By Nyamacoro S Silla
When I saw the controversy surrounding the Safe Motherhood Bill 2024 I thought it was worthwhile to have a look through and see why some sections of the population appeared to be against it whilst others were for it.
The bill, not exactly in its current form even if the controversial bit remains – was first introduced in parliament in 2015. It was unanimously passed at the time but the then-president refused to give it his assent so it fell short of becoming law. Like now, it was at that time a very unpopular bill amongst the religious community in Sierra Leone.
Firstly, I wish to make it known that I support the Safe Motherhood Bill. However, I am very concerned that a lot more needs to be done to make it effective within Sierra Leone. The reasons why abortion is required by so many is because the support structures, guidance and education which should be in place to help women and - let’s face it – girls during these difficult times just do not exist.
Where do women and girls go if they want or need a termination of pregnancy. The data is limited, but access to any form of healthcare remains problematic. It is said that “Sierra Leone is one of the least developed countries worldwide where access to healthcare is mostly constrained by geographical barriers extremely high out of pocket expenditures, lack of skilled medical staff and poor quality of service.” (Int J EnvironRes Public Health, 2021 Sep.”
The reasons for terminations of pregnancies are complex matters and those requiring such services should have access to counselling and decent health care support. I believe abortion and the many issues surrounding it can only be made safe within the context of a functioning justice system, and a responsible and an accountable healthcare system. There must be a concerted effort to shut down illegal clinics and bring to justice non-qualified people who offer and perform these services to the unsuspecting population.
I am concerned that passing legislation alone isn’t going to produce the active support and help women in need when having to make such choices in their lives, I listened to the Deputy Minister of Health in an interview stating that 44 women out of every 1,000 has had an abortion in Sierra Leone. She went on to say that the people who die and or are badly maimed as a consequence of abortion are mainly the poorer sections of society.
Whilst that may be true I believe that even those who are more well off in society suffer poor care also mainly because healthcare practice is largely unregulated and there may be no investigations or consequences for the healthcare professional if deaths and or injury occur as a result of a procedure. “The Sierra Leonean health system faces challenges due to chronic underfunding a heavy disease burden and vastly insufficient numbers and skewed distribution of skilled human resources for health.” (HRH).
I would want to know what else is being done to prevent women from having unsafe abortions. Are there police investigations on such matters and are the police equipped to bring such cases e.g the deaths of patients through to the justice system as murder charges? Are people prosecuted for their involvement in the deaths of women/girls when such situations occur. Are safe abortion clinics regulated? Are there any safe abortion clinics? Is there any provision for educating women and girls on avoiding abortions and appropriate non-judgemental care and support if they require it?
I think what should be made criminal are the deaths and injuries which occur when women undergo terminations of pregnancies.
Apart from passing legislation what else is being done by communities, government, the justice system and the healthcare community to ensure women and girls are educated, protected and safe in these circumstances?
It is no surprise to me that the religious community has taken the stance that it has with regards to the bill. Everyone feels they have the moral right to have an opinion on what happens to women and their bodies. Sadly, the religious community does not have women within their leadership structure. Women are best placed to give informed opinions on matters affecting women. The religious communities and their leaders do not come out in an uproar when other instances of problematic issues occur within the country.
I do hope as a citizen that decisions made are based on the welfare of women and that the appropriate background work is done to ensure the legislation, when or if passed, has the following right components to become effective.
- Women should have access to safe supportive and non-judgemental care if they require a termination.
- The bill is about the rights of women to have a termination perhaps calling it a Safe Motherhood Bill is misleading as terminations of pregnancies/abortions do not lead to motherhood.
- Significant work needs to be done with youths (male and female) to educate them on safer alternatives to terminations of pregnancies and sex education in general. The overarching issues of drug addiction, poor housing, poverty and family breakdowns need to be included in any response.
- All clinics that offer abortions must be staffed by qualified personnel and where they are not, the law must make it clear that offering such services without being medically qualified to do so is a criminal offence which is punishable by law.
- Unfortunately, women and girls sometimes lose their lives and may suffer injuries due to terminations in Sierra Leone. The law must take account of such instances and prosecutions brought against those responsible.
- Medical personnel should be better trained in terms of accountability and good clinical practice. Where deliberate errors have been made investigations must happen and lessons learned.
- I believe a memorial should be set up for those whose lives have been lost as a result of terminations of pregnancies. Many young Sierra Leonean women have died in shame and disgrace due to societal beliefs, religious and cultural practices.
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