By Pip Hinman
SYDNEY — For both Junilyn Pikacha, from the Solomon Islands Planned Parenthood Association, and Geraldine Maibani-Michie, from the Department of Community Medicine at the University of Papua New Guinea, women's rights are integral to the issue of family planning. Speaking here at a seminar on December 1 organised by the Australian Council for Overseas Aid, they emphasised that information and education are essential if women are to feel confident about the choices in their reproductive lives.
Pikacha, one of only two female doctors in the Solomons, said that while the country lacks resources, they do find it necessary to discriminate between donor agencies. "A lot of projects have failed because donor countries have pushed certain projects which did not meet our needs. We know what our priority areas are."
These, to name just a few, include more family planning clinics (the only one was set up in 1989, and it is hardly able to cope with the demand) to carry out routine gynaecological and other tests for cancers, STDs and AIDS; programs to train women health workers; more research on the causes of infant mortality (in 1992 the figure was 43.9 per 100,000) and maternal mortality (in the same year, 549 per 100,000).
Awareness of contraceptives, Pikacha said, is low. "Community education is essential in order to break through cultural and religious barriers." Prior to 1988, it was difficult to get policy makers to accept the idea that family planning involved much more than putting a limit on the number of children. "Family spacing" was much more readily accepted.
Surveys reveal that parents (especially the males) are keen to limit the size of their families but for economic reasons rather than any consideration about the woman's health. This is one of the reasons Pikacha is keen that the clinic involve itself more with the work of women's organisations.
According to Maibani-Michie, women in PNG face many of the same problems. Malaria, tuberculosis and prenatal mortality remain the leading causes of death. "About 1000 women die each year as a direct result of pregnancy."
Prior to independence, women had to rely on traditional ways of controlling their fertility, she said, but in the late 1980s a National Population Council was established to introduce a family planning policy. This has not been without its problems, Maibani-Michie, explained; some still insist that family planning programs violate traditional cultural beliefs and practices.
She argued that as long as family planning programs give women opportunities that they would otherwise not have had, and pay attention to problems related to reproductive health (for instance, the widespread preference for injectable contraceptives such as Depo Provera), they are essential.
While the pill and the condom are slowly becoming more accepted in PNG, and over the last five years couples are increasingly opting for vasectomies instead of the more complicated tubal ligation, many obstacles remain.
"A woman should have the right to control her own fertility and her own health as she wishes, but the culture does not allow this free will. It should be her individual human right. Why should she be denied that right and be made into a baby machine for the sake of conforming to her cultural norm and the expectation of the family or society?
"Women, especially in the traditional setting, cannot freely exercise this will because men, as well as the family, are still the decision-makers when it comes to reproductive decision-making."