Letters to the editor: May 29 to June 5 2015

Implant used safely by millions of women

Ina Skosana’s article, Birth control implant needs a shot in the arm, highlighted challenges with South Africa’s recent roll-out of the contraceptive implant, but didn’t discuss the importance of other options for women. More options mean more women can find a method that suits them.

Contraceptive use in South Africa is more prevalent than in many other African countries but bears vestiges of our political history. Under apartheid, the contraceptive injection was aggressively promoted among black women and it remains the most commonly used method today.

The national department of health’s February 2014 Contraceptive and Fertility Planning Policy and Service Delivery Guidelines championed new and existing but under-utilised contraceptive methods and places access to services in a human rights framework. The guidelines also took into consideration the debate about whether the hormonal contraceptive, the medroxyprogesterone (or Depo-Provera) injection, is linked to HIV acquisition and transmission. There is no definitive answer yet, but the guidelines wisely aim to reduce dependency on the method.

The introduction of a subdermal contraceptive implant was part of the strategy. Roll-out was quick. A 2014 campaign championed contraceptive use generally, but only the implant was highlighted by the minister in Parliament. The mid-term review of the Maternal Child and Women’s Health Strategy revealed concern about implementation, informed consent and quality of care.

Some outcomes were highlighted in the Mail & Guardian. Some operational challenges persist: training, confusion about which healthcare workers are responsible for insertion and removal, and delays in achieving competence. A new national service roll-out needs careful planning and monitoring, with the health and safety of those targeted by the service as the primary consideration – not speed or the production of statistics.

The implant, including the brand available in South Africa, has been safely offered to millions of women globally since the 1960s. Women need access to it in South Africa, albeit with improved management on the part of the government.

The guidelines are excellent. Blaming healthcare providers on the ground is not helpful, and not always justified. Many work in very difficult settings. South Africa requires stronger leadership at the national, provincial and district level if strong policies are to be implemented safely and adequately.

Efforts to increase contraceptive access and uptake must be carefully managed, taking into consideration the safety and appropriateness of particular methods for women with contraindicated conditions. Access to male condoms and vasectomy should also be scaled up.

No matter what method is being introduced or promoted, women’s rights and preferences must be respected; their safety is the utmost concern. – SHARISA/Sexual and Reproductive Justice Coalition with assistance from WISH Associates and Naomi Lince-Deroche

Holocaust is now part of the school curriculum

We endorse Mia Swart’s statement about the “almost unbelievable ignorance combined with poor education and judgment” revealed by the former student representative council president of the University of the Witwatersrand, Mcebo Dlamini ( Verwoerd would love Dlamini).

She says “the lack of Holocaust education in our schools is scandalous”, and that “Dlamini’s ignorance is an indictment of our educational institutions”.

Swart will be pleased to know that, since 2005, Holocaust education has been a compulsory module in the grade nine social science history curriculum in all government schools and more recently has been introduced into the grade 11 history curriculum.

A Holocaust Centre was established in Cape Town in 1999. From the outset, one of its overriding goals was to promote Holocaust and human rights education in schools. The Holocaust was only covered in a few paragraphs of history textbooks at the time.

The centre developed educational programmes and teacher support materials. It conducted a national seminar attended by curriculum advisers and subject specialists from seven of the nine provincial departments of education. The revision of the history textbooks began in 2002.

To meet the ever-growing need, the South African Holocaust and Genocide Foundation was formed and other Holocaust centres were set up in Durban and Johannesburg.

To date, almost 500 000 pupils have participated in programmes conducted by the centres and more than 180 training workshops have been held. There is still a great deal of work to be done in rolling out much-needed teacher training and classroom support materials. – Marlene Silbert, Cape Town Holocaust Centre, and Richard Freedman, South African Holocaust and Genocide Foundation

Witsies seem to essentialise ‘blackness’

The article Rhodes has fallen, now we must rise by the political science students from the University of the Witwatersrand grabbed my attention.

It reminded me of the debates we had in the mid-1980s at the University of the Western Cape about a “relevant” curriculum for psychology. The discussions led to a collection of all writings on apartheid and psychology, but also eventually in the 1990s to the teaching of Frantz Fanon and Lev Vygotsky as well as topics such as racism, sexism, trauma, and so forth.

What struck me about the discourse of the Wits students was the danger of essentialising “blackness” or “Africanness”.

Their focus on moderate black nationalist intellectuals reveals huge gaps. I could not help wondering about the exclusion of other ideological streams as represented by South Africans such as Isaac Tabata, Olive Schreiner, Benjamin Kies, Richard Turner, Govan Mbeki and Neville Alexander.

Glaring omissions were radical Africans such as Amílcar Cabral and Abdul Babu. Should a remarkable Algerian-French intellectual such as Daniel Bensaïd not be included? What about André Gorz, who wrote brilliantly on ecological disaster and the unemployment crisis? – Shaun Whittaker, Windhoek

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