Let’s make the provisions in the Addis Ababa Declaration real

by Zane Dangor, Special Advisor to the Minister of Social Development, South Africa, from Notes for a speech at a side event addressing the needs of young people in Africa, 49th Commission on Population & Development, New York

12 April 2016

Let’s meet Rosa. She is a 24-year-old living in Senegal where access to safe abortion is restricted. She fell pregnant at the age of 16, but because she is from a relatively wealthy family she was able to secure a safe abortion in a private clinic. The fact that she got pregnant and had to get an abortion strained her relationship with her family. She did, however, fall pregnant, again when she was 21 years old. She knew immediately that she would be getting an abortion as her circumstances were not conducive to having a child. Afraid of approaching her family she followed the advice of her friends and went to a backstreet abortion provider. The man inserted a tube and gave her some antibiotics. Two days later she bled profusely and was rushed to hospital where the doctors refused to provide her with post-abortion care. She would have been dead if her uncle, an influential army colonel, had not intervened. She was admitted and her life was saved.

In March this year, Noziziwe a 19-year-old student in South Africa died from complications due to an unsafe abortion. Noziziwe should not have died as the South African constitution and law provides for all women, the right to access quality, affordable, even free, acceptable sexual and reproductive health services, including abortion. Noziziwe died as she was a poor student, who could not access private health care. There was insufficient information available of the services that she could access at public health institutions, and there is also some speculation that she may have been afraid of the attitudes of the public health care workers based on the experiences of some of her friends.

Rosa and Noziziwe had two paradoxically different experiences. Rosa was able to acquire her first abortion safely in a country where abortion is illegal. Due to stigma her second abortion at the hands of a quack nearly killed her. Noziziwe died from an unsafe abortion in a country where abortions are legal, but she could not access these services, which was her right, because she was not informed of those rights or what services were available, she was poor and had no access to private providers, and the people who were supposed to help her and treat her with dignity scared her to the clutches of backstreet abortionists because of their discriminatory attitudes.

These two similar and yet different stories tell us that in countries where abortion is illegal, those with the means can access safe abortions and even in countries where abortion is legal, the poor can die due to a lack of access. In the end, Noziziwe died due to health systems deficiencies, stigma and discrimination, and Rosa only survived because of her status.

REPORT OF THE SIDE EVENT: Progress on realising the SRHR promise to African youth at CPD49