Stereotypical pictures of illegal abortion practices are of doctors with bloodied aprons and carving knives, but modern “clinics” are usually run by criminals. Women are instructed to take drugs (orally or vaginally) and are sometimes told that the baby “will dissolve” or be “flushed away”.
Researching child abandonment in South Africa is akin to opening Pandora’s box. Coupled as it is with illegal, late-term abortion, the body count (when you can find them) amounts to tens of thousands. It could be many times that amount; perhaps we would know if the government was ever prepared to count them. Criminal activity and clandestine practices are commonplace, and even for those children that survive, the result can be informal child trafficking or long term institutionalisation.
Despite this, abandonment is not on the government’s agenda for the upcoming “16 Days of Activism for No Violence against Women & Children”. No statistics exist to quantify the problem, policing is confined to opening inquests instead of murder dockets, and we seem entirely devoid of strategy to end or even minimise this scourge. It begs two important questions: What becomes of our “lost” boys and girls (who clearly are not in Neverland), and why do those in authority not seem to care?
Daniel* was the first abandoned child that I had met (at least knowingly). As he played on the carpet with my son, his adoptive mom told me that he had been abandoned under a highway bridge in winter. Seeing me shudder at the thought of a newborn, alone and icy cold, his mom shrugged. “He was one of the lucky ones” she said. Despite the cold conditions, Daniel was rescued by a traffic officer, and taken to a Place of Safety before he could die of exposure. He was also better off than the two babies in the cots next to his. One had been left to drown in a longdrop, and the other was buried alive.
Since then I have heard loads of abandonment stories, but Tami’s* is one of the most shocking. Her mother aborted her when she was just over six months pregnant. Tami was born, tiny but alive, on the floor of a toilet in the hospital where her mother (a nurse) worked, and then abandoned to die in a pool of blood. She was saved by a fellow nurse, only to spend her childhood being passed around in her community. By the time she finished school, she had lived with 10 different families; knowing, but estranged from the woman who carried her in her womb, who has never acknowledged her, or been sanctioned for her crime. She survived to tell the tale, and she, too, considers herself fortunate. Both Daniel and Tami are testament to the everyday horror of abandonment, where margins are so small that only the fortunate survive, and only the most fortunate avoid the long-term physical and psychological effects of a terrible, fleeting act of desperation that can either define or end a life.
These individual stories are heart-wrenching, but it is only when we explore how many stories exist (and tragically, how many do not survive to tell their tale), that we begin to understand the extent of the problem. In countless cases though, both the information, and the bodies, seem to have disappeared without a trace. It makes obtaining a full understanding of abandonment in South Africa a bit like trying to complete a thousand piece puzzle without the picture (and possibly without numerous pieces).
What we do know makes for scary reading though. For years we have been quoting one confirmed statistic about abandonment; in 2010, there were approximately 3500 children abandoned across the country. This number is noteworthy for two reasons; first, because it is already five years old and second, it only includes survivors of abandonment. The burning question must therefore be: if 3500 children survived, how many did not?
Tracking the dead is even harder than tracking the living. One of the few statistics available is from 2012, where in Gauteng, only about 60 out of every 200 survived—70% did not. The number may differ in other provinces (KwaZulu-Natal for example, report very high numbers of abandonments, others fewer). But if it is even marginally close elsewhere, it is worth asking how so many children are dying in plain sight without drawing public attention. According to Nadene Grabham, the manager of Door of Hope, a Place of Safety caring for abandoned babies, countless babies are simply never found. And no wonder, in her 2014 thesis focusing on child abandonment, researcher and child protection activist, Dee Blackie, determined that nearly 70% of abandonments were unsafe. She identified primary abandonment sites as toilets, drains, sewers and gutters; followed by rubbish sites, dustbins and landfills; and then parks or open veld. Bodies that are buried, flushed down drains or eaten by animals or rodents are seldom accounted for.
But even when bodies are recovered, two rather troubling “anomalies” in registering and managing abandoned baby deaths make compiling statistics very hard. The first relates to how they are recorded by the police services. Following the recent release of the country’s crime statistics, experts questioned why abandoned babies had been dropped from the violent crime category. There is no category for abandoned babies, and the police confirm that when they find an abandoned baby, they register an inquest (indicating an unnatural death to be investigated to determine if anyone is responsible), rather than categorising it as a murder or culpable homicide. Given that up to 65% of our abandoned children are newborns and 90% under the age of one, it is uncertain how the South African Police Service explain them “abandoning themselves”, but according to Luke Lamprecht, convener of the Shaken, Abused and Abandoned Baby Initiative, the results are two-fold: many of the inquests are never investigated further, and abandoned children are not included in our crime statistics. Even when charges are forthcoming, they are usually on the lesser indictment of “concealment of birth”. Not only do we have no idea how many such deaths are taking place annually, but, to quote crime analyst and retired policeman, Chris de Kock, “some people are likely to get away with murder”. Either way, abandonment, “becomes an easy option.”
To compound the problem of tracking these deaths, there is also no longer a category for abandoned children in the death statistics produced by our mortuaries. This, despite the fact that a report on fatal injuries in Gauteng in 2010, quoted local forensic pathology services as saying that, “babies dumped in Gauteng were increasingly becoming a large part of non-natural, undetermined deaths in the zero to four-year age group.” As confirmation, the Forensic Pathologist, Professor Jeanine Vellema, said: “These babies in dustbins, gutters, dumps…who are aborted or miscarried new-borns being disposed of… are becoming a large part of 60% of undetermined deaths (of young children) in Gauteng.” A study on child homicide by the Medical Research Council in the same year found that 16% of child homicides were the result of abandonment.
Since 2012 however, Forensic Pathology services have not officially tracked abandonments. Instead, they have a large number of babies classified as “stillbirths” in their records (even though stillbirths—seen as natural deaths—are not processed through the Forensic Pathology mortuaries). Forensic Pathology staff claim that these “stillbirths”, which number 1800 over three years in Gauteng alone, are actually abandoned babies. According to Lamprecht, the distinction is critical—to be classified as an infant in South African law and have legal rights, a child must take at least one breath. A hydrostatic lung test would show that many or all of these babies were actually born alive, and died thereafter. To close the circle of silence, mortality statistics in South Africa specifically exclude stillbirths.
It is hard not to conclude that these numbers—which for Gauteng confirm that for every abandoned baby found alive, two are found dead—are being deliberately obfuscated. And alarmingly, this may only be a tiny fraction of the real problem. Our abandonment focus has traditionally been around infants delivered on or around full term. However, the same report on child homicide states that “while the abandonment of new born babies shortly after birth is a huge problem requiring urgent attention, we are possibly reporting only the ‘tip of the iceberg’ because [they] do not include ‘dumped foetuses’”. In support of this statement, the Medical Research Council indicated that “abortions were the leading external cause of death in 2009 for children aged 0 to 4, where a cause of death was known”. It is perhaps unsurprising. Mortality statistics also exclude abortions, but global reproductive health group Marie Stopes state that of South Africa’s 260 000 annual abortions, approximately 52-58% are illegal—that is, up to 150 000 per annum.
Stereotypical pictures of illegal abortion practices are of doctors with bloodied aprons and carving knives, but modern “clinics” are usually run by criminals who illegally provide drugs like Cytotec (a schedule 4 drug used for the treatment of ulcers, but with a known side effect of producing uterine cramps) to bring on premature labour (or in less sophisticated areas, make women drink chemicals). Women are instructed to take the drugs (orally or vaginally) and then fain a miscarriage at a local hospital. They are sometimes told that the baby “will dissolve” or be “flushed away”. But of course, the babies don’t “dissolve” and although some of them are first and second trimester foetuses not able to survive outside of the womb, many are post-26 weeks and therefore viable. Like Tami, babies often survive the abortion process—born alive, only to be abandoned; or to die from prematurity, the effects of the abortion drugs or even from murder at the hands of shocked and desperate mothers (or family members), appalled at being faced with a living baby.
Lamprecht, who has studied illegal abortions extensively, concluded that in Johannesburg alone, up to half of the aborted foetuses found were actually viable. The conclusion cannot be applied wholesale across the country, but even a smaller percentage of 150 000 annual abortions is still a staggering number. What we know is that illegal abortions are growing the quantity of dead abandoned babies exponentially, so much so that a state mortuary doctor is quoted in Blackie’s research as saying: “we are swamped” with dead babies “on a weekly basis.” Small wonder that no one wants to tally up the figures.
But, if the numbers are so big, why aren’t illegal abortions being better policed or managed? The answer is complex. Despite isolated campaigns, the Department of Health argues that it does not have jurisdiction over illegal abortion practitioners because they are not registered doctors, and police say that their hands are tied. They cannot act without a complaint, and since the complainants would be pregnant women, typically fuelled by a combination of shame and desperation and themselves committing a crime, their co-operation is unlikely. Add to that the clever strategies of illegal abortion practitioners and the lenient sentences under the Termination of Pregnancy Act (a fine or imprisonment for a period not exceeding 10 years), and it is no surprise that the practice continues unabated.
However, experts also argue for a lack of will on the part of authorities to face the problem. As with abandonment of full term infants, the absence of quantification speaks volumes. As far back as 2012, the government admitted that more research was needed on the problem of abandonment, but it is yet to be commissioned. No response has been forthcoming as to why, but according to Blackie, it is not due to a lack of funds: this year, the Department of Social Development returned R1.4 billion of unspent funds to the treasury. Like the deceptive death and police statistics, the dearth of research seems to amount to plausible deniability, or worse, a lack of will to manage abandonment. Perhaps this is the real issue—if the government does clamp down on illegal abortions and unsafe abandonment, it will save tens of thousands of lives. But, it has no plan to care for those survivors.
Herein lies the problem: surviving may be “fortunate”, but those who do not necessarily fare well either. According to Blackie, not all abandoned children make it into care. During her research, she tracked multiple stories where the people who found these children and brought them to the police were asked if they wanted to “keep them”. A simple affidavit was all that was required to secure the “adoption”. In other cases, abandoned babies were presented to someone in the community seen to be in need of a baby. This practice, considered by most participants to be an extension of Ubuntu, is usually well-intentioned. But, “informal adoption” can have very troubling consequences because even if recipients care for the child, the process bypasses the Children’s Act and the stringent checks upon which adoption is contingent. In addition, children often end up with no legal documentation and cannot access welfare grants, medical care or schooling. Add to that a tenuous link to the family and the common practice of child disbursement, and these children frequently become easy targets for abuse and trafficking.
Worryingly, no one is trying hard to hide this illegal and morally ambiguous practice, and chief perpetrators are employed by the state. It seems to be directly linked to government policy, where the primary caregiving strategy for orphans is kinship care, predicated on knowing your family. Seen as “weggooi kinders”—unwittingly estranged from family and community—abandoned children often fall through the cracks.
In fact, although the government publicly advocates for family care for these children, unspoken negativity towards adoption and the resultant “constructive prevention of adoption“, lack of funds to advertise for birth families, along with the overloading of the foster care system, mean that abandoned children often end up in some variant of child and youth care centre, and stay there far too long. Notwithstanding good intentions, these centres are often overloaded and underfunded. This is particularly detrimental in the first 1000 days of life, says Lamprecht, when a lack of stimulation and touch can result in long term changes in brain structure leading to memory problems, learning difficulties, behavioural and attachment problems, and possibly even sociopathic behaviour later in life.
In addition, caregivers sometimes lack the expertise and resources to manage the worst consequences of illegal abortions and abandonment. Dr Janet Lumb of the Thusanani Children’s Foundation (which provides therapeutic and medical care to children in care facilities) says that of the abandoned babies she sees, half were abandoned unsafely and about 60% were born prematurely (some are as small as one kilogram). These babies often experience developmental delays and some are physically scarred, especially from rat bites and burns. Frustratingly, she says, even the worst affected thrive under care and special needs adoptions are surprisingly common (especially to overseas families), but many children are not provided with those opportunities. It becomes a heart-breaking self-fulfilling prophecy: too many in authority believe these children won’t amount to anything and ironically, our strategy for their care is making this a reality.
The societal factors resulting in abandonment are unlikely to diminish in the near future so this may all seem like doom and gloom. But experts have long been calling for constructive changes to help minimise this scourge. Proposed solutions range from crisis pregnancy counselling to effective policing, facilitating safe abandonments to policy amendments across a number of sectors. We also need to focus on increasing the numbers of adoptions in South Africa, and improving the process. For the “lost” boys in JM Barrie’s far more whimsical tale about abandonment, Peter Pan, the answer was adoption. Permanent care in a loving family, and in South Africa, adoption is still the best solution for meeting these children’s needs in the long term.
Above all, someone needs to add up the numbers; the inquests, concealment of birth cases, “stillbirths”, police reports and the numbers of children in the child protection services. Until then, we cannot know what the picture on the puzzle really is, and policies and interventions (and articles) are forced to rely on educated guesswork. Regardless, three things are clear: Child homicides are preventable so death through child abandonment and illegal abortions must be stopped, abandoned children (alive or dead) cannot stay hidden, and for policy makers, plausible deniability is no longer an option. Whatever happens next, someone will be accountable. DM
*names changed to protect their identities
First published in the Daily Maverick: 24.11.2015
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