A Summary of the Jackson Tali Case
In October 2017, the Court of Appeal of Kenya ruled in a landmark case on the conviction of a registered nurse, Jackson Namunya Tali, who was sentenced to death for offering abortion services to a patient in 2014.
Court of Appeal judges Philip Waki, Roseline Nambuye and Kathurima M’Inoti saved Mr Tali from the death penalty, stating that the evidence relied on by the High Court to convict him was not sufficient.
Tali said the victim, Ms Atieno, had sought help after a botched abortion elsewhere. Other witnesses, however, told the high court that Mr. Tali had agreed to help the woman to terminate her unwanted early pregnancy.
The incident happened in July 2009, when Christine Atieno visited a health clinic in Gachie, Kiambu County with severe pain and bleeding. Mr. Tali, who was working at the clinic, determined that she needed to go to a hospital to receive specialized medical attention.
However, the woman died in Mr. Tali’s car as she was being transferred to a higher-level facility that could better handle her complications. At trial, the High Court judge found Mr. Tali guilty of helping the young woman obtain an unsafe abortion and sentenced him to death for murder of a foetus and the woman.
Social regression in the Sexual and Reproductive field
Abortion in Kenya is legally restricted and can only be permitted when there is need for emergency treatment, or the life or health of the mother is in danger and, still, if permitted by any other written law. Under any of these circumstances, the decision must be supported by a trained health professional.
To ensure that abortion providers are trained and work within the law, the Kenya Ministry of health developed standards and guidelines on reduction of morbidity and mortality due to unsafe abortion. These guidelines were published in 2012 and withdrawn nearly one year afterwards.
In December 2013, USAID, who fund much of Kenya's family planning provision, warned that anyone receiving US aid should not attend an upcoming government meeting because the Standards and Guidelines were on the agenda.
The next day, the Ministry of Health withdrew the Standards and Guidelines, arguing that there was a need for wider stakeholder consultation on some of the contents of the document.
The publication was essential in clarifying when medical professionals could perform safe abortion services under the law. These actions have created confusion among health workers and denied women access to safe and legal abortion services.
The withdrawal of the guidelines was followed by a memo stating that it is illegal for health workers to participate in training on either safe abortion care or the use of the drug Medabon (a combipack of Mifepristone and Misoprostol) for medical abortion.
Jackson Tali’s case and the independence of Kenyan healthcare professionals
The sentencing and acquittal of Jackson Tali raises serious debate on the independence of health professional to carry out their mandate. The prevailing stigma around abortion and the lack of service delivery policies and guidelines from National Government have left health professionals afraid of attending to women asking for abortion services due to fear of being arrested.
This has made women seek alternative abortion services from quacks – as unsafe providers are called in Kenya - putting themselves at serious health risks.
Unlike doctors who receive some instruction on safe abortion practices in medical school, other health professionals such as nurses and clinical officers, who are also qualified to offer abortion services, rely on trainings led by medical associations and private institutions since the Ministry of Health has failed to offer such trainings.
The removal of the standards and guidelines and ban on safe abortion trainings threatens the working environment of services providers and expose women to severe complications, even death, due to unsafe abortion.
The World Health Organisation’s 2nd edition of Safe abortion: technical and policy guidance for health systems highlights the importance of creating conducive environment for both patience and service providers.
An enabling environment is needed to ensure that every woman who is legally eligible has ready access to safe abortion care which also involves planning and managing abortion services by ensuring the following;
- Establishment of national standards and guidelines facilitating access to and provision of safe abortion care to the full extent of the law.
- Ensuring healthcare provider skills and performance
- A systematic approach to policy and programme development which plans and implements policies and programmes with the end result being to promote women’s health and their human rights
- Financing healthservice budgets including costs of staff, training programmes, equipment, medications, supplies and capital costs.
Denying women access to safe abortion options creates a public health crisis. At HowToUse, we believe that all women deserve autonomy in their sexual and reproductive health decision-making.
All healthcare providers should be allowed to freely exercise their profession with respect to their patients’ decisions. When they are denied that right, abortion goes underground and becomes unsafe.