With 85 deaths caused by unsafe abortions in South Africa every month, medical doctor Tlaleng Mofokeng tirelessly fights for the right of women to make their own reproductive choices.

As an undergraduate medical student, Tlaleng was always drawn to obstetrics and gynaecology. Even while involved in other training blocks such as surgery, she gravitated towards women’s issues. Her reason for becoming a sexual and reproductive health and rights activist, specifically an abortion activist, is that she has seen women die after illegal and unsafe medical procedures performed by incompetent providers. ‘I remember being on call at King Edward Hospital in Durban – where we did our academic training – and two young women, both under 20, died that night because of complications from illegal providers and unsafe procedures.’

The patients who have touched her the most have always been women, she says, because socioeconomic issues and violence manifest on women’s bodies. ‘I’ve seen many victims of rape, for example. And some of the women were pregnant for reasons we may not understand. As young doctors at the time, we used to judge them, because we didn’t understand the context of their lives. It didn’t make sense to me that just because you make one bad contraception choice, this must mean your death.’

Tlaleng is from a small town in the Free State, and grew up with her mother giving her information about sex and her body, without judgement. She knew that if she found herself in trouble, she could go to her mother for help. ‘It’s not that the young women you saw back home were any less determined to succeed, that they didn’t have dreams,’ she says. ‘It’s a miracle that some of us made it. But when you look at why some women make it through school, it’s because they had access to contraception. It’s not a new thing that people are having sex when they’re young. We cannot treat young girls as if their behaviour is abnormal or they are hypersexualised.’

Abortion, Tlaleng says, is a fundamental human right. ‘Even in the Constitution, it’s provided for explicitly. This year we’re celebrating 20 years of the Choice on Termination of Pregnancy Act. We have this wonderful policy, and it’s still not translating into access to abortion for a lot of people. Approximately 85 women are dying every single month because of unsafe abortions. Abortion is a medical procedure, but is neglected because of the very moralistic, judgemental and paternalistic way in which the health system treats its patients. Women’s rights are always used by politicians as a ping-pong ball.’

Tlaleng took a deliberate decision not to specialise in obstetrics and gynaecology, and to focus on sexual and reproductive health as primary healthcare instead: ‘I’m a general practitioner with a special interest and focus on reproductive healthcare. Once you’re a gynae, you’ve probably dedicated five years or more to study, so it’s about working and earning a livelihood. You don’t have much time to spend on advocacy and primary healthcare issues. I feel that as a GP, I can provide contraception, proper counselling, follow-up and policy review. And once I’ve done that, I can go on with being a doctor.’

Yes, the presidency of Donald Trump in the US, and his reinstatement of the Global Gag Rule, is going to cause problems for South Africans, she says. ‘A lot of the NGOs working in reproductive health are funded by foreign aid; most of it US aid. People in power have allowed foreign-aid funders to dictate how we treat our women, how we value our women, how we give people access to abortion. Now we can’t use US money to offer any information, campaigning, or support towards abortion services. We’ve allowed this to carry on for years and years. If you go on any mobile site of the Department of Health and type in ‘abortion’, it will return no results. That, as far as I’m concerned, is a form of self-gagging. The Americans don’t even have to demand this – we’re doing it ourselves. Even when Barack Obama was president, we weren’t doing any work on abortion. Now Donald Trump has made the rules even more extreme. Not only is this going against our Constitution, but this is also leading directly to people dying. Literally, people die.’

Women have autonomy over their bodies, Tlaleng says. ‘I really think it’s time that men and politicians stay out of people’s uteruses, because no one’s in their scrotums and telling them when to ejaculate and when not to!’

by Louise Ferreira