Family planning for the third world woman

 

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Lydia is a young woman who sells tomatoes and seasonal vegetables along the bustling streets of Lusaka’s town center. Not the best way to make money- but with limited resources, little to no education and five children she’s doing her best with what she has. As close of business comes on this particular day she counts her coins. She’s hardly made anything. She saves her little money hiding it away in her wrapper opting to walk home instead of having to take a bus and spend money she really doesn’t have. 5 km is manageable she tells herself. As she approaches home, the sun has set and all her six children are waiting. Hungry. She puts together whatever scraps she can sacrificing eating herself in order to ensure all her children are somewhat fed. Not all her children though. While she fails to eat herself, she denies her seventh child who’s on the way the nutrients needed for any fetus to develop. Her husband? Down the road at the local tavern having his daily drink. As she puts her children to sleep in her two-roomed home she feels a deep sense of sorrow. I meet Lydia a as she sells tomatoes on the side of the street. I’m always looking for new stories and experiences to document. As she tells me her story, I ask Lydia if there was something she would change if she could. Something to make her life a little better. She says she wishes she would have been able to provide for her children. The years are passing and she’s been having children which she can’t support and here she is pregnant again. So, I ask “why have so many children?”. She responds by telling me it wasn’t planned, but there was nothing she could do. Having to go the clinic for treatment is too costly and too far. Even when she received free condoms from ministry of health her husband would completely refuse to use them. If she insisted she would be beaten. And while most nights he would come home in a drunken state, it became easier to comply. With her seventh on the way she’s filled with anxiety and fear. She cannot imagine another mouth to feed.

As I accompany Lydia to the clinic, which is a significant distance from her home- I meet Suwilange. She’s sixteen years old girl in high school uniform . She’s in line with other pregnant women at the hospital so I assume the obvious. I ask if she would mind answering a few questions. Reluctantly she agrees. I ask her why she’s there. She says she’s there to get medicine and for a antenatal visit. When I inquire about what medication she’s taking she responds in a hushed tone that she’s there to collect ARVs. She’s sixteen, pregnant and HIV positive. I’m lost for words, and amazed by her calm spirit. Almost as though she’s content. In a way I suppose she is. I ask her if she’s with someone- she shakes her head. Her parents don’t know. About her pregnancy or her status. She describes in detail how she found out months ago, that she was sick. She suspects it was from the father of her child. An older man who provided for her financially and sometimes provided food for her family. In exchange for sex of course. Unfortunately, the outcome was not so pleasant. She hasn’t heard from him since she told him about her status when she went to the clinic suspecting she was pregnant. The first question that came to mind was did she try to protect herself during her various encounters with this man? She says no. She never thought much of it. At some point some health workers visited her high school distributing contraceptives and educating students. She asked her partner to use protection, but he said he was fine so she thought nothing of it. She never actually thought she would get pregnant. Alas there she was in a three hour line at the local clinic facing her fate.

Lydia and Suwilange represent so many women in the third world who face the unfortunate consequences of not utilizing family planning services and not being able to make decisions about their own bodies. This is because of a number of reasons; but mainly because of lack of awareness, ignorance as well as limited access.

As I spoke to these women I got the feeling that if they knew that they had another option they would have taken it. Unfortunatly so many women are judged for taking precautions because its seen as wrong, disrespectful and in the African context un-African all together.

Family planning is a very complex topic in the African context. Only recently is it being widely accepted as an option and even still many still see it as a taboo. Culturally having children has a sense of pride attached to it, as to be expected. As years went on people were having more kids than they could take care of and even worse young girls- way to young- were being forced to have children when they were children themselves. Then came the spread of HIV/AIDS. To mitigate this, the government and various NGOs collaborated to bring family planning to Zambia. For women to have access to health services to make choices to better protect their health and well-being. Thing is: even still- it’s not the woman’s choice.

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Cultural pressure has made it so that something intended for the better is labelled as being against the norm. So, while health providers are providing contraceptives, and various health services, girls and women still steer clear. And while health authorities are aware of this little to no effort is being put in to ensure that access is provided information disseminated and contraceptives are actually being used. On a recent visit to a major hospital to find out more about family planning and Zambian women, a gynecologist there told me that the biggest hurdle for family planning in Zambia is fear. Fear of this medication that could jeopardize their relationship/marriage if their partner/husband or extended family are against the use or, prevent them from having children or sometimes they prefer to use traditional methods encouraged and once used by their elderly womenfolk, but whose efficiency cannot be verified.

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In many ways women, don’t actually get to make their own choices which concern their lives /bodies, and this is because of many perceptions. In many third world contexts societies are male dominated. In male dominant societies, female well-being is a selective priority. Family planning goes beyond just condoms. It’s includes various contraceptive methods and access to health care services that could save women’s lives. While I could go on and on about how wrong this is, the real question is: WHY? Why is this a still a problem? While in other parts of the world the health access scale is so well balanced, we have so many bridges to cross as concerns myths, getting across the right information and right products. This pace is slowed by autocracy at grassroots as there is usually and hierarchy to follow before approaching the womenfolk. More often than not this autocracy is headed by the menfolk… Using contraceptives isn’t a taboo nor does it make one less of a woman! Now is the time to recognize the importance of female health, ensure access is made easy, educate the masses, and for the Zambian woman to be able to make her health a priority. Food for thought… ∞

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