Rapes, unsafe abortions, preventable deaths: How many more injustices will it take for reform in Malawi?

Trigger warning: this article contains discussion of rape and sexual violence. 

In February 2024, Malawi’s Daily Times published an article about the death of a 16-year-old girl. The details reported were that she had been raped by a Kabaza (motorcycle taxi) operator. She became pregnant. She did not want the pregnancy. After several failed attempts to access a safe abortion to end this forced pregnancy, she procured an unsafe abortion which tragically ended in her death.

I want to unpack this tragedy as there are several injustices at play which are also prevalent in other countries and are indicative of a wider alarming global rollback of women’s sexual and reproductive health and rights.

The 16-year-old girl was raped. The Penal Code in Malawi lists rape under “Offences against morality” (chapter XV) with a very clear punishment: “Any person who commits the offence of rape shall be liable to be punished with death or with imprisonment for life.” Whilst I do not condone the death penalty, it is very clear that the act of rape is recognised as a serious crime, at least in theory. But what happens in practice?

Nearly half of all global pregnancies, including adolescent pregnancies, are unintended. While the reasons are complex, there is a strong correlation between sexual violence and unintended pregnancy.

In Malawi too, violence against women and girls (VAWG) is a lived reality for many. Sexual violence is no exception. A national survey conducted as far back as 2013 indicated that sexual, physical, and emotional violence against children is prevalent in Malawi and for many girls their first sexual encounter is unwanted. VAWG is exacerbated by gender biases, norms and attitudes whereby violence is somehow socially and culturally legitimised. Sexual violence is further complicated when being ‘male’ means dominance and control, whilst being ‘female’ comes with the expectation that one should be submissive and not say no to sex.

A study undertaken by Malawi’s Kamuzu University of Health Sciences (KUHeS), explored the experiences of child rape survivors who had become pregnant as a result of the violation. The findings presented to the Ministry of Health in 2022, showed that survivors face fear, embarrassment, stigma, and blame. Rape and subsequent pregnancies crush girls’ dreams and abruptly end education with lifelong consequences. Some girls become suicidal. The few who seek justice are allegedly mocked by police and face lengthy court delays, while the rapists are often set free with the risk that they could commit further crimes.

Many cultural practices and rites of passage perpetuate these power imbalances and gender inequalities. Despite the law prohibiting marriage before 18 in Malawi and many other countries, forced child marriages are pervasive. And despite the provisions in the penal code, there seems to be ambiguity around the meaning and severity of sexual violence. We do not know whether the Kabaza operator ever faced justice for the crime he committed – the rape of a young woman, which led directly to her death by unsafe abortion.

As in many other countries, abortions are only legal in Malawi when performed to save a woman’s life. Herewith the second injustice. Even though the law allows pregnant women whose lives are at risk to terminate their pregnancy, they are often denied access to safe abortion.

Women and girls who become pregnant after rape and are in desperate need of help, are turned away from health facilities as this case shows – and often there is nowhere else for the traumatised girls and women to turn. Pregnancy is risky, more especially child pregnancies, and complications related to unsafe abortions are a significant contributor to maternal deaths. Had the 16-year-old girl been able to access a safe abortion, which many of Malawi’s health workers can legally perform, she would have lived. Malawi’s current abortion law, a remnant from colonial days, is ambiguous. As a result of this ambiguity, it is easier for a health worker to deny the service than to risk criminal sanction by performing a safe abortion to save a pregnant woman’s life. Those seeking lifesaving abortions, including girls, are tragically told that it is against the law and turned away.

Legal restrictions do not stop abortions from occurring. In Malawi in 2015 there were an estimated 141,044 induced abortions translating to an abortion rate of 38 per 1,000 women (Polis et al., 2017). Most induced abortions are unsafe and treating complications is costly, adding further pressure to an already challenged and under-resourced health system. The global picture is equally bleak as 39,000 women and girls are estimated to die each year from the consequences of unsafe abortions, and over 9 million face complications, such as life-long injuries and severe disability.

How many more injustices will it take for concrete action and urgent reforms?

It is time to be bold and to start tackling these injustices head-on, so that we can do away with the traumatic, devastating, and harmful crimes of sexual violence and other criminal acts perpetrated against women and girls. We need to unravel the layers of hypocrisy and fear surrounding abortion and allow women and girls the right to defend and choose what happens to their bodies.

Malawi needs clarity on the existing abortion law so that no pregnant woman or girl whose life is at risk is turned away from a health facility. But it is high time the outdated existing law is reformed, both to align with international human rights and standards, and with regional commitments Malawi has ratified to enable women and girls to exercise their sexual and reproductive rights and freedoms in full. Individuals, coalitions, civil society organisations, the media, and parliamentarians must continue their efforts to push for change.

Malawi is not alone in facing these challenges: in many countries across sub-Saharan Africa and beyond (including in many States in the USA and parts of Europe such as Poland and Malta), restrictive laws limit access to safe abortions. Sexual violence and persistent gender inequality are issues that virtually all societies continue to grapple with. The international community must not drop the ball, and must continue to invest in initiatives that strive to achieve gender equality in countries where women’s sexual and reproductive health rights are restricted, which is a precondition for advancing development and reducing poverty.