South Africa is one of the few African countries to offer women legal abortions.
Despite its refusal to consider abortion in its maternal-health plan, the Harper government has given financial support to an international agency that provides abortion illegally in some African countries.
The organization does not want to be identified publicly because its abortion services are provided without legal authorization, but the practice is widely known in some of the African countries where it operates. The practice exposes the gap between anti-abortion laws and daily realities across the continent.
The financing that it has received from the Canadian government in recent years is not for its abortion services, but for other health services that it provides.
The agency, like a number of other health providers in Africa, has felt compelled to provide abortions at its clinics - despite the risk of jail for its staff - because the alternative for pregnant women can be death or maiming by dangerous backstreet practitioners.
Unsafe abortions are one of the leading causes of maternal deaths in Africa, killing at least 25,000 women annually and injuring an estimated 1.7 million every year. One-seventh of African deaths in pregnancy and childbirth are caused by complications from unsafe abortions. Many women are injured or killed by self-administered procedures, such as swallowing dye or inserting roots or herbs in their vaginas to induce bleeding.
More than 90 per cent of Africans live in countries where abortion is restricted. Abortion is completely prohibited in 14 African countries, and in most others it is permitted only to save the life or physical health of the woman.
The Harper government insisted that it would not discuss abortion in the $5-billion maternal health plan that it helped launch at the G8 summit in Canada in June. For years, however, European governments and private U.S. foundations have provided funds for safe-abortion providers in Africa, despite the legal bans.
The international agency, which is based in the West but operates in many developing countries in Africa and elsewhere, has unofficially provided abortions at clinics in a number of African countries where abortion is illegal.
In 2008, for example, it quietly began providing abortions at three clinics in one African country for the equivalent of about $20 per abortion. Although abortions are banned in the country, the government has turned a blind eye, allowing the clinics to provide abortions unofficially. But this could change at any moment, forcing the clinics to close abruptly - as has already happened at some other African countries where the agency works.
"It's very precarious," an official at the agency said. "You do run a risk. The practitioners could lose their licences or go to jail."
Even though abortion is illegal in the country, many people are covertly providing abortions for profit - even interns and porters at public hospitals, the official said. "It's a whole racket. Everyone is into doing abortions because there's a lot of money in it."
But most of these practitioners are charging up to $200 for an abortion - an almost unaffordable sum for most women in Africa. Half of the money often goes to private middlemen who arrange the abortions, the official said.
Almost every day, she said, women visit the agency's clinics to seek abortions, even though it is illegal. "A young girl in high school who becomes pregnant, and who knows it will jeopardize her entire future, will do anything to procure an abortion, and that means putting her life at risk. She knows what can happen, but she'll do whatever she has to do to procure an abortion. When abortion is illegal, women are obliged to use unsafe methods and go to unqualified practitioners in unhygienic conditions. It pushes it into the street."
She recalled the story of one doctor who was being recruited by the agency. At first the doctor hesitated to work for an organization that supported abortions. A few days later, she changed her mind and decided to work for the agency because of an incident that had happened to her. "She was on call at a hospital and performed a total hysterectomy on a 16-year-old who had a perforated uterus from an unsafe abortion," the agency official said. "That goes on every day - women lose their fertility through unsafe abortion."
Experts say the maternal death rate in Africa would be sharply reduced if abortion was legalized. In South Africa, for example, the number of abortion-related deaths fell by 91 per cent after abortion was legalized in 1997, according to a study published in The Lancet, the British-based medical journal.
Geoffrey York