The birth control burden

The South Africa government rolled out a free implant contraceptive that has become a burden for women across the country.

BIRTH CONTROL BLUES: Implanon Nxt, a small implant that gives women up to three-years of birth control, has been causing some of its users side effects such as excessive menstrual bleeding and fatigue. Photo: Lebo Mashiloane

BIRTH CONTROL BLUES: Implanon NXT, a small implant that gives women up to three-years of birth control, has been causing some of its users side effects such as excessive menstrual bleeding and fatigue. Photo: Lebo Mashiloane

 

 

Two years ago the government introduced a free contraceptive implant to the public health sector in what it called “the biggest family-planning programme South Africa has ever seen”.

But today, many young women are queuing to get the implants removed after complaining of side effects including excessive menstrual bleeding, dramatic changes in weight and fatigue.
And at Wits, the number of requests to remove the devices now exceeds the number of people getting the implant.

According to the Wits Campus Health, the clinic is currently at a stable rate of about three implant insertions a day and have about four requests for removal.

Matapelo Chauke*, a third-year Architecture student, is one of the students who has requested her device be removed. She has been on the free contraceptive for less than a year and is now living with the regret.

“It’s a nightmare,” Chauke said.

For Chauke, her troubles began shortly after having the implant inserted. “I got it last year around June and basically from the moment I got it I started experiencing the side effects,” Chauke said.

“The implant makes me really tired, I’ve lost so much weight and I’ve been bleeding excessively.”

“Look, it’s been a great contraceptive, you really can’t have much sex with it anyway,” jokes Chauke.

Sister Yvonne Matimba, head of Campus Health, said that when administered appropriately, the implant is safe. However, in many cases the “right patients” are not selected and patients are not informed fully about how it is going to work.

“We have had some of our own patients returning for the removal procedure, and others who had the implant inserted elsewhere,” said Matimba.

However, while some people do need to have the implants removed for medical reasons, others do not.

“One patient requested the removal of her implant due to fatigue while another sited her mother’s disapproval as her reason for the removal procedure,” Matimba said. “But most of the cases the clinic received are of students experiencing excessive bleeding over a lengthy period of time.”

However, Matimba said the clinic finds that some of the requests for removal are sometimes not as a result of the real side effects but because of perceived side effects.
“We don’t encourage them to stay on it, we are too quick to remove,” said Matimba.

Removing the devices can be a problem as well. The Treatment Action Campaign told Wits Vuvuzela that doctors and nurses had not been properly trained to remove the implant during the roll-out. In Mpumalanga, they claimed doctors were refusing to remove the device.

Sister Matimba said it was a challenge to remove implants that were inserted by other nurses or doctors. “We have had cases where we have struggled to take [the device] out. There was a girl who said she could feel it but I suspect she could have put on weight and could no longer feel it.”

“What happens once you gain weight, under the surface becomes fat and fat is very soft so anything can sit in the fat tissue which means you need to go really deep to get it,” said Matimba.

The devices were rolled out in 2014, when Health Minister Aaron Motsoaledi told of plans to introduce the female contraceptive Implanon NXT, a plastic matchstick-sized rod that is inserted under the skin of a woman’s upper arm. Each device is valued at R1 700 each and was made available to women across the country.

Motsoaledi called the campaign “the biggest family-planning programme South Africa has ever seen”.

The implant has been available at Wits since 2014, however the university was not part of the government’s initial strategy plan.

“Later on they may have realised that they left the entire education institutions behind and most young females are in university so they started targeting universities, particularly those who have family planning,” said Matimba.

 

*not her real name

“You should go see Josh”

weightloss-1

AT HIS BEST: A now healthy and strong Joshua Irwin at the Wits gym.
Photo: Sibusisiwe Nyanda

Joshua Irwin had been overweight all his life. During his first year at Wits, his weight reached the point that he was forced to use the disabled parking area.

He remembers the shame of being “effectively disabled” by his weight. At his heaviest, Irwin weighed 130kg.

But two years ago, the third year Psychology major took matters into his own hands and, on his own healthy eating plan, Irwin lost 55kg in eight months. And this year, the self-confessed former sugar and carbohydrate addict took his quest for health a step further.

He is now a nutritional coach and personal trainer. The business idea came to him after he joined the Wits gym and saw “most people doing stupid things”. He became the “go-to guy” after people heard about his success.

He has since landed 13 clients, eight of whom are fellow Witsies. A former anthropology major, Kirby Randall, lost 12kg on his plan. Irwin claims another client lost 9kg in two months and that his own mother lost 12kg after taking some of his nutrition advice.

Irwin’s approach to nutrition goes against some well-known theories about how to get healthy. He argues people don’t need six meals a day to function, especially because most people underestimate the portions they have.

He fasts 16 hours in a day and stays away from carbohydrates and sugar. “By accident I didn’t have carbs once and I decided to go a few days without.”
He says the cravings for unhealthy foods “disappeared” when he stayed away from bread, grains and sugar.
He also doesn’t believe in using food as a reward.
A friend once told him: “Never reward yourself with what you’re trying to recover from.”
At 77kg, Irwin has come a long way from the first year who couldn’t walk from student parking areas.
“Walking uphill and downhill from East to West Campus can be incredibly painful when you’re overweight.”

For a long while, he tried to lose weight but would gain it back. He saw nutritionists for help but felt their “cut and paste” eating plans were impersonal and out of date. Irwin said his confidence had taken a beating.
“I was just tired of it and it hurt. You get overlooked often. You’re not even in the friend zone – you’re just not an option because you’re not desirable.”
He enjoys being able to be more sociable now. “I remember feeling I was extremely visible for my weight, not because I was a nice person or because I was smart … It was just, you know, that fat white guy with long hair. People would have preconceived ideas about you.”

He believes being thin is linked to how well people deal with their past life experiences.
Nutritionists miss this point, he argues, and this leads to their clients not being able to conquer weight problems successfully.
Irwin plans to do his Honours and Masters in psychology, focusing on behavioural and eating abnormalities. He feels the person-centred approach of therapy will help develop more meaningful relationships with his clients.
He wants to be the “go-to guy” for fitness and health in Johannesburg and has his sights on famous South Africans.
“I want celebrities who have had weight problems to be able to tell their friends: ‘You should go see Josh’, because of my work.”
buyisiwe@witsvuvuzela.com