Source: IPS News
Under Article 26 (4) of the Kenyan constitution, "abortion is not permitted unless, in the opinion of a trained health professional, there is need for emergency treatment, or the life or health of the mother is in danger, or if permitted by any other written law."
She is just 14, but Janida avoids eye contact with others, preferring to look down at the ground and nodding her head if someone tries to engage her in conversation.
Janida (not her real name) was once a sociable and playful child, but that was before she was sexually abused by her stepfather and giving birth to a baby who is now four months old.
Her days marked by trauma and depression, Janida is just one of many girl children in Kenya who have been abused and robbed of their childhood, leaving them emotionally scarred.
"The little girl [Janida] underwent both physical and mental torture," Teresa Omondi, Deputy Executive Director and Head of Programmes at the Federation of Women Lawyers (FIDA) Kenya, told IPS. "Her best option was to terminate the pregnancy rather than suffer the mental and physical torture, but she could not afford the cost of a safe abortion."
Many of the induced abortions taking place continue to be unsafe and complications are common" – Teresa Omondi, Federation of Women Lawyers (FIDA) Kenya.
In September 2010, Kenya's Ministry of Health released national guidelines on the medical management of rape or sexual violence – guidelines that allow for termination of pregnancy as an option in the case of conception, but require psychiatric evaluation and recommendation.
Then, in September 2012, the health ministry released standards and guidelines on the prevention and management of unsafe abortions to the extent allowed by Kenyan law, only to withdraw them three months later under unclear circumstances.
According to Omondi, "the law has not yet been fully put into operation and many providers have not been trained to provide safe abortion, meaning many of the induced abortions taking place continue to be unsafe and complications are common."
The health ministry is responsible for doctors and nurses not being permitted to be trained on providing safe abortion, said Omondi, so "it is ridiculous that while Kenya's Ministry of Health accepts that post-abortion care is a public health issue regarding numbers, practitioners have their hands tied."
The issue of unsafe abortions in Kenya hit the headlines in September last year, when Jackson Namunya Tali, a 41-year-old nurse, was sentenced to death by the high court in Nairobi for murder, after the death of both Christine Atieno and her unborn baby in a botched illegal abortion.
Various inter-African meetings attended by Kenya have been held on reducing maternal mortality rates by providing safe abortions, with health ministers agreeing that statistics show that countries that do provide safe abortions have reduced their maternal mortality rates.
In a recent analysis, Saoyo Tabitha Griffith, Reproductive Health Rights Officer at FIDA and an advocate at the High Court of Kenya, said that despite Kenya having adopted a Constitution that affirms among others, women's rights to reproductive health and access to safe abortion, Kenyan women continue to die from unsafe abortion – a preventable cause of maternal mortality.
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For Dr Ong'ech John, a health specialist in Nairobi, perforated uteruses and intestines, heart and kidney failures, anaemia requiring blood transfusion as well as renal problems are just a few of the health complications arising from an abortion that goes wrong.
"Unsafe abortion complications are not just about removal of the products of conception that were not completely removed. One can evacuate but the perforated uterus has to be repaired, or you remove the uterus and it is rotten," Dr Ong'ech told IPS.
"When the health ministry issued a directive in February this year instructing all health workers, whether from public, private or faith-based organisations, not to participate in any training on safe abortion practices and the use of the medication abortion, many questions were left unanswered," said Omondi.
A highly respected Kenyan doctor, Dr John Nyamu, spent one year in prison in 2004 after his clinic was raided following the discovery of 15 foetuses on major roads together with planted documents from a hospital he had worked for but had since closed.
Speaking of his ordeal with Mary Fjerstand, a senior clinical advisor at Ipas, a global non-governmental organisation dedicated to ending preventable deaths and disabilities from unsafe abortion, Nyamu said that the publicity surrounding his imprisonment helped people to "realise the magnitude and consequences of unsafe abortion in Kenya; women were dying in great numbers. Before that, abortion was never spoken of in public."
He went on to say that Kenya wants to achieve the Millennium Development Goal of a 75 percent reduction in maternal mortality, but that "it can't be achieved if safe abortion is not available."
A May 2014 World Health Organisation (WHO) updated fact sheet indicates that every day, approximately 800 women die worldwide from preventable causes related to pregnancy and childbirth, with 99 percent of all maternal deaths occurring in developing countries.