Church dogma versus pragmatism

Rose Moremoholo

MASERU

SINCE 1968, the Catholic Church has had brawls with secular authorities over the issue of contraceptives, particularly the pill.

The Church has ruled that the use of all contraceptives is sinful.

That stance has often set the institution on a collision course with secular authorities who promote contraceptives.

For the Catholic Church’s billions of “faithful” adherents they are caught in a moral dilemma.

Either they continue to use the pill and deliberately break the Church’s moral code or ditch the pill and face ostracism from the Church.

It is a bruising battle between Church dogma on one hand and pragmatism by its followers on the other.

In Lesotho, a “war” is brewing after the Lesotho Planned Parenthood Association (LPPA)teamed up with the Ministry of Health to set up family planning facilities alongside Church-run clinics.

The Catholic Church has historically refused to provide family planning services in its clinics on religious grounds.

The Church’s teachings on family planning have not shifted an inch since that Papal enunciation in 1968.

According to the CRNet’s Catholic Marketplace,“sons of the Church may not undertake methods of regulating procreation which are found blameworthy by the teaching authority of the Church in its unfolding of the divine law”.

It further indicates that, “if there are serious reasons to space out births, reasons which derive from the physical or psychological conditions of husband and wife, or from external conditions, the Church teaches that it is morally permissible to take into account the natural rhythms of human fertility and to have coitus only during the infertile times in order to regulate conception without offending the moral principles.”

The Church condemns the use of unnatural methods of birth control and explicitly approves of the use of natural family planning methods when there is sufficient reason to avoid or postpone pregnancy.

According to a BBC report, the Roman Catholic Church believes that using contraception is “intrinsically evil” in itself, regardless of the consequences.

The report says the Church does not condemn things like the pill or condoms in themselves.

“What is morally wrong is using such things with the intention of preventing conception. Using them for other purposes is fine – for example, using the pill to regulate the periods of a woman who is not in a sexual relationship is not wrong,” the report reads.

Another 2008 study by the BBC suggests that most practising Catholics are ignoring the Church’s teachings on contraception and sex.

The Tablet magazine surveyed 1 500 Mass-goers in England and Wales 40 years after Pope Paul VI forbade the use of birth control methods in his encyclical Humanae Vitae (Of Human Life).

Eighty-two percent of people are familiar with the Church’s moral teachings but the contraceptive pill is used by 54.5 percent and nearly 69 percentsurveyed said they had used or would consider using condoms.

The survey also found that more than half of the respondents think that the Church’s teaching on contraceptivesshould be revised.

The LPPA spokesperson TlaliMatela says since 2013, with the support of UNFPA, the association has been providing sexual and reproductive health services including family planning services to people who live within the catchment areas of Roman Catholic Church-run clinics.

This is because the Roman Catholic Centres do not provide family planning services.

“Since its existence in Lesotho in 1968 the LPPA has been mandated to reach those who are unreachable and educate women and men on family planning and the vast range of contraceptives that are available,” Matela says.

“Our mandate was based on what we call “4 TOOs” where we are providing education and services to people to help then not to have children ‘Too early, Too Many, Too often and Too Late’. We have had a history of serving people at the community level with contraceptive pills and other means of available contraception,” he says.

He says around 2013/2014 the LPPA intensified its outreach programme to reach areas that fall within the RCC health facilities catchment areas.

He says for example, inthe Roma area “we have a facility where people access ourservices”.

He says the LPPA is sometimes called to offer family planning services or they identify areas of need.

“It is a two-way street, sometimes they request for our services to be delivered or we identify such areas through the Ministry of Health”.

He says sometimesthe LPPA sits down with the Roman Catholic health centres and discuss the most effective and efficient way to work together.

“We discuss how we shall work together to provide women with contraceptives while the health centre provides other services in the same outreach,” he says.

At least 20 nurses and two peer educator coordinators have been trained for the work they will soon be doing in the two districts.

“They are areas that have Roman Catholic health centres offering other health care services but modern contraception.”

The LPPA says the biggest challenge is the resistance they meet from some health facility managers who don’t understand the need for such services in the community.

Funding is also a problem as it sometimes restricts the goals and ambitions that they would have wanted to pursue.

“Sometimes the funders’ money isn’t enough to offer services to all vulnerable people and so we are confined to working with some villages and leave out others”.

The LPPA already has setup at a building which wasonce owned by MSF at Ha-Mafefooane in Roma to offer modern family planning services.

A Family Planning Manager in the Department of Family Health in the Ministry of Health, MongoseSithole, says they are working in partnership with the LPPA to bring family planning services to those who do not have access to them.

“The ministry has outreach programmes especially in areas around Roman Catholic clinics and hospitals where we have community based distributors who distribute condoms and contraceptive pills,” Sithole says.

“We have a health post at Roma, Ha-Mafefoane where we are using the MSF building together with LPPA for the distribution and offering of family planning services,” Sithole says.

Sithole says their biggest challenge as a ministry is financial constraints.

“We have outreach plans that happen and then stop because we do not have the financial muscle (to continue). We also have limited human resources and transport constraints to reach certain areas to carry out such outreach programmes,” Sithole says.

“We need money to build our own sites near Roman Catholic clinics such as the one we have in Roma because it is very expensive to deliver these services.”

Sithole says they have to bring their own nurses to provide services because the clinic or hospital does not allow its nurses to offer such.

“Outreach is not for Roman Catholic centres but hard-to-reach villages where people travel long distances to get to health services,” Sithole says.

A document which was released by MSF last year gives a vivid picture of the impactwhen a hospital does not provide family planning services in the community.

A local woman’MakeneuoeKhosisays she “left home at 5am this morning to get here, and arrived at 8 am”.

“It’s the only service like this near me,” she says.

She has two children and didn’t previously know there was such a thing as birth control.

According to the MillenniumDevelopment Goals status report 2013, the unmet need for family planning services by married women aged 15-49 for the purposes of both spacing and limiting childbirth declined from 30.9 percent in 2004 to 23 percent in 2009.56

The 2009 LDHS reveals that the unmet need is higher among rural women (26 percent) than the urban women (15 percent). The need is also higher among women in mountainous areas (33 percent) compared to those who live in lowlands (18 percent).

“This indicator reveals that more investment should be channelled towards improving family planning services as opposed to demand creation,” the report reads.