A report on the presentation of a paper titled “use of lemon/lime juice douching by  women to prevent infections and pregnancy  in Jos, Nigeria” at the 12th priorities in reproductive health and HIV conference 18-21 October, 2005, Spier Hotel, Stellenbosch, South Africa

The time was 4:30pm on Wednesday 19th October, 2005 in Stellensbosch, a town which is about 30 minutes drive from Cape Town, South Africa. Delegates from different parts of the world were gathered and seated in the main auditorium of Speir Hotel, Stellenbosch.

Spier Hotel, Stellenbosch, South Africa the venue for the conference

The 7th paper presentation session titled “Traditional Practices and Gender” at the 12th Priorities in Reproductive Health and HIV conference was scheduled to commence. The presenters for the session were ready and seated at the high table. The chairpersons for the session:  Prof. Eleanor Preston-Whyte, University of KwaZulu Natal, South Africa and Dr. Andrew Levack, Engender Health, Seattle, USA started off the session. The keynote address which showed that male circumcision is protective and reduced the risk of HIV transmission was presented by Dr. A. Pruden, National Institute of Communicable Diseases, South Africa. Three other presenters took their turns to present their papers.

                                                                         


Participants at the Conference

Presenters at Session 7-Traditional Practices and Gender

After these, it was time for the long awaited paper on lemon/lime douching to be presented. The conference participants were curious and had earlier on during the conference asked questions about the lemon study. They wanted to know who the presenter was. Now the time they were all waiting for has come. The presenter of the paper, Godwin E. Imade, a Senior Research Fellow, Department of Obstetrics and Gynaecology, University of Jos, Nigeria was invited to the podium. The presenter greeted the audience and brought out three big lemon fruits and held them high up as he introduced the title of his presentation-“Use of lemon/lime juice douching by women to prevent infections and pregnancy in Jos, Nigeria”. The audience which comprised of about 200 conference participants in the hall, listened with rapt attention.

    

Godwin Imade presenting his paper on lemon/lime juice douching

He stated that HIV was increasing at an alarming rate in Sub-Saharan Africa and that women accounted for 57% of the 25 million people infected in the region. The national HIV prevalence in Nigeria is 5% in a population of about 130 million. In Jos Nigeria, 1 in 10 pregnant women has HIV infection. HIV infection in STI patients and Female Sex Worker is as high as 30% and 54% respectively. He lamented that HIV infection in women in the region is fuelled by poor socio-economic circumstances and gender inequity. The women are vulnerable to HIV infection because they can not insist on condom use, cultural and traditional practices in the region favour the male more than female. Women in the region are in desperate need of a female-controlled agent they can use to protect themselves from sexually transmitted and HIV infections and pregnancy in the face of male dominance.

In his presentation, he showed that 81.5% of 200 Female Sex Workers (FSW) in Jos, Nigeria used lemon/lime douching before or after sex compared to 4% of 100 Family Planning Clients. Over 50% of the women that douched with lemon/lime juice believed that it protected them from infections and pregnancy. Nineteen percent of women who used lime/lime juice indicated that they experienced pain after douching. He could not ascertain whether the pain the women experienced was due to lemon/lime juice or as a result of pre-existing lesion caused by STIs. On the whole, 86% of the women were happy to recommend the use of lemon/lime juice for douching to others while 71% would be willing to participate in a study to evaluate its safety and efficacy.

The presenter said that the crucial question that may be asked is “Does lemon/lime juice douching really work?” He said that evidence available in literatures show that women over the years including those in Turkey in the 18th century used lemon juice for contraception. He also mentioned that recent in-vitro studies in the laboratory in Melbourne, Australia showed that 20% of lemon juice irreversible immobilised motile spermatozoa within 30 second and killed HIV in 2 minutes.

In his conclusion, he pointed out that lemon/lime juice is a natural agent which women in Jos who are at high risk of acquiring HIV infection are already using with a belief that it protected them from infection and pregnancy. He passionately pointed out the urgency in evaluating the safety and efficacy of the agent scientifically through a well designed study in order to determine whether  to encourage the the use of Lemon/lime juice douching or not. He said there is no doubt any more that women in economically constraint countries of the world are in dear need of a cheap, safe, effective and readily available female-controlled microbicide they can use to protect themselves from sexually transmitted infections and pregnancy. Will this agent come soon so that millions of our women be saved from untimely death? Only God knows!

Godwin posed for a photograph with Prof. Eleanor Preston-Whyte,

 The Chair person of session 7 at the conference

The presenter spoke for about 10 minutes and kept his audience spell bound with his findings and his exciting manner of presentation. As he concluded his presentation there was spontaneous clapping of hands and a resounding ovation.

Questions, discussions and jokes on lemon/lime douching continued after the presentation session and during the remaining days of the conference. The presenter earned himself a nickname -“The lemon man” for the remaining days of the conference.

The conference which was very well organised and packed full with relevant and topical burning issues in reproductive health and HIV came to an end at about 1.00pm on Friday 21 October, 2005. The official closing address was delivered by the energetic and dynamic lady- Prof. Helen Rees, The Chair Person Conference Organising Committee and Director, Reproductive Health and HIV Research Unit, University of Witwatersrand, Johannesburg, South Africa.

Acknowledgement

The Presenter, Godwin E. Imade wishes to thank the study subjects for their cooperation and participation in the study. He is appreciative of his co-authors:Atiene S. Sagay, Viola A

Prof. Helen Rees (The Chair, Conference Committee)

making a point at the conference

Onwuliri, Daniel Z. Egah,  Malcolm Potts, and Roger V. Short for their contributions. Finally he is grateful to the 12th Priorities in Reproductive Health and HIV conference organizers and The Mary Magdalene Project, The Australian AIDS Fund for the Bursary Awards he received to attend well organized conference.

NB: Power Point Format of the Presentation is available

Report written by:

Godwin E. Imade
Senior Research Fellow
Dept of Obstetrics and Gynaecology
Faculty of Medical Sciences
P.M.B. 2084
Jos, Nigeria
E-mail: ereimade@yahoo.co.uk

 

 

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