I recently spent 15 days traveling in Africa and, naturally, my curiosity about all things sexual led me to ask questions. I was pleasantly surprised by how open and willing people were to talk. All three countries I visited - Botswana, Zambia and Zimbabwe - had free and readily accessible family planning through their Ministries of Health. The most common methods used were pills (known as tablets), the shot (known as injectable) and implant. I’ll cover condom use and HIV in a future blog.
My first conversation about family planning was on a 5-seater plane between Chobe National Park and the Okavanga Delta in Botswana. A former Peace Corps volunteer, Debbie, was the roving nurse for the Wilderness Safari Company. She flew between tented camps throughout all three counties we visited, administering to the various needs of the extensive staff at each camp. She said family planning was readily accepted, free and easy to get. Botswana, in particular had a relatively low birthrate for many years. A bit of research led me to the fact that International Planned Parenthood Federation started work with the government of Botswana in 1969.
According to Mwani, the manager at the Lufapa Tented Camp in Zambia where we spent 3 days, all types of birth control are available in Zambia at no cost. Usually, birth control is not given until after the first child is born. Most commonly, a shot is given, unless the new mom strongly objects, at her six-week postpartum visit. The pill and shot are what is most used, but when I mentioned the ring, patch, IUD and implant, she said they were all available, too.
One of the most interesting conversations was with the daughter of a village headman in very rural Zimbabwe. Our group of 12 was seated in a large circular mud and thatch hut where the patriarch and leader of a village of around 500 held his regular meetings to solve family and village disputes. Mr. Johnson was surrounded by his sons, their wives and children, his wife, and his father’s second wife, who happened to be 7 years younger than him. Any question about “women’s issues” he deferred to his daughter and daughter-in-law.
When asked about family planning, his daughter confirmed what I had heard in Zambia. All methods were available. The average family size was 2 or 3 children. A van from the Ministry of Health came to the village once a moth to distribute supplies, give prenatal care, immunizations and administer basic health care. Babies were now delivered in the hospital instead of within the villages.
Every conversation I had was so matter-of-fact and natural. Even though all 3 countries are mostly Christian, there was no controversy about the use of family planning. Sometimes where you least expect it, sanity reigns.