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Wednesday, June 23, 2010

Girls and HIV/AIDS

School girls: Pregnant and HIV Positive
By Angel Navuri,Karagwe
An overwhelming 85 per cent of all secondary and primary school students in Karagwe District who fell pregnant in the last three years tested HIV-positive, according to District Commissioner Fabian Massawe.
He made the revelation to stunned journalists and Women Dignity staff currently in the district to conduct research on the magnitude and impact of the problem of schoolgirl pregnancies.
“The problem is mainly the work of crafty men fond of sweet-talking gullible primary and secondary school students into unsafe sex,” said the DC.
“These evil-minded men turn to the poor students wrongly believing that children of such relatively tender age have not been infected with the Aids virus, but the consequences are catastrophic,” he noted.
Massawe said when he was transferred to the district in 2008 (from Kinondoni District in Dar es Salaam) the problem was serious “because the majority of students taken to hospitals for pregnancy tests also tested HIV-positive”.
“A total of 102 schoolgirls fell pregnant that year alone but last year the number dropped to 45 and so far this year 20 schoolgirls have been put in the family way. In all three cases, the number of those also testing HIV-positive comes to 85 per cent,” he added.
Given the seriousness of the problem, explained the DC, the government has had to intervene “by deploying a strategy of monitoring and arresting all those confirmed to have made schoolgirls pregnant”.
“When I was moved to this district, the situation was alarming but the government’s intervention has helped to lower the number of schoolgirls falling pregnant,” he pointed out.
Massawe explained that some of “these destructive men” lure the students with money and gifts such as cell phones which facilitate communication between them.
He said the government has also been arresting parents whose school-going children fall pregnant, adding that some schoolgirls are made pregnant by their own schoolmates or other boys.
“The holding of the respective parents is meant to help sensitise other parents on the need for them to make a close follow-up of their children’s movements and behaviour,” he stated, who went on to reveal that they also deployed “secret informers” who cooperate with police in arresting people dating or flirting with schoolgirls.
He explained that nine teachers have been taken to court charged with impregnating schoolgirls.
Meanwhile, Massawe said the challenges facing them in fighting against early pregnancies included the fact that the law is silent on the action that ought to be taken against schoolgirls falling pregnant.
“Our laws stipulate the action to be taken against those impregnating the girls but it is silent on the girls, while it logically ought to have dealt with both parties,” he argued.
He said another challenge was that investigations into schoolgirl pregnancies usually take very long, sometimes up to six years, before confirmed offenders are sentenced.
The DC appealed to the public to cooperate with the relevant authorities “at least by reporting incidents relating to suspicious behaviour or practices by schoolgirls so that this war is indeed fought jointly”.
Mamelta Martin of Iguruwa village in the district, one of the parents taken to court after her daughter was impregnated, said it was hard for her “because I had never imagined I would one day land in court because of misconduct by my own daughter”.
She said her daughter was 17 when she was impregnated by a young man some three years older, adding: “It was a really difficult time for me because the girl vanished soon after discovering that she was pregnant. Her father had declared that he did not want to see her in his house.”
The daughter, Macnsesia Martin, said when interviewed by The Guardian that she did not imagine that she would end up pregnant “and I profoundly regret what befell me”.
She said she was advised to seek an abortion but she could not do so because she had no money.
Dr Pascal Ndyamkama of Rwaybza Mission Hospital explained that the rate of early pregnancies in the district was “really high” and some girls had been tempted into seeking herb-induced abortions – which he said carried serious risks.
“Most schoolgirls seeking such abortions develop serious problems and are rushed to district hospitals and even referred to the regional hospital for specialised care. But sometimes it is too late,” he said.
He added that two students died earlier this year after attempting herb-induced abortion in the hands of traditional birth attendants.
Meanwhile over 700 mothers in Karagwe district have taken contraceptives as a family planning measure to help them have a manageable number of children.
Assistant nursing officer for Mother and Child Health (MCH) in Karagwe district hospital, Esheza Mwombela, revealed this when briefing journalists and Women Dignity staff who are in the district to research on the problem of fistula.
She explained that during this month alone 420 women underwent tubal ligation in which a woman would be sterilised to prevent fertilisation, while 310 opted for reversible hormonal contraceptive implants.
Mwombela said the government introduced the family planning initiative in rural families to help parents have a manageable number of children. She said the fertility rate was high with parents in Karagwe bearing between 8 and 12 children.
“Having such a big number of children is a burden because parents cannot provide them with basic needs and they are, therefore, most likely to live in extreme poverty,” she said.
She noted that the initiative had been successful since they started implementing it early this month after talking to parents on the disadvantages of having a big number of children they could not manage to look after well,” she said.
She said although most people believed having many children provided them with social security and respect, they were not aware of the future negative implications.
Mwombela mentioned the villages in which the family planning initiative was implemented as Bahamira,Kakiro, Kayanga, Kibagoizi, Ihembe, Ruhita, Nyakasimbi, Nyahabanga, Kanuli, Songambele, Nyamiyaga and Businde.
She said other strategies they deployed to curb the problem included provision of family planning pills and condoms to men although many of them didn’t like them.
This reporter managed to visit Igulwa village where she met with Ananias Fredrick, a man who decided to marry a second wife because the first wife could not deliver many children, while he needed more.
Fredrick said he believed having many children was good but since the first wife had only four children he was forced to marry another one so that he could have more children.
“Right now I have two children with the second wife and the first wife has four children but I need more children with the second wife because the first wife has health problems,” he said.Fredrick explained that poverty was not an excuse for him not to have many children because there were many ways of earning a living.
For her part, the second wife Merceliana Ananias said she could not control her husband because he needed more children and due to her health problem she allowed him to marry another woman if he so wished.
“My husband insisted that he needed more children and my health status could not allow me to have more children. So, I had no choice but to accept the situation,” she said.
The national family planning programme is the sum total of all family planning activities provided by various agencies – and coordinated by the Reproductive and Child Health Unit of the Ministry of Health and Social Welfare.
The government started providing family planning services as one of the Mother and Child Health (MCH) components in the mid-1970s.
The Family Planning Unit (FPU) was operational in 1986, and has been gradually strengthened to its present capacity and is responsible for initiating and developing family planning standards and guidelines on service provision, training and other aspects of quality care.

Bariadi: Family Planning methods uptake still very low
Angel Navuri,Bariadi,Report
Family planning services are available in over 90 percent of health facilities across the country but the number of women using them in Bariadi is too low compared to other regions due to high bride price in the community of Sukuma.
This was revealed by Dutwa health centre Clinical officer James Mranga when speaking to journalists and women dignity official who are currently in the area doing research on early pregnancy and fistula disease.
According to the clinical officer reckon only 14-15 percent of women in Bariadi use family planning services secretly without their husbands knowing as they don’t allow them .
“The number of women using these services in urban areas is higher than in rural areas but we don’t have formal statistics to show the disparity,” he said
Mranga said that many of the women could not start family planning because the price paid to the women family has to be paid back by giving birth several children.
“many of the women could not undergo any family planning in Bariadi district because the bride price to the women its high so she has to deliver children in according to the cows given to her family, “said Mranga
He added that its not easy to convince the women to start family planning for their own good because they are afraid to be divorced by their husbands and also it’s a shame to the family.
Giving details he said that from January to May this year only 30 women have undergone intra Uterine Contraceptive Device(I UCD) comparing to Karagwe distrct that per one month in May more than 700 women have undergone family planning.
Mrunga explained that they have been providing education to many of the areas but it has happen that tradition belive on high bride price and delivering children according to the number of cows given to the women family its so high.
Speaking on fistula cases in the area he said that no such cases has happened to the area because many the percent of early pregnancy its very low to the area giving an estimation of 2 percent of those students found HIV positive during pregnancy.
He explained that HIV positive among students in Bariadi who are found to be pregnant its low because of the education the medical staff have been providing to the schools of early pregnancy and infection of HIV to the students.
Speaking to some students many of them seem to have awareness on the disadvantages of early pregnancy and infection of HIV.
Mary Martias a form four student from Nyakabindi secondary school she said that the the teachers have been proving them with information on the disadvantages of early marriages and infection of HIV.
She said that the pictures shown for those who are infected with HIV they are scaring of which it has created fear to students.
“according to what l know l cannot gage the health status of a person by just physical appearance as he or she has to undergo HIV test and this what we are taught by our teachers and health staff who visits our school every time, “she said
Several NGOs and the MoPH are involved in the delivery of family planning services, which include professional advice on gaps between pregnancies and free distribution of contraceptives, including condoms, tablets and injections.
Lack of awareness and strong conservative traditions which often hamper women’s access to health centres are major reasons why family planning measures are not making much headway in the countryside, health experts say.
Backed by the government, UNFPA has been training imams from around the country on the benefits of family planning and pregnancy gaps in a bid to increase public awareness and reduce pregnancy-related maternal deaths.
However, health officials acknowledge the problems of reproductive health in rural areas go far beyond a lack of awareness or restrictive traditions.
Insecurity, the high prevalence of child marriages, the dearth of professional female health workers particularly outside urban areas, and the lack of roads in remote areas are some of the big challenges contributing to high maternal and infant mortality and morbidity,healthy officials say.
Speaking to Regina Maluga who visited brought her child to the hospital for treatment she said that her father was given a bride of 10 cows of which she has to give birth to 5 children’s meaning that two cows for one child.
Maluga explained that if she doesn’t give birth to five children that is equivalent to the 10 cows that was paid to her parents as bride then it’s a shame to the family.
“this bride issue of our parents accepting many cows its affected us seriously because even if we need to have few children its impossible because l have to pay the price of the bride given to my parents by delivering five children, “she explained
According to the Deputy head master of the school Joseph Lubeleo he said that HIV infection and early pregnancy in the school its in a low percentage and its because of the information provided by teachers and health staff.
He said that the way the information is delivered to the students in a reality way it has created fear to them in a way that they are afraid to tempt in sex involvement.
Giving details he said that since 2007 to 2010 those who were found pregnant were 9 students and were taken to cought although those students who were involved have escaped.
Lubelo added that the problem is many of the girls who are pregnant are not cooperative don’t mention the person involved instead they lie that the one who pregananted her was a business person who has already left the area.
On his part The Director for Bariadi Municipal said that the family planning education has to be provided to the men more instead of the women because the men seem to be sturbon on health issues.
He said that no matter how the woman would want to start family planning she can’t because the man needs more children.
On his part Nkololo dispensary Clinical officer Muhaloni Kicha said that many of the women cannot undergo any family planning because of their husbands who cannot allow them.
He said that the few women who undergo the family planning then they prefer having depo injection instead of pills so that their husbands could not find out.
Birth spacing through better pregnancy planning and the use of contraceptives is recommended by health experts and is believed to be instrumental in curbing preventable maternal mortality.
Birth spacing is also believed to lead to improved infant health, experts say.

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