The Covid-19 pandemic induced lock down is having tragic effects on the health of women and girls around Zimbabwe’s rural communities. Women and young girls have been cut off from sexual reproductive health services when nature calls.
Ms Monalisa Chingwere (25) is expecting her first child and has only set foot at a local clinic once for antenatal checkups since the beginning of the lockdown on March 30.
She lives 15 kilometres from the nearest clinic and her last visit to the health facility presented her with challenges.
“I went to the clinic which is 15 kilometres away, it was a challenge because I had to walk and upon arrival I was told by the health workers that they were only attending emergency cases because of the Covid-19 regulations, since then I have not visited the clinic,” said Monalisa who is seven months pregnant.
Chingwere is one of the many women whose access to Sexual and Reproductive Health and Rights (SRHR) services has been affected by the Covid-19 pandemic. The difficulties they are facing during the lockdown where conventional transport remains grounded presents a burden to the women.
Those who are due, have had to rely on unskilled traditional birth attendants for delivery. However, this has devastating costs for the baby or the mother.
“I managed to give birth with the help of an elderly birth attendant. Because of the transport situation I have not managed to visit the hospital,” said Ms Grace Kagura who gave birth recently.
According to a health worker at a rural clinic in Buhera District, they have had challenges with expectant mothers seeking antenatal services.
“Since the beginning of the lockdown we have been attending to emergency cases where one might be having complications but they have been very few. We have been turning away the rest of the women on the basis that we are understaffed as well as maintaining the Covid-19 regulations,” said the health worker on condition of anonymity.
In rare cases where transport is available, many expectant mothers and girls may not afford the costs as some vehicle owners take advantage of the situation by soliciting for sex.
In a country where sanitary wear is elusive to many rural folks, girls have not been spared from the scourge of the pandemic as they are forced to make do with unhygienic and primitive processes for their monthly period.
“Covid-19 has presented us with challenges, it has become a burden to go and buy sanitary pads. We have been under lockdown since the end of March worse still travel bans prohibit us. We are left with no option but to use worn out cloth and some are resorting to cow dung,” said 17-year-old Memory Murairwa.
The situation is further worsened by hunger and girls are forced to turn to risky approaches to feed themselves resulting in teen pregnancies and sexual exploitation.
Girls are least likely to return to school and are more vulnerable to abuse and violence at home when the defensive umbrella of education is under suspension.
According to Ms Ekenia Chifamba, Director at Shamwari Yemwanasikana, a community based non-governmental organisation that seeks to promote the rights and empowerment of the girl child, the pandemic has left girls and women facing real risk in accessing reproductive health rights.
“Girls and young women faced significant barriers in accessing essential sexual and reproductive health information and services before the Covid-19 crisis. Now, amid this pandemic they are forced to experience a real risk in accessing and enjoying their sexual reproductive health rights.
“We have witnessed that in most cases, sexual reproductive health services had been left in the periphery of essential services accessed under lock down. Additionally with a strained health system, access to sexual reproductive health rights services becomes highly inaccessible,” said Ms Chifamba.
She said the challenges brought about by Covid-19 will likely lead to high cases of sexual gender based violence and lockdown regulations will leave girls and women without essential contraceptives.
“These challenges in accessing sexual reproductive health services will lead to a shadow pandemic of high sexual gender-based violence (SGBV), unwanted pregnancies, illegal abortions, GBV and forced marriages.
“Most rural women fail to access services due to distance which is posing as barrier. Women and girls travel on foot for distances exceeding 20-30 kilometres. With the imposed travel restrictions, they are forced to go without essential contraceptives,” she said.
“We also notice the unavailability of free contraceptives which are the common methods used by rural women such as the pill, so they are forced to buy these products from private suppliers. Hence the cost implications have also presented barriers to access”.
Ms Chifamba said though her organisation has done radio programmes campaigning and disseminating information on sexual reproductive health, there is need to provide mobile services for rural areas.
“There is need to provide mobile sexual reproductive health services to women and girls in hard to reach areas. Such interventions will help bridge the barriers to access at the same time reducing public crowding in health facilities in respect of the lockdown regulations,” she said.
Ms Cynthia Gwenzi, advocacy officer for Platform for Youth and Community Development another community based organisation based in Chipinge says contraceptives are being sold in foreign currency which is beyond the reach of most girls and women.
“Women in Chipinge are facing a lot of challenges during this lockdown. Contraceptives are being sold in foreign currency and this is leading to unsafe sex and a number of unwanted pregnancies. Domestic violent cases are on the rise since victims are housed together with perpetrators and some of which are ending in death,” said Ms Gwenzi.
A factsheet by the World Health Organisation titled “Disaster Risk Management for Health – Sexual and Reproductive Health” says that in times of crisis, disruption in reproductive health services can lead to a range of adverse outcomes.
The factsheet identifies negative outcomes including an increase in sexually transmitted infections, possible spread of HIV, increased unintended pregnancies and unsafe abortions as well as maternal and neonatal deaths.