Quality Health Care in a Beautiful Setting: Part Three
Carmen Barroso, Regional Director
When we accredit IPPF Member Associations, we work to assess the effectiveness of the association in providing accessible and quality sexual and reproductive health services. These ‘audits’ ensure that each affiliate complies with a comprehensive list of IPPF standards. As part of the accreditation, we also want to learn about the role our association plays in the country and how well it collaborates with other organizations working to advance sexual and reproductive rights and health.
In Suriname, we talked with directors of health organizations and hospitals, leaders of the women’s movement, a gay rights organization, an organization working with sex workers, and the Chair of the Parliament.
When I arrived to speak with Dr. Jenny Simons about our Member Association Stichting Lobi, I encountered a tall handsome woman with a discreet elegance who exudes authority and self-confidence. Dr. Simons, who has been a parliamentarian for 20 years and was elected Chair last year, is a medical doctor who is passionate about the national AIDS program, knowledgeable about our issues, and quite open to alternative views. Dr. Simons regards Stichting Lobi, our Member Association in high regard, and regards the team as a key ally in promoting sexual and reproductive health throughout the country. She thinks the Ministry of Health should offer more support to Lobi to ensure access to contraception in remote regions because she would like to see fewer abortions, and she is planning to address this issue in Parliament after more data is gathered.
In addition to increasing the accessibility of contraception, another opportunity for decreasing the need for abortions is the improvement of the quality of sexuality education in the schools. Dr. Simons proudly reminds us that Suriname in one of the only two Caribbean countries in which sex education is part of the core curriculum beginning in the third grade.
But Jacintha Dundas, a member of the Board of Stichting Lobi who is at the meeting, points out that the national curriculum is limited to providing information; there is no discussion about values, rights and skills in decision making. Dr. Simons thinks this should start with teachers and parents. Lobi has actually trained hundreds of teachers but very few of them were able to implement the new methods they learned because of the lack of support from their principals. Lobi is now following a different approach: on the job training for teachers in a few schools. Dr. Simons is open to taking another look at what the government can do to support Lobi’s work with teachers more widely because she clearly understands that sexuality education should be comprehensive, personal and transformative.
While we agreed with the desirability of decreasing the need for abortions, all of us also would like abortions to be safe when they are needed. And an area of concern in Suriname is the safety of misoprostol, a drug that women can administer to safely terminate their pregnancies. However, some women are getting it from unregulated sources in the market (rather than pharmacies) without quality control or instructions on how to properly administer the drug.
One approach would be to get the authorities to attempt to effectively ban its sale from sources other than pharmacies. Other countries have attempted this approach; however it became more difficult and expensive for women to get the drug, with some women resorting to even riskier methods that often lead to tragic results. A much better approach is the harm reduction method, which has shown results in other countries, which Lobi is planning to adopt. It basically consists of giving women the information they need to correctly use Cytotec (the brand name for misoprostol) and safely end their pregnancies.
Women are the best guardians of their health, and they will drive unscrupulous marketers out of business if given the correct information and access to safe medicines.