Other cultural issues complicate matters. Traditionally large families are prized. Some women feel pressured by their families to give birth again and again. Many must either hide their contraceptive use or forgo it altogether. The most common form of contraceptive in Kenya is the injectable Depo Provera which is administered every three months in health centres. And a mere 39 per cent of married women who do not want to become pregnant use any contraceptive method at all.

Young women are at an acute risk. The 2004 study revealed that nearly half of all terminations occur among those between ages 14 and 24. Sex education in schools is a political hot potato. Religious opposition to comprehensive sexuality education and stipulations attached to USAID funding mean that there is an uneven focus on abstinence education. This comes at the exclusion of information that could dent the country's high teen pregnancy and abortion rates.

Yet it took a dramatic case to galvanise reproductive rights advocates. In 2004 three health workers were arrested after a gruesome find. Someone dumped 15 mature fetuses near a river in Nairobi. The scandal erupted less than a month after the release of findings from the 2004 study and advocates worried that it was a move by anti-choice proponents to skew the national dialogue.

"The foetuses were found at seven in the morning and police and media were on hand," Onyango recalled. "We thought the providers ought to get a fair trial so we formed an alliance of individuals and organisations from the legal, medical and human rights communities."

One year later the three were acquitted for lack of evidence. But the work continued. With both the Kenyan Medical Association and Kenyan Obstetrics and Gynaecological (OBGYN) Society onboard, the RHRA has made significant strides with respect to research, advocacy and awareness after the case. But the media remained a challenge.

"It's largely about who owns the media houses. They have their masters to serve. Over the years we've tried to build relationships with people in the media to help them appreciate the issues we're talking about but overall the media tends to focus a lot on political issues and social issues are not given the priority they deserve," Onyango said.

The RHRA came up with novel strategy that would jumpstart local dialogue and attract international attention. In a June 2007 Mock Tribunal the country and the world heard the testimonies of real women about their experience of unsafe abortion. Threats of intimidation (and a pervasive rumour that police would be on hand to arrest the women) forced the group to tape the presentations. But despite the fact that anti-choice campaigners eventually stormed the meeting, the effect of the stories was not lost.

Knitting needles, water pipes and herbal concoctions were among the tools used by untrained providers. A nurse told of a 16-year-old brought to the hospital in a septic coma after an abortionist perforated her rectum and uterus. And one girl shared the sordid story of how she lost her 14-year-old sister after a botched procedure.

Onyango explained that unlike Trinidad and Tobago, medical abortions are not prevalent. Misoprostol, a drug used to induce abortions, is available in pharmacies but not used by Kenyan women and doctors with the exception of some gynaecologists. There is currently a drive to train doctors in the use of Misoprostol in order to reduce the reliance on invasive surgical procedures. But there remains a vast segment of Kenyan women who never consult a qualified doctor for their terminations.

Like ASPIRE, RHRA has drafted proposed legislation that it hopes will be drawn upon if legislators move to reform the law. The severe political unrest and riots that plagued the country after its general elections last year have given way to a new political accommodation. It means that RHRA will have to start afresh with sensitising new members of its coalition government.

"It's a long battle," Onyango said. "And it won't be an easy one to win but we are prepared to fight."