Everyone has a unique story

Backstory

I was born in Harare, Zimbabwe. My father then mother died of AIDS in 1997 and 2000 respectively. Conflicts were around who would take care of my brother and I. These conflicts were resolved and my brother and I had a roof over our heads for the time that we needed. Granted, part of the time with ‘a roof over my head’ involved being 17, living in a boarding house across from high school, hustling for a loaf of bread (or whatever I could get) to eat during break time at high school, and dating an unacceptably older guy to lighten up the gloom of living in Zimbabwe during the infamous hyperinflation of 2008. But, I made it through and landed myself an early decision acceptance to Yale University. From 2009 to 2013. I attended Yale College first intending to major in Biomedical Engineering and finally graduating with a double major and distinctions in African Studies and Women’s, Gender, and Sexuality Studies (it was hard but I made it!!!). After that, I did a stint at a famous educational institution in Johannesburg, South Africa as a fellow before following my true passion of building a career around something that would have an impact on my country and its people. So I’m back in Zimbabwe now, being who I need to be and trying to live my best life while shattering stereotypes and glass ceilings about who the African woman needs to be.

Fast forward to ‘kind of’ today

So, I clearly have to break down all my posts to my big issues. Otherwise, it may be too much. My big issue today is access to reproductive health services for Zimbabwean women of all ages. And when I say all ages, I mean every Zimbabwean female who feels they may need access to reproductive health services. This need has no cut off age. It’s not 16 or 18 or ‘age of marriage’. It’s age of need.

Before moving back home from South Africa, I was dating my boyfriend for about year. First we used condoms; after getting tested, I got on the pill (this was a struggle, I will get into it). It was great, until it wasn’t. I was getting depressed — and not the ‘casual depression’ but the real clinical depression that culminated in a hospital stay. So I stopped that. and for a while, it was pull and pray, This was obviously not ideal, particularly as I am a planner and see absolutely no reason for unplanned pregnancy given that there are more than ten methods of preventing pregnancy . So I wasn’t gonna be that girl, even after I moved back home. I still had to be on the pill. My boyfriend did not understand this — why was I on the pill if I wasn’t having sex with him? I explained this to him but, alas, the responsibility for preventing pregnancy still lies with me not only because I am a woman but because I have spent way more time researching these issues than he has ever probably needed to.

Because of all my issues with finding the right contraceptive, I finally settled on YAZ, a low hormone dose pill that did not seem to affect my mood as much as any other hormonal contraceptive method I had tried before. My challenge was that YAZ is not readily available in Zimbabwe. Some pharmacies required a special letter from a local prescribing doctor to import the contraceptive from South Africa and at others, it costs $30 (USD) or more for a 28 day supply. Even though I had moved back to Zimbabwe for better pay, I still felt that this was a high cost to pay for not getting pregnant just because higher hormone dose contraceptives are not compatible with my body. For the Zimbabwean woman without these contraindications, a month’s supply of the oral contraceptive pill costs $1(USD). As a stop gap, I got a 6 month prescription from my doctor in South Africa which I filled every time I went back to visit my boyfriend at a cost of about R150 per month (approximately $10 — $12 USD at the time). This was much more affordable but not ideal as I continued to suffer symptoms of depression on this pill. But I kept at it as the fear of an unwanted and unplanned pregnancy was greater than the anguish of mild depression for me — I did not want to become another statistic about ‘the African woman’.

At the beginning on 2016, I made the radical decision to get off the pill totally and allow my body to go back to its natural equilibrium, uninfluenced by external hormones. My research had led me to consider the copper IUD, particularly because it was hormone free and seemed ‘hassle free’ as I would not have to worry about taking it every day as with the pill. It was really difficult to get the IUD.

I went to the local New Start Center. The first time, there was no nurse or health practitioner trained or qualified to insert and pace the IUD for me. Although the wait was long, the nurse treated me with respect and no judgement. The second time, there was a nurse trained in IUD insertion and I made it through to her before the center closed. I had never experienced the kind of pain I felt as she tried to sound my uterus before she could she insert the device. Tears streamed out of my eyes. She tried four times. The insertion failed. I was left, legs wide open and exposed as she explained that she could not get through my cervix. She said my cervical muscle had contracted and there was no getting through. I wept. She said I should go see a doctor, but could not refer to me one.

Back at work, I asked a colleague if she knew any good gynecologist. She gave me three names and numbers. I called each. It was at least $300 (USD) for a consultation without a referral. This was not going to work for me. I decided to schedule an appointment at the Maries Stopes Clinic in South Africa for the next time I was going to be there. It was going to be much cheaper at about R500 ($35 — $40 USD) for the consultation, device, and insertion. So I took a risk and returned to South Africa while not taking any form of contraception. On the last day, I went to the Marie Stopes Clinic in Sandton, Johannesburg. It was closed. The call center had made a mistake and booked a number women for consultations and procedures on a Saturday afternoon after the Clinic was closed. I was one of those women. They never called me to let me know. I wept. Again. My boyfriend was convinced it was not meant to be. But I was tired of having that heavy hormone weight over my shoulders. And I was scared that maybe I was already pregnant.

I returned home, fearful that I was about to become another stereotype. But I didn’t. My period came and I was relieved. I had been crafting a plan to execute ifcmy period came. (If it had not, I would have returned to South Africa). I visited a private General Practitioner and narrated my whole history of hormonal contraceptives and clinical depression. I explained that I am sexually active and needed a non-hormonal contraceptive. I told her that I thought the copper IUD may be a suitable solution for me and that the nurse at the New Start Center had recommended that I see a doctor. She agreed. But, she could not insert the IUD for me. She said she did not have the experience and the procurement of IUD commodities was too cumbersome for their private practice so she could not place it even if she wanted to. She referred me to a gynecologist.

A week later, I went to the gynecologist’s rooms. After making my co-payment of $15, I narrated my whole life story again, including a request for an IUD. She accepted. She treated me very well, and was non-judgmental even after I clarified that I am a Miss not a Ms. I lay on the bed and spread my legs. Up to that moment, it was the most pain I had ever felt and this was evident in my scream. A testament to her experience, she successfully inserted the IUD despite my pin-point cervix — a textbook perfect placement confirmed by ultrasound. And it hurt — a pain I had never felt before.

The whole experience tested my limits of pain and made me recognize my privilege. I have since endured the most powerful menstrual camps and a period that can only be described as the red sea that overfloweth. I have had a twenty year old cousin get pregnant and attempt to self-abort leaving her hospitalized and bleeding, and childless. I though about all the hurdles she would have had to overcome to get access to the pill. I thought about if she would have been able to take the path I did and she couldn’t. I remembered all the judgement I had faced being single and looking for a long acting contraceptive. I thought about the gynecologist asking about my husband on my review visit even though she had been so non-judgmental at my first visit. All I could say was ‘Yes, my husband feels the strings, please shorten them’. That was the only scenario where it could be socially acceptable for me to be sexually active.

Part of what helped me navigate that is my privilege — the privilege of my age, my experiences, and of seeing how things could be that got me through this. It’s not a privilege that the ordinary woman has, but it is a privilege every Zimbabwean woman deserves.

A woman in Zimbabwe has to face some significant challenges to get uncommon oral contraceptives. And this is worse for those who do not have a steady income . But the nature of these challenges is not the same and there is great insight to be had from considering the complexity of challenges that women from different backgrounds within the African context face.