Once bitten, no contraception

 

Men bite! This is a familiar soundbyte to warn girls against premarital sex.

But it turns out that some women in wedlock are literally living with scars of their husbands’ bites.

Some men in the country are taking their resistance to family planning to bizarre levels by chewing off their wives’ muscles to get rid of implants.

Health workers in the Eastern Region have disclosed treating wounded arms of women whose partners cannot tolerate the contraceptive chips buried in biceps.

A health worker inserting an implant in a client’s arm

“Three years ago, one came with a bleeding wound. She was visibly in pain,” says Mangochi district family planning coordinator Joyce Chalusa.

The nurse-cum-midwife put the wound in context: She revealed that her husband had first attempted to remove the implant using teeth.

“When this failed, he used a razor blade and a needle to poke it out. Her husband did not want it, certainly.”

The wound was producing puss, she recalls.

“We couldn’t remove the implant immediately. We had to wait for the incision to heal first,” Chalusa recounts.

According to health workers, the brutal removal of implants in homes mirrors men’s hostility to contraceptives.

“There is a widespread myth among men that if a wife is on contraception, her husband will become weak in bed and infertile. But this is not true,” she says.

These misconceptions slow down the uptake of long-acting, reversible contraceptives.

Almost 70 in 100 women in Mangochi use injectable contraceptives, which work for three months, because they find it discreet.

But it requires a woman to get a new injection every three months.

Apart from frequent visits to clinics, it puts a woman at risk of an unintended pregnancy if she forgets to take the jab in time.

The risk is worsened by stock-outs of supplies, which compel some women to switch to implants.

Jadelle implants prevent pregnancy for five years while microganon works for three.

Skilled health workers say they take almost 10 minutes to place the implant in the upper arm.

But they need almost 10 minutes and painkilling injections to remove it.

“I cannot imagine the pain a woman endures when an angry husband removes the implants without necessary skills, tools and anaesthetic drugs,” said Machinga family planning coordinator Elizabeth Katunga.

She outlined the ills of the brutal, home-based surgeries.

“It’s not easy to remove it. It requires skilled hands. Women lose lots of blood and the wounds are susceptible to germs, especially bacterial infections, as these irate husbands use non-sterilised objects which may cut arteries and veins. Unfortunately, it happens in a clandestine environment which is usually unsafe,” says Katunga.

In the country, a woman requires her husband’s consent to seek health services.

Some women own two health passports to make their family planning history a top secret.

They leave the health book for family planning in concealment or at the clinic and take the other, meant for general ailments, home.

At Ntaja Health Centre, nurse-cum-midwife Rozerio Jere keeps a bunch of health passports for women whose husbands detest contraceptives.

“The women are afraid of a backlash from their husbands who would beat them if they took the top secret health passports home.

“Actually, some men approach us to remove the implants, saying their wives did not seek consent first. We mediate and clarify matters until we reach a common ground,” she says.

The challenge of getting men involved in ensuring every baby is wanted is immense, says Salima district family planning coordinator Elizabeth Chalera,

“If women ask us to keep their health passports, the situation is not okay at home. Men do not want to take part. We need to raise awareness to change the misconception that family planning is meant for women only,” she says.

For her, male involvement goes beyond men encouraging women to space children.

“It’s about couples going together to clinics to seek family planning services, getting the information together and making choices hand in hand. In fact, the man should take vasectomy,” says Chalera.

According to the nurse, almost 53 percent of women in Salima use modern contraceptive methods, but almost not a single man is on vasectomy.

The rate of men using any other contraceptive method, except condoms which protect users from unwanted pregnancy and sexually transmitted diseases remains negligible nationwide.

“In our culture, children are almost everything. Those with few or no children are frowned upon. This is why men create myths associated with infertility so as not to take part in family planning,” says Christopher Dinesi, one of 19 health assistants at Mlomba Health Centre in Machinga.

He started offering contraceptive services in 1998, but cannot remember any man asking for vasectomy.

However, this year alone, he has encountered three women with “rotting wounds” caused by men who do not want anything to do with family planning.

“All of them had shocking wounds. These are isolated cases, but more cases could go unreported. They do not come for treatment when the wounds heal without any complications.

“This is the tragedy women face in a culture where men want children now. They cannot wait for three to five years until the implants are due to be removed,” says the HSA. n

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