But crucial report is not made public

In 2009, 47% of all pregnancies in Rwanda were estimated to be unintended. (file photo)

A proposal to legalize abortion in specific circumstances has been sent to parliament for approval. This is likely to generate heated debate among the public (and lawmakers) since abortion is a divisive issue, with some seeking the moral high ground and saying “it is always wrong,” while others argue that it should be allowed in certain cases.

While Rwanda is signatory to the 2003 Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa (Maputo Protocol), it had made a reservation for article 14.2 (c) which requires states to authorize abortion “in cases of sexual assault, rape, incest, and where the continued pregnancy endangers the mental and physical health of the mother or the life of the mother or the foetus.”

Now, the cabinet has approved a draft Presidential Order lifting this reservation, which now awaits discussion in parliament.

However, Odette Yankurije, an official from the justice ministry, made it clear that the decisions would not be taken lightly, and that stringent criteria will be applied. “The law leaves no room for cheating. The cases will have to be established by a team of doctors,” she said.

That would nevertheless be a reprieve from the current situation, in which abortion is illegal under any circumstances. Unfortunately, that doesn’t prevent abortions from taking place, but they are carried out clandestinely, in poor hygienic conditions and often by people who are not recognized medical staff.

This seems to be a very sensitive issue, though, as was shown by an incident that took place last week. On Tuesday, the ministry of health had planned the presentation of the first-ever National Study on Abortion in Rwanda, conducted by the National University of Rwanda, the School of Public Health and the US-based Guttmacher Institute in collaboration with the ministry. The media were invited to cover this obviously important event.

However, when journalists arrived on Tuesday morning, they were told the meeting would be held behind closed doors. No explanation was given, and when The Rwanda Focus tried to obtain one, Irene V. Nambi of the Rwanda Health Communication Center (who sent out the invitations) could only reply by e-mail: “The Media cancellations were done at a last minute notice because stakeholders preferred to have a closed door meeting.”

Further prodding concerning exactly the reason behind that decision was met with silence.

Ugly picture

One can therefore only wonder what might be the reason behind this apparent secrecy, which however seems to be a silly strategy after having notified dozens of journalists of the existence of the report. And what makes it even more incomprehensible is that the fact and figures are already out in the open: earlier this month, the journal Studies in Family Planning (2012; 43[1]: 11–20) published a study entitled “Abortion Incidence and Postabortion Care in Rwanda.” It was carried out by Paulin Basinga, senior lecturer at the Department of Community Health at the NUR School of Public Health; Francine Birungi, assistant lecturer at the Department of Epidemiology and Biostatistics of the same institute; as well as Ann M. Moore, senior research associate and Susheela Singh vice-president for research, both at the Guttmacher Institute. Those are the exact institutions that are also behind the announced report.

The findings of that detailed 10-page study do indeed paint an ugly picture. It found that more than 16,700 women received care for complications resulting from induced abortion in Rwanda in 2009, or 7 per 1,000 women aged 15 to 44. Approximately 40% of abortions are estimated to lead to complications requiring treatment, but about a third of those who experienced a complication did not obtain treatment. Nationally, the estimated induced abortion rate is 25 abortions per 1,000 women aged 15 to 44, or approximately 60,000 abortions annually.

In addition, the study estimates that nationally 47% of all pregnancies were unintended, but in Kigali this was 64%.

The authors conclude that “an urgent need exists in Rwanda to address unmet need for contraception, to strengthen family planning services, to broaden access to legal abortion, and to improve postabortion care.”

While that recommendation might not sit well with the government, considering its vaunted family planning program, it can only benefit from holding the debate in the open, rather than behind closed doors.