Abortions across the border rampant

Clinics in Jaigaon receive around 10 inquiries from Bhutanese women every month

 Twenty-four year old Sonam Choden (name changed) is inside a pharmacy in Jaigaon, signs of anxiety visible on her face. She is here to get a pill to abort the child in her womb. A private employee yet to get married, she wants to do it without her parents’ knowledge. Abortion being illegal in the country, she has opted to get an abortion across the border.

Like Sonam Choden, hundreds visit Jaigaon for abortion, which is easily accessible at reasonable rates. Almost all the pharmacies and clinics in Jaigaon offer abortion services from pills to surgery to rid the unwanted fetus from the womb.

“I am really worried and came here to salvage the situation,” says Sonam Choden.

Each pharmacy in Jaigaon receives up to 10 women a month inquiring about the services. They offer three varieties of pills to flush out a fetus three months old or less from the womb.  Prices range from Nu 1,700 to 2,000 for a single dose.

“For those who are more than three months pregnant, we advise abortion through surgery,” said a pharmacist in Jaigaon who wished anonymity.

While some clinics in Jaigaon perform surgery for abortion, others are referred to Alipurduar and Siliguri in West Bengal.

The pharmacist said that it has become normal for Bhutanese to get abortions in Jaigaon.

A single operation costs Nu 10,000 excluding consultation fees of Nu 200. Most of the pharmacies maintain links with the doctors in the place whom they recommend. Altogether, around Nu 12,000 to 15,000 is spent on a single operation. The doctors said that most of the clients do not face post-abortion complications either from pills or operations. “We don’t receive such complaints,” a doctor at one clinic in Jaigaon said.

Bhutanese women mostly college students, teachers and nurses above 16 years comprise the clientele. Doctor S. Roy from a clinic in Jaigaon recalls receiving a 14-year old Bhutanese student in 2015 who was six months pregnant. He said that he advised her to refrain from surgery. The girl revisited after a month agreeing to pay whatever price the doctors asked if he performed the operation. “Still we denied the service because it was too risky and complicated,” he said.

However, local pharmacies in Phuentsholing do not receive many clients for abortion knowing its illegality. These pharmacies do not provide services either. “We do not provide such facilities here. And we do not receive inquiries,” said CB Saru, pharmacist with Tashi Medical in Phuentsholing.

Namsey Pharmacy used to receive a few inquiries a month for the service before. But the pharmacist, Shiva Kumar Sharma said that they advise the person concerned to either avoid abortions or visit the hospitals. “Now we do not receive many inquiries. Maybe they prefer to go across the border,” he said.

Meanwhile, a gynecologist at Phuentsholing General Hospital (PGH), Dr Kezang said that the hospital receives patients with post-abortion complications. But so far, information segregating the cases has not been documented. The doctor said that the hospital operates only on genuine cases where the fetus is physically abnormal. Otherwise the hospital refers the patients opting for abortion to the Jigme Dorji Wangchuck National Referral Hospital in the capital.

“We have never segregated records of complications related to post abortions,” she said. The hospital also provides care to incomplete abortion cases needing surgical interventions.

PGH operated around 105 cases of dilatation and curettage surgeries related to abortion in 2016.

Local media reported that in 2015, women aged 20 to 49 years had the highest proportion of abortions at 95% among  1,566 abortions.  About 15% of women less than 20 years also underwent abortions. Thimphu and Sarpang top the list of highest abortions followed by Chhukha. In 2015,  292 cases were reported in Thimphu, 252 in Sarpang and 237 in Chhukha.

According to the World Health Organization, abortion is termination of a pregnancy before 20 weeks of gestation or of a fetus weighing less than 500 grams.

Krishna Ghalley from Phuentsholing