Postbag
I write in support of the articles by Sanitsuda Ekachai ("Abortion law is misogynistic, not moralistic", BP, Jan 23) and Paritta Wangkiat ("Illegal abortions cost nation dear" and "Three held for abortion service," BP, Jan 24 and Jan 25, respectively).
As a gynaecologist who was the head of the obstetrics and gynaecology department at Ramathibodi Medical School and former president of the Thai Royal College of Obstetricians and Gynaecologists, I have been taking care of women's health here in Thailand since 1968. I have been trying, through education and training, to save women from needless disability and death as a result of unsafe abortions.
The past four and a half decades have seen many changes and challenges.
The Thai abortion law, first imported from Europe in the mid-19th century, has remained since 1956, when it was last amended. All the European and North American nations which originated these laws had already changed or amended their ancient abortion laws by the second half of the 20th century. Our Asian neighbours who inherited these outdated laws rejected or amended them after their independence, also in the latter half of the 20th century.
Our Thai law allows abortions to be carried out by a registered medical practitioner for specified conditions. However, the vast majority of people in Thai society and some medical colleagues are still under the misconception that Thai law prohibits abortion in all circumstances. This misconception must be changed through public and professional education.
It has been said that laws do not stop abortions anyway. They just make abortions more dangerous.
Second, abortion technology has seen remarkable improvements in the past three decades. The use of rigid metal curettage has been replaced by the safer plastic cannula for first trimester abortions. This simple vacuum aspiration is safe and efficient. It is now used safely by mid-level healthcare personnel such as nurses, avoiding the need to involve specialists. Internationally, it has been proven to be safe, simple and effective. Many nations in Asia have allowed nurses to carry out this simple procedure at primary health centres.
The newest technology revolution came in the form of drugs in the combination of mifepristone and misoprostol. This technique has been accepted worldwide as safe and efficient. The World Health Organisation has recommended that this combination of drugs be put on the national essential drug list. Thailand has yet to register these drugs, but they are sold on the black market here at predatory prices (up to 5,000 baht per tablet when the legal market price is about 13 baht). For poor women, this is beyond their means and they often resort to old-fashioned methods carried out by quacks, using sharpened bamboo sticks or caustic solutions with the risk of a fatal outcome.
Third, the majority of healthcare providers here look at this problem negatively as a moral issue rather than an issue of women's health and rights to medical service. Consequently, they will often deny women abortion services. This refusal of service drives vulnerable and desperate women towards underground abortionists.
The already-stretched healthcare system then has to spend a vast amount of its limited resources on caring for the subsequent preventable complications.
Finally, I would like to share a quote from Prof Mahmoud Fathalla, a former president of the International Federation of Obstetricians and Gynaecologists (the world professional body of women's healthcare professionals).
He wrote in 1997: ''Women are not dying of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving.''
When will we decide?
PROF KAMHEANG CHATURACHINDA
President, Women's Health and Reproductive Rights
Foundation of Thailand (WHRRF)
What's that smell?
Re: "Winning hearts and minds," by Roger Crutchley (Postscript, Jan 27).
Once again Crutch brings truth in Thai politics to the people in a humorous column. One point needs further comment, though.
In highlighting how one candidate is promising to build 4,900 toilets at all Bangkok bus stops, Crutch fails to question if this candidate will also hire enough people at 300 baht/day to keep the toilets clean. If not, I can just imagine what 4,900 bus stops will smell like after just one month of use.
Of course, this could force people to use the Skytrain, or any of the other planned electric rail lines.
CHARLIE BROWN
Pattaya
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Article source: http://www.thethailandlinks.com/2013/01/30/abortion-access-is-crucial/
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