Tuesday, March 4, 2014 | News

Out of the fire of anger: A women’s center in Tanzania opens a pharmacy to bring misoprostol to rural communities

When
the staff of the Women’s Promotion Center (WPC) in Tanzania’s rural
Kigoma Region realized women were suffering and dying unnecessarily from
unsafe abortion—and that misoprostol could provide an option for safe
abortion if only it was available—they got angry. So they started a
pharmacy to bring misoprostol to local communities to save women’s
lives.

Abortion is illegal in Tanzania except
to save a woman’s life, and unsafe abortion is a significant contributor
to the country’s high maternal death rate. WPC staff knew many women
were dying in the Kigoma communities where they had been working for
years on women’s issues like gender violence and economic empowerment.
But they didn’t have a practical solution to the problem until 2008,
when a staff member attended an education session by Women on Web on how
to safely use misoprostol.

“After that session, it was clear to
WPC that misoprostol—an easy-to-take and easy-to-keep medicine—could
prevent postpartum hemorrhage and safely induce an abortion,” explains
one of WPC’s long-time staff members, who chose to remain anonymous.
“From there, WPC committed to saving mothers’ lives, despite the
restricting legal context, by putting information on this life-saving
pill into women’s hands.”

In 2009, WPC launched its “Save
Mothers’ Lives with Misoprostol” initiative, which began with an
education and awareness-raising campaign to prevent unwanted pregnancy
and unsafe abortion—and to promote misoprostol as a method for safe
abortion and treatment of postpartum hemorrhage.

“Our community facilitators created
awareness on the potential of misoprostol, and women started looking for
this medicine,” the staff member says. “But there was no misoprostol in
local pharmacies in Kigoma at that time. It was available in other
regions, but was very expensive.”

WPC saw an opportunity: Misoprostol is
registered in Tanzania for treatment of postpartum hemorrhage. In 2010,
WPC opened a local pharmacy that sells misoprostol and also offered
counseling by a well-trained professional on how to safely use
misoprostol, as well as take-home information about how to use the drug
and referrals to doctors willing to help in case of complications.

Since the pharmacy opened, women’s
access to misoprostol and contraceptives in Kigoma Region has improved,
and WPC has noted a decrease in reports of women dying from unsafe
abortion. In addition, the pharmacy’s sale of misoprostol created
economic competition with private drug sellers in the area and reduced
the price from the equivalent of 12 USD to just 5 USD for a package of
12 pills. According to WPC staff, the presence of the pharmacy in Kigoma
has also positively influenced rural women’s health-seeking behaviors,
thereby increasing the local demand for misoprostol.

“What’s incredible about this story is
that Women’s Promotion Center is not a health organization—it focuses on
advocacy and women’s rights,” says Francine Coyteaux, director of the
Misoprostol Initiative at the Public Health Institute. “They recognized a
health need in their community and took a pragmatic, rights-based
approach to solving the problem.”

Looking to the future, WPC plans to
expand its pharmacy initiative, opening additional small pharmacies in
selected towns to provide women with high-quality, affordable
misoprostol and contraceptives. Advocacy to change Tanzania’s law and
grant women access to legal, safe abortion services is also on the
agenda. In 2012, WPC began advocacy initiatives that include building a
network of local organizations all focused on law change and improving
women’s access to reproductive health services. After all, advocating
for women’s rights and against injustice has always been WPC’s core
mission, and fighting for a woman’s right to access a drug that can save
her life is a natural extension of that impassioned work.

“The pharmacy initiative was born out of the fire of anger about unnecessary deaths and suffering of women, and also the fire of passion to save mothers’ lives in Kigoma,” the staff member says. “WPC’s enormous determination to prevent deaths due to postpartum hemorrhage and unsafe abortion is the basis of its success in operating the pharmacy.”

For more information, contact media@ipas.org