Access to Legal Abortions Still Hampered by Funding, Personnel

Although abortion was legalized in Cam­bo­dia in 1997, access to the pro­­­­cedure at a public fa­cility is still not officially available, experts and officials said recently.

A 2003 survey by the Repro­ductive and Child Health Alliance reported that 4.6 percent of wo­men between 15 and 49 have had an abortion. But there are no reliable statistics available and the figure could be higher, experts said.

Kun Konal, director of the Na­tional Maternal and Child Health Center, said recently that another survey indicated that at least 20 percent of Cambodian abortions result in death or serious injury.

“Many people died of illegal abortion in the past, that is why we needed to have a law to allow abortion,” he said.

“We have the law for abortion, but we have no enforcement be­cause we don’t have the funds yet for the training,” Kun Konal ad­ded.

The government center has been approved to train 500 staff members on abortion procedures for some time, but funding has yet to be released from the Ministry of Health, he said.

“Now there is no permission to do abortions…because they have no training,” he added.

A US law that would cut off all US funding to health centers that perform abortions may be playing a role in the delay, an expert in the field said.

According to the US Embassy, if the center implements its plan to train doctors on abortion procedures, any US-funded programs at the hospital would be ended.

“USAID is legally prohibited from funding groups that perform or promote abortion,” US Embassy Spokesman David Gainer said Monday. “If [the hospital] starts providing abortions, they will lose everything.”

The National Maternal and Child Health Center receives funding from Reproductive and Child Health Alliance, which is funded by USAID, so they have to be “careful” on the abortion is­sue, an official with the NGO Care International said.

“I don’t need to tell you the policies of the current US administration,” the Care official said.

US President George W Bush reinstated the prohibition on abortion funding, relaxed during the administration of former US president Bill Clinton, as one of his first acts in office. Bush had campaigned for the presidency on an anti-abortion platform.

Kun Konal, however, denied that the US policy was to blame for the delay in training.

“This is Cambodia, it’s not the US,” he said.

While public hospitals are not able to perform abortions yet, three internationally funded Marie Stopes clinics do provide safe procedures.

The clinics provide 50 to 60 abor­tions each month at their Phnom Penh center and at their locations in Koh Kong and Kan­dal provinces, said Marie Stopes Director Ros Thurn.

However, a culture of silence and shame still surround abortion, Ros Thurn said.

“The law [on abortion] was passed in 1997, but there has been no scaling up of activities since then,” he said. “This problem is happening al­ready in our communities and clinics, but no one is talking about it. We need to start talking about it.”

Kun Konal said the hospital sees the victims of botched abortions performed by untrained midwives.

Former minister of women’s af­fairs Mu Sochua said late last month that midwife abortions are all too common in Cambodia.

“They are happening all the time,” she said, adding that though private clinics offer safer ab­ortions, they too are unregulated.

“For those who can afford these abortions, it is a good op­tion, but no one is checking on these clinics either.”

For Mu Sochua, the key to de­creasing illegal abortion is in­creasing access to contraceptives.

Despite government efforts, which she described as successful, Mu Sochua said that still only 20 percent of Cambodians use contraception.

 

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