I rode to the clinic early, hoping to go with Dr. Abdoul to Sambava to meet the leprosy patients who are cared for by catholic priests. Dr. Abdoul had already left when I arrived so I spent the morning with the nurses in the dispensary. Then I went back to the house to give Eric Lan’s mother her perfusion. This time everything went well. In the afternoon I arranged for a car that would take 6 girls from Belfort village to the dispensary for contraceptive implants. It wasn’t easy. Victorie the teacher had been trying to convince the young female students who are particularly promiscuous to consider the implant. Valerie from France had talked several girls into it. These girls are as young as 13 and Victoire told me they have not been sleeping in their houses in the village, meaning they are spending the night with men. She is very concerned for these young girls because she wants them to continue their education, not drop out of school with a pregnancy like so many girls here. This is a very sensitive issue because in the end it really is up to the girl. She is very young and maybe doesn’t make the best decisions for herself, but it is her choice. If she does not want somebody to surgically insert a progesterone pump into her arm, she should have to have it. The youngest girl, 13, was so scared when we arrived in the village with the bus that she refused to move her feet. Two men carried the screaming child into the bus and slid the door closed. “She is frightened,” Victoire said. I felt really unsure about this. She is refusing the treatment and we can’t just force her into a car to go have the procedure. “No no,” Victoire told me, “we won’t force her; I will have a consultation with her at the clinic and she will have a choice.” At the clinic she, along with four other girls, chose not to have the implant but consented to the medroxyprogesterone shot instead. This prevents them from becoming pregnant for 3 months as compared to the implant’s 3 years but neither provides any protection from SDIs. I see a lot of men with STIs in the clinic…
Sexual education is very important here. It must be supplemented with free condoms and promotion of condom use. It won’t work here to tell the girls to abstain. That is simply unrealistic. So they should be educated. They should know the risks. They should have access to the best protection, and in the end they should make their own choice. This is what I believe.
I gave the injections one at a time and when all was done the previously nervous, crying, screaming girls were relaxed and I even small one or two smiles. Done! But… in 3 months please come back.
Tracing Leprosy 