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Farida Akhter Discusses Depo-Provera in Bangladesh

by Debra Isabel Huron

On the heels of Health Canada's April approval of the injectable contraceptive Depo-Provera, concerns are resurfacing over the drug's impact on women's health and autonomy, not only in this country, but also in the Third World.

Depo-Provera is one of several long-acting hormonal contraceptive methods (such as Norplant and Noristerat) that are widely used on women in developing countries where local health services are often inadequate or non-existent. These methods must be administered by a health care practitioner.

Network/Le Réseau spoke to Farida Akhter of Bangladesh, where Depo-Provera has been used for more than a decade, during her recent visit to Canada. Ms. Akhter is executive director of UBINIG (Policy Research for Development Alternatives) in Bangladesh and an active member of FINRRAGE (the Feminist International Network of Resistance to Reproductive and Genetic Engineering).

Ms. Akhter says Depo-Provera's harmful side effects have been well-documented in Bangladesh, where its use has been linked to blurred vision and weight gain as well as to amenorrhea (no menstruation) and excessive bleeding -- a side effect that is particlarly devastating for anemic or malnourished women.

Ms. Akhter believes that Canada's approval of the drug will likely give Depo-Provera more legitimacy in the eyes of the Bangldeshi government. "We used to be able to say that at least in developed countries women were not being exposed to this drug."

While injectable contraceptives such as Depo-Provera were originally produced for women in developed countries, Ms. Akhter says the drugs did not find wide acceptance because of their side effects, and pharmaceutical companies turned to the governments of developing countries to sell their products.

"We're going to be facing the fact that more governments like ours will be going more and more into injectables and implants," she says. "Nobody cares...the pharmaceutical companies want to dispose of the drugs in women's bodies and the governments want to control women's fertility."

The national family planning program in Bangladesh talks about "choices for women," but the fact is, says Ms. Akhter, that "the choice of the national family planning organization is a drug like Depo-Provera because it's easier for them to administer, easier for them to rely on, as compared to the birth control pill."

For many years, Noristerat, another injectable contraceptive has been given to Bangladeshi women in rural areas, almost interchangeably with Depo-Provera, even though the two drugs have different compositions and different effects on the body. Another difference is that Noristerat lasts for two months and Depo- Provera for three.

"For years now, because the rural health workers don't know whether they're getting Depo-Provera or Noristerat in their shipments from Dhaka (the capital city), they have been administering the injectables on an average time dose of two and a half months," says Ms. Akhter.

Debra Isabel Huron is an Ottawa writer whose articles on women's health issues have appeared in Herizons, Women Healthsharing and The Women's Monitor.