Covid-19: Blocks mean millions of women cannot achieve birth control

JOHANNESBURG: The callers wept. One by one, women in rural households in Zimbabwe had a pleading question: when would family planning services return?

Blockades imposed to curb the spread have put millions of women in Africa, Asia and elsewhere out of reach for contraceptives and other sexual and reproductive health needs. Confined to their homes with their husbands and others, they face unwanted pregnancies and little idea of ​​when they can reach the outside world again.

In these uncertain times, women `` have to close the uterus, '' Abebe Shibru, Zimbabwe's country director, told The Associated Press. `` But there is no way in a rural area. ''

Eighteen African countries have imposed national blockades, according to the Centers for Disease Control and Prevention in Africa. All but essential workers or those seeking food or medical care should stay home for weeks, perhaps longer. Rwanda, the first country in sub-Saharan Africa to impose a blockade, has extended it for two weeks, a possible sign of what is to come.

Even where family planning is still available, providers say many women fear venturing and being beaten by security forces and accused of defying the new restrictions. Meanwhile, outreach services, the key to reaching rural women, have been largely halted to avoid drawing crowds and the risk of workers spreading the virus from one community to another.

The International Planned Parenthood Federation, or IPPF, in a new report on Thursday, says more than one in five member clinics worldwide have closed due to the pandemic and related restrictions. More than 5,000 mobile clinics in 64 countries have closed. Most are in South Asia and Africa, but Latin America and Europe have also seen hundreds of closings.

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From Pakistan to Germany and Colombia, IPPF members say they have reduced HIV testing and response work on gender-based violence and face contraceptive shortages.

`` They have needs that cannot wait, '' IPPF CEO Alvaro Bermejo said of women in a statement, asking for help from national governments to help provide personal protective equipment that allows intimate care.

For most people, the coronavirus causes mild to moderate symptoms, such as fever and cough. But for some, especially the elderly and the sick, it can cause pneumonia and death.

In Europe, 100 non-governmental groups on Wednesday called on governments to guarantee reproductive health services during the pandemic, saying many facilities have drastically reduced or closed them.

The baby boom forecast in Africa alone, despite birth rates falling in many countries as more girls are educated, will add to the growth the continent of 1.3 billion people is already expected to see doubling its population by 2050.

In Zimbabwe, Marie Stopes provided family planning services to more than 400,000 women last year, Shibru said, including preventing nearly 50,000 unsafe abortions. But now the organization's outreach services, which reach more than 60% of customers, are suspended. Even in clinics that remain open, the number of clients has decreased by 70%.

That leaves a country of men, no longer free to work in the fields or elsewhere, and without the distraction of sports, confined to their wives for weeks.

`` Husband and wife, what else can they be doing in that house? '' Asked Future Gwena, a community worker from Marie Stopes. `` I think we are going to have a lot of pregnancies and, unfortunately, unwanted ones. And most will result in unsafe abortions, domestic violence. Our community is paternalistic. If something goes wrong at home, it's the mother's fault, even if the man started it. ''

Even in normal times, the average woman seeking contraception must obtain her husband's consent, Shibru said.

Meanwhile, travel restrictions and the slowdown in manufacturing in Asia as a result of the pandemic mean that some family planning providers are waiting for shipments of emergency contraception and other items as stocks run out at home.

`` Today I was expecting a shipment from Asia, but it is suspended, '' Shibru said. `` I don't know how to fill that void. He was supposed to come today to serve us for the next six months. So this is one of the tragedies. ... We expect a great shortage of contraceptives in African countries. Absolutely, condoms too. ''

In Uganda, Marie Stopes country director Carole Sekimpi said they do not know when an emergency contraceptive shipment will arrive because India, its source, has also been blocked. They have been exhausted for a month and also need oral contraceptive pills, he said.

`` Yesterday, when I heard (neighboring) Kenya talk about a confinement in Nairobi and (the port of) Mombasa, I thought: 'My God, what is going to happen to all our shipments? '', Said. `` Overall, there is definitely going to be a problem. ''

He was concerned about girls and women confined to homes with potential assailants, including uncles or cousins. His organization has suspended the scope, which provides approximately 40% of services, and clinics that remain open have seen a drop in client traffic of approximately 20%.

`` We don't see you anymore, '' say anxious callers. What is it? ''

Even the capital, Kampala, has been affected. Sekimpi said he visited a large government-run hospital there on Monday, `` but when I got there, my heart was broken because the only service suspended was family planning. With good reason, because it's generally crowded. ''

She expects not only a baby boom, but also an increase in unsafe abortion and post-abortion care, along with panicked women trying to remove their IUD ( intrauterine device ) or implant contraception sooner than expected, as they fear no family planning worker will be around to help them later.

Even the US Embassy. USA In Uganda, she has taken note of the challenges women face, tweeting that `` periods don't stop for pandemics '' and sharing tips on how to make washable sanitary pads at home.

The variety of problems is similar across Africa, Shibru said in Zimbabwe, citing a daily call with country directors in Ethiopia, Kenya, Malawi, Madagascar and elsewhere.

`` Look, everything has been diverted to COVID, '' he said of the disease caused by the coronavirus. `` But after COVID, another catastrophe will be women's health, unless something is done right now. ''