Addressing Unsafe Abortion in Pakistan: A Panel Discussion for September 28 Global Day of Action for Safe Abortion

**WGNRR member and safe abortion advocacy and campaign project partner, Shirkat Gah Pakistan held a panel discussion on unsafe abortions in Pakistan. This is the second public event in Karachi on unsafe abortion. Last year, Shirkat Gah also had a successful media event for September 28 Global Day of Action for Safe and Legal Abortion.

Thanks to Ms. Maryum Siddiqi, Shirkat Gah Karachi Office, Pakistan for writing the comprehensive report on the event.

 

September 28th 2013- The Global Day of Action for Safe Abortion

Panel Discussion on Addressing Unsafe Abortion in Pakistan

 Ms. Maryum Siddiqi, Shirkat Gah

 

 

According to a national study conducted by Population council concerning post abortion care, nearly 700,000 women in Pakistan last year resorted to abortion using unsafe methods. Despite such an alarming figure that clearly states the appalling cause of maternal morbidity, advocating abortion is considered a taboo, and therefore people shy away from being vocal about this vital topic.

On the 28th of September 2013, which is The Global Day of Action for Safe Abortion; Shirkat Gah organized an event, which included a panel discussion moderated by journalist Imran Shirvanee where key panelist along with the participants discussed exercising safe and legal abortion in Pakistan. The panel discussion was held with the support of the Women’s Global Network for Reproductive Rights (WGNRR), and was attended by several organizations namely; YELL, Peace foundation, Aahung, National Committee of Maternal and Neonatal Health (NCMNH), our community partners from Sindh and Balochistan, along with the members of our National Media Alliance and members of the Pakistan Reproductive Health Network from Karachi and Lahore. Likewise, individuals who have significant amount of experience in advocating safe abortions at grassroots level such as; Shanul Khoso and Mukhtiyar Memon were also present at the event to share their advocacy plans.

Members forming the panel discussion were:

·         Amina Mazhar  (Ipas)

·         Imtiaz Kamal    (Midwifery Association of Pakistan)

·         Dr. Shershah     (Pakistan Medical Association)

·         Dr. Zakir Shah  (Population Council)

·         Sophia Jamal    (CNBC)

 

Key Objectives:

·         Raising awareness of the consequences of unsafe abortion

·         Addressing misconceptions of abortion

·         Minimizing the number of unsafe abortion and the mobilization of youth groups

·         Share advocacy plans and strategies of different organizations and individuals working on the issue of maternal mortality and determine where efforts can be synergized

·         To increase awareness regarding access to safe abortion and to further strengthen post abortion care in Pakistan

·         To join forces with media in highlighting this imperative issue

This meaningful event kicked-off with welcome remarks from Dr. Tabinda Sarosh, Senior manager, Shirkat Gah who talked about Shirkat Gah’s vision for a just society in which there is justice not just for women, but for children, men, and people from all walks of life – without any discrimination based on sex, caste or religion. Further, she gave a brief overview of the nature of work done at Shirkat Gah, where emphasis is placed on supporting women to claim their rights by being facilitating so that there is gender equality and social justice. Plus, policies are made on the regional, provincial, national, and international level so that women can freely exercise their rights. In addition Dr. Tabinda mentioned that, we need a culture where there is peace, democracy and tolerance for all. She also brought up the importance of access to safe abortion and the reason why it is one of the central missions for Shirkat Gah – where the organization believes in women empowerment and women’s rights to make autonomous decision about their own bodies.

Dr. Tabinda added that unsafe abortion is a disturbing reality and prompt measures should be taken to strengthen abortion related services because if appropriate actions are not taken it will add on to the already sky rocketing figure of women mortality and morbidity. She also shared pictures from last year’s networking meeting and abortion advocacy training. Her speech ended with a pledge on behalf of Shirkat Gah to strive to end social stigma and stratification against women, a deeply rooted societal problem. She also shed light on the clear need to increase the contraception access and to deal with the availability issue, and finally to increase focus on the grassroots while continuing efforts at the policy level for post abortion care protocols.

The panel discussion commenced after a fifteen minute tea break with a brief introduction of each panelist by Imran Shirvanee. It was an informative and interactive discussion whereby the moderator managed to emanate a response from the participants present at the event as well. Along with the panel discussion, Samreen Shahbaz, National Coordinator Advocacy and Communications was participating on behalf of Shirkat Gah in ASAP’s and WGNRR’s Tweetathon for safe abortion rights which received huge Twitter viewership i.e. a total outreach of 10,000 Twitter users.  

The following are a couple of snapshots of the Tweets:

 

Abortion has been one of the most controversial topics and is considered a filthy word due to the undeniable stigma attached to it. The majority of Pakistan tends to get scandalized when someone mentions the word ‘Abortion’. It is this social stigma that hinders access to appropriate abortion care. “The biggest misconception associated with abortion is that women who get pregnant out of wedlock resort to abortion” quotes Dr. Zakir Hussain Shah, a renowned researcher in Population council. In relevance to the national study carried out by Population council on Post-Abortion Care in Pakistan, he said that the magnitude of complication has risen over the years. Rural women are more likely to fall under the category of those who resort for unsafe abortion due to lack of awareness. In addition, there are numerous other factors that may delay the necessary treatment like; cost of treatment, transportation issues, and the fact that women cannot travel unaccompanied, lack of autonomy, lack of access to family planning and contraceptives are few of the obstacles that rural women encounter.

Furthermore, Dr. Shershah began the discussion by talking about the negligence of state and how they have done very little to prevent unsafe abortion despite knowing that about 700,000 women precariously suffer in Pakistan. He pointed out that more than them it is few barbaric social mobilizers and religious people who purposely pay no heed to this crucial issue. He held the state responsible for an appalling number of unsafe abortions and repeatedly mentioned that the agenda of health and education are two things that only the state has the power to reform. Dr. Shershah also held the doctors accountable for the deteriorating condition of abortion care/facilities in Pakistan due to the fact that, even though the doctors are well aware of several other safe techniques for safe abortion such as prescribing Misoprostol or Vacuum Aspiration, the doctor still wants to continue with D&C because it delivers positive financial gain.

Sadly, Dr. Shershah pointed out that the state has not done much about Family Planning issues in spite of securing the necessary financial aid. Besides, he brought to light a significant point that the government has established plenty of medical universities which are manufacturing countless doctors, however there is not a single university or college that is specifically for nursing or midwifery courses; while the state is busy importing robotic surgical instruments, CT scans knowing that we still do not have proper access to PAC facilities. 

Later on, Amina Mazhar, Country Director of Ipas Pakistan repeatedly mentioned the usage of Misoprostol. In her words, “It is a wonder drug!” - Which is extremely cost effective considering that it costs only Rupees 10. She was optimistic as there is hope, however it is a long term process and change cannot come overnight, although gradual change is visible at the community level. She talked about the in-service training of mid level providers which is extremely crucial. Besides, she mentioned that we have all the resources, the required tools and equipment, and information, but the challenge is that we have to collectively raise this at the policy maker level and the government has to commit to this important cause. Amina further mentioned that, unsafe abortion personally touches us all whereby we know someone who has been through the process of unsafe abortion. She pointed out that most of the health care providers are not comfortable with the act of abortion, but she pleaded that service providers should keep his or her personal bias aside and provide the patient with the safest service, and if one cannot commit then your responsibility is to refer them elsewhere.

Interestingly, Imtiaz Kamal, Midwifery Association of Pakistan shared with us her experience of 60 years and her personal emotional story which initially made her an advocate. She laid emphasis on the importance of skilled nurses and midwives, and the lack of schools and colleges concentrated particularly in this domain due to social taboo. She also warned us about those women who have a diploma of midwifery even though they have absolutely no experience in this delicate field. Imtiaz Kamal urged every one present at the panel discussion to raise their voice without being afraid because it is a reality, an inconvenient truth.

Later on during the day, Sophia Jamal, media anchor at CNBC shared her perspective with us about the power of media and how influential this outlet is. Sophia talked about how our Pakistani media fails to incorporate programs that are extremely important to provide awareness to the masses. She emphasized how media is succumbed in portraying only those images, stories or information that helps them gain ratings when their role is to educate and inform the public. She asserted that media’s involvement in highlighting and promoting issues like abortion is crucial. However, it is a pity that our media takes zero social responsibility despite knowing the impact this mode of communication has on our society. She further added that, we are more interested in showing flashy and cheap shows with trashy themes than to disseminate information which is crucial for public awareness. Most importantly, these shows could be an extremely powerful tool in educating the masses on a plethora of social issues.

Recommendations and Response

The panel received an overwhelming response from the participants; the media representatives, our community partners/individuals and the various organizations present at the event. Each had significant recommendations and suggestions.

Farzana from Peace foundation criticized the attitude of the service providers which is extremely rude and the way they treat women who come for abortion is very harsh.      

Ghaffar Malik from Sindh development society and Sajida from Shirkat Gah had similar views where they both highlighted the issue of sex selection abortion whereby a son is preferred over a daughter and if the woman fails to give birth to a daughter the consequences are either aborting the baby or results in a divorce. They both pointed out that it’s indeed a matter of concern because it not only breeds gender discrimination but also devalues girls and legitimate steps should be taken to eradicate this prevailing problem from the roots of the society. Nevertheless, this does not mean that abortion is wrong!

            In addition, Mr. Sohail Dossa from Aahung emphasized on the quality of education and pointed out that opening an institute is not a big deal but the quality of education they provide is vital for the overall wellbeing of the society and also comprehensive abortion care should be included in curriculum.

            Mukhtiyar Memon from district Shikarpur talked about the imminent change and said that there is a positive change at the grassroots level where they have organized sessions with religious teachers and discussed family planning with them. Although he says, it remains a challenge however a minor change is observed. He pointed out that we always talk about spreading awareness among females though it is very essential that knowledge and awareness among males is also distributed because women in the rural areas are financially, physically, and emotionally dependent on their male counterparts.

            Lastly, Shaheen Siddiqui a journalist from Roznama Juraat shared with us that there is no concept of sterilization and infection prevention in public sectors. She stated that, D&C is one of the most common modes of abortion even though there are various other safes approaches, reason being money. Along her, many other media representatives had a unanimous view about abortion articles hardly being published because the targeted mass are either too narrow minded or they do not wish to acknowledge the existing problem.

The meeting ended with thank you remarks from Dr. Tabinda Sarosh and a vow of solidarity and unity from all the participants. The participants committed to share their plans of actions/advocacy and to work in cohesion to eliminate unsafe abortion.

Outcomes of the Event

·         Solidarity pledge from grassroots organizations to continue work to prevent unsafe abortion.

·         Engagement with like minded journalists for the first time at a large scale to upscale advocacy efforts.

·         Taking the message to the urban and rural youth.