By Azoma Chikwe
Fifty – Seven year old Grace Kambini popularly aka mama chips said she got married out of societal expectations, whereby women are expected to get married to earn respect from their communities.
After nine years of marriage, she realised that she could not give birth. Both her husband and his relatives started attacking her. The abuse and insults extended to her home where she was tortured and frequently denied food for weeks at a time. Her husband did not care about her woes.
“I remember asking my husband, how long I will continue to live this misery. He replied : You refused to leave my house as if your parents are dead, if they are dead you should ask them to open their grave so you may join them. You are of no use to me. Every time I remember his insult or talk about it, I feel faint and out of breath. Due to the stress I endured, I suffered hypertension and diabetes, now my life is about injecting insulin day and night,” Grace said crying.
She had nowhere to go. Unfortunately, Grace has no living relatives on her mother’s side and her in-laws did not seem to care about her suffering. At a point, Grace husband even asked her to go back to her late parent’s home and wake them from the graves so they can accommodate her.
Grace said that she did not have money but she soldiered on There was a point in her marriage when she missed her menstrual cycie for a month. The following month she started bleeding excessively instead of getting her period. She was also vomiting profusely.
She sought medical advice to find out what was wrong with her. The doctor advised her to go for an operation since she was pregnant and the fetus was developing in her fallopian tubes instead of the uterus.
Her husband of 10 years has divorced her and she started living alone with no one to support or advise her. Life became miserable with each passing day.
“I still ask myself who I am in this world? Is this the life I was meant to live? There is no one to love or help me, I have nowhere to go. When I travel to village my brother’s wives constantly insult me,” Grace said in agony.
She started her own small chips business by the roadside to eke a living.That is why she is called Mama chips. Grace advised young couples to visit hospital regularly and seek solutions as a couple, saying : “If I was younger with the knowledge I have now, I would have explored better fertility options to better life, but now, am too old”.
Jacqueline Kpeya, 37, married Abito, 46, who was her teacher in a vocational school where she learnt tailoring. The couple from Kenya were happy together for about three years until childlessness brought cracks into the marriage. Jacquiline tried as much as she could to find the cause of their problem, Abito was reluctant to go for tests. He came from a background where infertility was exclusively seen as a woman’s fault. As the years rolled by, the rift between Abitu and his tall, fair and beautiful wife widened because of childlessness. While he contemplated marrying another wife, he did not want Jacqueline to remarry when he leaves her and possibly carry another man’s baby.
To seal that plan, one night, he woke her up, engaged her in a brawl, and cut off her two hands from the wrists joint. Her desperate shout woke up neighbours who found her in a pool of blood, her two hands chopped off, her husband nowhere to be found. She was rushed to a hospital where the bleeding was stopped and regained her life. She lost her marriage, both hands, happiness because of infertility. The saving grace came when Merck Healthcare placed her on salary for life and opened a small business for her.
The stories of Grace and Jacqueline are examples of what millions of childless women pass through in the hands of their husbands and in-laws in Nigeria and indeed in Africa.
More than a mother
Dr Rasha Kelej, Chief Social Officer, Merck Healthcare said, “it is very important to help empower infertile women through improving access to awareness and fertility care so they can bear children as part of their human rights. In case they can no longer be treated, Empowering Berna project will contribute towards empowering and training them to establish their businesses so that they can be independent and re-build their own lives, a woman is more than a mother, Empowering Berna initiative will prove this every day. “
An inability to have a child or to become pregnant can result on the women to be disinherited or assaulted. This may result in divorce or physical and psychological violence. There is a campaign to support governments to define policies to improve access to safe and effective fertility care and address the need for interventions to reduce stigmatization and social suffering of infertile women and the necessity for a team approach to family building among couples.
Through this campaign Ministries of Health, Health care providers, women parliamentarian, academia, media and community members will be able to contribute to raising awareness about discrimination, stigma and ostracism women undergo for their inability to have a child. And encourage men to acknowledge and discuss openly their fertility problems and strive for a team approach to family building with their partners in order to progress toward shared fertility responsibility among couples.
Women can be more than mothers, they can be empowered in business, according to Dr Rasha Kelej, Chief Social Officer, Merck.
Chairman, Senate Comittee on Health, Dr Lanre Tejuoso, said, “the senate is happy to launch the campaign. One in every four women in Africa are infertile. I have moved a bill in the senate on Assisted Reproduction Technique(ART) to regulate assisted reproduction. Fifty per cent of infertility is caused by men though they will not admit it. Some of the infertility ases are due to infection and other disease conditions.
“If a lady can be deprived of hands because of infertility, it is rason to give the issue more attention. There are many people like Jacquiline in Nigeria who cannot speak out. It is because in Kenya, the awareness is being championed by a member of parliament, that people like Jacquiline came out to speak.”
Hon Joyce Lay, Member of Parliament of Kenya said, “ we are not defined by how many children we have, we are more than mothers. The stigma against childless women is very high in Africa. In some cases, the husbands were the ones that have the problem. In the case of Jacquiline, the man felt if he could not give his wife a baby, he could go out and get it, or go into another marriage, he permanently deformed Jacquiline by cutting off her two hands.
“When we started the campaign in Kenya, not many wanted to be part of it. I experienced similar dilemma. We have to change the policies. After having my baby through in-vitro fertilization(IVF), I had to adopt him. It took me four years to be acknowledged as his mother because of the laws of Kenya.
Consultant Gynaecologist, Prof. Oladapo Ashiru, said, “we have to be the agent of change. Contraceptive in those days were made impossible, along the line, they introduced contraceptives, not knowing that infertility is in the corner. Men will say they have had intercourse with their spouses, but they don’t know that the sperm can be of low count and may not fertilise the egg. Infertility is now regarded as a human right issue by World Health Organisation(WHO). I am touched by what happens by what happens to women because they cannot have children. Some have their hands cut, some commit suicide.
“Two factors that affect infertility are infection and environmental factors. When a woman has a discharge from the vagina, she should see a doctor. It is a pointer to infertility. Infertility is not witchcraft attack, if people are infertile, they should see a doctor, it reduces the incidence.
“WHO listed six protocols, they said before treatment, there should be prevention. The use of condom has gone down.”
President, Nigeria Reproductive Society, Dr Faye Iketubosin, said,” Advocacy is important, and we have been doing that in our own little way. We need to move forward. What actually do we want to achieve? We need to increase awareness with access. Women should not be denied access to health care. As practitioners, our role is to offer care. In the private sector, fertility treatment is very expensive, how many women in a country of 170 million people can afford it?
“Infertility can be defined as a condition in which a person cannot contribute to conception. This can be when a woman, under the age of 35 cannot conceive with consistent sexual intercourse for a period of 12 months. Although, women tend to become less fertile when they grow older, there are still chances a woman can conceive if she have consistent unprotected sexual intercourse.”
It is known that one in seven couples worldwide have problems of infertility. Being infertile or not being able to conceive can be psychologically rendering, especially when you are growing older, or receiving pressure from family (common in African societies) or seeing your peers who are able to conceive.
In African society for example, infertility is characterised by barrenness and could be associated with other superstitious beliefs.
Infertility could be primary infertility or secondary . Primary infertility can be defined as when a woman has never conceived while secondary infertility can be defined as when a woman has conceived but could not conceive again after a period. Meaning, she cannot have a baby after her first child. A woman who has miscarriages is also infertile. Causes of infertility vary from male to female.
Male
Male factors include low sperm count which is the number one cause of infertility in men. This is when the sperm is not enough to go through the acidity in the vaginal wall of a woman. Mostly, because they are not that much, there is high tendency that they will all be killed before any one of them could get a chance to fertilize a woman’s egg.
Diseases such as diabetes, prostate enlargement, adrenal disease can cause infertility in men. Some forms of chromosomal translocation or chromosomal abnormality where there is fusion of two already separated genes can cause male infertility. Hypothalamus factors such as high level of prolactin (helps breast development) in the blood, reduction of pituiry hormones produced under the brain that helps proper fertility.
Presence of anti-thyroid anti bodies is a factor. Certain environmental factors could be responsible, such as high level of breathing in carbon monoxide like in smokers and those near smokers, inhaling of pesticides, living near chemical industries, ingesting glues or soaps. Studies have shown that those that work in tire factories could become infertile.
Sitting on a position for a long time: your testes needs free air flow, and when this air flow is impaired, it affects the proper production of semen in the testes. Some types of viral infection can cause infertility in male
Female
Lack of immaturity of the ovaries. Damage to the fallopian tube which could be caused by some diseases like, pelvic inflammatory disease, surgery and ectopic pregnancy. Underweight which is found in some women. Problems or causes associated with age. Having ovulation problems that could be triggered by hormonal changes, your diet, and lack of exercise. Irregular periods, could be a sign there is ovulation problems
Uterine problems which could be caused by use of some birth control pills, thyroid problems, fibroids, polyps. A woman could have symptoms such as bleeding which usually occurs between during sex or after sex.
Though, a man or a woman could have gone through test to ascertain if they are infertile or not. The result could be that they are both fertile and this is unexplainable in the medical world because there is no associated cause to it. All problems are mostly on possibilities, but not proven. However, it is important to have the right set of mind if truly individuals want to overcome the problem of barrenness or infertility. Positive thinking and attitude alone will help a couple achieve their dreams of conceiving.