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Review: No More Deaths Because of Unsafe Abortion – Information is Just a Call Away

Every year more than 15,000 women die because of post partum haemorrhage and every day 10 women die because of unsafe abortion in Pakistan. If you know a woman who does not have access to hospital at the time of delivery or who wants to access safe abortion, then contact on the number provided.

“If my father came to know that I was raped, he would kill me.”

– Shaista*

Shaista, 24 years old, belongs to a middle-class family from Peshawar. She recently completed her Master’s degree from the University of Peshawar. Her father was strict and never allowed her to work outside the house, so she stayed at home most of the time helping her mother with the house work. Once her friend organized a birthday party and Shaista decided to go along with three friends who lived in the same street as her. On their way back home, their car was hit by some guys, and they came out of the car and raped Shaista and her friends. They screamed for help, but there was no one to help them on that empty road after sunset. She was worried that if her father came to know that she was raped, she would be killed. She was depressed and traumatised. She decided to consult a psychiatrist. She told her family that she is taking cooking classes in an academy, but her father was not in favor of this so he restricted her from going out of the house. It was the most terrible moment for her when the pregnancy test was positive after she missed her period. She decided to go to a doctor for help, but the attitude of the doctor was rude and unprofessional and he demanded a high fee which she could not afford. The doctor was reluctant to help her as she was unmarried. Shaista is not the only one, there are many girls who have no choice and either commit suicide or choose to have back street abortions.

According to an estimate by the Guttmacher Institute, 890,000 women have unsafe abortions every year in Pakistan, 30,000 women die because of pregnancy related issues and 197,000 are hospitalized as a result of complications. Talking about sexual and reproductive health in a 97% Muslim majority country is taboo. According to Pakistani law, abortion is permitted only to save the life of the woman, to preserve physical health, and to preserve mental health. There is a lack of abortion services in Pakistan and services providers provide biased and judgmental services charging huge sums of money with a minimum fee of US$95. According to an Asia Safe Abortion Partnership report 67% of medical professionals in Pakistan have an unfavorable attitude to abortion and 81% want stricter laws regarding abortion. Women who are unmarried, cannot afford and do not have access to health care services, and therefore prefer to choose backstreet abortion clinics where unsafe procedures threaten health and lives. The justice system in Pakistan is also not women-friendly and Shaista decided not to lodge an FIR after her rape as it would reveal the incident and make her vulnerable to violence from her parents and family.

At Aware Girls, we are working to empower young women, enabling them to take control of their own bodies. ‘Aware Girls’ is a young women led organization established in 2002, working in the North Western Pakistan Khyber Pakhtunkhwa Province. Aware Girls, in collaboration with Asia Safe Abortion Partnership and Women on Waves launched the Sahailee Hotline[1] in June, 2012. ‘Sahailee’ is an Urdu word which means female friend.

Aware Girls is not trying to argue for or against the legitimacy of abortion; for us, the most important thing is to prevent the loss of women who die because of  unsafe abortions. So, despite the risk involved, it is very important for us to reach women who need assistance. This hotline provides information on safe medical abortion, sexual and reproductive health services, contraceptives, sexually transmitted diseases and domestic violence, usage of Misoprostol for safe abortion and postpartum hemorrhage. The information on the hotline is given according to the World Health Organization guidelines. The hotline is working to save the lives of thousands of women in Pakistan who die unnecessarily each year. After the launch of the hotline, there was strong opposition, but the hotline has continued to deliver the information to women who are in need.

A hotline counselor at Aware Girls said, ‘Before, the word abortion seemed to me like a sin. I was not the only one who thought like this, all of my class fellows were of the same opinion. This hotline is a part of my life now and I am determined to save the lives of the women.’

Huma*, a caller, shared, ‘Sahailee hotline understood my situation, was in regular contact with me and guided me in a very supportive manner. Sahailee hotline helped me regardless of my marital status. I do not have words to express my gratitude to Sahailee hotline and their team’.

This hotline was expanded to Balochistan in 2012 which is another very fragile province of Pakistan having borders with Afghanistan. Balochistan has high rates of unsafe abortion because of the restrictive environment regarding abortion. The hotline information is disseminated among the women of Balochistan through different strategies like engaging community women and students. Values clarification and attitude transformation meetings have been organized with women’s groups, health-care providers, and local organizations to reduce the stigma and taboo related to abortion.

Based on a very successful experience in Pakistan, Aware Girls decided to extend the safe abortion hotline to Bangladesh[2] in October 2013. It has been estimated that every year 800,000 abortions are being performed in Bangladesh and at least 8,000 women are dying from abortion related complications every year. As estimated 572,000 women suffer from unsafe abortion complications each year and only 40% of them receive treatment from health care facilities. Therefore the hotline was launched and in the first four months we have received 400 calls, which is a tremendous achievement.

Three referral directories have been developed: one for Khyber Pakhtunkhwa, the second for Balochistan and a third for Bangladesh identifying the existing service providers and referring the callers to them if someone wants to have surgical abortion.  These hotlines are working to drive progress towards the MDGs – the Millennium Development Goal that aims to cut maternal death by three quarters by 2015 – but it seems hard to achieve. Besides restrictive laws, there is less investment in family planning in Pakistan contributing to maternal deaths and health complications.

More than 11,000 calls have been received on these hotlines in three years since June 2010, both in Pakistan and Bangladesh. We receive calls both from married and unmarried women. The information on all these three sites is given in local languages. The following numbers can be contacted for further information:

+92 315 917 0408 (Languages: Urdu, Pashto [3])

+92 344 805 3864 (Languages: Balochi, Brahvi [4])

880-1853 892424 (Languages: Bangla [5])

 

*Callers’ names have been changed to protect their privacy. 

 


[1] Number: 0315 9170408

Timings: 09:00 AM to 09:00 PM

[2] Number: 880-1853 892424

Timings: 09:00 AM to 02:00 PM

[3] 09:00 AM to 09:00 PM

[4] 09:00 AM to 02:00 PM

[5] 09:00 AM to 02:00 PM