AT a popular herbal clinic in Ngara, Nairobi, a woman enquires whether there are herbal contraceptives on sale.
An elderly attendant at the desk responds in the affirmative and fishes out tiny pink tablets from one of the drawers. Each pill goes for USD 5.00.
The pills have Chinese writings on them and the woman can’t read Chinese, so she engages the attendant for more information.
The pills go by the name Sophia, she is told, and they are taken once every month.
But the woman is still skeptical and keeps asking about the side-effects and the efficacy of pills. What if they don’t work? What if they make her bleed? she asks.
Seemingly worked up, the attendant hands back her money and asks her to leave, saying she cannot guarantee that the pills will not have negative side-effects on her.
“There are no contraceptives without side-effects,” the attendant says. “All I know is that we serve hundreds of clients every month and none of them has come back to say that the pills have given them problems.”
The Chinese contraceptives are on sale in many herbal clinics in the country. Most of those who sell them and those who use them do not seem to have much information on these pills because they are packaged in Chinese. The name of the pills and instructions on how to use them are all in Chinese.
In 2009, then Director of Medical Services Dr Francis Kimani raised the alarm on reports of health complications linked to the use of the Chinese contraceptives, but the warning seems to have fallen on deaf ears.
Kimani said children under the age of three were having enlarged breasts and uteruses after their mothers used these contraceptives. Breastfeeding children developed swollen feet, knock knees and stunted speech.
Mothers reported feeling pregnant all the time, while others went into depression. Kimani said the pills contain high levels of hormones, about 40 times those in conventional contraceptives.
Despite this warning, the Chinese contraceptives continue to be popular among women in Kenya. Most of the users interviewed said the pills are convenient since they are taken only once every month, unlike conventional pills that have to be taken daily. The pills also cause increased sex drive, a welcome side-effect for many women.
“For me the only side-effects I experienced are the good ones,” says Jane Maingi, a housewife in Nairobi. “My libido was so high that I used to beg my husband to sneak out from work and come back home.”
Maingi was on the pill for two years but then stopped because she wanted another baby. She is now eight months pregnant and plans to continue using the Chinese pills after giving birth.
The housewife says if the pills had any negative effects, she would have known by now. She says while she was on the pill, she made several visits to her gynaecologist and got a clean bill of health each time. Even her current pregnancy has been uneventful.
Annete Akinyi, a Busia businesswoman, says she has been on the pill for 10 years. Every time she travels to China for business, which is twice a year, she buys enough stock for herself and her friends.
“One of the people I sell the pills to is a doctor,” she says.
Akinyi says ordinary contraceptives suppressed her libido and made her gain weight. Since she discovered the Chinese contraceptives, she has never looked back.
The once-a-month contraceptive pill has been used in China since the 1960s. The pill is taken on the fifth day of menstruation for the first time, then after 20 days and after every 30 days thereafter.
Even though they are marketed as herbal products, studies conducted on the contraceptives show that they have high doses of estrogen and progestogen, which are artificial hormones.
A 2007 study published by the US National Institutes of Health says lack of good quality data prevents confident assessment of the safety and efficacy of the once-a-month pills. The report, however, notes that available evidence indicates a high incidence of bothersome side-effects and hypertension. About 5.8 per cent of the pill users developed hypertension during the first year of use.
The report says the high monthly hormone doses raise questions about the safety of the pills.
Since the contraceptives are sold in herbal clinics as herbal medicine, it is difficult for the government to regulate their sale and use. There are no control mechanisms for herbal medicines at the moment. In 2010, the Pharmacy and Poisons Board issued guidelines on the regulation of herbal medicine but these guidelines are yet to take effect.
Dr Joachim Osur, the technical director of reproductive, maternal and child health at Amref, says the Health ministry has no control over the so-called herbal contraceptives because they are not registered under the ministry.
“People selling herbal medicine are registered under the Department of Cultural Services. So the Health ministry has no control over them,” he says.
The reproductive health expert says even the director of medical services cannot ban the Chinese medicine because they do not fall under his jurisdiction.
Osur says the drugs are probably imported as herbal medicine or supplements and that is why they have never come under the radar of the Pharmacy and Poisons Board.
“If they are imported as medicine, they have to be registered in Kenya,” Osur says. “The registration process is very stringent and thorough. It takes about one or two years. As long as the Chinese contraceptives come in as herbal supplements or herbal medicine, then the board has no control over them.”
Osur says it is difficult for health experts to talk about the drugs’ efficacy and side-effects because they do not know what they contain.
“We don’t know whether they have negative side-effects because we don’t know what chemicals they contain. Sometimes those chemicals have long-term effects so we can’t tell what effects they will have on users in the long run. It is until someone carries out a chemical analysis on them that we can say whether they are safe or not,” Osur says.
The head of reproductive health division at the Health ministry declined to comment on the matter.
Source: The Star