Dr Fatumah Nakalembe talks to women about abortion

However, many women lose their lives in the process as they resort to crude methods in an attempt to hide their actions. 
Because abortion is deemed immoral in Uganda, it is a difficult subject.    

“At first it was hard for me to talk about issues related to abortion but I realised the more we keep quiet, the worse the problem becomes. I remained focused to save lives of women and girls,” Nakalembe says. 
 
She says community leaders largely do not want to talk about the subject yet abortion is a reality in their communities. She is frustrated that for some reason unknown to her, no one seems interested in discussing and addressing the subject of abortion.
   
“Since there are still cases of defilement and unwanted pregnancies, we cannot sit back and look because at the end of the day, these girls opt for abortion and in hard-to-reach areas, it’s even worse. Some of the girls are defiled by their relatives and end up pregnant,” she says.

Nakalembe says she was born to fight for the rights of women and girls. She works under the auspices of Community Health Rights Network (Coherinet)- a non-governmental organisation which deals with sexual reproductive health in Kasangati, Wakiso District. 
  
Coherinet was established in November 2013 as a network of an alliance of community-based organisations, community health workers, individuals and learning institutions from across the five regions of Uganda. Nakalembe did not join it until later. 

She says she resorted to fighting unsafe abortions after her friend lost her life in the process of abortion because they both didn’t know what to do. 

Nakalembe saw life slipping out of her friend’s body and, she says: “From that day, I was touched and asked God to give me courage so that I can save people’s lives, especially those who have had unsafe abortions. 

By the time they talked to people for help, it was too late because she had already lost too much blood and she died. 
“Since then, I realised I had to do something to save people’s lives.” 

Nakalembe would later train to become a doctor, and decided to channel her energies into addressing this problem.
“I talked to fellow doctors how this can be stopped and why it is still a silent pandemic. In the course of my consultations, I got several reasons and this also gave me courage to do something to end it,” she says.

That’s when she joined Coherinet. Her focus, she says, was to use the platform to save lives that would otherwise have been lost through unsafe abortions.

Nakalembe says although they have been handling several cases about unsafe abortions from the past, the situation became worse during the lockdown necessitated by the Covid-19 pandemic because people had no access to public means of transport to reach service providers, while others did not have money to buy what is required to procure safe pregnancy termination processes. Some health facilities services ran out of stock or the prices of the supplies were too high.

This meant a rise in cases of unwanted pregnancies during the Covid-19 period, and many of the victims were much younger people, mostly girls who were not attending school after they were closed.

How they work

Nakalembe spends a lot of her time talking to women and girls on phone. Her organisation has a toll-free line through which those who need help call in. 

It is toll-free because they don’t expect their clients to afford airtime to call in, and the phone-in system is favoured because some women fear to discuss their problems face-to-face.

Musah Yiga, the team leader at Coherinet, says Nakalembe has helped several women with issues of unsafe abortion. 

“We all know that people do not want to talk about abortion because of several factors but Nakalembe has come out to show us that this issue is very crucial and there is need to stop it because people are losing their lives,” Yiga says.

Yiga says cultural and religious beliefs are the major hindering factors in dealing with unsafe abortion because they don’t entertain any conversation about the subject. 

Although there is a post-care package (after abortion) which the government has rolled out at all government facilities, Nakalembe says they have discovered that some providers do not know how to provide these services. Worse still, she says, women of reproductive age at the community grassroots levels do not know that these services are available, and they fear to ask because they still have that belief that it is not allowed to discuss the subject in an open place.

Nakalembe says her efforts with Coherinet have taken her to a number of districts, including Amuru, Gulu, Kampala and Butambala. 
She dreams of a day when every Ugandan woman of reproductive age will have full information about abortion.