The Impact of Infertility in Africa
In addition to the personal grief and suffering it causes, infertility can create broader problems, particularly for the woman, in terms of stigma, economic hardship and social isolation. It is often considered a personal tragedy as well as a curse for the couple, impacting on the entire family and even the local community.
Women who remain childless may be seen as a burden on the socio economic well-being of communities. Childless women are often blamed and suffer from stigma, discrimination and even violence. The man may divorce her or, if their culture permits polygamy, ‘take another wife’. She may be seen as an evil eye, a shameful subject, and banned from any family and community activities. Facing social isolation and ostracism, childless women often consider that without children, their lives are without purpose and without hope.
Unlike the Western world, where infertility is openly discussed and help and information is widely available, in most African societies the topic is taboo, and help is scarce, contributing even more to the agony and isolation these women suffer.
This situation is further saddened by the lack of support women face, both emotional and financial. Women are not encouraged to seek medical treatment and modern fertility care, if at all available is very basic. Assisted reproductive techniques such as IUI and IVF are either very costly or unavailable. Combined with the widespread lack of insurance coverage, seeking fertility care often means a lonely path for women wishing to conceive.
Infertility, the Myths
In the Gambia, infertility is often thought to be caused by a curse or interference of spirits. Infertility is not considered a medical problem but causes, and therefore also remedies, are sought in the spiritual world. These may include prayer, spiritual healing, and herbal remedies. Gambian women struggling with infertility issues often spent thousands of dalasies on ‘marabouts’ and ‘black medicine’ before they seek medical help.
Even though male infertility has been found to be the cause, or contributing factor of a couple’s failure to conceive in up to 50% of the cases, infertility is almost always assumed to be a women’s problem. The blame, and social burden falls disproportionately on women. African men sometimes seem to think they can impregnate women at any given time and that few nights together should be sufficient. Men living in the Diaspora often marry a wife who stays behind in Africa. If pregnancy does not occur within one or two years, it is the wife that gets the blame, even if during that time the couple may have actually spent only two or three weeks together. Sexual and reproductive education should emphasize on correcting these ideas.
Conventional help for infertility is very basic and may involve the surgical repair of blocked fallopian tubes and blind hormonal stimulation with Clomid. Hormonal stimulation without monitoring follicle development has a risk of multiple pregnancies that in turn are associated with a higher risks of pregnancy complications such as diabetes, premature labor and low birth weight. Highly controversial is the procedure of D&C (dilation and curettage). D&C as an infertility treatment has long been eliminated from the reproductive medicine textbooks, and government hospitals and most private clinics no longer offer this procedure as infertility treatment. Still, many Gambian women feel that the process of ‘cleaning out the womb’ or ‘stomach washing’ will remove any blockage that might prevent a pregnancy or affect its viability and some are willing to offer large sums for the procedure. Sadly as of to date some doctors still perform D&C for these reasons.
Women’s Reproductive Health Rights & Care
To the casual observer of the international women’s health rights debate, it would appear that the greatest concern for women in Africa is the right NOT to have children.
The key areas for sexual and reproductive health investment in sub Saharan Africa have been the right to legal and safe abortion and the right to birth control ensuring that women can practice and enjoy sexual relationships without the risk of unwanted and unplanned pregnancies.
Yet the World Health Organization (WHO) demographic studies have shown that in sub-Saharan Africa, more than 30% of women aged 25–49 suffer from secondary infertility, the failure to conceive after an initial first pregnancy.
Infertility is deemed a low-priority issue in the context of scarce health care resources and infertility may be justified as a natural solution to reducing the birth rate and achieving accelerated economic growth from a declining and smaller dependent populations.
Infertility Organisations In Africa
With the exception of the WHO, few NGOs are prioritizing or funding infertility efforts or initiatives that will address the problem of infertility in Africa.
The Gambia’s First Lady, Her Excellency Fatoumatta Barrow, has recently been appointed by The Merck Foundation as an Ambassador for the “Merck More Than A Mother” initiative.
The “Merck More Than A Mother” initiative specifically aims to empower infertile women in Africa by delivering infertility awareness, prevention and treatment initiatives that will address the medical, financial, social and emotional problems of African women tortured by the silent agony of childlessness.
Organizations addressing Women’s Health Issues and or Infertility.
Fatoumatta Bah-Barrow Foundation is a non-profit charity organization that supports disadvantaged communities, women, children and vulnerable groups in The Gambia. The foundation is established for charitable purposes aimed to benefit areas in health, orphans,
children, widows, youth and women through educational projects and social development programs.
In the future they hope to further develop and expand their range of fertility treatments to Low Cost IVF (in vitro fertilization).
In order to break the taboo and demystify the causes of infertility Dimbayaa also aims to develop educational outreach programs, working with local women’s groups such as The Kanyaleng. Ideally combined with low threshold mobile clinics providing for early and appropriate diagnosis and treatment of STD’s that often lead to infertility.
Safe Haven has a vision to ensure the Gambian community has increase awareness on misconceptions surrounding issues of infertility and create a platform for women to share experiences with a view to getting the required guidance and counselling from experts in the
Author: Dr Cynthia Witsenburg- Read Original post here