Stories

Rewda Kedir works as a midwife in a rural area of the Oromia region in southwest Ethiopia. Only 14% of married women are using any method of contraception here.  The government hospital Rewda works in is supported to provide a full range of sexual and reproductive healthcare, which includes providing free contraceptives and comprehensive abortion care. In January 2017, the maternal healthcare clinic faced shortages of contraceptives after the US administration reactivated and expanded the Global Gag Rule, which does not allow any funding to go to organizations associated with providing abortion care. Fortunately in this case, the shortages only lasted a month due to the government of the Netherlands stepping in and matching lost funding. “Before, we had a shortage of contraceptive pills and emergency contraceptives. We would have to give people prescriptions and they would go to private clinics and where they had to pay," Rewda tells us. "When I first came to this clinic, there was a real shortage of people trained in family planning. I was the only one. Now there are many people trained on family planning, and when I’m not here, people can help." "There used to be a shortage of choice and alternatives, and now there are many. And the implant procedures are better because there are newer products that are much smaller so putting them in is less invasive.” Opening a dialogue on contraception  The hospital has been providing medical abortions for six years. “Before, there was no safe abortion," says Rewda. She explains how people would go to 'traditional' healers and then come to the clinic with complications like sepsis, bleeding, anaemia and toxic shock. If they had complications or infections above nine weeks, Rewda and her colleagues would send them to Jimma, the regional capital. "Before, it was very difficult to persuade them to use family planning, and we had to have a lot of conversations. Now, they come 45 days after delivery to speak to us about this and get their babies immunised," she explains. "They want contraceptives to space out their children. Sometimes their husbands don’t like them coming to get family planning so we have to lock their appointment cards away. Their husbands want more children and they think that women who do not keep having their children will go with other men." "More kids, more wealth" Rewda tells us that they've used family counselling to try and persuade men to reconsider their ideas about contraception, by explaining to them that continuously giving birth under unsafe circumstances can affect a woman's health and might lead to maternal death, damage the uterus and lead to long-term complications. "Here, people believe that more kids means more wealth, and religion restricts family planning services. Before, they did not have good training on family planning and abortion. Now, women that have abortions get proper care and the counseling and education has improved. There are still unsafe abortions but they have really reduced. We used to see about 40 a year and now it’s one or two." However, problems still exist. "There are some complications, like irregular bleeding from some contraceptives," Rewda says, and that "women still face conflict with their husbands over family planning and sometimes have to go to court to fight this or divorce them.”

The Safe Abortion Action Fund (SAAF) which is hosted by IPPF was set up in 2006 in order to support grass-roots organisations to increase access to safe abortion. One such organisation which received support under the last round of funding is called Lady Mermaid's Bureau. I am Pretty Lynn, aged 25. I am a sex worker but I went to university. I graduated with a Bachelor's Degree in Tourism in 2013. But now, during the day I’m sleeping and during the night I’m working. That is how my day goes every day. I got into sex work through friends. Okay it is not good but I am earning.  I tried to get a job when I graduated. I have been applying since I graduated in 2013. I’m still applying but I’m not getting anywhere. You know to get jobs in Uganda; you have to know someone there and no one knows me there. To be a sex worker is like a curse. People look at you like, I don’t know, as someone that has no use in society. People look at you in a bad way. They even don’t consider why you are selling. They just see you as the worst thing that can happen in the society. So it is not comfortable, it is really hard but we try and survive. The fact sex working is illegal means you have to hide yourself when you are selling so that police cannot take you. And then you get diseases, men don’t want to pay. When the police come and take us, sometimes they even use us and don’t pay. So it is really hard. They want a free service. Like if they come and take you and pay that would be fair. But they say it is illegal to sell yourself. But they still use you yet they are saying it is illegal. You can’t report the police because there is no evidence.  Abortion and unwanted pregnancies are really common because men don’t want to use condoms and female condoms are really rare and they are expensive. Though at times we get female condoms from Lady Marmaid’s Bureau (LMB) because there are so many of us they can’t keep on giving you them all the time. At times when we get pregnant we use local methods. You can go and use local herbs but it is not safe. One time I used local herbs and I was successful. Then the other time I used Omo washing powder and tea leaves but it was really hard for me. I almost died. I had a friend who died last year from this. But the good thing is that LMB taught us about safe abortion. I have had a safe abortion too. There are some tabs they are called Miso (misoprostol). It costs about fifty thousand shillings (£10 pounds or $20.) It is a lot of money. But if I’m working and I know I’m pregnant, I can say, "this week I’m working for my safe abortion". So if I’m working for twenty thousand, by the end of the week I will have the money. It is expensive compared to Omo at five hundred shillings but that is risky. So if I say I will work this whole week for Miso (misoprostol) it is better. But I'm working and I'm not eating. A project like this one from Lady Mermaid's can help young girls and women. But to take us from sex work, it would really be hard. They would not have enough money to cater for all of us. So what they have to do is to teach us how to protect ourselves, how to defend ourselves. Safe abortion yes. They will just have to sensitise us more about our lives, protection, female condoms and all that. I don't have a boyfriend but maybe when I get money and leave this job I will. But for now, no man would like a woman who sells. No man will bear the wife selling herself. And that will happen only if I get funds, settle somewhere else and become responsible woman. I don’t want this job. I don’t want to be in this business of sex work all the time. I want be married, with my children happily, not selling myself. Stories Read more stories about the amazing success of SAAF in Uganda