning methods were 16,943.

During the year under review, 435 women received post-abortion contraceptives. Those that received post-partum family planning services for 4 to 6 weeks were 12, 013. Those who got the services for 48 hours were 5,451. Implant insertion of one rod was done to 14,425 and 35,216 for two rods.

Working closely with Bumulusi CBO is Patrick Maende, a Catechist at St Kizito Catholic Lusumu in Navakholo sub-county. He has his reasons for championing access to family planning services despite his church’s stand on the matter.

“When my wife died and I remarried, I did not want more children. But my current wife gave birth to twins. That was an eye opener and we agreed that she goes for a long-term family planning method,” says Mr Maende.

He says teenagers get pregnant and resort to unsafe abortions because they lack sex education.

“I went to bury a Form Four student. Next to her grave was a smaller one that no one spoke about. I later learned that she had died due to unsafe abortion,” he said.

“I’m a Catechist, we teach people natural family planning. We tell people not to use condoms, but they still do. I tell girls to be safe. You can teach them to abstain, but they do these things. We need to avoid getting unwanted pregnancies. I don’t want to bury more victims of unsafe abortion. I now refer girls who come to me for advice to Bumulusi.”

Brenda Adhiambo, the Navakholo Division Assistant County Commissioner, says when she heard about the Bumulusi CBO, she contemplated arresting the members for promoting abortion.

“When I attended one of their community dialogue meetings organised by Ipas, I realised they were doing a noble job by educating women and girls about reproductive health and how to avoid unsafe abortion,” said Adhiambo.

She says the CBO is the biggest champion of the uptake of contraceptives and HIV prevention locally.

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