At 12 years, Jessy [not real-name] is supposed to be thinking about her next move in school. However, she has recently become preoccupied with issues to do with her womb, which she could lose, after a botched attempt to abort pregnancy after her step-father impregnated her. THOMAS KACHERE writes.
Her demeanor—aversion to eye-contact, a sheepish smile and consistent fiddling with fingers— betray her: She is a minor with the best part of her life ahead of her.
However, she has no time to observe cattle, common in areas under Inkosi ya Makosi M’mberwa, lumber about, or mango trees, which will soon be in season, grow piercingly green, let alone people going to and from.
“I have better things to think about than those,” she says, with an almost painful finality.
If she had her way, she would have strung her step-father from the nearest tree months ago. This is because, in her mind, he is the cause of all her problems.
In other words, he has allegedly been defiling her, which is why she found herself at Ekwendeni Mission Hospital late last month, where she was being treated for an infection of the womb.
The hospital is situated about 20 kilometres from Mzuzu City and serves as a general hospital with just under 200 beds providing health care to the local catchment area of approximately 50,000 patients.
The facility has five wards; male, female, paediatrics, maternity and a private ward.
Normally, common conditions that patients bring to the hospital include diseases such as malaria, tuberculosis (TB) and HIV and Aids.
However, according to one of the foreign medical experts who has been to the hospital, Daniella Cox, who has chronicled her experiences at the hospital on the CMF website, cases of diabetes mellitus, hypertension and heart failure pitch up here and there.
In fact, Cox “had the opportunity to help set up a Chronic Care Clinic which was mainly focussing on the diagnosis and management of hypertension and diabetes mellitus. I aided in the creation of Ekwendeni specific protocols which were to be used in the clinic which we based on protocols used in the United Kingdom. I also aided in training counsellors to help patients understand their disease, understand healthy eating and the importance of a good diet and compliance to medications”, according to a CMF article she has written on the facility.
However, workers at Ekwendeni Mission Hospital were, late last month, surprised to get a client whose case had nothing to do with malaria, TB, HIV and Aids, hypertension or diabetes mellitus. It was the case of Jessy, who is being treated at the facility.
But Jessy, whose parents are from the Northern Region, will have to wait for results of the medication she is getting. If the medication works, fine and good. If it does not, she risks losing her womb through a surgical operation.
The young girl, who was brought to the hospital by her mother, was found with complications after medical personnel discovered that she was weeks pregnant after unsafely aborting the other one a month before.
According to Elsie Kuluwani Nyirongo, one of the healthcare workers at Ekwendeni Mission Hospital, the 12-year-old girl was brought to the health facility by her mother after she [the mother] observed that the daughter was continuously breeding despite being pregnant.
‘‘We received a 12-year-old girl who was pregnant. We discovered that, even at 12 years, this was her second pregnancy. Medical examinations showed that she had earlier induced an abortion using traditional means.
“Unfortunately, it caused some injuries in the womb. We also learned that, a few weeks after the pregnancy termination process at a traditional healer’s place, the girl fell pregnant again but the fetus was growing inside the fallopian tube and injuries that the concoction caused in the womb resulted in continuous bleeding, which forced the mother to bring her to the hospital,’’ Kuluwani Nyirongo, who Jessy’s mother gave permission to speak on the issue, said.
“We discovered that the bleeding had nothing to do with the menstrual circle. It had everything to do with injuries sustained during the unsafe abortion services procurement process. So, after coming up with different suggestions, we made a decision to just remove the fetus which was growing in the fallopian tube and that we should monitor how other injuries caused are going to be healed. As of now, we are helping the girl by giving her the proper treatment but the fetus has been removed from the fallopian tube,’’ she said.
A fallopian tube is, according to the World Health Organisation (WHO), one of two long, slender tubes that connect ovaries to the uterus. Eggs pass from the ovaries, through the fallopian tubes, to the uterus. In the female reproductive tract, there is one ovary and one fallopian tube on each side of the uterus, it indicates.
According to her, the last option will be removing the womb if the wound will not respond well to medical treatment.
‘‘We don’t have any other option but to remove the womb because it might cause other complications that can lead to her death,’’ Kuluwani Nyirongo added.
On her part, Jessy, who we spoke to with the permission of her mother, said she was looking up to her God to perform miracles so that her womb could be saved for the sake of her future husband.
WHO estimates that the fatality statistics among those who procure an unsafe abortion stand at 30 deaths per 100,000 unsafe abortions in high-income regions and 530 deaths per 100,000 unsafe abortions in Eastern Africa.
According to the Reproductive Health Unit of the Ministry of Health, 0.4 percent of women that receive post-abortion care die in the country. That is, the case fatality rate for Malawi was calculated at 387 deaths per 100 000 post-abortion care procedures.
Maternal and child health expert Elizabeth Mkutumula said what has happened to Jessy is just a tip of an iceberg, adding that there could be many other girls who are suffering in silence after going through similar experiences.
‘‘We, as a country, want to keep up an impression that is not true. Let us look beyond the issue. How did a 12-year-old girl get pregnant? This is, in itself, a crime. This will, in the end, impact negatively on this child through the pain that she is going through— and for her entire life if they are to take out the womb,’’ she said.
Mkutumula added that the country needed to do self-reflection.
“Can’t we have a law where a child can have a safe abortion, especially because we know that people are accessing unsafe abortion services? One of the problems is that we have less representation of women in Parliament. Actually, how many youths are in the august House? You can see that the members that represent people do not face these problems,” she added.
Meanwhile, Foundation for Civic Education and Social Empowerment Advocacy Coordinator Prisca Kunsida has said, often, the poor, who are usually subjected to violence, are the ones that suffer the most when abused. These are the people that go for unsafe abortion, often from herbalists, which is dangerous.
“In the end, innocent girls lose their lives or develop complications,’’ Kunsida said.
As if to render credence to her words, in 2009, healthcare workers in the Northern Region treated 3,640 patients for complications related to the procurement of unsafe abortion.
Now, with girls like Jessy continuing to fall prey defilers, the situation could be getting worse.
Malawi is sitting on a time bomb.