Wadau, nimegundua kuwa Queen alikuwa na kesi mahakamani hapa Boston dhidi ya ndugu yake aliyemleta kutoa Tanzania. Kesi inahusu mambo ya kuchapwa. Hapa USA huwezi kumchapa mtoto, ni kosa la jinai. Watoto kutoka nje wanajanjaruka wakijua hiyo sheria. Utamsikia mtoto, ukinichpa, nitamwambia Mwalimu halafu nitaenda kukaa kwenye nyumba ya DSS (Department of Social Services)! Doh! huko si ndo kubakwa na kugeuzwa malaya, mlevi, mtumia madawa ya kulevya!
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Kindly Post this in your Blog!
From: Rev. G. Kutta
http://www.wavuti.com/4/post/2012/2/the-story-of-queen-b.html
Sorry, was interupted by powers cut! .....
Regards!
Mh! Whoever was and still act behind Queen on this issue had a mission behind! Without your help and mine, they can win! Do not underestimate your opponent! They have great minds! Tell me, what else can you do if you find Queen a threat? Entrench her in her own drain! This is what they wanted to do! Queen is bright and was doing very well in school such that envy and evil sent her opponents to disguise and now they have put her in this mess!
Lets act together to rescue our Girl!
1. Get her to realize that life may have been bad in the past but she was lucky to have a few who cared for her to their best and their simple faults of life activities led them blind of her tragedies, if at all they happened!
2. Get her to realize that Her family still desires to see her grow up good and strong! We are here still here! We want her alive and Blessed!
3. Get her to realize that, long lasting success can only come from a genuine heart!
4. Get her to realize that, the body of good willing Tanzanians, though dismayed by her accusations, yet know that Tanzania is her home! We Love her and she can make it good with us all by simply doing things the right way without defaming the good!
5. That those who play guardianship for her (Queen's) destruction should know that we know their fear! But they need not fear! Queen is born from a Family highly related to the United States! A family that got all its Good Potentials from United States! I myself had my baseline Education, grade One at Jefferson School, Spring field Ohio (1974/5) with Mr. Marckoch Head Master, Mrs. Carry my teacher! i love these guys! I love USA -But lets keep it up that way! Lets get Queen back to life!
Rev.Kutta,G.P.K.
Showing posts with label Kutoa Mimba. Show all posts
Showing posts with label Kutoa Mimba. Show all posts
Friday, June 01, 2012
Monday, February 06, 2012
Mimba na Siri ya Precious
Imeletwa na Mdau YM:
Mimba na Siri ya Precious
MIMBA
Mimba ilitungwa baada ya baba kutoa hongo kwa kimada
Ili kuthibitisha kama ni mimba kweli kimada akatoa rushwa kwa daktari ili apimwe harakaharaka kwa kuwa kulikuwa na msongamano wa wagonjwa
Kila alipoenda kliniki wakati wote wa Ujauzito alitoa 'chai' ili ahudumiwe vizuri na wauguzi na madaktari
Hata wakati wa kujifungua akatoa 'chai' kwa manesi apate huduma safi
BAADA YA KUJIFUNGUA
Baada ya kujifungua aliendelea kutoa hongo awe wa kwanza kuhudumiwa, mwanae awe wa kwanza kuchomwa sindano za Chanjo n.k.
Mwanae akaitwa 'Precious'
ELIMU KWA PRECIOUS
Kuandikishwa chekechekea akatoa hongo ili Precious apate nafasi katika shule nzuri kwa kuwa nafasi zilikuwa chache, Precious anaangalia
Kuandikishwa shule ya msingi mchezo uleule, Precious anaangalia
Tena sekondari akatoa 'Chai' kwa mwalimu wa Hisabati ili Precious apate alama nzuri
Chuo kikuu Precious hali ikawa ngumu, akagawa uroda kwa mkufunzi ili apate alama nzuri
KAZI
Precious akagawa uroda ili apate kazi, akapata
Precious akatishiwa mara kwa mara kufukuzwa kazi kutokana na utendaji mbovu kinga ikawa ni kugawa uroda
Akatumia nafasi yake kwa manufaa yake binafsi
Kwa tamaa ya vitu vya thamani kuliko mshahara wake akaendelea kupokea rushwa
NDOA
Kwa kuwa wazazi wake (baba yake) hakuwa mwaminifu katika ndoa yake (Precious ni mtoto wa kimada), naye Precious hakuona sababu ya kuwa mwaminifu ktk ndoa
Watoto wake wote walifuata mlolongo kama wa kuzaliwa kwake
KIFO
Hata alipougua ghafla , hongo ikatumika apate huduma bora lakini Mungu alimpenda zaidi
Walipoenda kuchonga jeneza, wakakuta kuna order nyingi ikabidi watoe 'Cha Juu' ili kuchukua jeneza lilokuwepo tayari
Wakati wa mazishi Kwaya iliyotakiwa kuimba wakati wa Maombolezo ilikuwa na safari , ikapewa 'cha juu' ili kuahirisha safari
MWISHO
Kwaya ikaimba na Kumsifia Precious alivyokuwa 'mtumishi mwema wa Mungu', tena wakamwomba Mungu ampokee kwa mikono miwili , amuepushe na Moto wa milele.
Risala ikasomwa, na kusifia utumishi wake uliotukuka, tena kaacha pengo lisilozibika.
TAKE HOME MESSAGE
Wazazi 'huwapakaza' watoto wao matope ya dhambi toka pale mimba inapotungwa hata baada ya kuzaliwa
Watoto wote huakisi tabia walizojifunza toka kwetu, kama wazazi (Observational Learning)
Kama hatuwezi kuwa wawazi hasa pale kaburini hata kwa mtu aliyekufa na sifa mbaya akasifiwa basi tunahalalisha matendo mabaya aliyoyafanya marehemu.
Ili Kupambana na Rushwa twahitaji kuanzia wakati wa Ujauzito, mtoto azaliwe bila rushwa, akue bila rushwa n.k
KWA LEO NI HAYO TU!!!
Mimba na Siri ya Precious
MIMBA
Mimba ilitungwa baada ya baba kutoa hongo kwa kimada
Ili kuthibitisha kama ni mimba kweli kimada akatoa rushwa kwa daktari ili apimwe harakaharaka kwa kuwa kulikuwa na msongamano wa wagonjwa
Kila alipoenda kliniki wakati wote wa Ujauzito alitoa 'chai' ili ahudumiwe vizuri na wauguzi na madaktari
Hata wakati wa kujifungua akatoa 'chai' kwa manesi apate huduma safi
BAADA YA KUJIFUNGUA
Baada ya kujifungua aliendelea kutoa hongo awe wa kwanza kuhudumiwa, mwanae awe wa kwanza kuchomwa sindano za Chanjo n.k.
Mwanae akaitwa 'Precious'
ELIMU KWA PRECIOUS
Kuandikishwa chekechekea akatoa hongo ili Precious apate nafasi katika shule nzuri kwa kuwa nafasi zilikuwa chache, Precious anaangalia
Kuandikishwa shule ya msingi mchezo uleule, Precious anaangalia
Tena sekondari akatoa 'Chai' kwa mwalimu wa Hisabati ili Precious apate alama nzuri
Chuo kikuu Precious hali ikawa ngumu, akagawa uroda kwa mkufunzi ili apate alama nzuri
KAZI
Precious akagawa uroda ili apate kazi, akapata
Precious akatishiwa mara kwa mara kufukuzwa kazi kutokana na utendaji mbovu kinga ikawa ni kugawa uroda
Akatumia nafasi yake kwa manufaa yake binafsi
Kwa tamaa ya vitu vya thamani kuliko mshahara wake akaendelea kupokea rushwa
NDOA
Kwa kuwa wazazi wake (baba yake) hakuwa mwaminifu katika ndoa yake (Precious ni mtoto wa kimada), naye Precious hakuona sababu ya kuwa mwaminifu ktk ndoa
Watoto wake wote walifuata mlolongo kama wa kuzaliwa kwake
KIFO
Hata alipougua ghafla , hongo ikatumika apate huduma bora lakini Mungu alimpenda zaidi
Walipoenda kuchonga jeneza, wakakuta kuna order nyingi ikabidi watoe 'Cha Juu' ili kuchukua jeneza lilokuwepo tayari
Wakati wa mazishi Kwaya iliyotakiwa kuimba wakati wa Maombolezo ilikuwa na safari , ikapewa 'cha juu' ili kuahirisha safari
MWISHO
Kwaya ikaimba na Kumsifia Precious alivyokuwa 'mtumishi mwema wa Mungu', tena wakamwomba Mungu ampokee kwa mikono miwili , amuepushe na Moto wa milele.
Risala ikasomwa, na kusifia utumishi wake uliotukuka, tena kaacha pengo lisilozibika.
TAKE HOME MESSAGE
Wazazi 'huwapakaza' watoto wao matope ya dhambi toka pale mimba inapotungwa hata baada ya kuzaliwa
Watoto wote huakisi tabia walizojifunza toka kwetu, kama wazazi (Observational Learning)
Kama hatuwezi kuwa wawazi hasa pale kaburini hata kwa mtu aliyekufa na sifa mbaya akasifiwa basi tunahalalisha matendo mabaya aliyoyafanya marehemu.
Ili Kupambana na Rushwa twahitaji kuanzia wakati wa Ujauzito, mtoto azaliwe bila rushwa, akue bila rushwa n.k
KWA LEO NI HAYO TU!!!
Labels:
Kutoa Mimba,
Mimba,
Precious,
Preganancy,
Ujauzito
Thursday, August 27, 2009
Wimbi la Kutoa Mimba Dar!
Navyoona wasichana was shule na wanawake wafundishwe uzazi wa majira. Pia wakazanie hao wanaume wao watumie kondomu. Pia wanaume na nyege zao waache kudanganya wanawake, "Oh usiponipa ina maana hunipendi!" au wanasema, "Usiponipa nitampata atakayenipa!" LOH! Nyie, nakumbuka kuona wanafunzi wenzangu wakifa kwa septic abortion.
Nimeona wakiteseka kwa maumivu na kuoza na kufa! Kisa walienda kwa watu wasiojua wanafanya nini kuzitoa. Napenda kuwe na sehemu ambayo mtu anaweza kuwa na sehemu ya kutoa mimba kwa usalama. Lakini pia sipendi wazo la kutoa mimba. Lakini kwa vile bado kuna sheria za ajabu, eti msichana akipata mimba afukuzwe shule, wengine wanalazimishwa kutoa ili waendelee na masomo.
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Kutoka ippmedia.com
ABORTION BUSINESS BOOMING IN DAR
Most private and some public dispensaries, health centres and hospitals camouflaged as family health planning units are centres for performing abortions, ‘The Guardian’ can report today.
A survey carried out over the last two weeks has revealed shocking statistics on health facilities engaged in abortions. A clinic in the city (name withheld) performs as much as 40 abortions per month, raising questions on safety and the health risks posed to their clients.
The Executive Director of Muhimbili National Hospital Prof Leonard Lema said that the institution does not perform abortions, but is forced to save the lives of the victims who are rushed to the hospital in critical state after bleeding seriously from unsafe abortion.
“Some victims are brought to us in a serious condition, bleeding so we help them in cleaning the blood clots so as to save their lives,” he said
Another gynaecologist from Muhimbili who preferred not to be named said that the government was ‘quiet’ about abortion and yet the practice is going on in many private hospitals and clinics.
“Professionally it can only be performed after clearance of two specialists when there is an adequate risk to the mother’s life if the foetus is retained,” he said.
He also noted that while abortion is going on, the rate of crude abortions is on the decline especially since the doctors who do it have adopted the use of the MVA (Manual Vacuum Aspiration) kits to carry out the illegal surgery.
Almost every private hospital checked during the investigation that covered more than 10 of them in Dar es Salaam, the story was the same, “You want to have an abortion? You will get it, just pay for it.”
The cost of the services is high. Some of the clinics have resorted to abortions as the quickest and most reliable way of generating income.
“Yes the majority of women coming here for gynaecological services want to abort…you cannot stop them, so we just help them do it in the safest way without subjecting their lives to danger,” said a gynaecologist at one of the clinics.
He said charges vary depending on how old the pregnancy is. For example it would cost 70,000/- to terminate a six-month pregnancy, while anything below that would cost 50,000/-.
The clients include students, unmarried and married women, according to our investigation. Another gynaecologist said it was difficult to turn away pregnant mothers who visited the clinics crying for help.
Two months ago a mother of a family residing at Mbezi Beach in Dar es Salaam, lost her only daughter, a 15 – year old, who took tablets prescribed by a quack doctor to induce an abortion.
The daughter had obtained a week’s leave from school in Arusha after complaining that she was not feeling well.
“When at home in Dar she seemed to lose her appetite and ate very little. I didn’t know what was going on because her condition got worse by the day, yet when I wanted to take her to hospital; she refused, telling me she had already taken malaria tablets. However her condition became worse,” the mother narrated.
She rushed her to hospital and after the usual medical tests, a drip was administered on the girl, but after 30 minutes, she passed away
“We were shocked to learn that she had been bleeding intensively. One doctor told me that she couldn’t make it because she had taken some tablets to abort,” the mother said, tears streaming down her face.
She said that she was shocked by the news and couldn’t believe that her daughter had been pregnant, opted for an abortion and never told her. She learnt from the doctor that the tablets which her daughter took worsened her condition, rupturing the foetus which was also rotting inside her, resulting into more complications which caused her death.
The woman talking to a friend later learnt that women who opt for abortion in most of these clinics in the neighbourhood are given an option of using either the tablets or a vacuum machine. Her daughter had probably been afraid to use the vacuum and went for the pills.
“She was the only daughter I had because her siblings are boys. It is like a nightmare to me up to now. It is important for these girls to be told and taught about pregnancy, abortions and their effects,” she said.
In a separate interview, Jangwani school teacher Grace Michael said that abortions happen frequently in secondary schools and can only be controlled if the students are made aware of the negative effects.
“Some of them who are day students have an abortion and we never know about it because one can decide to stay home for sometime after the operation to recover before resuming school. Sometimes, it is hard to identify such students,” said Michael.
She added that in some schools students are taken to hospital every month for pregnancy test and those found positive end up dropping out of school.
“I think there is still a lot to be done to protect students from getting pregnant and having abortions because the rate has really gone up,” she added.
A Makongo Secondary School student, Amina Abdul, said that as long as the students get pregnant and are still in school, abortions are likely to happen because they want to finish school.
“There is a lot to be done to create awareness among the students because abortion is performed as if it’s a simple issue. If you have money it can be performed, but it is dangerous when someone uses tablets. It is better to have the vacuum system. I haven’t experienced this, but I have heard other students talk about it,” she said
Another student, Anna Msekwa said that the rate of abortions has gone up especially for those girls who are staying in hostels.
“The rate has really gone up especially in boarding schools and hostels. This worsens during the cold months… and if it happens you have to do something before your parents become aware,” she said.
Residents in various parts of Dar es Salaam said that many institutions operating as family life health clinics were actually havens for performing abortions. Almost every member of the public who was interviewed concurred that the crime was rampant in the city.
“It is an open secret that hospitals in Dar es Salaam do perform abortions. A woman walks into a clinic and no one bothers to ask who made her pregnant. Most hospitals here are not there to treat patients but to perform abortions,” said Ali Omar a resident of Mbagala
Joyce Michael a resident of Mbezi in Dar es Salaam said some clinics were so careless that after inducing abortions they didn’t clean the tools they had used.
“So many women have been infected with diseases after undergoing abortions in some of the so–called private hospitals in Dar es Salaam. They know that women who are going for abortions in secret are desperate so they take advantage of them,” she said.
The deputy minister for Health and Social Welfare Aisha Kigoda said that most private hospitals perform abortions secretly because it is illegal, but warned that if such hospitals are exposed and evidence provided, they will be prosecuted.
“Private hospitals are performing abortions in secret because they know it’s illegal, but I am warning them that if they are caught with evidence, then legal action will be taken against them, including withdrawing their licenses,” said Kigoda.
She said that the government is planning to formulate a set of laws to allow for safe abortion so as to reduce mortality rate in the country.
“The government is still thinking over the proposals. We have to look at the advantages and disadvantages of such a move,” said Kigoda, refusing to be drawn into stating when the laws on safe abortion will be in place.
SOURCE: THE GUARDIAN
Thursday, June 04, 2009
Uzazi Tanzania Part II - Utoaji Mimba
A woman in Berega, Tanzania, who sought care after a botched abortion. In Tanzania, where abortion is illegal, the maternal death rate is high in part because of failed abortions.Wadau, hebu tuwe wakweli. Sheria Tanzania inasema kuwa ni mwiko kutoa mimba. Inaruhusiwa tu kama maisha ya mama iko hatarini. Lakini ukweli mimba zinatolewa kila siku. Wasichana wadogo na wakina mama wanakufa kutokana na madhara ya kutolewa mimba na watu wasiojua wanafanya nini!
Nilipokuwa nasoma Sekondari, nakumbuka wasichana watatu waliokufa kutoka na kutoa mimba. 'septic abortion'. Mara kizazi kinatobolewa, yaani acheni tu.
Na huwa nalaumu sana wanaume wanapenda wanawake wakilalamika 'utamu' kwenye mambo. Lakini hebu wanawake hao wakilalamika 'uchungu' wanaume wanakimbia! HEBO!
Na huwa nalaumu sana wanaume wanapenda wanawake wakilalamika 'utamu' kwenye mambo. Lakini hebu wanawake hao wakilalamika 'uchungu' wanaume wanakimbia! HEBO!
Haya someni Denise Grady wa New York Times alivyotuchora.
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By DENISE GRADY
Published: June 1, 2009
BEREGA, Tanzania — A handwritten ledger at the hospital tells a grim story. For the month of January, 17 of the 31 minor surgical procedures here were done to repair the results of “incomplete abortions.” A few may have been miscarriages, but most were botched operations by untrained, clumsy hands.
More than half a million women a year die during pregnancy and in childbirth, largely from problems that can be treated or prevented. This is the second of three articles on efforts to lower the death rate in one African country, Tanzania.
Abortion is illegal in Tanzania (except to save the mother’s life or health), so women and girls turn to amateurs, who may dose them with herbs or other concoctions, pummel their bellies or insert objects vaginally. Infections, bleeding and punctures of the uterus or bowel can result, and can be fatal. Doctors treating women after these bungled attempts sometimes have no choice but to remove the uterus.
Pregnancy and childbirth are among the greatest dangers that women face in Africa, which has the world’s highest rates of maternal mortality — at least 100 times those in developed countries. Abortion accounts for a significant part of the death toll.
Maternal mortality is high in Tanzania: for every 100,000 births, 950 women die. In the United States, the figure is 11, and it is even lower in other developed countries. But Tanzania’s record is neither the best nor the worst in Africa. Many other countries have similar statistics; quite a few do better and a handful do markedly worse.
Eighty percent of Tanzanians live in rural areas, and the hospital in Berega — miles from paved roads and electric poles — is a typical rural hospital, struggling to deal with the same problems faced by hospitals and clinics in much of the country. Abortion is a constant worry.
Worldwide, there are 19 million unsafe abortions a year, and they kill 70,000 women (accounting for 13 percent of maternal deaths), mostly in poor countries like Tanzania where abortion is illegal, according to the World Health Organization. More than two million women a year suffer serious complications. According to Unicef, unsafe abortions cause 4 percent of deaths among pregnant women in Africa, 6 percent in Asia and 12 percent in Latin America and the Caribbean.
Reliable figures on abortion in Tanzania are hard to come by, but the World Health Organization reports that its region, Eastern Africa, has the world’s second-highest rate of unsafe abortions (only South America is higher). And Africa as a whole has the highest proportion of teenagers — 25 percent — among women having unsafe abortions.
The 120-bed hospital in Berega depends on solar panels and a generator, which is run for only a few hours a day. Short on staff members, supplies and even water, the hospital puts a lot of its scarce resources into cleaning up after failed abortions.
The medical director, Dr. Paschal Mdoe, 30, said many patients who had had the unsafe abortions were 16 to 20 years old, and four months pregnant. He said there was a steady stream of cases, much as he had seen in hospitals in other parts of the country.
“It’s the same everywhere,” he said.
On a Friday in January, 6 of 20 patients in the women’s ward were recovering from attempted abortions. One, a 25-year-old schoolteacher, lay in bed moaning and writhing. She had been treated at the hospital a week earlier for an incomplete abortion and now was back, bleeding and in severe pain. She was taken to the operating room once again and anesthetized, and Emmanuel Makanza, who had treated her the first time, discovered that he had failed to remove all the membranes formed during the pregnancy. Once again, he scraped the inside of her womb with a curet, a metal instrument. It was a vigorous, bloody procedure. This time, he said, it was complete.
Mr. Makanza is an assistant medical officer, not a fully trained physician. Assistant medical officers have education similar to that of physician assistants in the United States, but with additional training in surgery. They are Tanzania’s solution to a severe shortage of doctors, and they perform many basic operations, like Caesareans and appendectomies. The hospital in Berega has two.
Abortions in Berega come in seasonal waves — March and April, August and September — in sync with planting and harvests, when a lot of socializing goes on, Dr. Mdoe said. He said rumor had it that many abortions were done by a man in Gairo, a town west of Berega. In some cases, he said, the abortionist only started the procedure, knowing that doctors would have to finish the job.
Dr. Mdoe said he suspected that some of the other illegal abortionists were hospital workers with delusions of surgical skill.
“They just poke, poke, poke,” he said. “And then the woman has to come here.” Sometimes the doctors find fragments of sticks left inside the uterus, an invitation to sepsis.
In the past some hospitals threatened to withhold care until a woman identified the abortionist (performing abortions can bring a 14-year prison term), but that practice was abandoned in favor of simply providing postabortal treatment. Still, women do not want to discuss what happened or even admit that they had anything other than a miscarriage, because in theory they can be prosecuted for having abortions. The law calls for seven years in prison for the woman. So doctors generally do not ask questions.
“They are supposed to be arrested,” Dr. Mdoe said. “Our work as physicians is just to help and make sure they get healed.”
He went on, “We as medical personnel think abortion should be legal so a qualified person can do it and you can have safe abortion.” There are no plans in Tanzania to change the law.
The steady stream of cases reflects widespread ignorance about contraception. Young people in the region do not seem to know much or care much about birth control or safe sex, Dr. Mdoe said.
In most countries the rates of abortion, whether legal or illegal — and abortion-related deaths — tend to decrease when the use of birth control increases. But only about a quarter of Tanzanians use contraception. In South Africa, the rate of contraception use is 60 percent, and in Kenya 39 percent. Both have lower rates of maternal mortality than does Tanzania. South Africa also allows abortion on request.
But in other African nations like Sierra Leone and Nigeria, abortion is not available on request, and the figures on contraceptive use are even lower than Tanzania’s and maternal mortality is higher. Nonprofit groups are working with the Tanzanian government to provide family planning, but the country is vast, and the widely distributed rural populations makes many people extremely hard to reach.
Geography is not the only obstacle. An assistant medical officer, Telesphory Kaneno, said: “Talking about sexuality and the sex organs is still a taboo in our community. For a woman, if it is known that she is taking contraceptives, there is a fear of being called promiscuous.”
In interviews, some young women from the area who had given birth as teenagers said they had not used birth control because they did not know about it or thought it was unsafe: they had heard that condoms were unsanitary and that birth control pills and other hormonal contraceptives could cause cancer.
Mr. Kaneno said the doctors were trying to dispel those taboos and convince women that it was a good thing to be able to choose whether and when to get pregnant.
“It is still a long way to go,” he said.
http://www.nytimes.com/2009/06/02/health/02abort.html?_r=2&ref=science
Published: June 1, 2009
BEREGA, Tanzania — A handwritten ledger at the hospital tells a grim story. For the month of January, 17 of the 31 minor surgical procedures here were done to repair the results of “incomplete abortions.” A few may have been miscarriages, but most were botched operations by untrained, clumsy hands.
More than half a million women a year die during pregnancy and in childbirth, largely from problems that can be treated or prevented. This is the second of three articles on efforts to lower the death rate in one African country, Tanzania.
Abortion is illegal in Tanzania (except to save the mother’s life or health), so women and girls turn to amateurs, who may dose them with herbs or other concoctions, pummel their bellies or insert objects vaginally. Infections, bleeding and punctures of the uterus or bowel can result, and can be fatal. Doctors treating women after these bungled attempts sometimes have no choice but to remove the uterus.
Pregnancy and childbirth are among the greatest dangers that women face in Africa, which has the world’s highest rates of maternal mortality — at least 100 times those in developed countries. Abortion accounts for a significant part of the death toll.
Maternal mortality is high in Tanzania: for every 100,000 births, 950 women die. In the United States, the figure is 11, and it is even lower in other developed countries. But Tanzania’s record is neither the best nor the worst in Africa. Many other countries have similar statistics; quite a few do better and a handful do markedly worse.
Eighty percent of Tanzanians live in rural areas, and the hospital in Berega — miles from paved roads and electric poles — is a typical rural hospital, struggling to deal with the same problems faced by hospitals and clinics in much of the country. Abortion is a constant worry.
Worldwide, there are 19 million unsafe abortions a year, and they kill 70,000 women (accounting for 13 percent of maternal deaths), mostly in poor countries like Tanzania where abortion is illegal, according to the World Health Organization. More than two million women a year suffer serious complications. According to Unicef, unsafe abortions cause 4 percent of deaths among pregnant women in Africa, 6 percent in Asia and 12 percent in Latin America and the Caribbean.
Reliable figures on abortion in Tanzania are hard to come by, but the World Health Organization reports that its region, Eastern Africa, has the world’s second-highest rate of unsafe abortions (only South America is higher). And Africa as a whole has the highest proportion of teenagers — 25 percent — among women having unsafe abortions.
The 120-bed hospital in Berega depends on solar panels and a generator, which is run for only a few hours a day. Short on staff members, supplies and even water, the hospital puts a lot of its scarce resources into cleaning up after failed abortions.
The medical director, Dr. Paschal Mdoe, 30, said many patients who had had the unsafe abortions were 16 to 20 years old, and four months pregnant. He said there was a steady stream of cases, much as he had seen in hospitals in other parts of the country.
“It’s the same everywhere,” he said.
On a Friday in January, 6 of 20 patients in the women’s ward were recovering from attempted abortions. One, a 25-year-old schoolteacher, lay in bed moaning and writhing. She had been treated at the hospital a week earlier for an incomplete abortion and now was back, bleeding and in severe pain. She was taken to the operating room once again and anesthetized, and Emmanuel Makanza, who had treated her the first time, discovered that he had failed to remove all the membranes formed during the pregnancy. Once again, he scraped the inside of her womb with a curet, a metal instrument. It was a vigorous, bloody procedure. This time, he said, it was complete.
Mr. Makanza is an assistant medical officer, not a fully trained physician. Assistant medical officers have education similar to that of physician assistants in the United States, but with additional training in surgery. They are Tanzania’s solution to a severe shortage of doctors, and they perform many basic operations, like Caesareans and appendectomies. The hospital in Berega has two.
Abortions in Berega come in seasonal waves — March and April, August and September — in sync with planting and harvests, when a lot of socializing goes on, Dr. Mdoe said. He said rumor had it that many abortions were done by a man in Gairo, a town west of Berega. In some cases, he said, the abortionist only started the procedure, knowing that doctors would have to finish the job.
Dr. Mdoe said he suspected that some of the other illegal abortionists were hospital workers with delusions of surgical skill.
“They just poke, poke, poke,” he said. “And then the woman has to come here.” Sometimes the doctors find fragments of sticks left inside the uterus, an invitation to sepsis.
In the past some hospitals threatened to withhold care until a woman identified the abortionist (performing abortions can bring a 14-year prison term), but that practice was abandoned in favor of simply providing postabortal treatment. Still, women do not want to discuss what happened or even admit that they had anything other than a miscarriage, because in theory they can be prosecuted for having abortions. The law calls for seven years in prison for the woman. So doctors generally do not ask questions.
“They are supposed to be arrested,” Dr. Mdoe said. “Our work as physicians is just to help and make sure they get healed.”
He went on, “We as medical personnel think abortion should be legal so a qualified person can do it and you can have safe abortion.” There are no plans in Tanzania to change the law.
The steady stream of cases reflects widespread ignorance about contraception. Young people in the region do not seem to know much or care much about birth control or safe sex, Dr. Mdoe said.
In most countries the rates of abortion, whether legal or illegal — and abortion-related deaths — tend to decrease when the use of birth control increases. But only about a quarter of Tanzanians use contraception. In South Africa, the rate of contraception use is 60 percent, and in Kenya 39 percent. Both have lower rates of maternal mortality than does Tanzania. South Africa also allows abortion on request.
But in other African nations like Sierra Leone and Nigeria, abortion is not available on request, and the figures on contraceptive use are even lower than Tanzania’s and maternal mortality is higher. Nonprofit groups are working with the Tanzanian government to provide family planning, but the country is vast, and the widely distributed rural populations makes many people extremely hard to reach.
Geography is not the only obstacle. An assistant medical officer, Telesphory Kaneno, said: “Talking about sexuality and the sex organs is still a taboo in our community. For a woman, if it is known that she is taking contraceptives, there is a fear of being called promiscuous.”
In interviews, some young women from the area who had given birth as teenagers said they had not used birth control because they did not know about it or thought it was unsafe: they had heard that condoms were unsanitary and that birth control pills and other hormonal contraceptives could cause cancer.
Mr. Kaneno said the doctors were trying to dispel those taboos and convince women that it was a good thing to be able to choose whether and when to get pregnant.
“It is still a long way to go,” he said.
http://www.nytimes.com/2009/06/02/health/02abort.html?_r=2&ref=science
Labels:
Abortion,
Air Tanzania,
Kutoa Mimba,
Mimba
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