Soa, on the outskirts of Yaoundé, a university neighbourhood, is beehived on Wednesday morning. Not far from the campus, a clinic is located a few meters behind the market and the bus stop. It is not by mistake that the Cameroon Association for Family Welfare, CAMNAFAW, established its clinic in a university setting.
According to the 2018 Demographic and Health Survey, DHS, the average age of first sexual intercourse is 15 for girls and 17 for boys, which may explain the prevalence of promiscuity among adolescents. Within this context, young women are exposed to unwanted pregnancies and subsequent unsafe abortions.
With ongoing education programs on campus and their premises, CAMNAFAW is well-known for its services to students and women in the neighborhood.
Clarisse, a married lady in her 30s, arrived at the CAMNAFAW clinic in Soa, panicked and terrified by her experience. It wasn’t her first visit; she’d been here for an ultrasound scan two months prior, and everything was fine. However, something went wrong later.
“I went back to the clinic after experiencing strange bleeding. When I stated my problem, I was greeted with warmth and concern and assured that everything would be alright. When the bleeding started, I stayed at home longer until the situation became urgent, at which point I was told it was too late to save the pregnancy.”
Clarisse is encouraged to visit the hospital as soon as possible if she has a similar experience.
Unlike Clarisse, a scan revealed that Solange had a transparent egg—an egg without an embryo—a pregnancy that would eventually result in an abortion, according to medical authorities.
“I felt symptoms and went for a scan after around three months into my pregnancy. Some pregnancies come with problems. Following confirmation of the second scan, the doctor suggested that the only option was a safe abortion. “I was concerned and afraid, but was told everything would be fine and I could still become pregnant, which motivated me. “I was given antibiotics and told to monitor my body for any problems.”
Despite these women’s experiences with spontaneous abortion, the majority of young women are brought to the clinic with induced and incomplete abortions.
Estelle-Rose Deme Onganya, midwife and the head of the CAMNAFAW Clinic, states that incomplete abortion occurs due to different circumstances. It might be spontaneous. Or induced—a woman decides to cause an abortion by consuming decoctions.
“We have had cases of women brought to the clinic with materials like the cassava stems used; some drink detergent while others drink coffee and quinine and many other things to provoke an abortion,” she tells the Cameroon Factfinder.
Young women seek assistance from roadside sellers and quack doctors and from acquaintances to whom they explain or disclose their difficulties. Onganya adds that they only come to the clinic if the abortion is incomplete.
According to the midwife, the clinic receives 5-6 cases of incomplete abortions per month (which increases around holidays and the rainy season, in her experience). In a year, 72 instances are registered at CAMNAFAW Soa, which is only one of eight CAMNAFAW Clinics and a small fraction of Cameroon’s several public and private health facilities.
According to the Society of Gynecologists and Obstetricians of Cameoon, SOGOC, unsafe abortions account for more than 25% of maternal morbidity and mortality in Cameroon, but further study is needed to collect country-wide data. According to the 2018 Demographic and Health Survey, DHS Cameroon has a maternal mortality rate of 467 deaths per 100,000 live births.
Thousands of hazardous abortion survivors are frequently left with long-term health consequences such as infertility, among others. “There are women who can no longer give birth today because they started an abortion, which they concealed, and it got complicated later when taken to the hospital, “states Onganya.
Generally, the issues reported at this clinic are related to bleeding. However, complications that may damage the woman’s fertility and death as a result of unsafe abortion do exist.
“Be it spontaneous or induced abortion, We do not judge women. We must not stigmatize. We are here to fight against maternal mortality,” Onganya reiterates.
When cases occur, the required care is provided, and individuals who wish to have another pregnancy are given little time to consider. The clinic provides a contraceptive strategy to allow the body to recuperate before attempting another pregnancy.
Different methods exist for dealing with partial abortions. Aspiration is one of the strategies utilized when there is a lot of bleeding. This method helps to completely clean the woman’s uterus. Sedatives are given because contractions produce significant pain. Antibiotherapy is administered, and the woman recovers.
The challenge of offering safe abortion services
Many people have accused CAMNAEAW of doing abortions. However, the midwife emphasized, “We fight against maternal death. We do what we call “safe abortions.” “Safe abortion occurs in a conducive environment with qualified and trained staff, which is what we have here,” the midwife says.
“We will not allow ourselves to play with people’s lives, and when we find ourselves in a situation that is no longer in our control, we refer to the higher level,” Onganya explains.
She describes how a lady was brought in with an incomplete abortion, a foul stink, and was unable to move after receiving first aid. She was then referred to the Yaounde Gynecological Obstetric and Pediatric Hospital.
“I was arrested during counseling with someone who claimed to be a patient but was working with gendarmes. The motive for the arrest was that she was practicing illegal abortion. I was released later, but even colleagues stigmatized me,” Onganya narrates her ordeal.
The Cameroon Penal Code, particularly Section 337(2), states that “Whoever procures the abortion of a woman, notwithstanding her consent, shall be punished with imprisonment for from one to five years and with a fine of from one hundred thousand to two million francs. However, the exceptions are when there is a rape case or when the woman’s life is at stake.
The Maputo protocol, which Cameroon ratified and which takes precedence over the national law, states that abortion is a human right and a public health imperative, yet the protocol is awaiting implementation.
Abortion Solidarity
Solidarity is needed if safe abortions can be achieved in Cameroon. Onganya says it is necessary to define values. “We must convince people that abortion is not a crime and that those who provide safe abortion services are not murderers,” says CAMNAFAW Soa lead.
The authorities should pass legislation making abortion lawful. “Not in the sense of libertinism, but have well-framed conditions and accredited centers with all the necessary equipment and qualified and trained staff for safe abortion.” Says Onganya.
September 28 is International Safe Abortion Day. Onganya says, “The day should be dedicated to public reflection with officials, legislators, the opposition, associations, feminists, religious organizations, and traditional authorities. those who are overly opposed, radical, and extremely radical to abortion meetings to pave the way forward.
“The risk of maternal death associated with abortion will be significantly lowered because women will realize they no longer need to hide if abortion is legalized. They don’t have to be terrified anymore, Onganya says.