Thursday, 28 March, 2024
HomeWeekly RoundupZimbabwe smugglers sell birth control pills illicitly in SA

Zimbabwe smugglers sell birth control pills illicitly in SA

With long queues at clinics in South Africa and COVID-19 restrictions, women struggling to access health services are turning to an illicit market for birth control pills, says a GroundUp report. The pills are widely used and freely distributed in Zimbabwe, but smuggled into and sold in South Africa. Familiar brands from back home are preferred by many immigrant Zimbabwean women instead of the brands supplied in South African clinics. Smugglers of the pills say they also have demand from Mozambican, Malawian, Basotho and South African women.

GroundUp reports that the pills are supplied free by Zimbabwean clinics through the country’s Health Department. But people who source the tablets for resale in South Africa get them in exchange for goods that are affordable in South Africa but expensive in Zimbabwe.

“I am expecting a batch of 500 pills, loaded safely on a bus from Zimbabwe as we speak,” a trader, who lives in Springs, is quoted in the report as saying. She also sells to sex workers and sometimes visits informal mining areas such as Payneville and Benoni, where people will pay R200 for a box of contraceptives.

Another woman told GroundUp she sells directly from her door and takes orders through Whatsapp. “This is no longer about the brand of tablets but about convenience. At clinics women go through lots of processes to get contraceptives. They get tested for pregnancy first and one has to be on their period to get the pill or an injection. With us there are no such complications; we just sell them the pill,” she said.

However, GroundUp quotes a leading pharmacologist as saying: “That is not entirely accurate – at the family planning or primary health-care clinics, when initiating hormonal contraception for the first time, the client would be asked about the last menstrual period, to exclude pregnancy. However, a negative pregnancy test is not an absolute requirement. This is what the guidelines state for the combined oral contraceptive (COC): “COCs may be initiated at any time, as long as it is reasonably certain that the client is not pregnant. If pregnancy cannot be ruled out (see Appendix 2: Pregnancy checklist), the client should be advised to avoid sex or use condoms until her next period starts, and start taking COCs on day 1 of her period (but not later than day 5). If her next period is late, she should come back for a pregnancy test."

GroundUp reports that he further advised:
The risks when women purchase hormonal contraceptives from unregulated sources include:
1. No screening for contraindications or adverse effects from prior use – these are prescription-only medicines for a reason
2. No screening for HIV and STIs
3. No consideration of other medicines which the women might be taking, and how those might interact with the contraceptive.
4. Being sold sub-standard or falsified products, or tablets which have not been stored appropriately and have deteriorated or expired (lost potency).

He noted that lastly, they are paying for something which should be available free of charge (though there are costs to accessing free care, in terms of transport or lost earnings). “If women who are undocumented migrants are either prevented from accessing services, or fear being refused or reported, that is also an issue that needs attention,” he is quoted in the report as saying.

 

Full GroundUp report (Open access)

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