By Ebenezer T. Bifubyeka,
In Mukono, Central Uganda.
TWO armed policemen enter the health centre. Each of them is holding an exhausted girl by the upper arm. Tears are running down the cheeks of the seemingly 10-year-old girl. Her dress, around the buttocks and genitals, is stained with blood spots.
“Police officers, what is the matter with her?’ one nursing officer asks. “She has been defiled,” one cop replies. “What? Sorry, little angel; you will be alright,” the nurse says to the girl, “Thank you officers for bringing her here; make sure you arrest the culprit.”
“That criminal is already at the (police) station,” one cop responds. The cops walk out. The nurse holds the girl’s petite hand and walks with her to the treatment room. Later, the nurse returns with her.
The girl has been cleaned and she has visibly calmed down. The nurse prescribes the pills for the girl to heal and prevent the possibility of acquiring Human Immunodeficiency Virus and other Sexually Transmitted Diseases!
It has been perceived that contraceptives are meant for Family Planning among couples aged between 18 and 49. What a wrong notion! Young girls do use contraceptives too.
Before we see how and why the young people use contraceptives, let’s look at the meanings of Family Planning and Contraceptives. The Regional Centre for Quality of Health Care (RCQHC) defines Family Planning (FP) as an individual’s or couple’s informed decision to adopt a FP method of their choice to limit family size or delay desired pregnancy.
And the term ‘Contraceptives’ refers to an intentional prevention of conception or impregnation through the use of various devices, agents, drugs, sexual practices, or surgical procedures. It’s all about birth control; and there are many different ways of controlling birth:
• By mouth (oral) - Birth control pills must be taken by mouth every day.
• Injected - Depo Provera is a hormonal medication that is given by injection every three months.
• Implanted - Norplant is a long-acting hormonal form of birth control that is implanted under the skin of the upper arm.
• Vaginal - Spermicides and barrier methods work in the vagina.
• Intra Uterine Device - The IUD is inserted into the uterus.
• Surgical - Tubal sterilisation is a form of surgery. A doctor must perform the procedure in a hospital or surgical clinic. Many women need general anesthesia.
Adolescents use these contraceptives. On a condition of anonymity, the Nursing Officer at Mukono Town Council Health Centre four says that adolescent girls – those aged between 10-19, need FP services like contraceptives - after informing them.
“Prevention is better than cure. So the under-age group should come for Family Planning services – if the need arises,” says the nursing officer, who boasts of 22 years of experience in the nursing career.
The ageing nurse, who only identified herself as Grace, says that a minor can be raped or defiled and we give her the pills to heal. She adds that pills also help people with abdominal pain and heavy bleeding regardless of age.
“Pills help such people to stop or reduce bleeding. People who have had abortion are given pills to stop or reduce bleeding. And women who are raped are also given pills for the same purpose,” she explains.
Grace however warns that pills contain both male and female hormones. They can react negatively in the bodies of barren women.
“It’s advisable for one to seek information about the pills from the health service providers before using them,” she says, adding that the user needs enough information about the pills because if she forgets to take the pill, she will get pregnant.
Grace says that although the 348 condom users they received in May alone indicate a positive public attitude towards FP, the turn up of males is still as low as 5%. “On average, 50 people come for FP services every month,” she discloses.
She says the centre is always equipped with pills and a standby doctor. She adds the centre offers injectables, condoms, minor surgical procedures like tubal-ligation (informally known as getting one’s ‘tubes tied.’ This is a permanent form of female sterilisation, in which the fallopian tubes are disconnected and sealed in order to prevent fertilisation. There is vasectomy (the cutting of sperm ducts to bar sperms from flowing to fertilise the woman’s eggs) and Norplant implant (capsules inserted under the skin of a woman’s upper arm – to prevent pregnancy).
Asked about the challenges of FP methods, Grace says illiterate patients don’t understand the lessons offered to them. She adds that besides ignorance, peer pressure obstructs the health service-providers from passing on FP information efficiently and effectively.
Grace says they are also facing a problem of myths and misconceptions about using FP methods, which the media should help highlight on thus providing the right information.
“People falsely believe that contraceptives: reduce fertility, reduce African population, make woman grow beards and break voice, can penetrate the baby’s brain, stop libido, make one sick, make the woman cold, create abnormal babies, cause cancer…,” she says.
However, commenting on HIV/AIDS, Grace says that government should emphasise and facilitate the carrying out of public awareness and training to reduce stigma and denial.
“Some men have divorced their wives who release their results to them after testing HIV positive,” she discloses.
The Nursing Officer in the Anti-Retroviral Therapy (ARP) department, Rose Kateeba says they get 30-60 people to take anti-retroviral drugs or ARVs everyday.
“Among those, men are few – yet the same men need information about family planning - given the fact that they are HIV positive,” she reasons.
She says that people don’t want to disclose their sero status over stigma. She adds that the majority of people who come here for ARVs are women. “Even some women come here without the knowledge of their husbands,” she says.
Kateeba, who reasons that men should also be sensitised about ART services, urges men to use condoms and come for ARVs that are abundant at Mukono health centre.
“However, the centre has no drugs to treat opportunistic infections. And the place here is too small to accommodate big numbers of patients and seekers of family planning service,” she discloses.
The Peer Educator from the Elizabeth Gladier Paediatric AIDS Foundation, Maria Nakzibwe says they have commenced carrying out public sensitisation about FP to save the lives of HIV positive mothers.
“We encourage mothers to test for HIV every time they go for antenatal care because the more children an HIV-infected woman gets, the weaker she becomes,” she says.
Nakazibwe, who boldly declares that she is HIV-positive, says she has one child who is HIV-negateve. “And I’m not willing to have any other child because of my condition,” she vows.
Nakazibwe, who lost her husband to HIV/AIDS recently, says that out 60 people they sensitise about FP, about 20 are men. “Most men have come to believe in a myth that contraceptives cause fibroids! Our people need a lot of sensitisation,” she says.
Asked about adolescents’ use of contraceptives, the Deputy District Health Officer for Mukono, Dr. Anthony Kkonde says that there are many private drug shops and retail shops, and they can’t know the rate at which the under-age group takes contraceptives.
He explains that they have over 200 drug shops and over 50 retail shops in Mukono and the operators don’t tell them how many pills or condoms they sell in a day and who buys.
“We don’t expect adolescents under 18 to go for pills! But in case of defilement or rape, we carry out examinations and then give the pills to the victims to heal up and prevent the possible transmission of HIV,” Dr. Kkonde says.
About the disadvantages of pills, Dr. Kkonde says that taking pills everyday is tiresome; and one might forget to take them and get pregnant.
He says men don’t allow their wives to take pills or even go for regular FP training. “Family Planning has not been overtaken by HIV training, treatment and prevention as it seems to be, but it is only because a few people go for family planning,” he says.
Dr. Kkonde says the issue of male involvement in FP is still a problem. “Maybe it’s a culture of men or maybe they spend a whole day at the workplace and report home late in the evening,” he thinks.
He says they have programmes to sensitise men and women about prevention of mother-to-child transmission of HIV (PMTCT). “Under that programme, we always call a mother and a father and sensitise them using peer educators,” he says.
Asked about whether the government has catered for quality and sufficient health in public health centres, Dr. Kkonde says, “Government is doing fairly but not enough, definitely. We don’t have enough medical personnel,” he says.
He adds that there is insufficient infrastructure in place and the supply of the required services is inadequate too.
Ends.
TWO armed policemen enter the health centre. Each of them is holding an exhausted girl by the upper arm. Tears are running down the cheeks of the seemingly 10-year-old girl. Her dress, around the buttocks and genitals, is stained with blood spots.
“Police officers, what is the matter with her?’ one nursing officer asks. “She has been defiled,” one cop replies. “What? Sorry, little angel; you will be alright,” the nurse says to the girl, “Thank you officers for bringing her here; make sure you arrest the culprit.”
“That criminal is already at the (police) station,” one cop responds. The cops walk out. The nurse holds the girl’s petite hand and walks with her to the treatment room. Later, the nurse returns with her.
The girl has been cleaned and she has visibly calmed down. The nurse prescribes the pills for the girl to heal and prevent the possibility of acquiring Human Immunodeficiency Virus and other Sexually Transmitted Diseases!
It has been perceived that contraceptives are meant for Family Planning among couples aged between 18 and 49. What a wrong notion! Young girls do use contraceptives too.
Before we see how and why the young people use contraceptives, let’s look at the meanings of Family Planning and Contraceptives. The Regional Centre for Quality of Health Care (RCQHC) defines Family Planning (FP) as an individual’s or couple’s informed decision to adopt a FP method of their choice to limit family size or delay desired pregnancy.
And the term ‘Contraceptives’ refers to an intentional prevention of conception or impregnation through the use of various devices, agents, drugs, sexual practices, or surgical procedures. It’s all about birth control; and there are many different ways of controlling birth:
• By mouth (oral) - Birth control pills must be taken by mouth every day.
• Injected - Depo Provera is a hormonal medication that is given by injection every three months.
• Implanted - Norplant is a long-acting hormonal form of birth control that is implanted under the skin of the upper arm.
• Vaginal - Spermicides and barrier methods work in the vagina.
• Intra Uterine Device - The IUD is inserted into the uterus.
• Surgical - Tubal sterilisation is a form of surgery. A doctor must perform the procedure in a hospital or surgical clinic. Many women need general anesthesia.
Adolescents use these contraceptives. On a condition of anonymity, the Nursing Officer at Mukono Town Council Health Centre four says that adolescent girls – those aged between 10-19, need FP services like contraceptives - after informing them.
“Prevention is better than cure. So the under-age group should come for Family Planning services – if the need arises,” says the nursing officer, who boasts of 22 years of experience in the nursing career.
The ageing nurse, who only identified herself as Grace, says that a minor can be raped or defiled and we give her the pills to heal. She adds that pills also help people with abdominal pain and heavy bleeding regardless of age.
“Pills help such people to stop or reduce bleeding. People who have had abortion are given pills to stop or reduce bleeding. And women who are raped are also given pills for the same purpose,” she explains.
Grace however warns that pills contain both male and female hormones. They can react negatively in the bodies of barren women.
“It’s advisable for one to seek information about the pills from the health service providers before using them,” she says, adding that the user needs enough information about the pills because if she forgets to take the pill, she will get pregnant.
Grace says that although the 348 condom users they received in May alone indicate a positive public attitude towards FP, the turn up of males is still as low as 5%. “On average, 50 people come for FP services every month,” she discloses.
She says the centre is always equipped with pills and a standby doctor. She adds the centre offers injectables, condoms, minor surgical procedures like tubal-ligation (informally known as getting one’s ‘tubes tied.’ This is a permanent form of female sterilisation, in which the fallopian tubes are disconnected and sealed in order to prevent fertilisation. There is vasectomy (the cutting of sperm ducts to bar sperms from flowing to fertilise the woman’s eggs) and Norplant implant (capsules inserted under the skin of a woman’s upper arm – to prevent pregnancy).
Asked about the challenges of FP methods, Grace says illiterate patients don’t understand the lessons offered to them. She adds that besides ignorance, peer pressure obstructs the health service-providers from passing on FP information efficiently and effectively.
Grace says they are also facing a problem of myths and misconceptions about using FP methods, which the media should help highlight on thus providing the right information.
“People falsely believe that contraceptives: reduce fertility, reduce African population, make woman grow beards and break voice, can penetrate the baby’s brain, stop libido, make one sick, make the woman cold, create abnormal babies, cause cancer…,” she says.
However, commenting on HIV/AIDS, Grace says that government should emphasise and facilitate the carrying out of public awareness and training to reduce stigma and denial.
“Some men have divorced their wives who release their results to them after testing HIV positive,” she discloses.
The Nursing Officer in the Anti-Retroviral Therapy (ARP) department, Rose Kateeba says they get 30-60 people to take anti-retroviral drugs or ARVs everyday.
“Among those, men are few – yet the same men need information about family planning - given the fact that they are HIV positive,” she reasons.
She says that people don’t want to disclose their sero status over stigma. She adds that the majority of people who come here for ARVs are women. “Even some women come here without the knowledge of their husbands,” she says.
Kateeba, who reasons that men should also be sensitised about ART services, urges men to use condoms and come for ARVs that are abundant at Mukono health centre.
“However, the centre has no drugs to treat opportunistic infections. And the place here is too small to accommodate big numbers of patients and seekers of family planning service,” she discloses.
The Peer Educator from the Elizabeth Gladier Paediatric AIDS Foundation, Maria Nakzibwe says they have commenced carrying out public sensitisation about FP to save the lives of HIV positive mothers.
“We encourage mothers to test for HIV every time they go for antenatal care because the more children an HIV-infected woman gets, the weaker she becomes,” she says.
Nakazibwe, who boldly declares that she is HIV-positive, says she has one child who is HIV-negateve. “And I’m not willing to have any other child because of my condition,” she vows.
Nakazibwe, who lost her husband to HIV/AIDS recently, says that out 60 people they sensitise about FP, about 20 are men. “Most men have come to believe in a myth that contraceptives cause fibroids! Our people need a lot of sensitisation,” she says.
Asked about adolescents’ use of contraceptives, the Deputy District Health Officer for Mukono, Dr. Anthony Kkonde says that there are many private drug shops and retail shops, and they can’t know the rate at which the under-age group takes contraceptives.
He explains that they have over 200 drug shops and over 50 retail shops in Mukono and the operators don’t tell them how many pills or condoms they sell in a day and who buys.
“We don’t expect adolescents under 18 to go for pills! But in case of defilement or rape, we carry out examinations and then give the pills to the victims to heal up and prevent the possible transmission of HIV,” Dr. Kkonde says.
About the disadvantages of pills, Dr. Kkonde says that taking pills everyday is tiresome; and one might forget to take them and get pregnant.
He says men don’t allow their wives to take pills or even go for regular FP training. “Family Planning has not been overtaken by HIV training, treatment and prevention as it seems to be, but it is only because a few people go for family planning,” he says.
Dr. Kkonde says the issue of male involvement in FP is still a problem. “Maybe it’s a culture of men or maybe they spend a whole day at the workplace and report home late in the evening,” he thinks.
He says they have programmes to sensitise men and women about prevention of mother-to-child transmission of HIV (PMTCT). “Under that programme, we always call a mother and a father and sensitise them using peer educators,” he says.
Asked about whether the government has catered for quality and sufficient health in public health centres, Dr. Kkonde says, “Government is doing fairly but not enough, definitely. We don’t have enough medical personnel,” he says.
He adds that there is insufficient infrastructure in place and the supply of the required services is inadequate too.
Ends.
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