Black market abortion pills in high demand

BY DONNA HUSSEY-WHYTE Sunday Observer staff reporter [email protected]

Sunday, May 29, 2011

JAMAICAN women have been secretly using a drug intended to treat something completely different, to abort unwanted pregnancies without a doctor’s prescription.

The drug, known as Cytotec — which is the generic name for the medication Misoprostol — was intended to prevent stomach ulcers, but has found widespread use as a means of inducing labour in pregnant women and, in secret, to terminate healthy pregnancies.

Bottles of the anti-ulcer drug Cytotec, which has gained popularity as an abortion pill and is sold without prescription on the local black market.
The Ministry of Health says under a new policy, only gynaecologists and obstetricians who are consultants in hospitals will have access to the powerful drug Cytotec.
FLETCHER… we were one of the first to publish its usefulness in inducing labour and now it has widespread use worldwide

FLETCHER… we were one of the first to publish its usefulness in inducing labour and now it has widespread use worldwide

3/3
The drug, which Sunday Observer sources confirm has become widely available on the local black market, sells for up to $15,000 for a course of treatment, which is about the same it would cost to get a more invasive surgical abortion done by a medical doctor.

One woman in an inner-city community, who spoke on the grounds of anonymity, has been selling the tablets for a number of years. She said demand for the ‘abortion pill’ has grown as more and more persons learn about it.

“Nuff people tek it,” she said. “Both teenagers and big people buy it. It don’t have no specific set a people, and nuff other people want it but don’t know where to get it. Nuff people just start hear bout it, so that’s why you find that more buying it.”

She said the tablets are supplied by another woman who travels overseas and purchases them and smuggles them into the country.

Four to six of the small white pills, she said, are sold on the black market for between $12,000 and $15,000. However, another woman told the Sunday Observer she got four pills for $4,000 at a pharmacy in Portmore.

She also reported that she was able to procure the drug at a downtown Kingston pharmacy, five for $8,000.

The pills are taken both orally and are inserted into the vagina. It is the vendor, without the benefit of medical or pharmaceutical training, who explains to the purchaser how the pills must be used.

The woman the Sunday Observer spoke with explained that all the tablets are taken and inserted at the same time and within an hour, the woman will expel or “bleed out” the foetus. This is usually accompanied by non-stop pain, high fever, diarrhoea, vomiting and the passing of large blood clots.

She noted that she would not recommend that women take the tablets after three months of pregnancy. However, she denied that there were any ill-effects from using them.

“It safe. It not doing you nothing,” she insisted. “A years now it selling and I never hear of anyone getting sick or going to the hospital because of it. It safe man.”

However, while it is an open secret that the drug is available for purchase illegally, some medical doctors are also giving it to their patients, without prescription, for ‘off-label’ use. In most cases, it is given to patients to induce the abortion of a healthy foetus, the Sunday Observer has learned.

Head of the Gynaecological and Obstetrics Department at the University Hospital of the West Indies (UHWI), Professor Horace Fletcher, who reiterated that abortion is against the law in Jamaica, said many doctors and patients nonetheless use Cytotec/Misoprostol to terminate pregnancies, sparking controversy over its use.

However, it has a perfectly legitimate and legal application.

“It is a prescription drug used to prevent stomach ulcers in people who use non-steroidal anti-inflammatory drugs like aspirin or ibuprofen,” Fletcher explained. “It has, however, been found to be very useful in women.”

He explained that Misoprostol has been used to induce abortion or terminate abnormal and normal pregnancies for social and medical reasons, but also to induce labour by softening and opening the cervix; to stop bleeding after delivery (post-partum haemorrhage); and to soften the cervix prior to surgical procedures like dilatation and curettage (D and C), or ‘scraping’ the womb.

Fletcher said it has its advantages and it is widely used in underdeveloped countries on mothers after they have given birth, especially because it does not need to be refrigerated like other drugs.

“It stops women from bleeding to death after having a baby,” he said.

He added that Cytotec has been in use legally in Jamaica for over 10 years. The tablets, he explained, are the most common method of inducing labour in Jamaica.

“We (the local medical fraternity) were one of the first to publish its usefulness in inducing labour,” he said. “And now it has widespread use world wide. It has resulted in a decrease in deaths from high blood pressure and bleeding after pregnancy.”

“In viable pregnancies (when there are no signs of miscarriage or impending pregnancy loss and the pregnancy can be expected to result in the birth of a live infant) near to, or at term, it is used to induce labour for certain conditions, decreasing the need for Caesarean section,” he explained

Nonetheless, he warned against unprescribed Cytotec being used by pregnant women, and offered the reminder that abortions are illegal in Jamaica.

Fletcher noted that the drug can be used legally to terminate abnormal pregnancies, but confirmed that despite this, some doctors are, in fact, giving it to patients who simply want to abort normal, healthy foetuses.

Twenty-three-year-old Alicia (last name withheld) said last year she found out she was pregnant at a time when she simply could not afford to have a child. It was her first pregnancy and she said she just was not ready. Neither was her 38-year-old partner, who already had three children he was struggling to look after.

Four and a half months into her pregnancy, despite feeling the baby’s movements inside of her, she visited a doctor who inserted one of the tablets inside her vagina and gave her two more tablets, instructing her to take them orally within seven hours after the insertion.

Alicia recalled experiencing horrific abdominal pain which felt as if she were giving birth. This was accompanied by very heavy bleeding. All this began within an hour of taking the pills.

“A day and half later, everything pass out,” Alicia recalled. “Ten days later I went back to the doctor to make sure that everything was out.” She was then given a prescription that would prevent any infection from developing as a result of the chemically induced termination.

Alicia said she has not experienced any problems since. However, she says her stomach remains enlarged and her breasts have sagged.

That abortion cost her $10,000.

While he does not know of anyone dying from the unprescribed use of the drug in Jamaica, Fletcher said he is aware of persons in other countries dying from complications associated with the drug.

“It has been a cause of maternal deaths in some other countries as it can cause rupture of the uterus,” he explained. “It can also cause death of the baby from excess uterine contractions.”

He added that the drug can force the fluid around the baby (amniotic fluid) into the mother’s lungs, which could result in death.

But, one reputable gynaecologist who did not wish to be named, said while he is not promoting the use of Cytotec for abortions, the drug is one of the most efficient methods of terminating a pregnancy and safer than abortions performed by many ‘back-door’ doctors using surgical instruments.

“It is much safer than other forms of termination,” he said. “A lot of the complications once associated with abortions have been reduced,” he added.

“We no longer see young girls coming in with their insides rotting out, or developing infections, or persons with their insides dig-up and ruptured from the use of unsterilised instruments.”

“Cytotec is very efficient and it does not leave anything inside of you. Nowadays you hardly see those complications. It’s just that termination is illegal in Jamaica, so it just can’t be used like that. There are specifications to termination of pregnancies, but a lot of complications have been reduced since the ‘abuse’ of Cytotec,” he said.

Studies have demonstrated that Cytotec can be used to terminate pregnancies at any stage of gestation, hence unconfirmed reports reaching the Sunday Observer of unborn babies as old as five and six months being aborted through use of the powerful drug.

Director of Standards and Regulations in the Ministry of Health, Princess Thomas-Osbourne said the ministry is aware of the misuse of the drug and steps are being taken to curb the practice.

“The Ministry has had several reports regarding the illicit use in this way, and harm caused to patients to whom it has been given,” Osbourne said. “A policy has been developed and is to be implemented.”

This policy, she explained, would remove the use of Cytotec from the private sector and allow its access only to gynaecologists and obstetricians who are consultants in hospitals. The medication could then only be used under the direct supervision of these consultants.

“Any use by anyone to procure an abortion is illegal, whether on a prescription by a doctor or dispensed by a pharmacist,” she warned.

Using the pills for abortion is considered to be ‘off-label’. This means that the drug has not been FDA approved for use as an abortion pill, for cervical ripening or to start labour.

Not having FDA approval for this also means there are no standardised dosages or guidelines in prescribing Cytotec for these purposes.

One manufacturer of Misoprostol, Searle, warned consumers in 2000 about the possible risks of the drug if used during late pregnancy.

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Britain, Canada to move against Robertson — US official

TWO other countries are set to join the United States of America in revoking visas issued to Jamaica Labour Party (JLP) deputy leader James Robertson, a reliable US Government official has revealed.

“There is ongoing collaboration between Britain, Canada and ourselves, and it is almost certain that, like the USA, those countries will also cancel visas issued to him, as long as it is established that he has those in his possession,” the Washington, DC-based US official told the Sunday Observer toward the end of last week.

Britain, Canada to move against Robertson — US official

Businessmen linked to JLP among those also under scrutiny

 

Sunday, May 29, 2011

 

TWO other countries are set to join the United States of America in revoking visas issued to Jamaica Labour Party (JLP) deputy leader James Robertson, a reliable US Government official has revealed.

“There is ongoing collaboration between Britain, Canada and ourselves, and it is almost certain that, like the USA, those countries will also cancel visas issued to him, as long as it is established that he has those in his possession,” the Washington, DC-based US official told the Sunday Observer toward the end of last week.

 

ROBERTSON… resigned as minister after his US visa was cancelled

ROBERTSON… resigned as minister after his US visa was cancelled 1/1

The official, who said that he was not authorised to speak publicly and gave information to the Sunday Observer only on condition of anonymity, stated that the US was convinced that the right thing was done in revoking the former Cabinet minister’s visa. The official added that the final decision was taken after careful analysis of the situation and the impact that it was likely to have on the administration of Prime Minister Bruce Golding.

The prime minister, the Sunday Observer learnt, had been informed as a matter of courtesy, of the US’ intention to withdraw Robertson’s visa and that of his wife, before action was taken on May 20.

That information could not be confirmed by Golding’s office at

Jamaica House when contact was made on Friday.

Robertson, the member of parliament for St Thomas West and former minister of energy and mining, confirmed that his United States visitor’s visa was revoked, in a statement issued late Monday, a day after the Sunday Observer broke the story that a minister had lost the document.

“On Friday, May 20, 2011 the Government of the United States of America cancelled the visas of my wife Charlene and me,” Robertson said. “We readily acknowledge that as a sovereign nation it is the prerogative of the US Government to issue and revoke visas.”

Since the revocation, Golding has stated that his deputy, Foreign Affairs Minister Dr Ken Baugh, would be holding talks with US Embassy officials, led by that country’s ambassador to Kingston Pamela Bridgewater, to attempt to sort out the matter.

Robertson too, said that he had assembled a team of lawyers in the USA to handle the issue from that end.

The Washington, DC-based source admitted that every individual was entitled to legal protection or redress, but stopped short of

saying that Robertson was wasting his time by choosing to go that route.

“The withdrawal of his visa is one step along the way. There is more to come and other things will happen at other times,” the official said.

It is not customary for Cabinet ministers or members of parliament to be denied travel to the US. Updated records show that the move is unprecedented, as no other Cabinet minister has ever had his/her US visa revoked since Jamaica gained Independence from Britain in 1962.

Having a US visa makes the job of any government minister that much easier, and, in the case of Robertson, not having one would all but cripple his efforts at sorting out matters that pertain to areas under his portfolio, the bauxite and alumina sector in particular, as the companies that do business with Jamaica have strong boardroom clout in the US.

“Robertson would be like a fish out of water if he were to remain as

energy and mining minister without having a US visa,” a retired senior civil servant of the former Ministry of Mining and Natural Resources in a previous political administration told the Sunday Observer. It was a point that was backed up by Information Minister Daryl Vaz.

“The revocation of a visa to the United States makes your position as a minister of government almost untenable,” Vaz told journalists at a post-Cabinet news conference at Jamaica House last Wednesday.

The US Embassy in Jamaica, as a matter of course, does not comment publicly on visa-related issues, and speculation continues to make the rounds regarding the real reason for the withdrawal of the visa.

Robertson himself suggested that it might have resulted from allegations made by a former political ally, Ian Johnson, who made damaging allegations against the politician to US and Jamaican authorities.

“No details have been provided as to the

basis for the cancellations, although we are of the view that this could have resulted from the uncorroborated statements forwarded to various departments of the US Government in support of a failed application for political asylum. The allegations made in those statements have been, and remain, wholly rejected,” Robertson said in the initial statement confirming that his visa was cancelled.

Johnson, a self-styled JLP activist, sought political asylum in the US, but the world’s most powerful country refused.

Johnson also had, on December 17, 2010, filed a claim in the Circuit Court of the 17th Judicial Circuit in Broward County in which he put forward hair-raising allegations against Robertson.

A Florida court threw out the suit in January.

Information reaching the Sunday Observer is that the US is also moving to yank visas from other prominent Jamaicans, among them another key government official, two businessmen with links to the ruling JLP, one of whom has been under investigation for some time now for his alleged involvement in money laundering and human trafficking.

A member of the local customs department is also under scrutiny, the Sunday Observer was told.

The decision by the Supreme Court this week upholding an Arizona law punishing employers for hiring illegal immigrants was an energy boost for state lawmakers across the country who have proposed bills this year to curb illegal immigration. As if they needed it.
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According to the National Conference of State Legislatures, state lawmakers set a new record in the first three months of the year, proposing 1,538 bills related to immigration, with 141 measures in 26 states passed into law. While some of those laws extended new opportunities to illegal immigrants, like permitting them to pay lower in-state tuition rates at public colleges, most of the laws imposed restrictions on them.

With its decision on the hiring law that Arizona passed in 2007, the Supreme Court indicated that it would not flat out disallow any action by states on immigration enforcement, even though federal law generally pre-empts state measures in that area. State lawmakers now know for certain that there is some firm legal ground for the recent round of bills that seek to drive illegal immigrants out of the country by preventing them from taking jobs and even living here.

But it remains unclear just how large the playing field is that the Supreme Court has opened. Arizona’s employer law was carefully tailored to conform to specific, narrow terms in federal immigration law, and it was never suspended by any federal court. To date, only a handful of states have passed laws with requirements and penalties for employers similar to Arizona’s.

Instead, this year many more states weighed whether to emulate the more sweeping and politically polarizing law that Arizona passed last year, known as S.B. 1070, which expanded the powers of the state and local police to ask about the immigration status of people they detain. The Supreme Court has not yet considered that law, which has been largely suspended by federal courts.

By now, however, with the legislative season either winding down or over in most states, it seems clear that lawmakers’ decisions on whether to follow Arizona’s lead on police enforcement ultimately had more to do with state politics than with concerns about potential legal challenges and Supreme Court rulings.

Kris Kobach, the constitutional lawyer who has been the intellectual if not the actual author of many of the state immigration enforcement laws, was elated by the court’s recent decision. The ruling “has vindicated our position that states are not pre-empted by federal law from these actions,” said Mr. Kobach, who is now secretary of state of Kansas.

He predicted that many more states would soon “jump on the bandwagon” to impose new responsibilities on employers.

Arizona’s statute includes the most severe penalties of any state hiring law, imposing what employers call a “business death penalty”: on the second offense of knowingly hiring an illegal immigrant, the business loses its license permanently. Arizona also mandated the use by all employers of a federal electronic program for verifying the work authorization of new hires, known as E-Verify.

Only Mississippi and South Carolina followed Arizona in requiring all employers to use the verification system. In the storm of lawmaking this year, Georgia and Utah passed laws requiring larger businesses to use the system (in Georgia, by July 2013). Virginia required employers to use it, but only for state contracts.

Far larger is the number of states where Arizona-style enforcement laws were debated, voted, praised and protested. According to the National Immigration Forum, which opposes such laws, bills like Arizona’s failed after sometimes furious debate in 15 states.

Georgia was the first state to pass a law close to Arizona S.B. 1070, and Gov. Nathan Deal, a Republican, signed it into law this month. Georgia growers raised an outcry against the law, saying it would cripple their labor force. But Republicans who control the legislature strongly supported the law, which built on an earlier set of measures against illegal immigration Georgia passed in 2006.

In March, Utah passed an enforcement law that echoed Arizona’s, but tempered it politically with a measure that would create a temporary guest worker program. A federal court has temporarily held up the enforcement law.

With their session in its last days, Alabama lawmakers are close to passing a broad measure that could be even tougher than Arizona’s. In addition to requiring most employers to use the verification system, Alabama’s bill would ban illegal immigrant students in public schools from participating in band, cheerleading and any other extracurricular activity. The bill has faced little organized opposition.

An enforcement measure is also close to passage in South Carolina.

Several states stood down at the last minute. After intense opposition by Florida growers and the tourism industry, legislators let an enforcement measure die in the final hours of their session. On Thursday, Democrats in the Texas Senate blocked a measure that would have stepped up immigration enforcement in cities. Texas police chiefs turned out forcefully against the measure, although Gov. Rick Perry, a Republican, had made it a priority.

Finally, Maryland and Connecticut, with small but rapidly growing Latino populations, went a different way entirely, passing laws to allow illegal immigrant students to attend public colleges at in-state rates.