Is our Voices Still Voiceless?

_BSL9604I observed the so called Reproductive Health Right activists/ advocates are still afraid to talk about abortion issues in public. “We should not sound like we are promoting safe abortion. Our action needs to be subtle. This will have good impact on media. Our message won’t be misinterpreted”- one of the Reproductive Health Right Activists.  SERIOUSLY!! You are the one who has good following in your network and outside. You can influence 1000 of people in and around. But you are feared being  misquoted.

I had same observation when we were celebrating third national safe abortion day. To mark Safe Abortion Day- 28th Sept 2017, Reproductive Health Right working group organized a candle light event to remember women who lost lives due to unsafe abortion by lighting candles. There are series of program the working group will be organizing which aim to campaign as a movement to promote universal access to safe, legal and confidential abortion as a women’s health and human rights issue.

We celebrated the candle light event in the most heaped area of Kathmandu where biggest political protests, social campaigns and discussions take place every year. All those discussions are fairly covered in the media and have great impact on readers. Ultimately, this is what we wanted when it comes to media coverage on abortion to spread relevant facts on safe abortion to demystify stigma surrounding the issue. Only 38% of women are aware of legality of abortion in Nepal. It has been 15 years of abortion legalization in Nepal and women are still seeking unsafe abortion resulting into complications. This article gives us a glimpse to real women accessing abortion in Nepal.

I participated in the event too. We had play cards with information on abortion. I requested the team to let’s go outside of the place and display the play cards to general people so that they will be informed on what we have been doing in the Mandala. The team hesitated to do so. It seems like they wanted to completely the event in few seconds sharing information within us and leave the place before someone comes and interrogates on lightening candles. It’s a public place and we are supposed to invite more than 100 people and start interacting with public on abortion being safe and legal in Nepal. Only thing that going around my mind was “Could you please leave to young people? We have much more and effective ideas to make this event memorable. Kindly get us in the board and discuss with.” Upcoming generation should be aware of why abortion needs to be safe, legal and confidential.

All Reproductive Health Right activists are scare of getting into trouble. Or should I called it getting their name in front page of national newspaper associating them with abortion. This is called DOUBLE STANDARD. We are supposed to spread accurate and reliable information on Safe and Legal abortion outside of our network. We, as abortion activists have enough information on abortion being human right. This needs to be replicated to those who are unaware and against safe & legal abortion. The objective of celebrating international campaign on safe and legal abortion is to aware communities, sensitizing media, advocating political parties and reforming unfavorable laws and policies which are barrier for a woman to access her right to healthcare. However, this event was celebrated only in the presence of organizations, partners and stakeholders who are pioneer on advocating for abortion. This in deed won’t support our campaign to make our voice heard. IS OUR VOICES STILL VOICELESS? Obviously yes!

We as abortion activists are not prepared to answer the question “Why are you promoting ABORTION?”. We always try to avoid the questions and most reply “We are not promoting abortion. We are promotion family planning”. As if “family planning” is the solution to prevent abortion incidence. If it was all Government health facilities and NGOs have been promotion free family planning services for many decades now. Why we are not confident answering this simple question. Unless our collective voices won’t advocate for  “Abortion”, the issue will be stigmatized every time.

Last year, we organized similar program in same place lighting candle in memory of women who lost their life due to unsafe abortion. One of the social media group posted saying “What a shame! People are celebrating the issues which kills unborn child”. On sharing the issues with the team working for women’s choice and access to safe abortion, they do not strategy to deal with hate comments/ negative remarks. One of them told, “Don’t worry! This will not make sense.” WHAT? The page has more than 1000K followers, mostly young people. The young people have started supporting the notion ” Abortion is not safe. It should be punishable.” It’s surprising when the activists close their eyes saying these remarks won’t affect the cause. Anti abortion groups are actively working in Nepal and they are not leaving an opportunity to stigmatize abortion. But we are carefree and are not setting strategies to back out those hater calls. Then we, Youth Champions took the initiation and at least try our best to reply positively sharing facts and data. It is important to clear the myths and misconception associated with abortion. If we don’t, this will stigmatize activists like us for advocating for safe abortion.

We need to make more noise to make our voice heard by women and young girls in communities. Around 322,000 women undergo abortion in Nepal every year and more than 186,000 cases are unsafe. Unless our campaign are effective and our messages getting to women and young girls, we won’t be able to reduce unsafe abortion cases. More than 3,000 health professionals have been mobilized in safe abortion service in Nepal. Around 1,100 health facilities have been authorized to carry out the comprehensive abortion care. We need to shout-out in all possible ways to aware people about safe and legal abortion sites and these sites providing safe, legal, confidential and free abortion service which is carried out by trained and qualified health professionals.

Advertisements

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.

 

Media Sensitization on Safe Abortion

Youth Champion Advocacy Network Nepal, YOUTHCANN had received a small grant from Asia Safe Abortion Partnership to organize various advocacy session on safe abortion to different groups like young people, service providers and media people. On the occasion of September 28, Global Day of Action for Access to Safe and Legal Abortion, YOUTHCANN organized half day sensitization program on safe abortion to media persons from print and radio.

Media is one of the most powerful instruments of communication. It plays a very constructive role in today’s world. As we know media plays an important role in increasing of public awareness and collect the views, information and attitudes toward certain issues. It presents the real stage of society. Without the media, people would be isolated, not only from the rest of the world, but also for the total formation of creditable world.

The media has got a vital role in molding positive perspective on abortion among people and spread positive message in the society to #BustTheMyths. But there is a myths on media

Myths: Most Media People Object the Abortion.

Facts: Media People are Often leading Advocates for Safe & Legal Abortion

Resource person Ms. Madhabi Bajracharya from Ipas shared that Ipas Nepal also closely works with media people and organize sensitization program for them regarding abortion. It has been observed that media people have their own values and they rarely accept abortion a woman’s right. Holding ones values on abortion might give rise to bias news and information which simultaneously lead to #abortionstigma and discrimination.

Likewise, one of the Youth Champions shared that she has been following various articles been published in newspaper and online news regarding abortion, the media always covers news on women deaths and complication due to abortion but they never specify where the deaths and complications are due to safe or unsafe abortion. There is difference between safe or unsafe abortion and reporting accordingly.

LM-abortionStigmaSP-info3-130915_02-1024x1024There was very good discussion among participants and facilitators. One of the media person asked what YOUTHCANN is doing to avoid abortion? Avoid Abortion…….. Well YOUTHCANN never promotes abortion. We are pro-choice and we respect informed choice and decision of every woman. We encourage young people to use modern contraceptive to prevent unwanted pregnancy which may lead to abortion. Even if Government has been giving more emphasis to contraceptive and it is free in almost all the health facilities, women do seek for abortion services. We encourage women and men to have safe and legal abortion which has less complication instead of unsafe traditional abortion which leads to death.

The participants were more curious to know about data on abortion and its failure rate. Also, they were keen to know the percentage of young women going for abortion. They perceive various myths on abortion like:

  • Infographic-2Most of the young unmarried women undergo abortion.
  • Abortion is a crime.
  • Fetus has its right of survival
  • Young people are using abortion as family planning.
  • Repeated abortion is dangerous.
  • Service providers do not want to perform abortion
  • INGOs are promoting abortion.
  • Abortion leads to infertility.
  • Woman needs husband consent for abortion.
  • Young people should not be given SRHR information and access to service.

All these Myths are cleared by the resource person Madhabi and Deepndra Khaniya. Deependra Khaniya is Managing Director of nation’s leading radio station Radio Audio which supports young people’s SRHR and on-air program on safe abortion. Deependra shared that his team receives more than 200 SMS daily from young people between 15 and 24 years which is mostly related to SRHR. Even if we do not allow young people to talk, listen and see SRHR stuffs they will definitely receive information from somewhere which might be incorrect and lead to unexpected situation. These days young people are more prone to social media and it is not always necessary they absorb only good information. Even we are helpless to block or stop the inaccurate information to reach our young people. Therefore, it is our job: media people’s job to clear our own values regarding abortion and provide reliable information to them.

Media should be sensitive when they write articles, news and on-air program on safe abortion. No woman undergoes abortion with her interest. It’s due to some reason and media should analysis those situation. One of youth champion shared that she had read an article which says, “Young girls in school uniform goes to abortion clinics and its increasing.” Well most of our government health facilities are Youth Friendly Service centres. It remains after school to reach most of the young people with information on SRHR. It’s government’s initiation. The YFS centres are in health institutes which provides safe abortion service as well. So, it would be discrimination to young school going girls if we publish on one sided information. May be she was there in health facilities for science project work or her regular meeting with community girls. This kind of bias information only hampers young girls and our country will never progress.

Youth Champion Prabina Sujakhu led value clarification exercise. Upon asking the statement: HIV infected woman should not give birth, most of the participants raise their hand in favor to the statement. The concern was if mother is infected she is not health enough to give birth to healthy baby. Some said infected mother gives birth to infected baby. Upon asking what if she knew pregnant. Most of the participants replied abortion is best option for her. But we facilitator shared its her right whether or not she wants to have her baby and knowing about safe procedure now we have in medicine which protect baby form HIV infection, the participants were forced to rethink.

Likewise, on asking whether husband’s consent is necessary for abortion most of the male participants were in favor to the statement stating mutual decision is the best which won’t lead to disturbance in family. Due to conflict in family, the marriage ends in divorce. But female participants shared that its woman’s body and she has her full right to decide about her pregnancy. There were argument between male and female participants on this statement.

Similarly, on asking abortion is killing fetus all most all the participants agreed upon address fetus as baby and life starts from conception. But the participants seem to be convinced when facilitator shared that there is not any study to show when life begins. Fetus depends on woman’s body as parasite. Life is only counted when it survives with its own.

At the end of the program, a video was shown “News Room Bahira”. The video talks about Sushila Jaisi’s death due to unsafe abortion. This video make the participant realized that even if there is availability of contraception for free of cost, abortion occurs. Abortion is always woman’s last decision. Use of contraception leads to prevent abortion.

The participants shared that this was the first time they had attended session on abortion. They realized bias information leads to #abortionstigma and discrimination. They also promised to contact YOUTHCANN for accurate information and resource materials on abortion as well as SRHR. In deed it was a fruitful orientation.