How conmen are minting millions in risky abortion procedures

Carol paid Sh10, 000 and was given four pills and instructed to swallow two [Photo: Courtesy]

Carol, 20, almost became a static because of an orgasm. “I had to get rid of the pregnancy. I am still waiting to join college and my parents would have been mad had they known,” Carol revealed.

A friend advised her to visit a private doctor within the Nairobi CBD, where she was charged a consultation fee of Sh3, 000.

“I was then given options. Pills would have costed me Sh10, 000, while the charge for a surgical procedure was Sh30, 000,” she says.

Carol paid Sh10, 000 and was given four pills and instructed to swallow two and insert the other two in her vagina. What followed were three days of excruciating pain, accompanied by menses-like bleeding on the first two days and heavy bleeding with clots on the third day.

“On the fourth day, the bleeding subsided, but the pain became unbearable, This forced me to call the doctor who asked me to go and see him,” she confides, claiming she had to keep taking painkillers to help relieve pain that “almost made me lose my mind”.

She thought the doctor would examine her before making a diagnosis. He never did!

“He just asked me if I was in pain and when I said yes, he said I needed to be cleaned in a theatre at a cost of Sh38, 000. He never examined me to establish if there were complications,” Carol recalls.

But because she didn’t have that kind of cash, Carol opted to go back home. Eventually, the pain subsided and the bleeding lessened and finally disappeared.

“I only came to realise that I could have actually walked into any chemist myself and bought a drug to stop the bleeding for just Sh200 per tablet and swallowed it instead of wasting all that money on a private doctor,” she adds.

Dr John Nyamu, a consultant gynaecologist, says there are clear guidelines on how registered doctors should handle cases, but some choose to take advantage of clients.

The Kenya Medical Association (KMA) estimated in 2012 that nearly 465,000 Kenyans undergo abortions annually. Carol could have died, but she was fortunate to be among the 119,912 women who experience complications related to induce abortions every year.

These women, according to a report titled, Incidence and Complications of Unsafe Abortion in Kenya, include educated and uneducated women, urban and rural women, Christians, Muslims and women of ‘other faiths’.  They are treated for bleeding, sepsis (bacterial infection), shock and organ failure.

Health experts argue that those who do not seek medical attention after unsafe abortion could get well, suffer in silence, or die.

A spot check by The Nairobian found that the drug which is mainly intended to be used to stop excessive bleeding among women after giving birth is readily available in most pharmacies. Some chemists however claim they only sell to those with prescription from gynaecologists.

Prof Joseph Gatheru [Photo: Courtesy]

Prof Joseph Karanja, a consultant gynaecologist says that abortions could end up in complications which have to be cleaned. He attributes this to the fact that abortion is criminalised in Kenya.

“Most of those who find themselves with complications go for procedures to clean the mess, which could cost between Sh3, 000 and Sh100, 000, depending on where it is being undertaken,” says Karanja.

He does not rule out the possibility of some doctors taking advantage to mint money out of their patients because of desperation.

While some doctors ask for as much as Sh50, 000, post-abortion care costs only a tenth of this in most public hospitals. A source at Marie Stopes in Eastleigh confided that post-abortion care in the clinic costs an average of Sh8, 000.

Dr John Ong’ech, a leading gynaecologist, says that post-abortion care is a common feature in public health facilities which mainly try to solve a problem created by rogue practitioners in backstreet clinics.

“After the damage has been done out there, public healthcare facilities end up with the burden of care, which is not cheap,” he says.

Dr John Ong’ech [Photo: Courtesy]

A report released in February this year by the Ministry of Health found that treating medical abortion costs an average Sh4, 822 to treat. Medical vacuum aspiration costs about Sh4, 488.

Karanja however points out that in a circular by former director of medical services, Dr Francis Kimani, had directed that post-abortion care be included as a part of free maternity care, but it seems that was quietly ignored.

A research published in BMC Pregnancy and Childbirth in 2016 indicated that young women aged 10–24 years are at heightened risk of unsafe abortion due to their high vulnerability to unintended pregnancies.

“Comprehensive post-abortion care services targeting young women are needed. In particular, post-abortion care service providers must ensure that young clients receive contraceptive counselling and effective pregnancy prevention methods before discharge from the healthcare facility to prevent unintended pregnancies that may result in subsequent induced abortions,” concludes the research,” says Evelyn Opondo, Africa director of the New-York based Center for Reproductive Rights (CRR).

Treating an abortion complication requires about eight hours of a medical practitioner’s time according to the report by Africa Population Health Research Center (APHRC) which further estimated that public facilities in Kenya spent half a billion shillings on such cases in 2016. This figure to

The APHRC report states that Rift Valley had the greatest expenditure on complications of unsafe abortions at Sh112 million, followed by Western at Sh83 million, with the two regions having the greatest number of women admitted for complications in 2012.

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