Inside Lagos markets where deadly herbal concoctions induce teenage abortions (II)

  • Test reveals cancer, liver damage tendencies

In this concluding piece of a two-part story, results of laboratory tests carried out on the herbal roots and other substances procured from the markets, revealed high levels of dangerous compounds capable of causing grievous health complications and incapacitating an individual for life. ALFRED OLUFEMI reports

To ascertain their safety for ingestion, the herbal cocktails were taken to the University of Lagos Consults laboratory. For three weeks, the samples were subjected to a series of tests that include analysis for Polycyclic Aromatic Hydrocarbons, metals and microbiology characteristics.

The results of metal analysis on them showed that some contained traces of metals such as lead, zinc, copper, manganese, iron, nickel, but within the WHO recommended limits.

Microbiology analysis results also fell within the WHO standard. According to the WHO, there is an estimated 65 to 80 per cent of the world’s population that rely on traditional (alternative) medicine as their primary form of healthcare.

However, the use of herbal medicines has come under scrutiny due to their perceived long-term toxicity among other considerations.

A medical review by Everyday Health, an online health portal, explained the accumulation of certain metals such as zinc, copper, chromium, iron, and manganese in the body due to exposure through food, water, industrial chemicals, or other sources, can lead to heavy metal poisoning.

It noted that while the body needs small amounts to function, toxic amounts are harmful.

“If your body’s soft tissues accumulate too much of these substances, the resulting poisoning can cause serious health problems,” it warned.

The possibility of having metal poisoning, a medical practitioner, Olusina Ajidaun noted, might not be ruled out as herbal cocktails are usually ingested without specified dosages, thus making the risk of accumulation inevitable.

…Unsettling discovery

The most unsettling discovery came from the PAHs analysis, which showed that some of the cocktails contained chemicals like naphthalene, acenaphthylene, fluorene, anthracene, phenanthrene and triphenylene.

According to the Centers for Disease Control and Prevention, PAHs are a class of chemicals that occur naturally in coal, crude oil, and gasoline. It noted that exposure to mixtures of them increases the risk of lung, skin, or bladder cancer.

The result stated, “The health implication of PAH in sample A1 include eye irritation, vomiting, diarrhoea, confusion, skin irritation. The chronic health effects include cataracts, kidney and liver damage, breathing difficulty, decrease in immune functions, lung malfunction, symptoms such as asthma are significant and the point of PAH toxicity is cancer.”

Reacting to the findings, Ajidaun said that some of the metals detected in the samples could destroy vital organs in the body.

He said, “These things have toxic content that can damage the kidneys, eyes, liver, brain, among others. It is dangerous. Some people also put different things inside their vagina, hoping that it can also help. These things are capable of causing terrible infections that can kill women.”

Unsafe method fuelled by foggy legal framework

In Nigeria, legal abortion is permissible only to save the life of a pregnant woman and not for any other reason.

Abortion is governed by two major legislations in Nigeria – Penal Code for the North and Criminal Code for the South.

Section 228 of the Criminal Code stated that anyone that carries out abortion voluntarily is guilty of a felony and liable to imprisonment for fourteen years.

Similarly, section 229 prescribes up to seven years imprisonment for the mother involved, while section 230, criminalises supplying drugs or instruments to procure abortion, with offenders liable to three years imprisonment.

However, section 297 of the criminal code stipulates that a person is not criminally responsible for the termination of pregnancy if it is done by a skilled health practitioner and done for the preservation of a woman’s life.

The Penal Code has its abortion laws contained in Sections 232, 233 and 234.

According to section 232, “Whoever voluntarily causes a woman with child to miscarry shall, if such miscarriage be not caused in good faith for the purpose of saving the life of the woman, be punished with imprisonment for a term, which may extend to 14 years or with fine or with both.”

However, despite these legislatures, nearly one-third (28 per cent)  of women of reproductive age have had an unwanted pregnancy at some point in their lives, while an estimated one in five pregnancies in Nigeria are unplanned, a report by Guttmacher Institute titled, ‘Unwanted pregnancy and induced abortion in Nigeria: causes and consequences,’ revealed.

Medical law frowns at abortion

Ajidaun, told PUNCH Investigations that the law governing medical practice forbids voluntary abortion and running afoul of it may result in the withdrawal of medical licence.

He said, “Abortion is restricted in Nigeria, but that doesn’t mean people are not aborting. Most times, you will find them in hospitals as emergencies and incomplete abortions. But currently, the medical practice law in Nigeria doesn’t allow doctors to do casual abortion.”

The medical practitioner noted that safe abortion was beyond the termination of a fetus before the age of viability.

He explained that it also involves connecting the woman to other aspects of healthcare.

“In the global standard, when we say safe abortion, it is not just about the abortion. After the procedure, there is family planning and integration into society. There are many psychological problems and stigmatisation associated with abortion. Counselling is important,” he added.

The 2018 guideline on safe abortion

To expand the legal allowance for safe abortion, the Federal Ministry of Health came up with a ‘National Guideline on safe termination of pregnancy for legal indications,’ in 2018.

In the 26-page document, a former minister of health, Prof. Isaac Adewole, said lack of clear guidelines and effective procedures to ensure that the law is correctly interpreted has contributed to increased risk of unsafe abortion.

Adewole said, “Therefore, having a guideline on safe termination of pregnancy for legal indications is of extreme importance to control unnecessary death of women who lose their lives as a result of conditions that are aggravated by the continuation of pregnancy.’’

Checks through the document showed that it allowed women with certain life-threatening conditions to benefit from safe legal termination of pregnancy. It listed the following conditions; maternal heart, vascular diseases, kidney diseases, blood diseases, cancer, psychiatric and other mental disorders, as those that could necessitate abortion.

The document also noted that these conditions could only be ascertained by two or more medical professionals.

Speaking with PUNCH Investigations, a Professor of Obstetrics and Gynaecology, who was among the medical professionals that contributed to the guidelines, Prof. Oliver Ezechi, emphasised that one medical practitioner cannot determine a woman’s eligibility for abortion.

“It’s not just anybody that can go on to terminate a pregnancy. So, you can’t say a woman’s life is in danger. One doctor alone cannot say that. If I say a woman’s life is in danger, a consultant physician must say that it is true. If I am saying that the woman has a mental health issue, a consultant psychiatrist must confirm it to be true, “Ezechi said.

Botched attempt to revisit Lagos abortion laws

On June 28, 2022, the Lagos State Ministry of Health launched a 40-page policy document on ‘Lagos State guidelines on safe termination of pregnancy for legal indications.’

The ministry’s permanent secretary, Olusegun Ogboye, noted that it gives guidelines for safe termination of pregnancy and allowances within the ambit of the criminal law of the state.

He said, “In 2011, the Lagos State House of Assembly updated the criminal code, providing for abortion to save the life and protect the physical health of the woman.

“While physical health is covered under the Lagos legal framework, services conforming to the law have not been available in Lagos State health sector. This document provides information on relevant laws applicable in Lagos State while providing standards and best practices with regards to legal indications, pre and post-procedure care, methods, and monitoring.”

Despite stating that it had undergone wide consultation with relevant stakeholders within the legal and health service context, the document was suspended indefinitely less than two weeks after its launch by the state governor, Mr Babajide Sanwo-Olu.

The Commissioner for Health, Prof. Akin Abayomi, explained that the guidelines generated immense public interest, which necessitated more sensitisation to ensure a clearer understanding of its objectives.

He said, “In this regard, it became imperative to examine, in keeping with existing national and state laws and policies, if there are indeed justifications and medical reasons to offer abortion to a woman whose life is threatened by a pregnancy.’’

Women groups mount pressure

Meanwhile, no fewer than 150 women groups under the aegis of Women Advocates Research and Documentation Centre have mounted pressure on the state government to reverse the suspension.

In a letter addressed to the governor and signed by the centre’s executive director, Abiola Akiyode-Afolabi, it was noted that the guidelines would build the capacity of medical professionals to save the lives of pregnant women whose pregnancy continuation poses danger to their lives and physical health.

Akiyode-Afolabi stated, “Unfortunately, some religious, cultural and persons with certain philosophical convictions have kicked against the document that was developed over four years. Through painstaking work by experts in law, obstetrics and gynaecology, it created an opportunity to reduce maternal mortality in line with existing laws.

“The denial of safe abortion care to survivors of rape violates the right to health and privacy and may violate the prohibition of ill-treatment. Nigeria is bound by the provision of Maputo Protocol, which is the Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa. It is the main legal instrument for protection of the rights of women and girls in Africa.”

When PUNCH Investigations contacted the Director of Public Affairs, Lagos State Ministry of Health, Tunbosun Ogunbanwo, to know the time for the reversal of the suspension, he said he does not have any information on it.

“Lagos should adopt national guidelines”

Ezechi advised the Lagos State government to domesticate the national guidelines drafted in 2018 rather than dilly-dally with a new policy document.

He said, “The problem with Lagos State was that they just advertised when they were launching that book. It was not necessary. What they should have done was to domesticate it and look at it in the context of Lagos state and that is all.”

More laws to prevent teenagers from patronising quacks— Experts

Reproductive and sexual health rights advocate, Aleshinloye-King and Dr. Ajidaun suggested that beyond the national guidelines and existing legislations, the country should provide robust legislation to cater for voluntarily safe abortion.

“The abortion law is becoming obsolete. If we are saying we are working to reduce maternal mortality because Nigeria has the highest rate in the world and unsafe abortion is a major cause, we need to work around the legal framework around abortion.” Aleshinloye-King said.

Ajidaun averred that more lives would be saved if abortion laws permit voluntarily safe abortion.

He said, “I feel that if we get to a point where we are able to institute safe abortion law, it will help to reduce mortality and morbidity. A lot of people can’t walk up to doctors to say they want an abortion and they will get it. The thing is that abortion laws never stop people from getting abortions. What it does is that it makes them patronise quacks and I have seen a lot of people die from complications arising from such acts.”

Contraceptive is key

Ezechi said although the abortion law can be expanded to cater for peculiar cases such as minors and women who had failed family planning methods, he recommended the encouragement of contraceptives use.

He said, “The solution is that anyone that goes on to have sex should know that it will likely lead to pregnancy, and the person should use a contraceptive, which is the solution. What we should do is to advocate contraceptives use to prevent pregnancy, because if you prevent pregnancy, we will not be talking about termination of pregnancy. Most doctors will not terminate pregnancy for a woman that deliberately had sex and got pregnant. Contraceptive should be offered to prevent pregnancy.”

Abortionists violating our code of conduct — Trado-medical board

Registrar, Lagos State Traditional Medicine Board, Mr Olorunkemi Kadiku, said abortion is at variance with the board’s code of conduct. Kadiku

He explained that the board was saddled with the responsibility of regulating, licensing and training traditional medicine practitioners including botanical and herbal medicine dispensers.

Kadiku said, “Our code of conduct forbids them from making any herbal concoction or mixture that will procure abortion for people.’’

Arguing that those reflected by PUNCH Investigations in its report may not be licensed members, Kadiku said that the board was keen on enforcing its code of conduct and promoting safe abortion practices.

He said, “Many of the people doing these things, you will be surprised that they are not registered with us. We train our members and carry out routine monitoring of those licensed.

“In the entire state, these people are almost 15,000 to 20,000. We started registration in September last year and those trained and licensed are not more than 600. A large number of them have not been captured in our register.

“Since January, we have been doing sustained enforcement. We go out and raid them. In some cases, we have to do persuasive enforcement. We go to them and do advocacy and tell them to see reasons why they should come for training.”

We will investigate herbs sellers — Iyaloja

Folashade Tinubu-Ojo

Confronted with findings about herb sellers in Lagos markets and likely complications that could arise from consuming the herbal cocktails they sell, President, Association of Commodity Market Women and Men of Nigeria and the Iyaloja General, Folashade Tinubu-Ojo, promised to carry out an independent investigation.

Speaking through her personal assistant, Oluwaseun Olowokere, she claimed not to be aware of such practices.

“The Iyaloja-General is not aware of this and being a mother, she can’t in any way be in support of it. It is impossible not to find some bad eggs in the market. Iyaloja-General’s office will investigate the allegation and get to the root of it,” he assured.

Findings can spur us into action — Lagos Police

The spokesperson for the Lagos State Police Command, Benjamin Hundeyin, said that though the police had not received any report on activities of herb sellers facilitating abortion in Lagos markets, he assured that the command may act based on PUNCH Investigations findings.

He said, “In all honesty, if anyone brings the allegations of people selling abortion herbs to us, we are duty bound to get the person arrested and prosecuted. Your reports can spur us into action.”

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