Young People and Unsafe Abortion

Recently the National Daily Newspaper- Kantipur published an article with heading “Abortion Among Teenagers On the Rise”. The article shares, “A 17 year teen girl arrived at Lamjung Model Hospital situated at Beshisahar. The girl who had come from rural part of the district did not agree on continuing her pregnancy and demanded to terminate her pregnancy.”  Don’t you think this is a good news. I am really proud that young people are being vocal about their unwanted pregnancies and taking their own decisions  whether or not to continue with their unwanted pregnancies. The headline of the news should have been “AWESOME TEEN GIRLS CALMING THEIR ABORTION RIGHT AND ACCESSING SAFE ABORTION” – simple !!

The article continues and says “It is clear that underage as well as illicit sexual relationships are increasing along with abortions.” Lamjung Model Hospital is the only authorized abortion centre in the district. Dr. Tilak Babu Ghimire said, “Even the teenage girls of 17-18 years are coming for abortion. We try to convince them not to terminate their pregnancy as far as possible, but they are adamant.” I believe that service providers should be non-judgement and maintain confidentiality. The doctor should be proud on providing safe abortion to young girls, else they would have opt unsafe abortion which could have risk their lives. The article also talks about young women visiting neighboring district to access abortion. This clearly indicates that women do not trust the nearest health facilities- the reason might be service providers being judgmental and the facility does not maintain privacy and confidentiality. In Nepal even if abortion has been legalized and government health facilities provide safe abortion, women still have to travel different places to seek abortion. Another reason could be stigma. Stigma related to abortion has forced women to terminate their unwanted pregnancy seeking service from quack doctors or using herbal products.

For young women, complications from pregnancy and childbirth are the leading cause of death, and unsafe abortion is a major contributor to this mortality. Unsafe abortion can also result in lasting and devastating consequences, including, sepsis, peroration of the uterus or intestines, hemorrhage, chronic pelvic infections, and infertility. (1)

Deaths due to unsafe abortion are on the decline, but the proportion of women dying from unsafe abortion globally remains the same. 

  • MSI_Unsafe_Abortion_Infographic_080714_ARTWORKAccording to the World Health Organization, deaths from unsafe abortion worldwide have dropped from 69,000 in 1990 to 47,000 in 2008.(2)
  • Parallel to this decline, there has also been a one-third decline in maternal mortality from 546,000 deaths in 1990 to 358,000 in 2008. (2)
  • Despite the decline in the number of deaths due to unsafe abortion, the proportion of women dying from unsafe abortion has remained the same at approximately 13% of all maternal deaths.(2)
  • The number of unsafe abortions increased from 19.7 million in 2003 to 21.6 million in 2008 while the unsafe abortions per 1,000 women aged 15-44 years. (2)
  • This increase in the number of unsafe abortions without a corresponding increase in the rate is mainly due to the growing population for women for reproductive age.(2)

Young women account for a significant proportion of unsafe abortion worldwide. However, the article reflects that most of the teenagers are seeking services from safe places like, Lamjung Model Hospital and Marie Stopes Centres. This is commendable that young girls in rural areas of Nepal who are stigmatized for being a girl and getting pregnant before marriage accessing safe and legal abortion services. Without projecting this as a success story of Government of Nepal after making history for legalizing abortion 14 years back, our media is only sensationalizing the reality and reinforcing stigma around abortion.

According to the most recent data available from 2003, almost 14% of all unsafe abortions in developing countries were among women under 20 years of age. 

In developing countries, 2 in 5 unsafe abortions occur among women under age 25, and about 1 in 7 women who have unsafe abortion is under 20. Similarly, in Asia 30% of unsafe abortions are among women under 25 years of age and 60% are in women under 30. 

This is a request to all media personnel to analysis on the impact of your article. Instead of presenting data of abortion as terrifying issue, it would have been great if it was analyzed the difference between safe and unsafe abortions.

Even where abortion is legal millions of women across the world, especially young women, face barrier to access. In context of Nepal, many women, especially adolescents and women from rural Nepal cannot afford to access safe abortion. The geography of Nepal is another reason because of which women are deprived of safe abortion services. Unavailability of trained and certified service providers and continuous supply of Medical Abortion pills, women in many places in Nepal could not access safe abortion service. Stigmatizing abortion is discouraging trained service providers and capable human resources from providing safe abortion services. Even, volunteers like FCHVs are stigmatized for providing information on abortion. Marginalized populations like young persons with disabilities, women living with HIV, LGBTI and others are facing stigma and discrimination when seeking safe abortion services, resulting in denial of care or required authorization. Gestational limits, the need for parental consent for service is another barrier to accessing safe abortion services.

This article is an example that really hit me this month. I had discussion and argument on this. One of the people questioned me, “Why are you advocating and promoting abortion for young people? Why don’t you promote contraception instead? Excuse me! While more young women are using contraception in Nepal, there is till a tremendous unmet need for contraception and young women experience higher failure rates than older women. And I am not advocating for abortion, instead I am advocating for Safe & Legal Abortion. SIMPLE

Recently, I had received a call from Radio Station. The radio station is compiling data and information on abortion. They would like to know number of abortion cases. I replied them that I am not the person to talk about numbers on abortion. They should have visited to respective District Public Health Office and talked to concern department. She asked me what percentage of young girls seek abortion and what is the average age. Why these media people are more concern about the data on young girls accessing abortion. They concern and their queries is indeed stigmatizing young girls accessing safe abortion services. Instead for creating content that would provide wrong message to the community, it would be great if media could be sensible in this issue and support on preventing deaths due to unsafe abortion.

Please read this piece as well to get more incite on the articles publish on abortion by Youth Champion Advocacy Network Nepal.



Youth Champions during Humanitarian Crisis

Youth Champions Nepal were planning for its country seminar to introduce itself among network working in dedication to young people’s sexual and reproductive health & rights when Nepal was struck by its worst earthquake in nearly a century on April 25, 2015. The earthquake destroyed nearly 600,000 and damaged almost 300,000 homes, and displaced some 2.8 million people. More than 8.800 people were killed, tens of thousands were injured. The people are still frightened by aftershocks and the devastation was compounded by number of powerful aftershocks.

Once the earthquake struck our cities, there was urgent need for food, water, shelter and other basic stuffs including first aid. There were numerous causalities reported in district hospitals. The first step of our Youth Champions Network in Nepal we distributed rice, dal, water, sugar, oils, traps & tents, etc. This is what we immediately understood about a humanitarian crisis of this nature. This was the first experience for us living in Kathmandu valley and dealing with natural disaster. But in-coordination with Asia Safe Abortion partnership we realized, there is also an urgent need to provide life-saving reproductive health services and to prevent and respond to gender based violence. Asia Safe Abortion Partnership allowed to use funds to prepare “Hygiene Kits” and distribute among women and girls being affected by earthquake.

“I am sharing about the situation in my community “Bhaktapur”. Since Bhaktapur is a very old and traditional city, most of the houses are made of mud and wood. The earthquake had destroyed most of the old and traditional homes of the Bhaktapur city. People are now staying in open places like field, party palaces, ground and even in dumping sites. We have been calling those places as “CAMPS”. As, the earth has decreased its vibration and we are getting after shocks which we are used to, people who have their house safe and fine to stay have returned to their places.

Among the people in the camps, there are limited tents, electricity, water and food. The people who have lost everything and do not have any alternatives are staying in the camps. As per our team’s observation, there are many pregnant women in the camps. In particular camp, there are 2- 3 women who are pregnant and 1-2 women who recently gave birth to their child. There are more than 25 campsites in Bhaktapur. Some of the places are unreachable as the pathways are closed due to destruction.

Since, there is no work at all and most of the people are emotionally challenged, alcohol has been the best alternatives to pass the time and means of entertainment in the camps. This is also affecting young women and they might be in risk of sexual abuse in coming days. Likewise, smoking among men has been tremendous which is in directly affecting pregnant women and women who just have delivered. As we have set-up our HELP DESK in Bhaktapur Hospitals, there are many changes regarding pregnancy after the devastating earthquake. I personally attended a couple, who were 3 months pregnant and came to visit hospital after the women started to feel the pain on her stomach as she jumped to escape from falling home. But the case was not serious.

Other remarkable affect on women’s health is there are physically and mentally been challenged by the situation. In one side, they have lost their near and dear ones and on other side they have lost their properties. In same time, there is overburden of the work to single women as they have lost their husband and now they suddenly have the responsibility of running the house. Other major effect is on sanitation. There are no proper toilets in CAMPs. Similarly scarcity of water, people are defecating wherever they like. There have been spread of many diseases and women have been the worse affected.

People in camps are mostly provided with raw noodles and biscuits. Proper nutritious food is not available to young women, pregnant women and women who have just delivered. Essential medication like TT, ANC/PNC, iron tab, etc. is also not available. There is a scarcity of contraceptives and we are unable to provide with much help, there are also women who had miscarriage during the situation but there is no care available for them. Health camps are being conducted by different organizations and medical teams have been mobilized but no one is focusing on women’s Sexual and Reproductive health.”- one of our Youth Champions Nepal

Likewise, our youth champions working in coordination with Bhaktapur Youth Information Centre were engaged in assessing pregnant women, lactating women, adolescent girls their SRH and VAW. By, there were many articles online as well in print media which had been reporting continuously about women and girls in crisis situations who face special perils. Pregnant women need ante-natal care, a clean, safe place to give birth and medical attention in the event of complications. new mothers need vital nutrients and postpartum care. And women and girls of all ages need protection from gender based violence, including sexual violence, which tragically follows in the wake of most humanitarian crisis.

“There is a drunken man in our tent. We are mostly girls and women in the tent and we don’t feel safe, him being around. I went and told the camp management committee but they told me to come and complain only if something happens, but won’t that be too late? It’s a day time, but he can do anything to us at night.” A young girl taking shelter in a temporary camp in Kamalbinayak, Bhaktapur.”- One of BYIF volunteers

One of our Youth Champions met Mrs. Sarita Fhutuwar of Balambau, Changunarayan. She is a mother of two daughter and now is pregnant of 8 months. She thought she would have a normal delivery as before but due to earthquake she is in deep thought and is not sure about her post pregnancy. Her house is also badly collapsed and now.lives outside the house in tent. This is the time where she (every pregnant women)has to be given especial care but situation is just the opposite. Keeping in mind her health and situation we BYIF supported her with.some supplements like horlicks, nuts and biscuits(which is enough until delivery). She was also assured that with help of FPAN we will refer her to hospital nearby for safe delivery. This has made her feel much secure and relief.

Then we released we need to come up with a kit that address immediate need of pregnant women, lactating women, adolescent girls and children. Youth Champions Nepal planned to develop hygiene kit with materials like maxi, sari, towel, soap, panties, comb, cream, mosquito coils, sanitary pads (home-made), socks, tooth paste, tooth brush, diapers, supplemental food for babies, torch, napkins, ear buds, nail cutters and more.

Nepal and Nepalese are rising from rubble. The crisis in Nepal is far from over. As Monsoon is here, it has been followed by landslides. Aftershocks are regular occurrences but monsoon has made it difficult for locals to clear all rubble. Meanwhile, human traffickers are targeting the region to abduct vulnerable women and girls. In many ways the dangers are as great as ever.

Girls, Nutrition and Sports for Development

You are a girl. You should have feminine quality. Do not act like a boy! OMG….. this is a ball! this is only for boys! No pants please wear skirt! Oh ho…. how could you participate in sports? No no… No way! Football: it is boy’s game not girls. Go and play with dolls in your room.

This is how an adolescent girl in most of the South Asian Countries come across. And Nepal is not exceptional. The trend of participating young girls in sports during their schooling has been increasing but drop-out once they start menstruating is high in deed. Personally I never participated in out door games like football, basketball and volleyball. My childhood has a great memory of my female cousins spending our weekend at home, in a close room with Barbie and so called girl toys. I swear our parents were happy to see us enjoying their daughters totally draining into feminine character where male toys were always superior than female.

Also I remember my first menstruation and I made my family shocked. I belong to a Newar Buddhist community where an adolescent girl must perform a traditional ritual called “Barah” before she starts her period. You wont believe I was not given salt in my food. Can you imagine an adolescent girl in her first stage of puberty and going through menstruation not given salt in her food? I still could not understand this and this ritual still continues in our community. But I am 100% sure in my family and area where I live have gradually coming out of this ritual for putting their adolescent daughters in a dark room for almost 12 days during her first menstruation. We still need to advocate about this.

Well why I am talking about this is I recently attended  two days workshop Sports for Development Conference organized by the AFC ans One goal in collaboration with the 2014 AFC Women’s Asian Cup final which was hosted in Ho Chi Minh City from 23rd-24th May, 2014.  The Conference brought together NGOs, sporting agencies, corporates, AFC member associations, sport for development community-based organisations, and government bodies to discuss:

  • The current landscape of nutrition, women in development, and grassroots football for girls in Asia
  • International best practices, effective program models, and a way to move forward for nutrition, gender, and grassroots football for girls in Asia
  • CSR in Sports and Sports as CSR
  • The need for strong partnerships between governments, sports organisations, corporations and NGOs to make Sports for Development a success

Conference special guests and attendees shared their expertise, concerns, and best practices which made for lively panel discussions and engaging themed sessions. Here are the highlights from the Sports For Development Conference Ho Chi Minh City.

The above statement I presented during my presentation entitled “Sexual and Reproductive Health and Rights for All” During my presentation I linked young people’s SRHR with nutrition and sports.

Yes! I do believe that football can make a difference. I am so fortunate to be part of the two day workshop and learn more about adolescent girls participation in football and how life changing with One Goal Campaign. I would like to thank Women Deliver for providing me this opportunity to represent my Local NGO Bhaktapur Youth Information Forum in such a great platform.

“Football is the most successful sport in the world. It’s the sport anyone anywhere can play anytime. The power football has to change lives [is real]. It’s about how football can be relevant in all areas — not just the elite, but at the grassroots. …20% of football players in Australia are female. Girls must have the opportunity to play. …Football is more than just a game…” -Emma Highwood (Head of Community Football, Football Federation Australia)

New One Goal Report released: Improving Nutrition for Adolescent Girls in Asia and the Middle East: Innovations are Needed

Dr. Regina Moench-Pfanner from the Global Alliance for Improved Nutrition (a core ONE GOAL partner) presents a new report that highlights the need for innovations in improving the nutrition of adolescent girls in Asia and the Middle East to Dr. Nguyen Cong Khan (Director General, Administration of Science Technology and Training, Ministry of Health Vietnam).

Dr. Regina Moench-Pfanner from the Global Alliance for Improved Nutrition (a core ONE GOAL partner) presents a new report that highlights the need for innovations in improving the nutrition of adolescent girls in Asia and the Middle East to Dr. Nguyen Cong Khan (Director General, Administration of Science Technology and Training, Ministry of Health Vietnam).

“Eat, Play, Live Right” – pan Asian photo exhibition on football, nutrition and children 

Healthy children equals healthy communities. The ONE GOAL campaign seeks to help build healthy nations by ensuring nutrition for every child, leveraging the power of football. The “Eat, Play, Live Right” photo exhibition showcases the amazing work of developing communities through sport, especially football, being done by One Goal partners around Asia. AFC Deputy General Secretary Dato’ Windsor John and Ministry of Health Vietnam Director General Dr. Nguyen Cong Khan open the photo exhibition at the Sports For Development Conference.

Freestyle Football demonstrations

“All you need is a ball” is the motto of Freestyle Football who combine freestyle tricks and dance by using a football.

Themed session highlights

Nutrition and Maternal Health
  • There are clear linkages between the health of girls and women, nutrition, and participation in football.
  • It’s critical that we look at nutrition through a woman’s lifecycle, and particularly how nutrition intersects with maternal health. For example, half of all pregnant women in developing countries are iron deficient, which can lead to hemorrhage during childbirth.
  • Access to nutrition and to maternal health services is a rights-based issue.
  • When addressing youth health services, it is critical to ensure that young people themselves are involved in the planning and implementation of these programs.
Women’s Health and HIV
  • There are 1.7 million women living with HIV in Asia. In Vietnam, 54& of HIV positive women report that their only possible exposure to the disease was through their intimate partner.
  • This is a rights issue: women and girls need equitable access to services, and to live free of violence, coercion and stigma.
  • When addressing nutrition, there is a critical need to shift the focus to adolescent girls, for their own sake and that of their offspring, to break the cycle of malnutrition, prevent obesity and chronic diseases later in life. Doing this requires working with boys as well.
  • Football can be a useful mechanism to send messages on nutrition.
  • Young people in humanitarian/crisis settings can be particularly vulnerable to HIV. Often, youth needs are not adequately addressed.
  • Again, meaningful youth participation is needed.

Girls participation in grassroots football

  • The opportunity to take part in grassroots football and other sports, for millions of girls around the world, depends on them having the same fundamental rights and freedoms as boys.
  • There is a way forward. This doesn’t have to be a continual problem.
  • Grassroots football can empower girls by helping them realize opportunity.

One Goal in Vietnam – a way forward

  • Members from National Institute of Nutrition, World Vision Vietnam, Football For All Vietnam, Libero Sports, World Vision Australia and Royal DSM met to discuss the way forward for One Goal in Vietnam.
  • There are proven models which can be used to scale up efforts to address nutrition: Fortified food products, Nutrition education materials, Nutrition clubs – holistic community based approaches to extend Government health services, Football for development models. We know what can be done and through One Goal there is an opportunity to leverage sport to scale up effective models to ensure more children in Vietnam get the right nutrition and can participate in sport for a healthy lifestyle.
  • There are great distribution mechanisms and institutional infrastructures in place in Vietnam: Women’s Union, Youth Union, Health networks, Schools, Parents, Provincial football structures. There are opportunities for inclusive business to improve the food choices at the base of the pyramid.