Archaic Equipment, Inability to Provide Post-Abortion Care Services Bothers Activists

Health workers are still using outdated equipment to carry out post-abortion care procedures such as the removal of fetal tissue which could create more harm to the mother.

Dr Justus Ampaire, an Obstetrician/Gynecologist based in Mbarara District says that protocols that are supposed to guide them in handling cases have never been reviewed and health workers, especially in upcountry districts, are still using equipment that has globally been phased out.

He says for instance that instead of the curette, a sharp instrument used to remove uterine tissue, they are currently using special syringes as curettes were found to be unsafe and can create more tears to a woman’s cervix in the process. He was speaking at an event held to mark International Safe Abortion Day on Wednesday.

While abortion is illegal in Uganda, post-abortion care is legal and provided at no cost in government-run health facilities. But activists say when women go seeking these services, they go through a lot of questioning by health workers for fear of being accused of procuring an abortion.

As a result, Annet Immaculate Asiimwe, a sex worker and activist says some of her colleagues have resorted to using rudimentary ways and herbal medicines to recover for fear of being questioned or even handed over to police by some health workers. She says that she was personally barred by a health worker from revealing that she had been assisted to complete her abortion.

However, abortion is highlighted as one of the reasons for high maternal mortality in Uganda as the Ministry of Health Figures attribute 10 per cent of maternal abortion deaths which is many times done crudely.   Also, abortion rates are said to vary across regions where it’s estimated at 18 per 1,000 women in the Western Region where it’s lowest and highest at 77 per 1,000 women in Kampala.

Activists say these figures can be reversed if Uganda puts in place progressive laws that can enable women to access safe services.

Ruth Ajalu, a lawyer based at an NGO Center for Health, Human Rights and Development (CEHURD) says that while the constitution provides for a right to life and several policies allow for an abortion to be procured under specific circumstances such as incest and health-related reasons to the mother, they are outdated and distant from the current reality.

For the activists, there is a need to offer safe abortion services at every health facility if unnecessary maternal deaths are to be curbed.  They also call for former training of health workers on post-abortion care to guarantee safety.

However, when these concerns were put to Dr Shaban Mugerwa a Senior Medical Officer in charge of Care and Support at the Ministry of Health he said women shouldn’t be asked to pay to access post-abortion care and that there are special centres in place which can help key populations access such services.

But, he declined to comment on how often health workers are trained and when the care protocols were last updated.            

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