Vasectomy Issue in Africa Health

By Lawrence Mbae.
After Dr Charles Ochieng, a father of two had a vasectomy five years ago; his family wondered what had gotten into him. Vasectomy? This is an abomination, they said. He was the talk among friends and family for quite some time. However, being a focused and an independent-minded person, Ochieng has never regretted making that decision.

“I had done my reading around the procedure so their talk did not bother me much,” he says. His wife had been on the Norplant, a form of birth control inserted under the skin and it had serious effects on her health. Norplant has since been withdrawn from the market.

Ochieng decided to have a vasectomy to relieve his wife of the misery she was going through. According to Dr Ochieng, there are 15 family planning methods in the market. Thirteen of them target women and only two are for men; the condoms and vasectomy. “I found Vasectomy as the superior one,” Dr Ochieng says. “It is effective, it is safe, no compliance issues and it is a one-off procedure, he says.
Initially, my wife was hesitant about it but now she is one of the ardent supporters for male involvement in family planning. Ochieng says it was extremely difficult to identify a doctor or a health facility where he could undergo the procedure. “It was even harder to find men who had undergone vasectomy to discuss the issue with,” says the Medic. He moved from hospital to hospital enquiring about the service and finally found one that performs the procedure.

“I am very happy with the decision I made,” he says. “It has now given me a chance to focus on my family and career. I have also founded Winam Safe Parenthood Initiative to educate men and schedule the procedure for men who have made up their minds,” he says.

What is Vasectomy?
Dr Ochieng defines vasectomy as a permanent method of birth control, done by blocking the ejaculation ducts therefore preventing the flow of sperms from the testes through the penis when a man ejaculates. “In some countries, a vasectomy can be reversed, the success rate of reversing is low therefore we let you look at it as if it is permanent,” he says.
As a practising reproductive health doctor, Ochieng recommends vasectomy especially when a man feels satisfied with the number of children he already has. “It is highly effective, safe and permanent. It shows a deep commitment to a relationship.

It can help our government to reduce public health expenditure on the procurement, shipment, storage and distribution of female-based family planning methods. One vasectomy kit can be used on thousands of men because it can be re-sterilized.

All cadres of health care providers can be trained to offer, it doesn’t have to be a doctor all the time,” Ochieng says.
“It doesn’t help to have more children than you can take care of. After a vasectomy, you will still maintain your bull-like sexuality; your erections will still be as stiff as ever. Your semen will still be the same in volume; your sexual performance might even go up due to mental freedom from unplanned and unwanted pregnancies,” he adds.

According to the medical report, women account for 99.9 per cent of family planning is carried out in Kenya. Most men consider it as a woman’s role and those who are willing to take charge are unwilling to take full control, maybe due to various challenges posed by the available options for men i.e. condoms, withdrawal, vasectomy and the male pill which is still under research.

Although condom use is the most preferred family planning method among men, very few do use it. The same applies to withdrawal and the biggest question about the male pill is whether women can trust their men with it.

 Barriers “To an African man vasectomy is the secret of enjoying sex with beloved wife without making her pregnant.” In some communities, it is a taboo. To some religion, it is a sin. According to Dr. Ochieng, the rate of vasectomy absorption is relatively low with New Zealand leading with 11.8 per cent, USA 10 per cent, Asia 3 per cent, North Africa 0.1 per cent, Sub-Saharan Africa 0.1 per cent and Kenya 0.1 per cent. There has been a lot of misconception about vasectomy, making it unpopular not only in Kenya but in the whole of Africa.

Where there is a lack of information, the gaps are filled with rumours and misconceptions, which lead to stigma then inaccessibility of service. Such rumours are vasectomy is castration, makes one fat? it is for the educated, painful, subjugated and a breach of privacy.