Sexual reproductive rights; putting unsafe abortion in the policy agenda

I wish to start with a disclaimer. I am not a demographer nor am I a human rights activist, I am not a feminist. Yes, Men can be feminists. I do not play any role of advocacy on women and health issues. I am just an academic, a scholar and researcher with back ground training in International Health Policy and Management from USA through the Fulbright Scholarship.

I am also a recipient of the Global Health Fellowship from the Duke University, Sanford School of Public Policy, a distinguished award that gave me an opportunity to work as an attach├® with the World Health Organization, Geneva, Switzerland in the department of pandemic and epidemic disease in the Global Hepatitis program. I am holder of the Roderick Ross Award, an award given to the best graduating student in Public Administration from the University of Botswana and also a recipient of the Belgian/GTZ Masters scholarship award. I have attended Harvard University, School of Public Health summer school training on “Ethical Issues in International Health Research. I have a professional membership of Public Responsibility in Medicine and Research (PRIM&R, USA). I have previously worked with a team of experts from the Institute for Health Measurement in Lesotho on PMTCT, IKAP and on Enhancing Strategic Information (ESI) studies. I have done individual consultancies for EU, ILO and have collaborated and published with researchers from across Africa and internationally. Politically I have served as a volunteer in the President Obama election campaign team (Unite for Action), in New Hampshire, Boston, MA in the 2012 USA Presidential Elections.

It is 20 years since the UN held its ground breaking International Conference on Population and Development (ICPD) in Cairo. The ICPD conference often dubbed the “Cairo Consensus” presented a political victory for women. Cairo touched on many sensitive issues often highlighting the will of some to control the lives and values of others. It made significant advances in the formulation of reproductive policies and programs towards strengthening the rights of women. The ICPD became the first international conference explicitly to recognize reproductive rights as human rights.

The needs and rights of the individual having control over their sexuality and fertility were emphasized, people were also allowed to choose how to live their lives and that freedom was to be extended to apply to women in that their lives must no longer be governed by men. Since then a number of International and regional initiatives have taken up this call amongst them the Maputo Plan of Action 2006, which commits member countries to an action plan of which unsafe abortion is one of the nine key areas. Family planning programs occupy an unusual place in the public policy arena. They are widespread and are also generally considered effective public health policies. Yet family planning programs are persistently controversial. In part because they center on birth control, reduction of unwanted pregnancies through safe abortion by strengthening family planning programs, a sensitive subject that has drawn criticism from a wide range of perspectives, religious, political, ideological and Scientific.

However, while many may pretend or out rightly deny to have ever carried out abortion, many have participated in carrying out back street abortion and many have done it more than once, using it as a vital reproductive health option. The decriminalization of abortion in South Africa gave rise to cross border abortion operation thus saving many women from unwanted pregnancies. Both female and male have jointly participated in the abortion practice with the male counterpart playing a significant role in abortion as instigators, facilitators, advisors, informers, supporters, or even punishment givers. Whether or not abortion is permitted or prohibited by law, women will seek abortion services and obtain abortion. They will seek them because of their social, economic, health or other personal circumstances. If safe services are not available, they will turn to unsafe ones. For the poorest women and for the young women with no money and no access to information about what services might be available the only option is self abortion despite the risks it involves.

Abortion has become an ever more controversial issue provoking strong reactions both for and against. The very language that is used to frame disputes over whether or not women should have access to safe and legal abortion indicates just how polarized debates have become. Many women die every year because they are unable to access safe abortion and protecting themselves from HIV infection. Access to safe abortion is a matter of human rights, democracy and public health and the denial of such access is a major cause of death. Whilst there has been legislative advances made by a number of countries particularly geared to reducing un-safe abortion, Botswana is still lacking behind. For, example, when Assistant Minister of Local Government and Rural Development Hon Botlhogile Tshireletso, called for the decriminalization of abortion in the country many people were in disagreement and saw that as very irresponsible suggestion coming from a minister. Tshireletso had decried about the increase in the number of abortions in the country and also stated that women in Botswana were forced to conduct illegal backstreet abortion as the operation was forbidden by law.

South Africa enacted the legislation in 1997 allowing the termination of pregnancy on a wide range of grounds. With more than 20 African countries having ratified protocol on the Rights of women in Africa authorizing abortion cases of rape, incest and maternal health and growing number of African leaders speaking out on the need to safe abortion, positive change seems to be afoot in some parts of Africa but remains a great challenge in Botswana which is also yet to ratify the SADC Gender Protocol. Women continue to encounter many challenges; safe abortion, voluntary sterilization or emergency contraception are often prohibited or difficult to access, they lack financial resources to pay for reproductive health services or the transport to get them. The illusion that their poor economic and reproductive behavior is the source of most of their misery, and that capitalism and private resource ownership is their only source of hope, will continue to be propagated.

The claim that their reproductive behavior is largely irrational will meanwhile continue to obscure the actual determinants of fertility, even her work place in some instances is contaminated with pollutants that have adverse effect on pregnancy and in worst case scenarios can be harassed by parents, a husband or in laws who will beat her if they find out that she uses birth control pills. If she cannot conceive she is looked down upon and treated as an outcast a reject that will attract so many derogatory names and in Setswana commonly called “Pholo”. If she is married and cannot conceive she lives in terror at times leading to divorce, such is the un- fortunate state of a woman. Those promoting women’s rights are often frustrated by how reproductive rights are swept aside to accommodate religious and cultural traditions and the prevailing dynamics, such as in instances where they shift the blame to the woman’s family or parents. In this scenario it is claimed that the girl child is used as a form of commodity that is exchanged for monetary gain and wealth accumulation and sometimes rushing them into marriage to men who just don’t love them.

The families use their daughter (s) as honey pots and in worst case scenario (s) auction or sell them to mere spazas, every Dick and Tom. However, on the contrary, it has also been stated that not only are women abused, but men are too. Some people even claim that women can marry just in a period of year and there after connive with their respective small houses to murder or kill their husbands so that they can inherit their estate and in a small space of time become instant millionaires, something that can even shock investments analysts working in the stock market. With questions thrown around as to how someone can accumulate so much amount of wealth in a small space of time. In Setswana / Sotho this is commonly referred to as “Lefu la Hahe la Mphedisa”. Go rugiwa madi a moswi le bo ra moshwe and in most cases these shameless widows go to the extent of fighting their in laws contesting the will. At their best it is stated that these widows are always too quick to remind their in laws that they have the right and entitlement to their husband’s estate, so “Fotsek Matsale” ga se wena o ne onyeetse. Whilst it is undisputable that they do have the right and the entitlement to their spouse’s estate, there should be some decency and respect not driven by outright greed, because display of such characters and attitude clearly shows what in Setswana is called “Bo gogoshane,”.

In Tswana custom and culture there is always a perception and believe that “Malwapa a mangwe tota o ne ga a tsenwe” and the onus is the widow’s family to prove pessimists wrong. Those in the know how, claim that such unfortunate state of affairs does not only happen to the dead, even in real life situation it happens, where in some instances the financial parasites attempt to turn (weak) men into mobile automatic teller machines and those who refuse to subject themselves to financial abuse are called all sorts of derogatory names. Men must therefore, stand up and not allow themselves to be abused by the desperate and pathetic so called lovers and their families. They must not give into the Setswana old adage “Monna o bolaiwa ke se a sejeleng” (the deeds of a man can lead to his demise).

* Seleke is a Scholar & Researcher in Global Health Policy

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