Women wanting abortions have resorted to sleeping overnight on the pavement outside Durban’s Addington Hospital because the unit treats only 10 women a day, on a first-come, first-served basis.
But, says a Sunday Tribune report, this is not unique to the city – it is part of a countrywide problem where the shoddy treatment of women at public health facilities is driving many to seek backstreet terminations, risking injury and death.
The report says an investigation revealed that: women have been barred from the hospital’s waiting rooms at night; security guards claim the ban was enforced because some were “noisy or stole from other patients”; the unit treats only 10 women a day on a first come, first served basis and there is no option of making an appointment; this limit is not advertised, and often more than 10 women queue overnight, only to learn in the morning they can’t be seen; there is a shortage of health professionals countrywide who are able and willing to perform termination of pregnancy services at public health care facilities; Addington’s termination of pregnancy unit was not open on at least one day this week as its nurse was on leave; and the stigma attached to abortion has resulted in many doctors and nurses refusing to provide such services.
Admitting that “health service delivery times had been compromised”, KwaZulu-Natal Health Department spokesperson Ncumisa Mafunda said the department encouraged “women who might have any pressure to terminate a pregnancy to seek legal Termination of Pregnancy in the right place” through its clinics. Mafunda provided a list of 42 public health institutions that offered services in the province, including seven in eThekwini.
But, the report says, the experiences of women seeking terminations at Addington Hospital have raised critical questions about the quality of these services, as well as other issues.
Mafunda said health authorities had been unaware of the plight of pregnant women recently forced to queue overnight outside Addington Hospital to receive attention at its clinic. “Neither the facility nor the department was aware of such an occurrence until it was brought to its attention. The department wants to emphasise no health care user has ever been denied access or asked to wait outside its facilities,” he said.
The report says as far back as 2015, KZN’s Health MEC Dr Sibongiseni Dhlomo acknowledged the plight of women seeking to end their pregnancies and the impact on the health system when things went wrong. He said in 2014-2015 alone, 20,013 patients were admitted to various health care institutions in the province because of illegal abortion complications, including 1455 where the women’s wounds had turned septic.
He launched an awareness campaign and criticised the prevalence of back street abortion providers’ adverts which, he said, made women believe they were a legitimate service. Two-and-a-half years later, not much has changed.
Dr Tlaleng Mofokeng, the vice- chair of the Sexual and Reproductive Justice Coalition and a member of Global Doctors for Choice, said it was “disgusting” that women awaiting abortions had to sleep on the pavement. “Can you imagine if that were to happen to those waiting for renal treatment? Why should it be allowed just because these woman have been stigmatised?”
Mofokeng said in the report that there was no point in the National Health Department placing adverts on billboards and in newspapers opposing unsafe abortions when it could not provide a safe alternative for women who wanted to end their pregnancies.
“If you go on to the department’s website, there is no information about how or where women can go to have abortions. It is appalling that the department wants to talk about unsafe abortions when it cannot provide alternative facilities, resources and options,” she said.
Whitney Chinoqwenya, a spokesperson for Mary Stopes South Africa, the country’s largest non-profit provider of sexual and reproductive health-care services, said there were multifaceted problems with the department’s provision of services.
“There are not a lot of doctors and nurses trained in the procedure. There is also conscientious objection – the right of a provider not to give the service based on moral, religious or ethical beliefs,” said Chinoqwenya. “And if a manager has the attitude that he will not provide the service, then all the health care practitioners in that facility will have to adopt that policy, too.”
According to Chinoqwenya, only one public health facility performed abortions in Johannesburg, forcing many women to choose a riskier solution. “Back street abortion clinics see more clients than Marie Stopes does for a number of reasons, such as pricing and accessibility. These illegal providers are mushrooming. You just have to walk along the street in the city and you will see signs on how and where to get a backstreet abortion done,” said Chinoqwenya.Sunday Tribune report