Family planning body to set up special clinic for teenagers

By Gitanjali Singh
Stabroek News
December 29, 1999

The Family Planning Association of Guyana (FPAG) enjoys a 96 per cent success rate in advocating the use of contraceptives as a means of preventing unwanted pregnancies.

Dr Neville Gobin, head of FPAG, said that almost 96 per cent of the women who have visited the clinic and have had terminations have accepted that they need to use contraceptives to prevent such pregnancies.

The clinic, established in April 1998, is also a provider of termination services for low income persons, and insists on the use of contraceptives and only provides termination once to a person. The clinic charges $200 as a consultation fee and $1500 for the abortion as well as the contraceptives issued whereas private clinics charge as much as $5,000 for the abortion and $1,000 as the consultation fee.

To date, the clinic has facilitated over 5,200 persons for services including abortion, contraceptives or counselling. It has also trained three doctors to do terminations using the manual vacuum aspiration (mva) method. This is recognised as the safest method for abortions under eight weeks as against the dilation and curettage (d&c) and can be done using a local anaesthetic.

Dr Gobin, who underwent training in Rhode Island, USA in a training of trainers programme in the use of mva, said five doctors have been identified for schooling by the Clinic in January in the use of this method.

He said he would be willing to work on a programme with the Ministry of Health to course doctors countrywide in the use of manual vacuum aspiration for the termination of pregnancies.

"MVA is extremely safe compared to other methods of terminations and it can be done under local anesthesia. It can be done in the office in compliance with the law," Dr Gobin said. He also noted that the issue of parental consent for anaesthesia for minors will not hold as mva can be done using local anaesthesia or an anaesthetic bloc.

FPAG, in playing a meaningful role in reducing the incidence of abortion in Guyana, has also been providing counselling services, seen as key to abortion reduction in Guyana.

At a nominal cost (so that the clinic after five years will be sustainable), the clinic provides the intrauterine device, pills, condoms and injections to the most vulnerable who visit the clinic in New Market Street, near to Carmichael Street.

To date as well, FPAG has trained 59 health workers in counselling, 25 of whom are public health workers, mainly in Regions Three and Four.

"Here again we are not averse to going out to the regions (with the ministry) and train health workers in counselling," Dr Gobin stated.

FPAG has a reference training manual which Melissa Humphrey, who runs the clinic, said has been found to be very effective. Six persons were trained by FPAG last year, two of whom are public health nurses. One of the trainers is also attached to the prisons, another to the National Insurance Scheme and two to FPAG.

The clinic has a number of community health workers in Sophia and Cummings Lodge who provide counselling services to those areas.

Meanwhile, FPAG, currently funded by Family Planning International, has a number of plans for the future, including the establishment of a Teen Clinic to target vulnerable groups.

Dr Gobin said there is a high incidence of teenage pregnancy and a high level of sexually transmitted diseases among teenagers as teenagers are now sexually active around the age of 14.

He said many teenagers have died from AIDS and there is an increase in the incidence of cervical cancer which has its genesis in many partners or one partner having had many partners.

"We are hoping to establish a special clinic once a week, only for teenagers, with the main focus being education. There will be peer counselling by teenagers trained in matters related to reproductive health," Dr Gobin said.

He said the big issue for this teen clinic will be the promotion of abstinence from sexual activities and how to prevent AIDS and STDs.

He said that the medical cases which show up in the process will be treated. Dr Gobin noted that many of the teenagers whom the clinic intends to target would have already dropped out of school and it hopes to reach them via youth groups.

FPAG has already had sessions talking to students at Bishops' High School, Queen's College and Christ Church Secondary.

The second issue which the clinic intends to work on in the new year will be cervical cancer.

Dr Gobin said that given the seriousness of this issue with women in their 20s dying from cervical cancer and the lack of treatment in Guyana, the answer will lie in early detection. As such the clinic will be launching a comprehensive pap smear campaign. It will insist that all women attending the clinic should have a pap smear and any person desirous of doing so can visit the clinic.

Dr Gobin said in the case of an abnormal smear (not cervical cancer), the clinic will work in association with a US clinic to read the slides, and have the necessary investigation done. Funding is to be put up for this programme.

FPAG sees itself as having a positive impact on women's reproductive health in Guyana, and is not averse to working with the Ministry of Health in the interest of women's reproductive health.

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Guyana: Land of Six Peoples