23 November 2015

"When Conscience and Laws Clash"

I was very grateful to be asked to attend a medical conference in Rome at the beautiful convent Instituto Maria SS Bambina overlooking St Peter’s Square at the beginning of September this year. I found this conference very important as I learnt so much from other doctors, nurses, theologians, religious and philosophers from around the world.
The conference was entitled: “Maternal Health Care and the Catholic Conscience.” It was organised by MaterCare International. This organisation was started by Canadian obstetrician and gynaecologist Professor Robert Walley, at the instigation of St John Paul II in 1995, to care for mothers and their children before and after birth, in accordance with his encyclical Evangelium Vitae. MaterCare has since set up six hospitals in disadvantaged countries under his auspices. The conference was attended by over 60 doctors from 20 different nations including Europe, Africa, North and South America, India, Australia and New Zealand. At the commencement of the conference we were addressed via video link by Archbishop Anthony Fisher of Sydney. [...]
The hope is that although small in number, Catholic doctors and nurses have done heroic things and maintain a positive outlook.

9 November 2015

What is #GivingTuesday?

GivingTuesday is a global day of giving. After the sales of Black Friday and Cyber Monday, GivingTuesday is a time to celebrate and encourage activities that support charities and non profits. Whether it’s making a donation, volunteering time, helping a neighbour or spreading the word, GivingTuesday is a movement for everyone who wants to give something back.
We've partnered up with CanadaHelps for #GivingTuesday!
Imagine a day dedicated to giving back … around the world, across Canada and in your own community! Just as Black Friday kicks off the holiday shopping season, GivingTuesday is the opening day of the giving season.
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30 October 2015

OB/GYNs warn caution during development of ‘remote control’ contraceptive chip

October 30, 2015: MaterCare International (MCI), an international group of obstetricians and gynaecologists, proposes the need to flag the potential problems with the soon to be released (2018) contraceptive chip and its indications for use, stating that the chip has significant potential side effects.  

The group states that the remote-controlled levonorgestrel chip is a long-life contraceptive implant that may have significant side effects and be disadvantageous for women in the developing world.

The remote-controlled contraceptive computer chip has been developed at Massachusetts Institute of Technology (MIT). The chip, which measures 2x2x0.7 centimetres, is implanted under a woman’s skin and can be switched on or off using a wireless control device placed at skin level. Once activated, the chip releases 30 micrograms of levonorgestrel hormone daily. The device has a lifespan of 16 years. It is said to be ‘competitively priced’ in relation to other types of contraceptive implant however; no other device has the same lifespan and potential to be switched on and off.  The development team are currently working to ensure absolute security of the chip, so that the device cannot be activated or deactivated without the woman’s knowledge. The project has been backed by Bill Gates and is expected to go to market by 2018. Whilst the chip technology can be used to administer other drugs, the contraceptive product comes at a time when governments and organizations around the world have agreed to try to bring pharmaceutical family planning to around 120 million more women by 2020. It is planned to use this contraceptive implant technology in areas where access to other pharmaceutical contraceptives is limited.

MCI warns that without appropriate medical monitoring, the potential side effects could last throughout the life of the device and beyond. The device is therefore not suitable for women who are unable to attend a medical office for follow-up, as is often the case for rural women in developing countries.

The chip needs to be implanted and activated, and may require requested or mandatory deactivation, removal and replacement, leaving rural women with implanted chips unable to access practitioners to deactivate the device when necessary.

Levonorgestrel is a synthetic progesterone hormone which, whether administered orally, via an intrauterine device or as a subcutaneous implant, has the potential to cause side effects which affect every body system: 

Genitourinary: abnormal vaginal/uterine bleeding and ovarian cysts occur very commonly and affect >1/10 users. Less common side effects include vaginal discharge, period-pain, breast discomfort, abnormal smear and decreased libido. Gastrointestinal: abdominal pain, nausea, vomiting and diarrhoea. Neurological: depression, headache, dizziness and anxiety. Skin: acne, angio oedema. Cardiovascular: high blood pressure. Respiratory: sinusitis and URTI. General: weight gain and fatigue.
Other potential side effects include an increased risk of ectopic pregnancy and osteoporosis. In addition, levonorgestrel may affect the blood sugar level of women with diabetes. It may interact and should not be taken with nevirapine, rifampicin or St John’s wart. Levonorgestrel should be avoided in women with a past history of stroke, breast cancer or blood clotting disorder. 

All of the above indicate the need for appropriate patient monitoring. In addition, a ‘lost implant’ may require special imaging to be retrieved (something that is unavailable in most family planning clinics in the developing world).

In addition to the potential side effects, the possibility of abuse is also a concern. The chip lends itself to abuse in situations which enslave women as sexual objects for men, specifically in cases of prostitution and human trafficking. Any visibility of the remote at skin level also lends itself to the possibility of social stigmatization toward women visibly seen as contraceptive users. The last century saw a litany of abuses of the human rights and integrity of women and men including: 

  • China’s on-going one child per family policy enforced since 1979 by various means including forced abortion (now being increased to a limit of two children). 

  • India’s coercive sterilization of 11 million men and women between 1975 and 1977, and the country’s continued two-child “norm” practice toward elected officials. 

  •  Peru’s coercive sterilization of over 300,000 women, mainly indigenous, during the late 1990’s. 

  • UNFPA and USAID programs which routinely inundate women with contraception that they do not want. 

MCI will make presentations to key stakeholders in women’s health in the developing world to explain the potential disadvantages of the contraceptive chip and to promote modern methods of Natural Family Planning that are both safe and cost effective. These include: Sympto-Thermal Method, Billings Ovulation Method and Creighton Model of Fertility Care. Each of these methods offer an effective, scientifically-proven way of deferring pregnancy which is natural, non-invasive, avoids pharmaceuticals and devices, low cost, environmentally friendly, medically safe with no long term side effects.

The remote-controlled levonorgestrel chip is a long-life contraceptive implant. It may have significant side effects and be disadvantageous for women in the developing world. Modern Natural Family Planning, in combination with basic obstetric care, is the preferred means of improving maternal health.

Lee, Dave. ‘Remote control’ contraceptive chip available ‘by 2018’. BBC News. 7 July 2014. (source: http:/www.bbc/com/news/technology-28193720).
Levonorgestrel Side Effects in Detail (source: Drugs.com)
“Nine Facts about Two-Child Norm” (source: http://www.thp.org/files/Coalition%20fact%20sheet-%20final.pdf)

Professor Robert Walley Founder and Executive Director MaterCare
St John’, Newfoundland, Canada
Email: info@matercare.org
Tel Office: + 1 (709) 579-647221