A health programme conducted by the SFPA mobile clinic team at a longhouse.
DESPITE sex-related information nowadays being just a click away from the Internet or TV channels, basic education on reproductive and sexual health is still lacking — or even taboo — in our schools and communities.
Based on reports that babies are being abandoned almost every day, there is an urgent need for the authorities and civil society to non-judgementally broach the subject which is still viewed as an anathema by most Asian families.
Sarawak Family Planning Association (SFPA), Miri branch chairman Susie Lau has stressed the need to promote awareness of sex education in the local communities, especially among the young.
Lau (right) after receiving a donation from head of the Consular Office of Japan, Hiroko Matsuo (left). Also pictured is SFPA Kuching chairwoman Wee Chong Hui.
“There’s a strong tendency to associate family planning with contraceptive pills. It’s actually not the case. But unfortunately, the stigmatisation has reached such an extent that the mere mention of the subject can cause misunderstanding and controversy.
“Being a non-profit organisation (NGO), we’re striving to provide healthy sex education, regardless of age,” she explained.
SFPA was set up more than five decades ago to improve reproductive health in Sarawak, especially in rural areas and among underprivileged groups to encourage a resilient family system.
While most of the members are volunteers, there are paid staff at static clinics to help clients on issues relating to their sexual health.
A chart listing out the roles and services provided by SFPA.
Sex education important
Lau said as sex education was important, especially among the younger generation, it was no longer a subject that could not be discussed.
According to her, a person’s physiological and psychological make-up changes with age and correlates to the environment. Therefore, adolescents need to have appropriate exposure and guidance to sex-ed so that they can learn to protect themselves.
Many may have been misled to focus only on aspects of physical and biological development. The holistic approach such as self-acceptance and being responsible to others as well as oneself are also vitally important.
Lau pointed out that stereotyping young, single women, taking hormonal contraceptive pills, as indecent, was still a concern.
“The hormonal pills serve more purposes than just for birth control. There should be no discrimination of any sort because single women could be put on the pills due to other health issues such as acnes, boosting metabolism and stabilising mensuration.
The SFPA building next to Miri Polyclinic.
“For older women, they could be taking the pills for pre-menopause transition period often under the doctor’s advice.”
Educating adolescents on contraception cannot be overlooked because it can affect their future.
“For youngsters coming of age, the curiosity about the body structure cannot be avoided. Without the proper knowledge and guidance, such curiosity can lead to rash action and an unmendable mistake.”
Raising ECPs awareness
She said the SFPA was constantly raising awareness of Emergency Contraceptive Pills (ECPs) to educate the local community on self-protection.
A staff member attending to a client at an SFPA static clinic in Miri.
Emergency contraception, she added, was a way to prevent pregnancy from sex without contraception or through a contraceptive accident such as a burst condom or a missed pill.
“In fact, SFPA has been constantly visiting longhouses in remote areas around Miri and one of the topics often shared with the dwellers is contraception and pregnancy control which are important in birth control and family planning.
“Usually, those with lower level of education do not know how to control family size and can end up having very large families.
“We have constantly stressed to them the importance of using contraception for the well-being of their families, especially finance, and the health of the mothers.
“Our effort has borne fruit. We can see there are those who really listen and space out the interval between pregnancies,” Lau noted.
She said another misconception was that birth control applied only to women.
“There’re different birth control options usually for women such as hormonal injection, oral contraceptive pills and intrauterine device (IUD).
“For men, however, condoms seem to be the only option and often their ego would see them forgo the option.
“We also counsel couples on pre-marital and marital status, as well as advise husband and wife on their family planning roles.”
Social stigma
Lau added that the health of the reproductive system was often overlooked because of the nature of the subject and social stigma.
“At our static clinics, we offer various services such as pap smear, gynaecology treatment and infertility check-up, among others.
“The reproductive system directly affects the body’s health. Diseases relating to women’s reproductive system include ovarian cancer, cyst, fibroid (or tumour), cervical cancer and endometriosis.
“Infertility is a subject people tend to avoid discussing openly. Regardless, we offer infertility scans and blood screenings for both men and women to detect the root of the problem.”
Some of the brochures distributed by SFPA to promote awareness of sex-ed.
In Sarawak, SFPA has static clinics in Kuching, Sri Aman, Bintangor, Sarikei, Sibu, Bintulu, Miri and Limbang.
Clients, whom Lau refers to as those visiting the clinics, have a wide age difference — from teens to those entering menopause.
“Unlike flu, fever or headache, most people would never know what happened to their body until the symptoms had turned serious.
“Even the condition of menopause could lead to something serious, therefore we want to spread the word so that people could really pay attention to their body.”
Strictly confidential
Lau said services at SFPA static clinics were usually for the lower income group and information on clients were strictly confidential.
There are about 50 different services available, including for Hepatitis A, B and C blood screenings and injections; HPV (human papillomavirus) screenings and injections; ultrasound scans; sexually transmitted disease (STD) check-ups; infertility hormone screenings; HIV screenings and heart indicators; general screenings for full blood count, diabetes and liver function; thyroid screenings and screenings for cholesterol and glucose blood.
According to a staff nurse at a static clinic next to Miri Polyclinic, HPV is a common sexually transmitted infection.
“We’re offering HPV injections for both men and women because it’s vitally important to understand men are usually the carriers of this virus and women who have this virus have a high probability they got it from men. Thus, instead of focusing on women, we want to provide education on this without any gender bias,” she said.
Constraints
The Sarawak Family Planning Association is supported financially by several organisations such as the United Nations Family Planning Association (UNFPA), the International Planned Parenthood Federation (IPPF), the Federation of Reproductive Health Associations, Malaysia (FRHAM), and most recently, through collaboration with Mercy Malaysia.
A consultation and scanning room at a static clinic.
Apart from static clinics, SFPA provides mobile services such as home visits to longhouses (from Bakong to Batu Niah), usually once every three months. These visits are repeated to ensure every longhouse is covered.
“We are now facing manpower and financial constraints which have prevented us implementing a lot of programmes,” Lau revealed.
She said doctors giving consultations at the static clinics were from public and private practices and they volunteered to provide humanitarian service.
“It depends on which doctor will be providing the consultation, but generally, the consultation will be every Wednesday and Friday from 2pm to 4.30pm.”
Donations
In July this year, SFPA received donations of medical equipment worth RM124,000 from the government of Japan through its Consular Office in Kota Kinabalu, Sabah.
“We’re grateful for the donations and support from the Japanese government which has been continuously channelling assistance to SFPA, Miri,” Lau said, adding that the government of Japan had also donated medical equipment to the Association in 2009 and 2010.
The SFPA is constantly seeking to promote family planning awareness and conduct workshops for younger groups.
“The subjects covered are safe sex relationship and preparing young adults for parenthood. It’s a good channel for those who are in a courtship and talking about marriage,” she said.