An explosion in backyard abortion ‘clinics’

. . . 60 000 illegal terminations a year

Knitting needles, spoons, dish-washing liquid, prescription pills and other items are the everyday paraphernalia for abortionists, who“help”even pre-teen kids to terminate unwanted pregnancies. In an in-depth report, The Sunday Mail investigation team covertly visited some of Harare’s notorious backyard “surgeries” for a rare insight into the thriving vice that has seen Zimbabwe’s girls and young women go through untold suffering.

Asecret network of traditional healers, doctors and unrepentant apostolic sect leaders is working outside the confines of the law and medical establishments to provide unsafe illegal abortions.

Syndicates operating illegal backyard abortion “clinics” are using knitting needles, spoons, dishwashing liquid, dangerous pills and assorted concoctions to terminate pregnancies of young, vulnerable and scared women.

An abortion is the medical process of ending a pregnancy so that it does not result in the birth of a baby. Some of these terminations fail, thereby posing serious health risks to those that attempt to abort.

These backyard abortions are putting the lives of hundreds of women at risk, while a lot more are dying and suffering in silence because of the stigma associated with them. Victims often refrain from seeking medical help until it is too late to remedy the damage.

Last week, The Sunday Mail Society conducted an in-depth investigation into the vice which seems to have reached alarming levels in Harare.

The entry point into the investigation was Mercy Tsivo (not her real name), who lives in Harare’s Kuwadzana high-density suburb. As we sat down with her, there was a hint of pain in her captivating smile. Beneath that smile is a layered story of abuse and exploitation by her boyfriend.

But to get her full story, it is important we start from the beginning.

The 19- year- old was nearly four months pregnant when she decided to get rid of the pregnancy. However, she could not go to the hospital as an abortion without compelling reasons is illegal in this country.

Her only solution was a backyard abortion.

She vividly describes the agonising pain she endured when she tried to clandestinely terminate the pregnancy through an illegal abortionist in Mbare.

“When the pain started, I called him and begged him for help because I was bleeding so much. The pain became more and more severe. I could not sit or stand, or lie down. I could not move. He told me not to contact him again, as it was not his problem. He told me to go to the hospital if I had problems. After that, I never got hold of him again,” said Tsivo.

She almost bled to death, with pieces of her uterus in her blood, when she was found by her friends.

Ever since that fateful day, Tsivo is still bleeding. She emits an unpleasant smell.

What was meant to be a simple procedure turned out to be a nightmare

— things went awfully wrong at the backyard “clinic”.

“I was haemorrhaging to death from that botched abortion. They first gave me a prescription drug called Cytotec. After a while, I felt an excruciating pain that tore through my spine,” she said.

Cytotec, according to medical experts, is a medication used to prevent and treat stomach ulcers, start labour or cause an abortion, among other things.

“They then used forceps to open my cervix. They dug the foetus out using a spoon and a knitting needle, it was agonising but I had no choice,” she said, adding that she still feels that something is still inside of her womb.

Tsivo is one of the thousands of women across the country who constantly navigate the hazards associated with illegal backyard abortion “clinics” that are thriving in Harare.

Clandestine backstreet “clinics” offering illegal abortions are one of the prime causes of unnecessary maternal deaths across Africa, statistics have shown.

The lack of facilities for safe procedures makes the statistics even worse.

Network of abortionists

“Street doctors” and traditional healers, who trade at the famous Mupedzanhamo Market in Mbare, are at the heart of this gory business. They are the chief suppliers of concoctions, which they believe completely terminate pregnancies. They also work with unscrupulous doctors, bringing together a coterie of operatives and runners from the major hospitals.

Information gathered by The Sunday Mail Society shows that some doctors at Zimbabwe’s major referral hospitals are facilitating the unlawful termination of unwanted pregnancies using prescription drugs.

One of the infamous drug is popularly known as chigeza

mudumbu. It is largely believed to be Cytotec. Illegal street doctors are cashing in on the tablets that have now flooded the market.

Their operations bring together runners and middlemen such as traditional healers, “street doctors”, accredited health practitioners and even hairdressers, who are cashing in on the growing demand. Sources said health practitioners from public hospitals are the major players in the thriving backyard abortions market.

Some are now even renting apartments in the Avenues, where the abortions take place, an indication that demand for their services is high.

In case the procedure does not go according to plan, the syndicates smuggle their patients into health centres for treatment.

Pretending to be in need of help, The

Sunday Mail Society team was directed to Matapi Flats where we met a woman who would help an “imaginary girlfriend” to abort her five-months pregnancy.

She demanded US$12 for the pills ( chigeza mudumbu).

Another dealer that we met at Fife Avenue Shopping Centre said they used pills such as Misoprostol to induce preterm labour and abortion.

“We get them from our ‘doctor friends’. We source some of them from pharmacies at a much cheaper price. We then resell the drugs for US$12. For our services, we charge US$20,” she said. There are two ways to terminate pregnancy — either through taking the prescription drugs or through a minor surgical procedure. Doctors say a medical abortion involves taking pills (the abortion pill), usually 24 to 48 hours apart, to induce a miscarriage. The surgical abortion is when a pregnant woman goes through a procedure to terminate the pregnancy. Abortions at private clinics cost an arm and a leg, ranging from US$ 150 to US$ 300. This is probably why many are opting for the backyard abortion “clinics”.

‘Unsafe abortion is life threatening’

Sometimes illegal providers overdose women, giving them mixtures of laxatives, aspirin and medication used for stomach-related ailments.

At times, backyard doctors remove the foetus using household equipment like wire hangers and fire tongs.

However, once they have taken their victims’ money, they usually disappear. Most of them cannot be tracked or traced as they change phone numbers and locations.

A Harare specialist doctor and gynaecologist, Dr Alfred Nyoni, said most women are resorting to backyard abortions because of poverty.

“There are more girls who are resorting to illegal abortions because of poverty. Most of them lack proper information on birth control pills, hence the unwanted pregnancies,” he said.

Added Dr Nyoni: “Some of these women risk psychological trauma, womb infections, life-threatening bleeding and infertility. The illegal abortion industry is huge and women are losing their lives due to unsterile operations performed by individuals with no medical knowledge.

“For those that use these unsafe methods, the life-threatening consequences include severe haemorrhage, sepsis (severe general infection), poisoning, uterine perforation or damage to other internal organs. Urgently admitted to hospital, a woman may need a blood transfusion, major reparative surgery, or a hysterectomy — a complete and irreversible removal of the uterus,” said Dr Nyoni.

He also said although some women are able to access black market drugs, they may still suffer complications due to poor drug quality, incorrect dosages or inadequate information, or a combination of these.

The law on abortion

While abortion is illegal and controversial in Zimbabwe — a largely Christian nation — more than 60 000 women still undergo unsafe terminations each year, thereby risking death from haemorrhage, infection or shock.

This is according to the healthcare provider Marie Stopes

International, headquartered in South Africa.

The Termination of Pregnancy Act stipulates that termination of a foetus is only legal when the life of the mother and her physical health is threatened or when there is a risk that the child will be born with physical or mental defects of such a nature that the child will be permanently or seriously handicapped. Those who break the law can be jailed for five years.

Chairperson of the Parliamentary Portfolio Committee on Health and Child Care Dr Ruth Labode has called on the Health Ministry to revisit the Termination of Pregnancy Act with a view to expanding its scope so that young people and those suffering from debilitating health conditions such as diabetes and HIV/Aids can be allowed to abort.

Late last year, Family Health director in the Health and Child Care Ministry, Dr Bernard Madzima, said statistics from previous researches show that 16 percent of maternal deaths are due to unsafe abortions.

Half of the figures occur among adolescents.

The 2016 national adolescent fertility study by the Zimbabwe National Family Planning Council showed that nine percent of adolescents between 10 and 19 years had fallen pregnant.

These pregnancies sometimes end in unsafe abortions, reads part of the report.

Campaigners say a comprehensive evaluation of the Termination of Pregnancy Act is required in order to save lives.

According to the United Nations, Zimbabwe’s maternal mortality rate of 443 deaths per 100 000 live births is triple that of neighbouring South Africa, where abortion is legal.