If you’re a teenager in Mtwara, Tanzania, getting hold of trustworthy information about sexual health isn’t always easy. But now, thanks to an anonymous text line set up by ICS alumni, the ‘Contraceptive Conversation’ is connecting doctors with young people in the city to provide safe, free and reliable sexual health advice and confront the misconceptions.
Medical student and ICS volunteer Innocent Grant, 21, tells ICS how the project is filling the gap.
When I was 14 and in secondary school, one of my classmates fell pregnant.
She faced a lot of stigma – and ended up leaving school for a year while she had the baby. She wasn’t given the option of returning. Luckily for her, her family were able to pay for private school, but it’s a reality in Tanzania that most others won’t be as fortunate.
Here, part of the problem is a negative attitude towards talking about sex from the older generation. If you go to a pharmacy to buy condoms, you’ll be judged by the person serving you. My family and school didn’t teach me about sex well. It’s hard to learn how to have safe sex.
I think sometimes that if that girl was taught more about safe sex at school, if she’d been given the access to contraception that she deserved, she wouldn’t have lost that valuable year of education.

The 15-year impact of volunteers in Mtwara
In 2014 I joined the Clinical Officers Training College in the city of Mtwara.
I was training to become a clinical officer, a qualified medical professional working in the district and village hospitals across the country. I was studying so I could help make sure primary health services are accessible to everyone – and in particular to the rural populations.
Ten years earlier, a group of sexual health experts and Kings College lecturers had visited our college to collaborate with VSO on a reproductive health project. They spent two years setting it up and in the process established a sexual health club to help give students first-hand experience.
That was almost 15 years ago – and it’s still going strong. With 100 new students from the college involved in the project each year, and support from VSO volunteers every year since, it’s giving them early access to the conversations that they’ll be having during their career that will follow.

UK volunteers showing implants helped change minds
I volunteered with VSO ICS in Malindi in June on an employability skills programme. We were working in a vocational college teaching interview and entrepreneurship skills to young people – and in our day-to-day work speaking with the young people about sex and relationships.
By coincidence, all of the UK volunteers on our project were female – and many were happy to show their implants and answer questions about contraception. For the girls they spoke with, hearing other young women from outside Tanzania talk openly about sexual health really opened their eyes.
When I returned from placement I wanted to do something. I knew that reliable information on contraceptives is available online. Most households – even in the rural areas – have access to mobile data. And, as you’ll guess, a lot of young people have Instagram and Facebook accounts.
We had a solution that was free, open and online. And so the Contraceptive Conversation was born – an anonymous online platform for young people to send in questions around sexual health and contraception to be answered by both students at the college and the VSO doctors back in the UK.

Will masturbating make me infertile?
During the sessions our project officers have with students in schools on contraception, HIV and sexual health, they share our WhatsApp number, and ask them to send in any questions they didn’t have the confidence to ask in class.
Then, in a WhatsApp group with the clinical officer students and the VSO doctors, we prepare accurate and fast answers to the young people’s questions, post them on a Facebook page we’ve set up and share the number to encourage people to submit more questions.
And so far it’s working well. We’ve answered almost 90 questions, including on when to have sex to have a baby, whether masturbation can cause infertility and even if contraceptive use leads to constipation. These are easy questions to answer but the cause is simple – a lack of information.

Buying contraceptive pills without a prescription
When we speak with them, we hear how they struggle to access services. We hear how they buy contraceptive pills without a prescription. We hear how they go through illegal abortions.
A lot of them are getting the wrong information and because they’re scared to ask questions they follow the routes that are wrong for them. I hope that with the right information, these young people will be the political leaders and forward-thinking parents of the future.
And before joining, even some of our students have negative attitudes towards family planning. But these are the young people going on to become our doctors. It’s been great to see their minds changed and them become passionate about helping our youth. It’s going to have a huge impact.

Representing Tanzania – and meeting our project’s founders
In November, I represented Tanzania at the International Family Planning Conference in Rwanda. 26 youth speakers like me came together to share stories on family planning and sexual and reproductive health rights to a 4,000-strong audience of global experts and NGO leaders.
But a personal highlight for me was meeting VSO volunteer Dr Paula Baraitser and Dr Michael Brady, two of the team who’d set up the project in Mtwara all those years ago. We travelled back to Tanzania together and carried out a week-long project training 300 young people on HIV and STIs and how to become youth educators – as well as discussing plans for the future of the club.
And as for me, I’d like to go on to study public health. I want to create solutions for sexual health for Tanzania’s youth population. Currently I’m developing a YouTube channel for young people affected by sexual health issues, but in the longer-term I hope to start an NGO.
My dream is a future where young people have free access to contraception and sexual health services and can live a life free of negative attitudes towards them. I want HIV to no longer become an issue. And I want no more young girls to have to drop out of school because of pregnancy.
