Photo courtesy of Marie Stopes

For Female Market Porters in Ghana, Access to Contraception Can Save Lives

Linda Yang

Linda Yang

In Ghana, girls as young as ten leave their homes to work as porters in markets, where they are vulnerable to sexual abuse and unplanned pregnancy. One organization is working to help by providing access to reproductive care.

Photo courtesy of Marie Stopes

A war against reproductive rights is brewing. As right wing and nationalist parties popularity rise in Europe, so do fears of further restrictions on abortion access. The United States presidential debate isn't helping, either, as Republican nominee Donald Trump virulently attacked abortion rights during the final presidential debate, promising to appoint justices to "automatically" overturn Roe v. Wade.

While women are storming the streets in Poland and those denied abortion coverage in the United States might be able to seek help from private abortion funds or even assist help from a radical doula, worldwide, millions of women have nowhere and nobody to turn to.

In Ghana, a community of marginalized women are more vulnerable than most. Women and girls—some as young as ten years old—leave their homes in the impoverished Northern Regions of Ghana in order to find livelihoods in Accra's markets. The locals call them Kayayei, and they find menial jobs as porters, transporting goods and wares between markets and lorry parks.

Read more: The Women Battling the Post-Ebola Teen Pregnancy Epidemic

There are over 50,000 Kayayei in the city. Without traditional community ties and familial assistance, many Kayayei find themselves sleeping on the streets, leaving them vulnerable to sexual assault and related abuse. Some of them become pregnant and resort to illegal, underground abortions. According to the director of an Kayayei association, almost 25 Kayayei have died from unsafe abortions in the six month period of January to June of this year.

Ghana may have one of the most liberal abortion laws in Africa, but access is still restricted: Terminations are only allowed in cases of rape, incest, fetal abnormality, or if the woman's mental or physical health is at risk.

Dina is 27 and works as a security guard in Accra. All photos by Ruth McDowall, courtesy of Marie Stopes

This means that many women—Kayayei included—resort to DIY abortions. Some attempt to self-induce a termination by inserting the leaves and stems of plants into the vagina or drinking toxic herbal mixtures, laundry detergent, and even ground glass bottles in a sugar solution. According to the Guttmacher Institute, almost half of Ghana's abortions are performed in unsafe conditions.

Dina, a 27-year-old security guard in Accra, has firsthand experience of the procedure. "I have had so many abortions and I did all eight on my own," she says. "You feel severe pain when you take the medicine. One time I felt like dying, my body was so weak, I couldn't move and I lost so much blood I thought I would die. I am too afraid to tell anyone when I'm pregnant so there was no medical attention."

Gifty ran away to Accra after she was forced to marry an older man.

Many Kayayei have worked for years and must balance the relentless physical labor with childcare. Gifty, a 37-year-old Kayayei, already has three children. "The first pregnancy spoilt my schooling," she said. "My father had just died and nobody could help me. My uncle said he'd take care of me and help me go back to school but he was lying. He tried to force me to marry an older man and beat me because I wouldn't."

Before going to Accra, Gifty recounts that "everyday [she] was forced to have sex with the man." After becoming pregnant again, she ran away to Accra and began working in the markets.

"I've been doing this work for eight or nine years," she said. "Working as a Kayayei is hard. Women often carry heavy loads and a baby on their back. We don't get enough work, sometimes we work all day and go home with no work or money, and if you've got to eat, it's a problem. Sometimes the women are raped and if you fall pregnant and don't marry them, what are you going to do?"

Hawa works as a market porter in Accra and dreams of learning tailoring.

Hawa, 23, is also a market porter. She works in the Agbogbloshie market in Accra. "I have a three-year-old child who I gave birth to in my home town in northern Ghana when I was 19. My child still lives there with my father," she said. "I came to Accra to make money so I can afford to learn tailoring. I haven't saved much so far. The work in the market is not good, there's a lack of people needing our services and the work is hard."

Though Kayayei life remains arduous, there are still hopeful signs for one of Ghana's most marginal female communities. Marie Stopes International, a reproductive health charity, is working with the Kayayei community in Accra to provide contraception, education on sexual health, and family planning advice.

For women like Gifty, the support has been invaluable. "I said to myself that this will change my life and it has. I had a five year implant fitted," she said. "Now I can take care of my existing children."

Marie Stopes International is celebrating its 40th anniversary beginning on the week of October 31. For more information about Marie Stopes, visit mariestopes.org.

A woman sleeps in a market in Ghana.

Women at a Marie Stopes clinic.