As Thunder Is Not Yet Rain, In Ethiopia, Legal Rights to Abortion Are Not Yet Access


In 2006, Ethiopia
legalized abortion for minors, women whose health was threatened, victims of
rape and several
more indications
. Although the law is
one of the most liberal in Africa and has already saved lives, many Ethiopian
women remain confused or unsure of their rights and don’t know how to prevent
unplanned pregnancies. In a 23 minute documentary produced in association with Ipas (viewable here), filmmaker Lisa Russell spends time with a
woman who lost her daughter to an illegal abortion, a local medicine man
who claims his mixtures are more effective than the modern clinic and a mother named
Asnaketch who induced multiple abortions in her youth and now seeks to educate
girls. But most movingly she follows two young girls, Tigish and Belynash, as
they go to a clinic and then a hospital to avail themselves of their new right.
A deeply moving viewing experience, Not
Yet Rain
paints a clear picture of the value of legal abortion while also making
clear that just legalizing abortion does not go far enough to guarantee women’s
health and rights. Russell spoke to RH Reality Check about the process of
making the film and what she hopes will result from it.

In cooperation with Ipas, filmmaker Lisa Russell went to Ethiopia to study how women’s lives have changed as a result of the recent liberalization of abortion law.

First of all, what led you to choose this specific subtopic for the film and
how did you go about researching? Did you know that Ethiopia had recently changed
its laws and that you wanted to set a film there?

I have a background in public health and got into filmmaking secondarily.
In 2004, I did a film on obstetric fistula, which is an issue that not too many
people had heard about. Because of that experience of seeing how powerful film
can be in getting people to talk about something as difficult as obstetric
fistula, I wanted to pursue another issue that was not getting enough
attention–and that was unsafe abortion. I was co-presenting with Ipas at a
conference and we realized we had similar goals. We chose Ethiopia because we also
wanted to make a film that had a positive message that showed some progress
being made. The law was so new there so we knew there would be some instances
where women didn’t have the information or access that they needed, and there
would also be stories about women who were able to successfully access
services, so we could get a good look at the possibilities and also the
challenges.

I found the film very moving and compelling, partly due to the people in it,
partly the  music and style. You did it in a very artistic way. Can you
tell me a bit about the stylistic choices you made?

In all my films everyone mentions the music because it’s such an important
part of the films. I feel that it’s a difficult story, but these are beautiful
women and a beautiful country so why not expose that as well? I was brought up
under the training that said the greatest documentaries made illustrate
and don’t tell. The best way to do that is to show women as human beings.

The women in the film who were seeking
abortions had been raped. What is the connection you saw between sexual
violence and the need for abortion?

I’ve seen the connection with sexual violence with every single women’s health
issue that I’ve covered. Unwanted pregnancies can be cause by a lot of things.
One of the biggest things is the incidence of rape. A woman with an
unwanted pregnancy due to rape gets stigmatized twice. That’s why providing
access to safe and legal service is so important, because women in that
stigmatized position will go to desperate means.

Seeing the connection between the need
for reproductive health services and sexual violence, does it frustrate you
that aid for the latter is politicized?

Women are dying because they don’t have access to care. What’s unfortunate too
is that because of politics
about abortion we’ve exported our controversies with policies like the global gag rule, and the de-funding of
UNFPA.  Programs and support are affected because of the politics
surrounding abortion. Stigma is one of the most pressing barriers.  I was shooting
the fistula film in Niger, and I asked about unsafe abortion which is illegal
in Niger. They said it’s really unfortunate, but if a woman has tried to self
abort and needs post-abortion care she can be turned away because of the
stigma. It’s a genuine public health problem and human rights issue. Women are
dying. They are presenting themselves in need of emergency care and being
turned away.

There was also an emphasis in the film
on how little knowledge many young women have about family planning as well as the
new abortion law. Is that changing?

A couple of organizations I talked to were deeply affected by the global gag
rule. I shot the film in 2008 before the election before global gag was
overturned and people were witnessing a decrease in family planning because of
funding issues. Now [that President Obama overturned the gag rule] there is a
commitment and interest in getting the information out there. It’s relatively
new, this abortion law. Ipas is doing a great job working with local community
groups, getting information about safe abortion services as well as
contraception and contraceptives out there.

There is new training happening for midwives, to get them trained not only in
terms of the MVA (manual vacuum aspiration) procedure but also with information
about contraception.

The film highlighted Asnaketch’s young son, who talked about the need for
women’s empowerment. Was his enlightenment just a result of his mother being so
extraordinary or being a member of a younger generation?

I think it has to do with both. It’s because he’s young, and more
importantly educated — in the film, he was walking out of a school during the
scene where she’s holding his hand. So he had the combination of being an
educated young man, and also his mother was very open and very clear about her
experiences. If young people get access to education they are more likely to
have more progressive views of the rights of women and young girls.

Is there the same stigma facing doctors who provide abortion in Ethiopia? Are
they targeted or shunned the way they sometimes are in the US?

I didn’t see [the doctors] outside of the hospital setting, so I didn’t know
about their personal lives. But I did notice that one of midwives was wearing a
cross. I asked, "Does this conflict with your religious beliefs?" He
said, "I have seen many women, even some of my sisters face these
challenges." [The doctors] are the ones who see women dying and that
impacts how they feel and their commitment. The doctor in the film is one of 3
ob/gyns for a population of five million. He sleeps at the hospital; he hasn’t
had a vacation in 8 years. He told me he once saw a woman who had been in labor
for five days.  Our generation and those close to mine have forgotten what
it was like when abortion wasn’t legal. When you’re faced with that there’s a
different perspective and commitment level.

Was the shoot emotionally difficult?

When I was in the hospital room with Belynash, and her hands were over
her eyes my battery died. And in the end I was glad it did. It was an intense
moment.  Here were two young girls who have never been to a doctor getting
an exam in front of several strangers. And there was Tigist whose mother died
in childbirth who thought she might not live through the operation. The doctor
did a good job counseling them and telling them what was going to happen but
Tigist was yelling and screaming. Also I realized that this was due to a rape
incident so she was going through the trauma twice. Then our translator who was
trying to be a mother figure to both almost fainted on the floor. I felt
sadness, and rage. 

And then there was Aster, who for a good hour was just crying and talking about
how her daughter died from a botched abortion.  Fifteen years later this
mother is still feeling partly responsible. Her daughter lied about what
happened and her mom took her from clinic to hospital, clinic to hospital. She
was reminiscing about something which happened 14 years ago, but it was just
heartbreaking. They were such incredible women.

Do you think what’s happening in
Ethiopia is likely in any way to affect her neighbors or other countries to
have a more humane policy?

I don’t know the statistics, but I do think South Africa [which has
legalized abortion but still struggles with deaths from illegal abortions] and
Ethiopia are going to be looked at. Maternal mortality is a very real and
tragic reality in developing countries. If this really does decrease the number
of women dying people will pay attention, because it’s that bad.

What has the response been like to the
film so far?

When people first hear that there’s a film about unsafe abortion it’s sort of
like "is that something I can stomach"? But people feel something
when they watch this. It has a story to tell and it showcases women. There was
a screening at Cornell and there’s one planned at USC. People are starting to
watch it and forward it around. In terms of outreach and who we want to reach,
we have high hopes for it. Getting other people to feel like they take
ownership of it, that’s the first step.

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  • invalid-0

    I really commend the producer for taking such a burning issue and document it so that the whole world know about it.Movies are probablt the most powerful way of making the public informed in a very short time though it takes a lot to have one.

    However, for a country as poor as Ethiopia legalizing abortion without a caveat will be a strain on the already weak and overwhelmed health infrastructure. I guess priorities should be set pertaining to the gravity of excisting problems. Needless to say, abortion and its complications probalby will land at the tip of the pyramid if we see all medical problems facing the country. Since we have a government run healthcare, we can’t afford to provide such a care without diverting resources from basic primary care services: immunizations, acute care of the sick and health education.

    The most cost effective way of tackling the issue may emanate from edcuating the youth and addressing family planning, wide and easy access of contraception. If we do a simple math, we can easily provide effective contraception for almost 50 women with the same amount of money we spend on a single abortion.

    Thank you again for allowing us to have such a public discourse.

    • http://www.governessfilms.com invalid-0

      Dear Zeleke,

      Thanks so much for your thoughtful and thorough comment.

      As the director/producer of the film, I agree that lack of access to family planning is a major barrier in Ethiopia. They estimate that prevalence is about 14%. However, I would like to point out that even in societies such as ours- where we do have improved access to family planning methods, unwanted pregnancies unfortunately do exist.

      By providing access to safe care in Ethiopia, we accomplish several things:
      - Decrease maternal mortality and the implications at the community, societal and national levels;
      - Lower hospital costs related to the care of women who present with severe complications from unsafe abortions; and
      - Reach women who may not otherwise visit a health care center for reproductive health care and give them education and contraception.

      The idea for the film is to generate a discussion about the unnecessarily deaths and disabilities due to unsafe abortion. I think its beautiful that we are having this public discourse and I think we all agree, that we would like to accomplish the same things – decrease unwanted pregnancies and save women’s lives.

      Thanks for listening.

      Lisa

  • http://marika-barbie.blogspot.com/ invalid-0

    The most important problem in obstetrics and gynecology in the world is preservation of reproductive health of the woman.
    One of methods is a method of preventive maintenance of not planned pregnancy, decrease in number of medical and criminal abortions. Abortion is an interruption of pregnancy to term of premature birth – often leads to serious complications in the early ambassador the operational period, to such remote consequences as barreness, the endometriosis, pregnancy interruption, inflammatory diseases of female genitals, extra-uterine pregnancy, hormonal infringements that leads to the complicated current of the subsequent pregnancy, the postnatal period, adversely influences a fruit and newborn condition.
    It causes all not only medical, but also the social importance of a problem of preventive maintenance of abortions.

  • http://cutingdate.info invalid-0

    The average age of marriage for girls in Ethiopia – 16 years.
    54% of pregnancies among girls under 15 years of age are unwanted. For groups of 20-24 years there are 37% of unwanted pregnancies. What leads to doing abortions. And the younger, the more often. And most criminal abortion. What leads to the fact that 60% of hospital admissions in gynecology in Ethiopia in general cases, either relating to the abortion, or to treat the consequences of criminal abortion.