DevelopmentFeature

Adolescents groping in the dark

 

Youth-friendly interventions array of unfounded misconceptions that drive school-going boys and girls into danger zones. JAMES CHAVULA writes.

Right now, I’m coming from the theatre where a 17-year-old has just undergone a caesarean delivery,” states Dr Albert Mkandawire, the district health officer for Nkhata Bay.

Nkhata Bay District Hospital is the biggest health hospital in the district
Nkhata Bay District Hospital is the biggest health hospital in the district

The shoreline district’s largest hospital, with 150 beds, is overwhelmed by patients. The surgeon reveals how teen mothers overstretch healthcare delivery as most of them require surgical operations.

“Teen pregnancies are naturally risky and the C-section makes delivery more expensive. It needs a surgeon, a nurse and two more assistants in the theatre. After giving birth, healing takes longer than normal births,” he said.

The doctor offered a glimpse of a graver information gap that puts numerous teenaged Malawians in danger of unwanted pregnancy and sexually transmitted infections (STIs), including HIV and Aids.

Pregnancies are a result of unprotected sex, a common risk factor for STIs and HIV infections.

But if a green tree is burning, what will happen to dry ones? Do these young mothers know their status and that of their sexual partners? Was the baby by choice or unplanned? Were condoms handy?

The Constitution bars girls below the age of 18 from marrying. The unmarriageable age group constitutes 57 in every 100 Malawians, according to 2010 Demographic and Health Survey (DHS). This means under-18s add up to about nine million of the country’s estimated 16.3 million population.

Experts say the early onset of parenthood raises the likelihood of a woman to have more children in her child-bearing age. According to the DHS, the country’s total fertility rate is at 5.7, which means an average Malawian woman is likely to have about six children.

Unfortunately, Malawian youths have scanty access to sexual and reproductive health services, partly because culture makes sex a taboo.

‘Damned if you do, damned if you don’t’ is the reason the sexually active group winds up at-risk. Some of those that visit a clinic in search for contraceptives watch over their shoulders to ensure nobody is watching them.

Like extra-marital affairs, sex before marriage is hugely detested by both cultural and religious norms.

Learners at Katoto Secondary School talked about some health workers being unfriendly to youths that seek condoms, which safeguard sexual partners from both pregnancy, HIV and other STIs.

“Some stare at you like a criminal, almost saying: ‘your parents must know this!’. It’s frightening,” said a Form Three student.

Choosing to ignore sexual activity among the youths has left the country with a rapidly growing population and HIV infections.

Keeping girls in school delays child-bearing and reduces the number of children in womanhood, says UNFPA assistant representative Dorothy Nyasulu.

To Nyasulu, child pregnancies and HIV infections offer a renewed call for youth-friendly outreaches to provide adolescents with correct information about sex and how to protect themselves from perils of unprotected sex.

“Where do they get information?” she asks. “Are they reliable sources? Is the information accurate?”

As the boys and girls grow, she argues, they tend to associate with their agemates more and more. Peer pressure sometimes drives them to trying out risky behaviours.

Nyasulu’s questions abound: “What is better: Parents to lead the way in discussing sexual issues with their children in a truthful manner or to let them get into risky behaviour due to misinformation?”

To the population expert, opening up is a must to safeguard the leaders and workforce of tomorrow.

Mkandawire concurs: “The youth face difficult choices. They want to have condoms, but they cannot access them. Some need antiretroviral drugs, but they need safe spaces: with no prying eyes.”

Accordingly, Nkhata Bay hospital has youth-friendly clubs where under 24s living with HIV meet every month, discuss shared realities, ask burning questions, cheer up the sick, encourage each other to take ARVs and remain in school.

Their success stories include emancipation of peers who acquired the virus through parent-to-child-transmission and grew up taking life-drugs without being told why.

Together, they have become agents of change. They sensitise their peers against risky sexual behaviour with their lakeshore setting’s vibrant tourism and nightlife culture plunging girls and boys into sex work.

“In Nkhata Bay, about 30-40 percent of 5 000 people on life-prolonging drugs are below 30,” says Mkandawire.

Safeguarding the dominant adolescent population guarantees the country the healthy labour force it needs to jumpstart the economy.futures. n

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