reports that at the Semma Hospital in Santo Domingo, 16-year-old Esperancita went without treatment for several weeks even though she was dying of acute leukemia and was in need of aggressive chemotherapy. Doctors were faced with the purely legal problem arising from the fact that the girl was nine weeks pregnant and chemotherapy could terminate the pregnancy in violation of Dominican anti-abortion laws.
According to Reuters
, a change in the constitution of the Dominican Republic in 2010 imposed a blanket ban on abortion in the country, even in circumstances where the mother's health or life was in danger. The Dominican Republic's powerful conservative lobby backed by the influential Catholic Church were the main promoters of the country's stringent anti-abortion laws.
A Dominican doctor who provides chemotherapy treatment for a pregnant patient that results in the termination of the pregnancy may find himself in trouble with the law. Reuters
reports that gynaecologist Lilliam Fondeur, said: “The treatment will very likely deform the foetus. The young girl should be able to get an abortion as well as the treatment. But doctors in the public health system are afraid to carry out the procedure because it’s unconstitutional."
Esperencita's case was brought to national attention in the Dominican Republic when Fondeur wrote an article about her in her column in the El Nacional
Esperencita's mother Rosa Hernandez, worked frantically to convince the Dominican government to make an exception in the girl's case. CNN
reports Hernandez said: "My daughter's life is first. I know that [abortion] is a sin and that it goes against the law... but my daughter's health is first."
Article 37 of the Dominican constitution, says "the right to life is inviolable from the moment of conception and until death." Domincan courts interpret that as an inviolable mandate against abortion. Article 37, passed in 2009, also abolished the death penalty in the Dominican Republic, CNN
Miguel Montalvo, director of bioethics council, said the council favored allowing the treatment. He said: "At the end of the day the patient may decide for himself or herself. In this case, the family may decide what's more convenient for the patient."
Women and human rights groups expressed outrage at the delay in treating the girl.
Lilliam Fondeur said that conservative politics was blocking necessary treatment to save a young girl's life. She said: "How can it be possible that so much time is being wasted? That the treatment hasn't begun yet because they're still meeting, trying to decide if she has the right to receive the treatment to save her life -- that's unacceptable."
Esperencita's case dominated the headlines in the country for a week. There was overwhelming support on social media networks for the girl and her mother.
Liberal politicians called for renewal of debate over the blanket abortion ban in the country. A former representative Victor Terrero, argued that illegal abortions were still exposing women to risks. He said: "The constitution is going to have to be modified sooner rather than later. We cannot allow under any circumstances that pregnancies that present complications for women be permitted to continue as normal."
Bautista Rojas Gomez, Dominican minister of health, said he favored chemotherapy over protecting the girl's pregnancy. Pelegriin Castillo, one of the sponsors of the Article 37, also said the ban does not prevent doctors from administering the treatment to treat cancer. He said it only prevents the doctors from using chemotherapy specifically to induce an abortion. He said: "It's an artificial debate. What we have clearly said is that in this case doctors are authorized by the constitution to treat the patient. They don't have to worry about anything. They have the mandate of protecting both lives."
But doctors continued withholding treatment because of absence of a legal guarantee of freedom from prosecution.
Esperancita finally receives treatment
According to Reuters
, Esperancita finally underewent chemotherapy on Tuesday following mounting public presssure on the doctors. Fondeur said: “The hospital said it has started the treatment but it’s not clear whether this has really happened. The facts of the case have all been covered up. The doctors should have started treating the young girl earlier. Why the delay? We hope the case of this girl serves as a symbol to show that the life of a mother must always come first." She added: “It’s also a symbol of the plight of poor, young mothers who have to use the public health system. With money, rich women can buy abortions but poor mothers simply don’t have that choice.”
reports Amnesty International says that in countries where abortion is totally banned, the rates of maternal mortality rise because doctors are unable to provide life-saving treatment that endangers pregnancy even when such treatment is necessary to save the mother's life.
The Dominican Republic is not the only country with stringent abortion laws in Central America. Nicaragua and El Salvador also forbid abortion, even in cases of rape, incest, foetal malformation, or if the life of the mother or foetus is in danger.