On Tuesday last, women’s rights activists picketed the Medical Council of Guyana and the Ministry of Health over the sloth in the investigation of the abortion death of Karen Badal, and also to lobby Minister of Health Dr Bheri Ramsaran to make abortion procedures accessible countrywide.
Karen Badal was just 18 years old, already a mother of two, and four months pregnant with what would have been her third child when she sought an abortion at the office of a medical practitioner who was not licensed to do medical termination of pregnancies. Ms Badal sustained a perforated uterus as a result of the procedure and died subsequently at the Georgetown Public Hospital (GPH).
It is because of cases like Ms Badal’s that this country even has a Medical Termination of Pregnancy (MTP) Act. Prior to the MTP Bill being piloted in the National Assembly by the then Minister of Health Gail Teixeira, many women were dying and being damaged from ‘back street’ and home-made abortions. There were also reports of the burgeoning misuse of the drug Cytotech, which is used to treat stomach ulcers, but can cause uterine contractions that could lead to incomplete miscarriage, infertility and in some cases death.
The MTP Bill was very controversial; religious leaders lobbied heavily against its passage and eventually, members of parliament were asked to vote with their consciences rather than along party lines. The bill was passed. The year was 1995. The MTP Act became law some months later in 1996. Back then, Karen Badal, who was 18 years old when she died on December 20, 2011, would have been just about one or two years old.
The mere fact that she died as a result of a complication of a botched abortion, which legislation had been passed some 16 years ago to prevent, says that the legislation has failed. It is not being enforced; if it were, no doctor not licensed to do terminations would dare make a move in that direction. As it is, the doctor involved in Ms Badal’s botched abortion is probably not the only transgressor. In fact, were the legislation and its regulations working the way they should, women would have no need to turn to such doctors.
In an interview in 2008, then Minister of Health Dr Leslie Ramsammy had announced that additional public institutions were offering the service, among them the New Amsterdam and Suddie hospitals. It was only two years prior to this—in 2006—that public medical institutions actually began offering the service. Before then, women could only go to private licensed hospitals and doctors, and would have to have been able to afford the fees charged.
Guyana’s main public medical institution, the Georgetown Public Hospital, has never offered medical terminations and this is still the case today. Dr Ramsammy had said years ago that the reason was for fear that its already overburdened workload would not have been able to cater for the numbers of women seeking the service. However, over the years, it has continued to repair the damage done by incomplete and botched abortions performed by unscrupulous quacks.
In separate interviews with this newspaper in January, shortly after Ms Badal’s death, both Ms Teixeira and Secretary of the now defunct MPT Advisory Board, Pamela Nauth, had insisted that a lot had been accomplished since the legislation has been in force and pointed to the reduction in deaths of women from botched abortions. However, there are no statistics available as to how many women have been rendered infertile as a result of these quack jobs. And while senior medical officials agreed that there had been a reduction in the number of women seeking medical attention after botched abortions, this was still occurring.
Ms Badal’s death has brought to the fore a few key things that everyone knows but no one really talks about. One is that poverty is a huge driver of abortions and more so ‘back street’ abortions. The second is that women who have abortions, for whatever reason, are still stigmatised, which is why they prefer to seek out the shady characters in the secret locations. A third is that the information about legal and free MTP is still not reaching its target audience—women like Ms Badal. A fourth is that despite all claims to the contrary, discrimination against women clearly persists. It is obvious in the lack of access to family planning and in the fact that the country’s major medical institution refuses to offer a legal medical service on the flimsy claim that it lacks resources, though over the past 16 years resources have been found to open new clinics and build a new wing.