More needs to be done to ensure that young people fully understand sexual and reproductive health, according to Executive Director of the Guyana Responsible Parenthood Association (GRPA) Renata Chuck-A-Sang who also said that the country’s young need to be challenged more, educated more and provided with more options as there is more to life than what they are exposed to.
In a wide-ranging interview with the Sunday Stabroek, which focused largely on the services GRPA offers adolescents, Chuck-A-Sang said options should be provided to young people in terms of schools, jobs, businesses, as one of her pet peeves is to see people sidelined or discarded because of where they came from or for what they were not given an opportunity to learn.
Describing GRPA as a one-stop shop, Chuck-A-Sang said it currently has a subvention from government that caters specifically to the needs of adolescents and this entails counselling. With the counselling, she noted that at times people just want somebody to talk to who is nonjudgmental and they can use that person as “a sounding board.”
The association also has a lot of content for comprehensive sexuality education, which is a ten-module programme that is normally delivered to schools, youth organisations and whoever is interested. At present, the association is working with the Child Care and Protection Agency to have the content delivered to young people with whom the agency is working.
Access to the counselling, however, is by appointment through telephone number 225-3286, but if it is an urgent need then the person can call 225-6493 which is the association’s hotline number.
The counselling is not taken up on a long-term basis by many and Chuck-A-Sang believes this is so because mental trauma is not something that is visible on the outside and as such many persons don’t prioritise mental health in the same way as they would an open wound.
“I think we need to get to that point where people are aware and know that it is okay to seek help, and to want that help because it is important to them,” she said.
She pointed out that if a person is being counselled because someone else suggested it and they absent themselves mentally then it would not be beneficial. Another issue as well is the fact that during counselling, persons have to make themselves vulnerable and many are not prepared to do this. People also do not want to pay for such a service because they do not see a tangible value in it.
That being said, GRPA’s counselling book is generally filled and most persons pay the minimal fee of $1,000 a session.
Walk-in clinic
Girls experiencing irregular periods can access assistance at the association and this is done at the walk-in clinic. Hormone counselling, thyroid, liver and kidney testing coupled with cholesterol, diabetes, sickle cell, and testing for a range of sexual transmitted diseases are also done at the clinic. Malaria and cancer screenings (for both men and women) are also on the list of services provided.
“We offer the widest range of contraceptives. We do everything, pills, injections, implants, IUDs and condoms of course and I am hoping before the end of this year we would be able to offer vasectomy… I want men to be aware that they have an equal responsibility with respect to contraceptives, it shouldn’t be on the women alone…,” she noted.
She pointed out that society gives tacit approval to men’s noninvolvement when it comes to contraception.
For most of the services, especially those provided to adolescents, there is a means assessment done and persons are charged based on what they can pay.
“It depends on our budgets but we have concessionary rates for adolescents and one of the things we would like to encourage adolescents, is that you are moving from childhood to adulthood and therefore the responsibility for your health is on you now and you need to say to yourself, ‘I need a once-a-year checkup to ensure everything is fine’…,” Chuck-A-Sang said.
She cautioned that persons should not wait until they are really sick before going to a doctor but must have regular checkups.
The association also provides annual medical checkups and usually does schools’ medical checkups for students.
Abortion
GRPA also offers abortion and according to Chuck-A-Sang under the law the association does not have to consult a parent to administer the service.
“As long as they are pregnant and that child is counselled and they don’t want it, it doesn’t matter, it is not for me to judge…, that is a responsibility that person has to take… whether they want to continue the pregnancy or interrupt the pregnancy,” she said.
She stressed that the GRPA’s job is to provide a safe service and the project under which it operates stipulates that once someone seeks an abortion then that person is encouraged to be placed on long-term contraceptives, particularly young women, so that there is not a reoccurrence.
Questioned whether GRPA is not mandated to report the matter if the girl is under the age of 16, since her being pregnant would have been as a result of statutory rape, Chuck-A-Sang responded in the negative. She pointed out that if the child is around 15 it depends on who the other person is since there is a ‘close-in age’ defence and the man has to be above the age of 24.
Pressed about younger girls, Chuck-A-Sang agreed that they would be obligated to report the matter even though she pointed out that at times the girl is not willing to say who committed the crime. She noted, however, that children don’t generally turn up alone asking for an abortion, but in the presence of an adult.
Quizzed as to the possibility of the accompanying adult wanting to hide the rape, she said they can report the matter to the Child Care and Protection Agency and can advise the parent as to the steps to be taken. She pointed that the ChildLink’s advocacy service is also available in the GRPA’s building and as such if such a case comes up it would be forwarded to that office.
She said they have not had such cases as listed in the scenario above, but they have had parents and children with traumatic experiences, and they have advised them on the route to go.
Meantime Chuck-A-Sang believes that Guyana has the best laws in the Caribbean when it comes to abortion although she does not subscribe to the fact that persons have to be counselled and then return after 24 hours. She said that would be fine when it comes to young people who may not know what they want but for older women by the time they approach the facility they know what they want.
Prior to 2014, abortions were not available at public hospitals but now persons can access the service at the New Amsterdam, Lethem and Georgetown public hospitals. GRPA assisted in training persons to make this possible and it is hoped that midwives will also be trained to conduct medical abortions, which is abortion using pills.
In recent years, GRPA has also provided fertility services and according to Chuck-A-Sang more people are admitting that they have problems conceiving and it is a problem the association embraces and it assists persons once they want it. Persons with sexual dysfunction can also access services at GRPA as they can be counselled and if there is need for medication this would be administered.
Youth group
GRPA also had a youth group, which Chuck-A-Sang said she has suspended for a while but when it was up and running it taught them to work together and be interested in sexual and reproductive health. Because it was called the Youth Advocacy Movement, the members were expected to be advocate for better sexual and reproductive health education in schools and services for adolescents.
“The group is suspended right now because we want to relook at the strategy and basically [we] want to improve the buy-in and inter-activeness of the group. I don’t feel people understand why they are in the group. I think people have just been saying, and I don’t want it to continue, ‘oh we have a youth group must come,’ as opposed to knowing why the youth group exists, what are their interests, do they mesh with the youth group before getting involved,” the Executive Director said.
As it relates to the operation of GRPA, which has been in existence for over 45 years, Chuck-A-Sang said the association is challenged to make itself more self-sustaining as donor funding is drying up.
There are some days when the clinic is not full, and she would like to ensure that every hour at the association is productive.
Of concern is the fact that the association does not see as many adolescents as it should and the Executive Director, who has been at the helm for less than a year, noted that people in that age range tend to access services very late and they would like to change that mindset.
GRPA’s focus will remain on sexual and reproductive health which covers a wide range as Chuck-A-Sang noted that for a person to have “good sex” then the entire body has to be involved, persons need to be in “a good relationship” and know how “to protect themselves if they are going to have sex.”
She described her time at GRPA as an “interesting ride so far” adding that instead of making changes the association has been expanding the work it has been doing with respect to abortion as they would like to see the service available nationwide.
GRPA wants to ensure that safe abortions are widely available, even though there is still a lot of stigma attached to the service, as people feel that women have abortions “willy-nilly” which is not the case.
Chuck-A-Sang said what she would like to see change is the issue of women’s sexuality as people tend to think that women shouldn’t have sex or rather, they should not enjoy sex.
“Women should be able to enjoy their sexuality. They should be able to enjoy sex and they should be an equal participant in sex. I see people judging girls on what they wear, how they behave… but that judgment is not equally applied to young men and so I have a problem with that,” she said.
And often when people say young people do not have morals and you dig dipper it is really about what girls wear, how they look and how they behave, which, she said, “is unfair because girls don’t get pregnant by themselves.”
She encouraged that parents should have the same conversations with their boy children as they have with their girl children. Also, it should not be okay for a girl child to drop out of school and almost prostitute herself, “so that the family could eat.” Then there is the issue of women being told that their boyfriends should “sponsor” them, or to make sure they get something from them, and this should not be Chuck-A-Sang said since it engenders a certain level of disrespect.
GRPA is located on Quamina Street and can also be found on Facebook and Instagram.
