By Emily Bowers
Sunday, March 9, 2008
Traditional female leaders in Ghana are beginning to open their communal gatherings to discussions of women's legal rights to abortion. The country has one of the most liberal abortion laws in the continent, but women are dying in ignorance of it.
KOFORIDUA, Ghana (WOMENSENEWS)--When a Ghanaian queen mother calls for a durbar, it's a pretty safe bet most of the community will turn out.
The traditional gathering--involving an afternoon of drumming, dancing, speeches and skits--is used by everyone seeking publicity from campaigning politicians to well-meaning nongovernmental organizations.
These days they are also being used by traditional female leaders in Ghana's eastern region to send a message about safe abortions.
About once a month Nana Yaa Daani and a group of 20 other queen mothers from the region conduct regular public-health sessions in gatherings in towns and villages. Typical topics include the risks of teen pregnancy, safe sex practices with a special emphasis on abstinence when it comes to teens.
But lately a new topic is being added to the mix: the conditions under which women have a right to a safe and legal abortion.
Until last August, Daani, the head of female traditional leaders in her eastern Ghana municipality, was omitting the subject for the simple reason that she didn't have a grasp on the law in the West African nation.
Passed in 1985 it is one of the most liberal on the continent. It allows abortion in all cases of rape and incest and provides leeway for other circumstances. If a pregnancy will cause physical or mental stress on the woman, she can request an abortion from a government-recognized medical practitioner. Exactly how the stress would manifest isn't spelled out and there is nothing in the law that requires a woman to prove the potential stress. A woman can also have an abortion if there's a strong risk the child will later suffer from physical anomaly or disease.
Daani's attention to the law was drawn by a presentation made to her and other female leaders in August 2007 by staff members of Ipas, an international women's reproductive rights group based in Chapel Hill, N.C., that started operations in Ghana in 2006.
After the presentation Daani and other leaders began finding that the young women in their communities were certainly no better informed about their legal access to safe services.
"Many of them do not know they can go to a hospital," Daani said through a translator.
So far, Ipas is only working with this group of queens in the eastern region as part of a few pilot initiatives in the country.
In Ghana, abortion--and any subject to do with sex--can be considered taboo, says Koma Jehu-Appiah, country director of Ipas. While Ghana is one of Africa's more democratically progressive countries, traditional and religious culture exerts a conservative influence.
From a dark side room in the spare traditional palace of the New Juaben traditional area in the eastern city of Koforidua, Daani tells Women's eNews in her native Twi language she had no problems speaking openly about abortion once she realized the several circumstances that make it legal in her country.
In 2007, Ipas and the Ghanaian government surveyed the staff of 90 health care facilities--485 women and 138 men--to find out how able and willing they are to provide safe abortion services. It was part of a government initiative developed in 2006 called Reducing Maternal Morbidity and Mortality that provides for contraception and abortion care.
Nearly 48 percent of health care workers aren't sure when the law permits an abortion, the study found. Half of those surveyed said they were hesitant to offer abortion care because of their religious beliefs.
About 52 percent of health care workers surveyed also said they were worried a pregnant woman would falsely claim mental or physical distress to access a safe abortion while 72 percent were worried about false claims of rape.
The World Health Organization's 2005 study on maternal mortality recorded 3,800 deaths in Ghana, or 560 per 100,000 live births, that year. Jehu-Appiah estimates 20 to 30 percent of those deaths are from botched abortions.
The Ipas survey found that more than 105,000 women are treated in hospitals and clinics each year for incomplete abortions.
Jehu-Appiah said Ipas is funding a pilot project in 57 clinics across Ghana to provide them with safe abortion facilities along the new Ghana Health Service guidelines including counseling and contraception. The project is part of the government and private sector's effort to start spreading the word about Ghana's abortion laws, he said.
He hopes the program will help cut down on the number of women doctors are forced to treat after botched, back-alley abortions that can leave a young woman sterile, or can even lead to fatal complications.
"The woman who is desperate to get rid of an unwanted pregnancy will go to all lengths," Jehu-Appiah said. "I've seen patients who take high doses of chloroquine and paracetamol mixed with Guinness." Chloroquine is a widely-used malaria treatment and paracetamol is a common painkiller. Both are available over the counter in Ghana.
Other home remedies include drinking broken glass, inserting sticks and other sharp objects in a woman's vagina and even jumping from heights.
Jehu-Appiah said Ghana's traditional and religious beliefs can also be a hindrance to accessing safe abortions.
"People think that every pregnancy should be allowed despite who made who pregnant," he said.
Slowly, though, education and public acceptance is growing, says Benjamin Marfo, director of the Ghana Health Service for the New Juaben municipality where Daani is queen mother.
"People do not treat such topics as a taboo as it used to be," Marfo said.
While abortion is still not widely discussed, sex education is now being taught in schools and public service ads warning youngsters about the risks of teen pregnancy run on local television.
Marfo said Ghana's traditional society means the health service wants to go slow in implementing its safe abortion care program.
Both Marfo and Jehu-Appiah say the support of queen mothers in a society, who are widely revered, go a long way in getting young people talking about safe sex, abstinence and safe abortions.
Nana Yaa Daani agrees. "As a queen mother I'm seen as a leader of the community so what I say carries weight," she said. "I'm a leader, they'll listen to me."
Emily Bowers is a freelance journalist based in Accra, Ghana.