& çâÌæÚUæð´ ·¤è ¥ôÚU Îð¹Ùæ ÁæÚUè ÚU¹ð´ ¥ÍæüÌ ¥ÂÙð ÜÿØ ÂÚU ŠØæÙ ÚU¹ð´Ð ãæÚU Ù ×æÙð´, €UØô´ç·¤ ·¤æ× ·¤ÚUÙð âð ¥æÂ·¤ô ©gðàØ ·¤è Âýæç# ãôÌè ãñ ¥õÚU ÁèßÙ ·¤æ ¹æÜèÂÙ ÎêÚU ãôÌæ ãñÐ ÖÜð ãè ÁèßÙ ×ð´ ç·¤ÌÙè Öè ·¤çÆÙæ§ü €UØô´ Ù ¥æ°, çÁ™ææâæ ¥õÚU ©ˆâæã ÕÙæ° ÚU¹ð´Ð ŠØæÙ ÚU¹ð´, ÜÿØ ã×ðàææ ¥æÂ·Ô¤ Âæâ ãôÌð ãñ´ çÁ‹ãð´ ÂæÙð ·Ô¤ çÜ° ÂýØæâ ¥æÂ ·¤Öè Öè àæéM¤ ·¤ÚU â·¤Ìð ãñ´Ð

Where IUD, Copper T or Foam are Not 'No-Nos*
***The Star Feature Writer, Fayza Haq, visits a Camilla village to see for herself the progress of family planning campaign among the local inhabitants.
***It was one® believed that without proper employment. adequate education and sufficient income the population rate cannot be controlled. Matlab proves that this is not so. With sufficient back up the family planning programme can be a success.'
***The village people believe that vasectomy makes men sexually wepk. They equate it with castration.
***In a tubectomy the fallopian tubes are ligated and severed. There is no risk of getting fat, as is the common belief.
BEYOND (he pale mor ning glories and the even more exotic water hyacinths is the village of Chhoto Lokhhlpur In Co ml I la. One ha.* the misconception that perhaps the women In the Village are stow In the pick up. But this is certainly not so when one ' speaks about contraceptives with them.
While the city women tn Dhaka blush deep at the mention of 'periods' or "breasts', and a century back people hesitated to mention the breasts of a chicken or the leg of the piano, even in the west, these garrulous and uninhibited women from the sleepy thatched huts of Chhoto Lokhhlpur speak about their problems and facilities with contraceptions without any hesitation With overpopulation being a major problematic issue In Bangladesh the village is a Utopia where family planning
MayJ. 28. with three children. the youngest bring five years old. says loudly and proudly that she takes contraceptive pills, and the necessary Iron tablets that go with It. "I know of a lot of women who use other types of contraceptions like the IUD and the Injection" she Informed me. There are about 150 women of child bearing age in the village
With the children spared out and limited Maya has now money enough to keep a ser vant (although she is paid only with cloths and food) and a TV that runs on battery, and has regular trips to Dhaka where here husband works for the WAPDA Commenting aside on the polls in her chatterbox shrewish manner she says "Here no one tells the truth about whom they voted for u. what they actually ever do ' Maya Is glad to have children she says, as she would have found the concept of being barren and childless a InUe hard to bear. "1 could not have been contented with the notion of adoption either.' she confides.
Khurshid Begum from the same village, with her five children—three boys and two girls—takes contraceptive injections once month, she complains that she had very heavy periods once and felt "I get a raw deal from the Matlab ICDDR I've been tested for infection in the urine and stools and have spent some money on medicines. Yet 1 still have pc rlod problems and the medical visitors fall to give me satisfactory medicines." Khurshid's husband advises her not to take Injections, but Khurshid is told otherwise by the health visitor and doctors from Matlab. 1 fell the heat Intensely after the injections, and 1 wonder if my discomforts are correlated", she confides
Along with other village women Khurshid elaborates diat the iron give excuses about their health when asked to use prophylactics. The society being a male dominated one as everywhere in the Subcontinent. explains an 1CDDRB guide "Women try not to anger their husbands Some are even scared of divorce in ease of annoying their husbands" The "maulvls* In the areas, accord ing to the reports of the women, have also never encouraged contraceptive. Again, elder relatives, women specially, have tried to talk them into giving up the tablets and other means of contracep
Husna Ara 29. with three children complains of spotting and the issue of white fluid even after using a reliable German brand of contraceptive tablets. The health visitors somehow told her there was no need to contact the doctors despite the discomfort she complains of. Like most other men at Chhoto Lokhhipur. Husna Ara's husband too has some lame excuse for not using prophclectics
Sabina Begum uses the IUD or Copper T. She has had problems of painful blood flow. Each IUD has lasted her three years. There Is no need of anaesthesia for IUD Insertion. The doctors however, have advised her to stop the IUD since she had the complain of a white discharge.
Mr J. Chakraborty, the manager of the Health Services Programme at ICDDRB at Matlab. comments on the contraceptive methods available to the women in Bangladesh Tt is a cafeteria system'. There is a choice. They can have the pill or the injection or the IUD". He comments "It was once believed that without proper employment, adequate education and sufficient income the population rate cannot be controlled. Matlab proves that this is not so. With sufficient back up the system of family planning can be a success."
"With better spacing out of families both mothers and children are better fed", says Dr. Mohammad Yunus of the Health and Research Centre of the ICDDRB.
The city women of Bangladesh, despite a Master's degree, a career of say ten years, and being a mother of two children often has a limited knowledge of the contraceptives. Talking to Dr. Shamim Akhtar Khan of the MCHFP project at Matlab. I personally gathered a treasuretrove of information.
"In the pills we have the combination of oestrogen and progesteron—two kinds of female hormones. In the normal adult woman oestrogen hormones are released in the first few days just after menstruation. This causes the maturation of the ovum containing follicle. In the midcycle 15 days," she continues, "before the next 'periods', there Is L. H. surge and these causes the rupture of the matured ovum containing follicle and delivery of the ovum." Dr. Shamim next explains "then the progesteron causes ripening of the Inner layer of the uterus for embedding of the fertilised ovum. After ovulation the ovum is caught in the fibrta of the fallopian tubes. This Is then transmitted through the tubes and to the ampulary region of fallopian tubes where fertilization does not occur, and the two hormones come down to normal level. This cause destruction of the inner layer of the uterus uid results in menstruation
The lady doctor further elaborated "The pill causes anovular cycle and produces the withdrawal of the bleeding. She also Informs" The pills contain both the oestrogen and progesteron and these pills, taken dally at the same time, makes sure that the body contains the same amount of hormones throughout the cycle. The oestrogen progesteron combination prevent maturation of the ovum containing follicle and so the ovulation does not take place. "Dr. Shamim add " In oral packets included apart from the 21 hormone >pllls seven iron tablets are also included.
The doctor then comments the Intra Utrine Contraceptive Device is sometimes considered the safest and the most convenient, depending on the health and the metabolism of the patient. She says that after screening of the patient the IUD Copper T is inserted through the cervix into the uterus by aseptic precaution. There is a plastic bore canula with a copper T which is inserted into the uterus after proper lithotomy position. She adds that sufficient lighting is needed for vlsualusation of the cervix and the OS. Dr. Shamim further explains the that the copper T acts as a foreign body and it expels all foreign bodies from the uterus. Copper released from the Copper T also causes spermicidal action. "No sperm enters the uterus and so there is no fertilisation." she elaborates.
The Depo Provera (Dcpo Medroxy progesteron acetate), the lady doctor also says "acts on the ovum containing follicle in the ovary and prevents maturation. of the ovum, as in the case of the pills. No matured ovum come out during ovulation period and fertilization does not take place.
She then tells me "Foam tablets like Joy' act as a barrier for spermicidal action. They look like a Polo' sweet and are introduced through the upper part of the vagina. They dissolve and produce lather which acts as a barrier for sperms and has spermicidal action.
Yet another new form of contraceptive the "Norplant", Is a capsular form. It produces a deposit and It Is gradually released into the blood and acts on the uterus and overies to prevent the maturation of the follicle. This has yet to be introduced in Bangladesh.
Dr. Yunus, also present during the discussion, spoke of the storing and destroying problems of the condom. The men somehow take a physical dislike to It furthermore, he adds. As for vasectomy, the village people believe that it makes them sexually weak.. They equate ft with castration. Dr. Yunus explains. Since this involves an operation, the women too are afraid for their husband's health.
The doctors also explain that in a tubectomy the fallop ian tubes are ligated and severed. There is no risk of getting fat. as is the common belief. even in the cities in the Subcontinent With the pill and the Injection, however, there Is fat deposition, the doctors say. because there are hormones which retain sodium, and this causes deposition of fat.
In the IUD the bleeding sometimes Increases during the normal cycle, the doctors. admit The bleeding Increase both in duration and volume they say. There may be further complications of the Copper T missing threads Earlier “loops" used to be used instead of the copper T.
Dr. Yunus concludes the discussion by saying that there is no single answer to contra ception. It al) depends on the age of the mother, the number of pregnancies and Iier body's capacity to accept any part ku lar form of contraception. Newly married couple* nor malty prefer the foam or the condom, he elaborates.
It is not up to the ICDDRB alone to set up Ideal situations where contraceptives will im prove the health and the eco nomic situation of the faintly It is for the government to take firm steps in this direction.