By William A. Baruwa
Especially with the current Ebola virus disease (EVD) ‘scare’, this issue could typically become relevant, even as experts affirm that it cannot spread through the air via coughing or sneezing thereby drastically limiting its transmission speed compared to pandemic flus. There is a valid concern however, that during a pandemic, women will be inclined to put on hold care for their sexual/ reproductive health needs. Experts say a global crisis is not exactly an ideal time to shelve important appointments for example.
“The message should be loud and clear that critical screening practices absolutely should continue,” said Dr. Lori Brotto, a psychotherapist and the director of the UBC Sexual Health Laboratory in Vancouver, Canada.
“Women are on a fixed schedule for a reason and that regular surveillance is very critical.”
The issue of screening for cervical cancer and doing mammograms for detecting breast cancer, or pregnant women attending antenatal clinics are on the whole vital for women.
Of course individuals will have various reasons for wanting to postpone or neglect to pay close attention to these things. Sometimes it may be due to fear of visiting a medical facility whereas others could be having scarcity of funds – making visiting a clinic and getting treatment very problematic.
According to Dr. Rachel Spitzer, an obstetrician/gynaecologist at the University of Toronto and Mount Sinai Hospital, financial problems could pose a major hindrance at times like these.
“Truthfully, I’m not worried about somebody waiting three and a half years to get their pap instead of three years,” Spitzer said. “But I am very worried about people running out of contraception and maybe not being in a relationship where they can have the autonomy to avoid intercourse and having an unplanned pregnancy.”
Spitzer said in Canada for instance, pregnancy care and abortion services have been well taken care off except that a pandemic can equally hinder in a number of other ways the accessibility of reproductive health services.
These problems are more so in developing environments like Nigeria and Sub-Saharan Africa where social amenities or infrastructures such as transportation are seriously inadequate.
Spitzer thinks a major concern has to do with the issue of contraception: “I do worry about access for people who have lost their jobs — what happens if suddenly you can’t afford your contraceptive anymore?.”
“All of those intricacies become highly complex at a time like this, where getting to places is more difficult or leaving the place that you’re at is more difficult. And so we worry significantly about people experiencing intimate partner violence also.”
Another case for worry experts say, is the issue of reported rising instances of domestic violence at such periods – as observed during COVID-19. Regarding such periods, Skolnik said, “We need to be screening patients for intimate partner violence”
Skolnik was among the many University of Toronto OB/GYN residents work together with the student-led COVID-19 Women’s Initiative (CWI) preaching equal treatment of the sexes.
“There’s a lot of uncertainty around the availability of services and what constitutes an essential medical service,” Skolnik said. “We felt that one of the (problems) is actually just knowing where to go and what is available, and that’s evermore an issue during a pandemic.”
Meanwhile a number of Canadian sexual health clinics have relocated a lot of their services online such that initial consultations and prescription refills can be carried out online using video appointment.
As a result of these developments Spitzer said, “Patients are spending less time in the clinic, encountering less people in waiting rooms, and they’re out of the clinic fairly quickly.”
Also, patients are advised to report alone, that is to say they would not need the accompaniment of a friend or family member, even if the appointment wells up some anxious moments.
Spitzer said dealing with this can really be problematic for people but she then urges her patients to make video calls to a supportive friend in the course of the appointment. She added that translation services which normally would take place face-to-face can as well be organised over the telephone.
Brotto, who is also a sex therapist who has been meeting with patients over a distance, said there are snags about doctors not being able to interact face-to-face with clients.
“People use that opportunity to talk about things like violence in their relationships or other issues about their sexual health,” she said. “So it remains to be seen what the impact is going to be — is this going to result in people holding back and not getting the care they normally would?
“Or is moving online actually going to increase (access) because now people who live in more remote areas are able to get care?”
Spitzer emphasises the urgency of letting people know they could still access sexual health services at such periods, adding that anyone who does not know how to get in a serious request should call a healthcare practitioner.
“Let us be the ones to help determine the urgency,” she said.
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