Practically every mention of condoms in the second draft of the National Sexual Health Policy has been removed, The Malta Independent on Sunday has learnt.
Consultant in Genito-Urinary (GU) medicine Philip Carabot said a National Sexual Health Policy was first requested, as a matter of urgency, by the government in 1999, as it was one of the suggestions made by the EU before
membership.
Dr Carabot explained that a multi-disciplinary committee had been set up and a wide-ranging sexual health policy had been drafted. This was subsequently rejected and a re-write was ordered.
“The STIPC (Sexually Transmitted Infections Prevention Committee), which is a multi-disciplinary team nominated by the minister to advise on sexual health matters, disagreed with the amended document that included, among other things, the deletion of practically every mention of condoms. The draft policy was reduced to mainly rhetoric. It is nothing but a paper exercise with no bite whatsoever,” he said.
Dr Carabot added that he had never received an acknowledgement to a letter he had sent to the Ministry of Health on behalf of the STIPC in November 2005, which gave the reasons why the draft policy, as amended, was considered to be less than ideal.
In the GU Clinic’s annual report for 2007, Dr Carabot clearly stated: “The ‘revised’ document, drawn up seven years ago and unanimously rejected by the STIPC as being too weak, should be shelved permanently and re-written.”
Nevertheless, in an article published in The Times a month ago, director-general of health Ray Busuttil was quoted as saying that the National Sexual Health Policy should be finalised in the coming weeks.
But the STIPC’s term of office expired at the end of 2007 and to date, it has not yet been re-appointed, Dr Carabot said in his report, adding: “Clearly one is not needed.”
The GU Clinic doctor said the sexual health policy has to give a clear presentation of the current situation, a very clear idea of what needs to be done, as well as set targets and a time frame to implement corrective measures, and a definite set time for the re-assessment and, if necessary, re-thinking of the whole campaign. Such a crucial policy must have the input of world-recognised experts in this field, said Dr Carabot. He is the first to admit that, while he would give all the help he could, he most certainly does not have all the answers!
“Condoms are not the answer to all our problems, but they are an essential in prevention. The ‘revised’ draft policy we received was out of date in many areas and included a number of inaccuracies.’
“It is actually good news that this particular ‘revised’ policy has not been published and I hope it will never be; it will simply make us even more complacent.”
The GU clinic was opened in 2000 and Dr Carabot said that, since then, his yearly reports have repeatedly shown that a very large number of people have casual sex, very few use condoms consistently and sexually transmitted infections (STIs) are on the increase.
“We need to decide whether we are happy with the situation as it is now. If we are, then we do not need a sexual health policy, or a STIPC, come to that, but if we are not, what are we waiting for? It’s been nine years: a pregnant elephant would have become a grandmother by now.”
Dr Carabot thinks that sex education is rather arbitrary and certainly not uniform in schools, and that it is important to thoroughly review what children and young teenagers are being taught.
“Maltese society has changed dramatically – not necessarily for the better, but changed it has. We have acquired the life-style of other affluent countries but without the crucial background knowledge of how to deal with it.”
A proper sexual health policy would also quantify the problem and examine the effectiveness or otherwise of the type of sex education given. It would also need to look into the ever-increasing number of teenage pregnancies and establish ways of tackling the problem, said Dr Carabot.
Speaking about HIV, he argued that there is currently no proof as to whether or not it is a problem. In any case, he said, there is always a greater unknown number than a known number of people who are HIV positive in the community.
The National Sexual Health Policy would need to look seriously into sexual health promotion, as well as the services provided in both primary and secondary care.
It would have to go into the different approaches that should be used to serve different groups in society – heterosexuals, gays, teenagers, the prison population and drug users, as well as the immigrant population. Each different group has its own needs and concerns, he said.
However, Dr Carabot insisted that young teenagers would have to be given utmost priority, particularly since there is increasing evidence that they are having sex at a very young age.
’’Often enough”, he said, “they are forced reluctantly into sex due to peer pressure and the media; they are simply not prepared for the consequences of their actions either physically or psychologically.
“What are we doing to help our children face these realities? What are we teaching them in school?” he asked.
Dr Carabot says he is rather disappointed that he usually never receives any feedback to the GU Clinic’s annual reports. This year, however, there was a happy exception. “This year,” he said, “I was very happy to receive an acknowledgement from Education Minister Dolores Cristina. She had the courtesy to acknowledge that she had received the report and made helpful and encouraging comments. I am entirely at her disposal to collaborate with her, since this is not just a health issue – the importance of education can never be stressed too much.”
Finally, Dr Carabot said that the Maltese Association of Dermatology and Venereology is also very concerned about the current situation and is currently studying the feasibility of organising a workshop on the subject to which world experts would be invited to contribute their expertise.