Unsafe abortion is a complex and contentious issue. Although the World Health Organization estimates that the majority of cases in low-income countries are by women aged 25-49, in Subsaharan Africa, youth aged 15-24 are the majority.  The WHO has also found that laws against abortion do not effect its incidence (occurence). In Europe, where most countries have pro-abortion laws, the abortion rate is 28%, whereas in Africa, where most countries have anti-abortion laws, the rate is 29%. This leads some to think that abortion is something that women are going to attempt regardless of legal limits. It is important to recognize that  although laws may not affect abortion incidence, laws do effect the proportion of those who end up experiencing unsafe abortion. Where abortion laws are particularly restrictive more than 55% of those in developing countries will experience an unsafe abortion compared to 8% of those in developed countries (where abortion laws are generally more permissive). The WHO also estimates that over 95% of abortions in Africa  and Latin America are unsafe and more than 60% in Asia.  The primary cause of abortion is unintended pregnancy which is more than 30% of pregnancies, and 19% of those end in induced abortion (8% safe, 11% unsafe).

What are the consequences of all this unsafe abortion? Unsafe abortion is estimated to cause 67,000 deaths per year or about 13% of cases of maternal mortality. Clinically this is usually manifested as hemmorhaging (uncontrollable bleeding) or sepsis (infection).  The social and economic burdens this maternal mortality places on families, children and health care systems is significant. For those who survive, the morbidity (related illness)  is also a problem, with infertility as an important long-term outcome.

IPAS is an international organization dedicated to reproductive justice. They have partnered with Lisa Russell, a documentary film maker known for her films on international women to make a film on unsafe abortion in Ethiopia called "Not Yet Rain."  Lisa Russell works primarily in Subsaharan Africa. She got an MPH before she went into film and her interest in health really shines through, she has covered issues such as obstetric fistula, traumatic fistula and now unsafe abortions.

Lisa has also worked with Youth in Liberia on a media project. I have yet to see this but I would love to because I also worked with youth last summer in Liberia. Youth in Liberia have it particularly hard because not only did most of them grow up and come of age during the 14 year civil war but now that the war is over they still face many difficulties related to the lack of development and infrastructure (yet amazingly, some overcome these obstacles). While in Liberia I met quite a few young women suffering from unsafe abortion complications (I worked at a maternity hospital) and I saw first hand the type of desperation that these women feel. This was quite moving and personal for me because as a Liberian-American, I was quite fortunate to never experience an unsafe abortion or the high levels of sexual violence these young women suffered through.

I had a chance to speak with Lisa Russell again this year. She mentioned that making Not Yet Rain was difficult for her because it is such a divisive topic. However she also mentioned that she also really likes the job of getting such a contentious topic out there, and hopes that if she can get the discussion going about unsafe abortion, then she has already made a huge impact.

I am quite fortunate to know Lisa Russell and she serves as a inspiration and role model for me. Not only because she has discovered how to combine her passion for social justice and health with her filmmaking talent but also because she is also doing it in a way that is bringing about positive change in the world. I also think that in her case, it took her a while to figure out her passion and her true calling. This is an important lesson for us young activists, who sometimes feel like we need to have it all figured out now, I know I often feel this way.  I think  Lisa Russel would agree with me that although the road is not always easy, sometimes the journey may be the best part!

 
TAKE ACTION:

1. Learn more about unsafe abortions, check out this comprehensive group of papers by the World Health Organization , TheLancet Student Article, an article from Planned Parenthood.
2. View the Not Yet Rain in its entirety
3.  Plan a film viewing on your campus, use the tools at the Not Yet Rain website, click on Get Involved, they have presentation tips and background information for you to share.
4. Share the film on facebook by clicking on share film and then clicking on the facebook, myspace or whatever you use
5. Join the Not Yet Rain facebook group
6. I first met Lisa last year at the Unite For Sight conference on Global Health and Development at Yale.
7. 2009 Summit on International Women's Issues, This is where I spoke with Lisa Russel this year. The best part about 6, 7 is that these conferences not only give young activists the chance to get educated and network but can also help you meet inspiring people.
8. The work that Lisa Russell does with Youth in Liberia reminds me of  4Real. Check out the youth-led initiatives (and their celebrity advocates).