MICHEL MARTIN, HOST:
This is TELL ME MORE from NPR News. I'm Michel Martin. We're going to spend some time today talking about issues in health, particularly in the developing world. Later, we're going to hear what it's like to be a trauma doctor in one of Africa's most populous and, yet, still underserved areas. And, hint, her house calls involve a helicopter. That's just ahead.
But first, we want to take a look at a health crisis emerging in Haiti. And you might be thinking about illnesses like dysentery after that devastating earthquake back in January 2010 that destroyed so much of the country's infrastructure. But actually, we're talking about something else - and this is probably a good time to say that this is a sensitive topic because we're talking about abortion, which is illegal on the island nation. But for some reason, more and more women are turning to dangerous way to terminate unwanted pregnancies, to the point where health ministry officials say post-abortion complications now account for as much as 30 percent of maternal deaths on the island. Jacqueline Charles, Caribbean correspondent for the Miami Herald, has been looking into this. And she's back with us now. Welcome back, Jacqueline Charles, thanks so much for joining us once again.
JACQUELINE CHARLES: Thank you for having me.
MARTIN: Now I need to clarify here that Haiti's anti-abortion law is not new and a high rate of maternal death in Haiti is not new, and I don't mean to be cavalier about that. So is there something new happening here that you need to call our attention to?
CHARLES: Suddenly people are starting to take notice of this. What happened with this earthquake is that a lot of things that were hidden before the disaster suddenly came to light. And this issue of the abortion crisis, this is emerging as a public health crisis today because with all of the NGOs, the medical aid groups that were down there in Haiti, in Port-au-Prince in particular, they started to notice with the explosion of the tent babies that there were a lot of women who were suffering from post-abortion complications.
MARTIN: You said there's been so much focus on the tent babies, what is that?
CHARLES: Yeah, what we found after the earthquake, you know, there was an explosion of tent cities that took place around the capital and the cities in surrounding areas, that had been struck by the quake. There was a high fertility rate that was happening in these tent cities, I mean, some of it because it was voluntary, some of it because it was survival, some of it because it was rape. And there were a lot of babies that were born.
MARTIN: You were saying that this could be for a number of reasons. It could be people turning to sex for comfort, but you're saying it's also because these young women were vulnerable. They really had no way to keep people out.
CHARLES: Exactly. It's been documented that there were increased reports of sexual violence that were happening after the earthquake. Now, again, we have to use a caveat that, you know, rape or sexual violence has always been an issue in Haiti, especially in times of disaster or unrest. But because you had so many eyes in Haiti and so many eyes on the ground, suddenly things that were not documented before were getting documented. And one of the things that was noticed were these explosions of pregnancies that were happening, especially among young girls.
MARTIN: What are some of the stories that you have heard from women and from medical professionals who are treating these women?
CHARLES: Well, when you talk to these women, I mean, it's just really tragic because what happens is that someone who has money can go to a private doctor and they can secretly get an abortion with anesthesia and in a sterilized environment. But when you talk to young girls or poor girls or poor women, what you learn is that they turn to herbal concoctions. They turn to this pill that's actually an anti-ulcer drug, but it's readily available on the streets of Haiti or at any pharmacy without a prescription. But because they don't know how to use it properly, they suffer from hemorrhaging, infection and just other complications. And often it leads to death because they are so afraid to turn to help because abortion is illegal.
One girl in particular, her story was just heartbreaking. She was a young girl in school - almost finished - but she was so afraid of the reaction from her parents. She first went to a clinic and they inserted some instrument in her and perforated her uterus, that didn't work. She was four months pregnant. Then she went to a herbal doctor, who she swore to me was a doctor when I interviewed her. He then came there, gave her some special bath using all of these different concoctions, including Haitian moonshine. And then he gave her herbal remedy to drink. Well, she drank it, she aborted, but she had an incomplete abortion and she spent three days suffering before she finally landed at a Doctor Without Borders hospital.
MARTIN: She - I'm sorry - it's amazing that she survived. I mean, how long was she under medical care?
CHARLES: She spent two months hospitalized there. They had to do emergency surgery to repair her uterus. And she was so weak when I met her - this was a month into her hospitalization - she didn't even have any strength to lift her body and she had lost a lot of weight.
MARTIN: You told us that, you know, abortion is strictly illegal, but what about modern methods of contraception? Are those available?
CHARLES: Modern methods of contraceptions are available, but what the Haitian government's most recent national health study shows is that there is still a huge gap in terms of women who would like contraceptions but they don't have access to it. So when you look at, for instance, with married women - 35 percent said I would like to space out my children or I would like to limit the number of children that I have, but I don't have access to birth control of any sort. So that...
MARTIN: And why is that? Is it because of cost? Is it because it simply isn't available? Is it because there's some political prohibition against making this available? Why is that?
CHARLES: First of all, let's start with the fact that 35 percent of the health institutions in the country do not provide any method of birth control, even though it is provided free by the United Nations Population Fund and also by the United States government Agency for International Development. But there is an issue in terms of access - where do I go to get it? And then there's also the issue of taboo. So there's a lot of issues that the health ministry recognizes that they have to tackle. But one of the things the experts have said to me is that if you have that political will, if you have it from the top, than that's how you start to get the momentum going.
MARTIN: Now that you're saying that this issue has come to light, what's being done and is there any kind of public discussion of this?
CHARLES: You have abortion that's illegal, but you have some people, even NGOs or doctors, who aren't exactly sure what the law says. So even in the case of the life of a mother, they think that it's OK for them to interrupt a pregnancy, but under the law it says, no, it isn't. So because of that confusion, the health ministry, earlier this year, brought together religious leaders, women's groups, doctors, and said, listen, we need to start to address this issue. We need to talk about it, can we put together a law, present it to parliament, so there is some clarification.
Now women's rights groups, they want full legalization because they're saying just having therapeutic abortion in the case of the life of the mother or the fetus, that's not going to help the maternal death rate. That's not going to stop women and girls from turning to back alley decisions or avenues in order to terminate. President Michel Martelly, himself, earlier this year, issued a presidential decree calling on all of the institutions in the country to provide counseling on birth control - free counseling and free birth control if a woman chooses or decides that's what she wants. So we're going to watch that and see how that goes, but I think that's an important first step to say, hey, this is something we care about, this is something we're taking afoot and let's address it.
I'm not exactly sure if they're going to do that in terms of the abortion issue because it's, you know, Haiti is predominantly Catholic. It's very religious, still very conservative. You know, everyone wants to act like this is not happening, but everyone knows who the abortion doctors are. But at least on the issue of contraceptions, we're seeing that there is some leadership taking place to say, hey, let's look at our population rate, let's start to help women and men address this issue of large families.
MARTIN: Jacqueline Charles is the Caribbean correspondent for the Miami Herald and she was kind enough to join us from Miami. Jacqueline Charles, thanks so much for speaking with us once again.
CHARLES: Thank you for having me. Transcript provided by NPR, Copyright NPR.