It's either long-term contraceptives or nothing for Boni women

Women in terror-prone areas of Lamu have been forced to endure long-term contraceptives due to the disruption of health services.

While the rest of the women in Kenya have a variety of contraceptives at their disposal, Boni woman can only choose either the coil and intrauterine devices.

The situation is worse for those whose bodies have rejected the devices as they have found themselves undergoing permanent procedures to avoid pregnancy.

Dispensaries in Milimani, Mangai, Mararani and Basuba were closed down after they were vandalized and torched by al Shabaab militants at the peak of terror attacks in Lamu between 2014 and 2015.

The situation is the same for women in villages on the Lamu-Somalia border like Kiunga, Kiwayu, Mkokoni, Ishakani, Ras Kiamboni, Sarira, and surrounding areas.

Those who want alternative and favourable family planning methods like the three-month Depo Provera injection and pills must arm themselves with fare to travel to King Fahad Hospital in Lamu island for the services.

Most, however, prefer the single costly trip where they have the long-term devices placed after which they travel back home and await another six months or so when they have to again plan the exhausting journeys back to hospital for checks or removal.

“If by bad luck the coil gets out or the implant gives you issues, you are unlucky because it is either you go back to hospital or persevere,” said Boni women leader Khadija Gurba.

There have been reports of women plucking hanging coils from their vaginas or,worse, having to pluck out implants from their arms using their kitchen knives just because they couldn’t afford fare back to the nearest hospital.

A single journey from Boni villages to King Fahad Hopsital in Lamu island costs not less than Sh3,000 on a boat.

The roads in these areas have been rendered impassable due to insecurity that has seen al Shabaab militants plant explosives that have killed scores of civilians and security officers.

Gurba says though long-term family planning methods have saved many of them the headache and cost implications of having to travel frequently to hospital, they don’t always work for everyone.

“It's not something they want considering many are still in their child-bearing ages but then there are no options for the women here,” Gurba said.

She said many have reported suffering side effects from the long-term methods but have been forced to live with the situation.

“Some of them will bleed daily and their sexual lives have suffered. There are no dispensaries here to help us experiment with what works for us. I tell them to hang in there and pray,” she says.

A huge number of these women however have no idea what contraceptives are and so live without.

Saida Abashumi, a mother of 12 in Basuba, says she doesn’t know where to start making inquiries about what works for her.

“I have a baby at least each year and it’s not like I want. My husband and I are poor and we definitely don’t need more kids but I can’t stop them from coming. I can’t also afford fare to Lamu island. So, I just manage,” Abashumi says.

Community leaders have urged the county and national governments to deploy health workers to these areas to enlighten Boni women on contraceptive use.

“Many women here don’t know a thing. Even those who use the implants and the like were coerced into it by friends. We need people to come down here and tell our women what to do and why so we can all live healthy reproductive lives,” said Maryam Muasham.

Boni men say they have been forced to rely on natural methods like withdrawal and calendar tabs to try to control their family sizes.

Boni elder Doza Dizo however said as the men of the community, they have no qualms with their women failing to plan their families and encouraging them to give birth to more kids.

“We are a minority community and that means our numbers are low, so we encourage our women to give birth as much as they can. We try natural methods sometimes but mostly we just do our thing and let nature take its cause,” Dizo said.

Boni community elder Sulemani Aden, however, expressed concern about the overuse of long-term family planning methods among women of child bearing age as it could affect their population.

“We want something that is quite reassuring like the three-month Depo or something just not these things they take for years, then normally getting a baby becomes difficult,” he said.

A recent report by the Lamu county health department indicates the region still has low uptake of family planning services at only 49 per cent.

Lamu county executive for Health Anne Gathoni blamed the situation on socio-cultural beliefs, myths about contraceptive methods as well as religious and cultural barriers.

“We are calling on the community and especially the men to take the front seat in these issues so that the women are not doing it alone. Our view is that people need to plan their families so that you can comfortably cater to them,” Gathoni said.

Edited by Henry Makori