Abortion drugs selling freely in Malawi

Against anti-abortion laws in the country, some pregnant women wishing to terminate the pregnancy are consuming drugs which they easily access over the counter in some pharmacy stores.

However, the drugs have potentially dangerous effects if mishandled, according to medical experts.

One of the drugs, Misoprostol (Cytotec), is originally meant to treat gastric ulcers caused by the consumption of another drug.

However, some women interviewed at random in Lilongwe yesterday said the decision to turn to the drugs is because under the laws of Malawi, women cannot seek abortion in the health facilities.

One source added that the women who buy the drugs are knowledgeable and have the money to buy it.

“Those who are buying this drug in the shops are knowledgeable and have the means with which to buy the drug although the issue of dosage is there.

“But think about a woman in the remote part of Dowa who has decided she does not need the baby. They will use unsafe means to get rid of it and in the end harm themselves,” said one woman on Monday.

Another woman, who requested to be identified only by her first name, Evelyn, said she had once used the drug herself and she knew a number of other friends who have also used the drug to induce abortion.

The drug commonly used is Kontrac 200, one of the drugs under the Misoprostol range.

It is manufactured in India by Fourts Laboratories Pvt. Limited.

It has safe abortion message which reads “Warning: Misoprostol is contraindicated in pregnant women and also in those women who are going to be pregnant in a short period of time. It can cause abortion”.

The Daily Times managed to procure the drug over the counter of a pharmacy store in Lilongwe on Monday.

The cost of a full dose of the drug is between K560 to K2,000 depending on the location of the store.

The Daily Times investigation found that the drug was available on the counter in three major pharmacy stores visited in the city.

In one of the shops in which The Daily Times bought the drug, an attendant wanted to know why we wanted the drug.

But he proceeded to sell it to this reporter anyway even without getting the reason why we wanted the drug.

He, however, urged the reporter to bring prescription next time.

According to Dr Grace Chiudzu, Obstetrician and Chief Gynecologist at Ethel Mutharika Maternity Wing at Kamuzu Central Hospital, the danger of the free availability of the drugs in Malawi is that women taking it would have no information on acceptable dosage.

This, she said, results in the drug causing complications instead of procuring a safe abortion.

Chiudzu said post abortion care is costly to public health facilities.

She spoke against the sale of the drug over the counter, saying the drug would be better used if accessed through the prescription of qualified health professional.

“The drugs have to be taken in correct dosage. Those who use them wrongly can actually rapture the uterus, which would then require surgical removal.

“My feeling is that this drug should not be sold over the counter. There must be a prescription,” she said.

She, however, emphasised the need for parents to provide their children with correct information on sexuality as young people are now flooded with information that may be misleading and resulting into unwanted pregnancy.

In his observation, Ipas lead in Malawi Chrispine Sibande said there is need for strong advocacy for safe and legal abortion as a right for women in Malawi.

Ipas is an international organisation that promotes the protection of women’s reproductive rights.

“Women’s rights should be respected, protected and fulfilled. These include their right to life and attainment of the highest standard of health.

“Failure to give women access to safe abortion puts these rights at risk,” Sibande said.

He added that the laws of Malawi restrict, prohibit and criminalise abortion, except on medical reasons determined by the hospitals.

He, however, noted that while women in Malawi cannot request abortion in public health facilities when they think they need it, the same facilities have to provide care to backstreet abortion.

District Health Officer for Lilongwe, Dr Mwai Mwale, said recently that Bwaila Hospital sees up to 800 cases of abortion in a month.

During a recent visit to a number of public health facilities in the four regions of the country, a team of journalists learnt that all the referral hospitals have unsafe abortion clients on a daily basis.

Provision of legal abortion services in Malawi is only acceptable where it is done for the purpose of saving a woman’s life or where pregnancy follows an incident of rape or incest.

Ministry of Health spokesperson Henry Chimbali said unsafe abortion contributes between 19 and 24 percent of maternal deaths in this country and that the Public Health Act is under review and may take into account issues of abortion in Malawi.

“In 2009 we did a strategic assessment on the extent of unsafe abortions in Malawi and the results show that abortion is a problem even in married women. Women still procure abortion and die from unsafe abortion.

“The process of law reform to regulate abortion is long and we have made some strategic preliminary steps by collecting the data,” Chimbali said.

The women interviewed in Lilongwe said increasing access to the internet has opened the gates of information which was previously privileged to only few health personnel.

A recent media visit to public health facilities showed that the majority of the women showing up for post abortion care in public health facilities were those in the age ranges of 12 and 35.

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