Out of the fire of anger: A women’s center in Tanzania opens a pharmacy to bring misoprostol to rural communities

Reposted from Ipas
This article was published in Medical Abortion Matters (May 2013)
 
When the staff of the Women’s Promotion Center (WPC)* in Tanzania’s rural Kigoma Region realized women were sufferingpilland dying unnecessarily from unsafe abortion—and that misoprostol could provide an option for safe abortion if only it was available—they got angry. So they started a pharmacy to bring misoprostol to local communities to save women’s lives.
 
Abortion is illegal in Tanzania except to save a woman’s life, and unsafe abortion is a significant contributor to the country’s high maternal death rate. WPC staff knew many women were dying in the Kigoma communities where they had been working for years on women’s issues like gender violence and economic empowerment. But they didn’t have a practical solution to the problem until 2008, when a staff member attended an education session by Women on Web on how to safely use misoprostol.
 
“After that session, it was clear to WPC that misoprostol—an easy-to-take and easy-to-keep medicine—could prevent postpartum hemorrhage and safely induce an abortion,” explains one of WPC’s long-time staff members, who chose to remain anonymous. “From there, WPC committed to saving mothers’ lives, despite the restricting legal context, by putting information on this life-saving pill into women’s hands.”
 
In 2009, WPC launched its “Save Mothers’ Lives with Misoprostol” initiative, which began with an education and awareness-raising campaign to prevent unwanted pregnancy and unsafe abortion—and to promote misoprostol as a method for safe abortion and treatment of postpartum hemorrhage.
 
“Our community facilitators created awareness on the potential of misoprostol, and women started looking for this medicine,” the staff member says. “But there was no misoprostol in local pharmacies in Kigoma at that time. It was available in other regions, but was very expensive.”
 
WPC saw an opportunity: Misoprostol is registered in Tanzania for treatment of postpartum hemorrhage. In 2010, WPC opened a local pharmacy that sells misoprostol and also offered counseling by a well-trained professional on how to safely use misoprostol, as well as take-home information about how to use the drug and referrals to doctors willing to help in case of complications.
 
Since the pharmacy opened, women’s access to misoprostol and contraceptives in Kigoma Region has improved, and WPC has noted a decrease in reports of women dying from unsafe abortion. In addition, the pharmacy’s sale of misoprostol created economic competition with private drug sellers in the area and reduced the price from the equivalent of 12 USD to just 5 USD for a package of 12 pills. According to WPC staff, the presence of the pharmacy in Kigoma has also positively influenced rural women’s health-seeking behaviors, thereby increasing the local demand for misoprostol.
 
“What’s incredible about this story is that Women’s Promotion Center is not a health organization—it focuses on advocacy and women’s rights,” says Francine Coyteaux, director of the Misoprostol Initiative at the Public Health Institute. “They recognized a health need in their community and took a pragmatic, rights-based approach to solving the problem.”
 
Looking to the future, WPC plans to expand its pharmacy initiative, opening additional small pharmacies in selected towns to provide women with high-quality, affordable misoprostol and contraceptives. Advocacy to change Tanzania’s law and grant women access to legal, safe abortion services is also on the agenda. In 2012, WPC began advocacy initiatives that include building a network of local organizations all focused on law change and improving women’s access to reproductive health services. After all, advocating for women’s rights and against injustice has always been WPC’s core mission, and fighting for a woman’s right to access a drug that can save her life is a natural extension of that impassioned work.
 
“The pharmacy initiative was born out of the fire of anger about unnecessary deaths and suffering of women, and also the fire of passion to save mothers’ lives in Kigoma,” the staff member says. “WPC’s enormous determination to prevent deaths due to postpartum hemorrhage and unsafe abortion is the basis of its success in operating the pharmacy.”
 
*WPC is a member of WGNRR in Tanzania and a lead partner for Safe Abortion Advocacy Project of WGNRR. The project is supported by Safe Abortion Action Fund