COVID-19 has forced countries around the world to take unprecedented measures to combat the rapid spread of the virus. Although the pandemic affects all of us, it has hit people in urban poor settlements in developing countries especially hard. The global focus has rightfully been on containing the virus, but some sectors are being dangerously neglected. One of these is sexual and reproductive health and rights (SRHR), including safe abortion services.
At Women Promotion Centre-Kenya (WPC-K), we work with vulnerable and marginalized communities (women, youth, LGBTQ groups) in the Kibera slum. It is the largest urban slum in Africa, characterized by high unemployment and crime rates, deplorable sanitation, poor housing conditions, and a lack of schools and healthcare facilities. The facilities that do exist are poorly structured private entities lacking qualified personnel or adequate equipment.
With the outbreak of COVID-19, the health situation has worsened in the Kibera slum.
This is especially true for girls and young women who need access to comprehensive SRHR – including safe medical abortion. Cases of rape and unprotected forced sexual encounters are on the rise due to movement restrictions. This has led to an increase in unplanned pregnancies and demand for abortion.
Girls and young women are facing hostility from already overstretched healthcare services. The majority of service-seekers are turned away without any form of support or service. After receiving numerous complaints from our beneficiaries, I decided to see what was happening for myself at one of the privately-owned healthcare facilities.
On arrival, I was received by a receptionist who seemed disgusted by my appearance. I was adhering to all sanitizing and social distancing guidance, so I ignored her and asked to see the clinical officer (we rarely have doctors in Kibera). After waiting 30 minutes to be seen, I inquired about family planning options I could use during the current situation. The clinical officer was not willing to help me. Instead, she advised me that contraceptives are ‘not good’ for girls and young women.
This might sound shocking, but it’s common for health workers to make judgements towards young women who are sexually active.
It is also common for them to discourage use of contraceptives by overstating negative side effects and creating excuses about availability. On this particular day, I tried to convince the clinical officer that I and other girls of my generation need contraception desperately. She told me to seek services elsewhere since this facility did not have supplies of contraceptives – even basic ones like condoms – due to restrictions on movement.
Young women are also being denied access to safe medical abortion services. One young woman we work with, Adhiambo (not her real name), found herself in a life-threatening situation. Adhiambo was denied safe services at her local healthcare facility due to the social distancing directed by the governement. Since movement in and out of Nairobi has been restricted, she could not travel to another town. As a result, she attempted to procure abortion secretly with the help of her friend who was equally unqualified.
In Kibera, due to the measures put in place to combat Coronavirus, many girls and young women are resorting to unsafe abortion practices. These include drinking a herbal concoction, inserting metal clothes hangers into their bodies, drinking Jik (washing detergent) and taking an overdose of prescribed medicines. This is all because they cannot access safe abortion services at a health facility, and will lead to unprecedented health issues in the near future.
Although there is a need to focus on COVID-19, it is self-defeating for governments to ignore ongoing healthcare needs like SRHR.
It is the right of every girl and woman to have control over her body. This right can only be realized if she is enabled to access comprehensive SRHR, including safe abortion. Women Promotion Center is one of the leading feminist organizations in the Kibera slum. We are currently implementing a SAAF-funded project to tackle community-level, abortion-related stigma. During the current pandemic, we have stepped in to fill the SRHR gap, too. We are distributing essential contraceptives, such as pills and condoms, as well as re-usable sanitary towels and other COVID-19 related personal protective equipment (PPE).
Our staff and volunteers are using public forums to talk to community members about the major symptoms and prevention measures of COVID-19. Additionally, WPC is promoting safe self-managed abortion by strengthening the capacity of community volunteers. These volunteers can provide information and appropriate commodities (such as Misoprostol and Mifepristone) to those who need them.
Despite its overstretched resources, WPC continues to work with young women to strengthen their capacity to demand their rights to comprehensive SRHR services and information – including safe abortion. We are working to ensure that the Ministry of Health and other key stakeholders in the Kenyan health sector prioritize SRHR, especially in the slums like Kibera where they are so urgently needed.
Women Promotion Centre is a Safe Abortion Action Fund grantee partner.
Good narrative on the reality of poor women and girls in the context of developing countries. One caveat though when health authorities were not providing safe abortion medicla service the volunteers tried to fill in the gap but this is still “unsafe” by definition although this was the best option available at the moment. Also I wonder about the Kenyan government’s view on health issues during the pandemic as they should have allowed all health servcies to function at this time incluidng SRHR services – may be safe abortion is not prioritized.
Super! I’m so in love with the fight for such an unending cry. For sure this has touched my heart and bravo for what you’re doing at Kibera and beyond.