Contraception, or “Family Planning” as they call it in Papua New Guinea is a very sensitive topic. Rightly so… as there are often misunderstandings, fears and cultural and even religious beliefs that come into the equation. But despite it all, it’s one of my favourite topics!
One day you can hear a family tell you that they don’t need medicine because they boil up the roots of a special tree on their property that makes them sterile, while the other day you get a desperate mother with eleven children who’s had more than enough and wants to care for the children she has without having to worry about feeding one more. And being able to assist her in that way, and give her ownership over her health and that of her family is just very special. Too often I hear of unwanted pregnancies and unsafe abortions, which can be avoided by education and proper use of contraception. In some villages not a single soul will opt for contraception whiles in the next village multipara mothers queue up all day to get this precious medicine.
I usually start the day with introductions, a word of prayer and some health teaching. Most days I’ll do a family planning talk. If throughout the day I see that not many women come forward for contraception I’ll give another talk. Once in the Gulf Province during of those talks, I could clearly see the interest in the women’s comments, and reactions, but still no one dared come forward. I asked an older lady why nobody wanted family planning, and her response surprised me… “Their husbands aren’t here.” “Ok” I thought… let’s get the men here, educate them and get these ladies some life saving contraception! I turned around to find the village counselor and asked him to bring the men of the village for some vital health education. Some thirty minutes later, I started my speech all over again. This time making sure the men understood the risks incurred with every multipara pregnancy, the importance of adequate spacing for the mother’s recovery as well as the advantage it was for them not to have to travel to the health centre if they received family planning from us. The men agreed and the women received contraception. (We use mainly three types of contraceptives: oral/daily tablet, injection/quarterly Depo Provera, and sub-dermal implant good for 4-5 years.)
After I was done teaching the men, I asked one of the local health workers if he thought he could teach the men in the next village. He seemed uncertain, not too willing, and even ashamed… Which made me think I’d be the one teaching forever :(
Little did I know… when I asked Nitchkey, half-jokingly, the following day to use our family planning flip charts with a group of men just how well he would connect with those men!
He had a group of fifteen men who agreed to sit down and listen to this “important talk about women’s health”… they didn’t seemed too engaging but Nitchkey decided that he was going to get his message across…! So he pretty much opened up by saying: “If when your wife is about to go fetch water, you say ‘No, no, no honey, let me do that for you’… when your wife is about to go chop fire wood, you say ‘No, no, no honey, let me do that for you’… when your wife is needing to go to the health clinic you say ‘let me paddle for you’, you can be sure your wife will give you ‘the best in the night!’ ”
Suddenly Nitchkey had all their attention!!! He talked to them for nearly an hour… Talked about why it’s important for a woman to rest in-between pregnancies, comparing the uterus with a bow and an arrow. How a uterus that has given birth to more than three children is like an old and slack bow that can’t propel an arrow, just like a mother could die in prolong labour from weak uterine muscles.
He explained feeding the family in terms of limited resources. If a family has only one packet of bisket (4 dry navy-type crackers) and has eight children, each child would get half a bisket. On the other hand, if the family had only four children, each child would get an entire bisket or twice as much food.
By the end for his talk not only he convinced the men that family planning was the rightful duty of the head of the family but he also had a group of fifteen men say “You’re right Nitchkey, we should all get vasectomies!”
Needless to say, I was surprised by this outcome and Nitchkey was “voluntold” to do all of the remaining contraceptive talks with the men for the rest of our time on outreach! And he secretly loved it! ;)