Why Birth Control is cheaper and better in Sierra Leone….


                                             (image of me holding the coil)
Generally the thought of seeking care at a local medical facility is scary. Like many other sierra leonans, we know someone who knows someone, who was feeling fine, went to the hospital, and a misdiagnosis led to an untimely death. In the case of my grandmother, she spent months in pain, with doctors unable to diagnose that she had cancer until she was flown to the States for care. It is a running joke that everyone in Sierra Leone has traces of typhoid and malaria, because no matter when, where, or how one goes for a blood test, it always comes back positive for those two ailments. The problems in our barely there medical system are pervasive, so you can imagine how excited I am to discuss something positive in health care.

On this season of the Vickie Remoe Show we’ve decided to do a show on reproductive health after a series of blind date shows made me realize that many young people were misinformed about reproductive health. Whether it was issues relating to birth control and contraceptives or gender based violence, young women especially seemed to be making poor decisions.

In a segment of the show already recorded, I went into the MarieStopes-SL Clinic on Ahmed Drive to receive family planning advice. I had already decided that I would choose one of the birth control plans on offer during the taping of the show after learning that only 8% of the nations adult women used any form of family planning/contraception in comparison to about 24% in Ghana. Growing up in Banana Water a coastal fishing community off MurrayTown Rd, the statistics confirm the norm, as our girls and women are known for early and unplanned pregnancies, which in turn explains high maternal and infant mortality rates in the community. In Banana Water when a girl makes it beyond form 3/Grade 9 without getting pregnant, it is an anomaly.

On the day of our shoot, I went to clinic and registered as a regular patient. Then I met with a sister nurse with 30 years of nursing experience who explained each family planning method they had available at the clinic.
There was the coil, the implant, the Depo injection, the pill, the morning after pill, and male and female condoms. I have vague memories of the coil and the implant from childhood but as a gossip and urban legends of things that nasty raray gyals and prostitutes did.  The “t” shaped coil lasts for up to 10years as a birth control device once inserted in the uterus, while the silicon based coil lasts for up to 4 years once inserted in the upper arm. I was amazed at how tiny both methods were and i wondered why they weren’t promoted in the States where the anti abortion campaign is so passionate. I decided on the silicon Zarin implant and after 5 minutes in the operating theatre i was good to go. I got a fee waiver for my implant which regularly costs Le.9,300 ($2.00), ridiculously cheap.

The Zarin Implant is manufactured by a Chinese Pharmaceutical company (in use in Chine since 1994, and up to 99% effective), the implant is made up of two silicon rods containing 75 mg levonorgestrel (a synthetic progestin). I found that while i knew nothing about this method of contraception while i was in the States that it is available. The USDA approved implant brand currently prescribed in the States in Implanon, which is a single silicon rod that works for up to 3years. Some insurance companies cover some of the costs of the implant but i found that Planned Parenthood charges anywhere from $400-$800 up front for the procedure. That is crazy!!!

So there you have it boys and girls, even though the rate and use of contraception is low, here in salone it is more affordable and accessible, and i will argue that we have better here than in America. I am planning on going on a campaign to educate young girls and women about Reproductive Health but for those of you in the States possibly tired of the pill, next time you are on holiday for christmas know that you’ve got the hookup on the implant and the coil. My implant has healed already and I am happy to say that this little bird shall have no unwanted pregnancies. As they say in MarieStopes, babies by choice and not by chance.

for more information on family planning in Sierra Leone visit www.mariestopes.org.uk 

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