WORLD VASECTOMY DAY PRO­MOTES QUICK, SAFE AND REV­ERSIBLE BIRTH CON­TROL METHOD

The Star (Kenya) - - Big Read / Men’s Role In Family Planning - BY RHODA ODHIAMBO @Od­hi­amboRhoda

To­day marks the first time the World Vasectomy Day is be­ing held in Kenya, high­light­ing a sub­ject rarely dis­cussed es­pe­cially among men.

In any re­la­tion­ship, there comes a time when a cou­ple de­cides to talk about fam­ily plan­ning. Such con­ver­sa­tions are usu­ally held if a cou­ple wants to space their chil­dren or if they feel the num­ber of chil­dren they have is enough.

Some of these con­ver­sa­tions are held in a class­room set­ting, where one party rep­re­sents the teacher and the other the stu­dent. The stu­dent in this sce­nario is a woman in a so­ci­ety that as­sumes fam­ily plan­ning is her re­spon­si­bil­ity.

Which begs the ques­tions: What hap­pens if the ta­bles are turned and the man opted to take the bul­let? Would his ac­tions be viewed as an act of love or would he be the laugh­ing stock of the so­ci­ety?

Some 30 men will un­dergo free vasectomy at the Kenya Na­tional The­atre to­day free of charge. Five doc­tors from the US to­gether with a few lo­cal doc­tors will carry out the pro­ce­dure on men whose fam­i­lies are com­plete.

Zachary Ka­giri, 45, is among those who de­cided to un­dergo the op­er­a­tion. He said it will ease the bur­den his wife has been fac­ing for 10 years. “I made up my mind when my wife told me that she was go­ing to re­move the fam­ily plan she had (im­plant). She would al­ways com­plain that it made her feel dizzy and have mood swings, but all that was mu­sic to my ears,” Ka­giri said.

Zachary has four chil­dren, two of whom are with his wife. He said he was al­ways em­bar­rassed when­ever he went out with his wife be­cause ev­ery­one knew the fam­ily op­tion she was us­ing be­cause of the type of clothes she was wear­ing.

“I tried pick­ing dresses for her but she would not wear them. She opted for the sleeve­less clothes which al­lowed ev­ery­one to see the mark on her hand,” Ka­giri added.

As the man of the house, Ka­giri re­searched about the fam­ily plan­ning op­tions avail­able to men in the mar­ket, and by sheer luck, he met the founder of World Vasectomy Day, who ex­plained to him why a vasectomy would be the best op­tion for him.

“When I met Jonathan and his team in Kangemi and told them about my predica­ment, they ex­plained to me what a vasectomy is and where I could do it. It is at that point that I kept ask­ing my­self why I can’t save my wife,” Ka­giri said.

When he told his wife about his de­ci­sion, she said it was the best news. “It shows that you re­ally love me and I will sup­port you,” she said.

MYTHS ABOUT VASECTOMY

Jonathan Stack, 59, is the founder of the or­gan­i­sa­tion. He came to Kenya in Au­gust with the aim of learn­ing about the up­take of fam­ily plan­ning op­tions in the coun­try, es­pe­cially among men.

Jonathan, an Emmy Award-win­ning and two-time Academy Award-nom­i­nated doc­u­men­tary film­maker, and also the founder of World Vasectomy Day, got his vasectomy five years ago. He has six chil­dren.

“Be­fore the pro­ce­dure I asked a friend of mine what he thought of men who got a vasectomy.” His re­sponse made him de­lay his de­ci­sion to get a vasectomy. “He said men who got a vasectomy are not al­pha men but al­pha lite.”

How­ever, when he told his wife about his de­ci­sion, she re­sponded with a ques­tion: “What took you so long?”

Jonathan says it was the only state­ment she made apart from be­ing happy. Pre­vi­ously, she has used an IUD and hor­monal pills.

His or­gan­i­sa­tion has marked three World Vasectomy Days in dif­fer­ent coun­tries, the fourth one be­ing cel­e­brated in Kenya to­day.

“Kenya, like many coun­tries, faces chal­lenges of cul­tural, re­li­gious and eco­nomic dif­fer­ences. A lot of men fear get­ting a vasectomy be­cause of the neg­a­tive per­cep­tions from peers with no aware­ness from both na­tional and county gov­ern­ments,” Jonathan said.

He said his pro­ce­dure, which took about 20 min­utes, did not af­fect his life. Most men think that if one gets a vasectomy, it will af­fect his sex life and make him less of a man.

“Women put up with a lot in life that we men take for granted. Men should be em­bar­rassed of how wimpy we are. If men had to give birth to ba­bies, there would never be a sec­ond child be­cause they can­not tol­er­ate the dis­com­fort women go through,” Jonathan said.

Ac­cord­ing to a re­port by the Na- tional Coun­cil and Pop­u­la­tion Devel­op­ment, men rarely get in­volved in fam­ily plan­ning mat­ters be­cause the in­for­ma­tion be­ing re­layed only fo­cuses on women.

The 2014 re­port, ti­tled Male In­volve­ment in Fam­ily Plan­ning and Re­pro­duc­tive Health, also in­di­cated that men fear talk­ing about it.

“The re­sults in­di­cate low male in­volve­ment in the mat­ter. This is mainly due to the stigma as­so­ci­ated with fam­ily plan­ning and ma­ter­nal and child health clin­ics be­ing per­ceived as a woman’s is­sue,” it read.

The re­port showed most men sup­port a fam­ily plan­ning op­tion cho­sen by their spouses by pro­vid­ing fi­nan­cial sup­port or trans­port to and from the clin­ics.

“The find­ings fur­ther in­di­cate that

con­doms are mostly used as an al­ter­na­tive to long-term meth­ods, such as vasectomy. In all the re­gions, the men and women, both young and old, were in agree­ment that vasectomy is the least pop­u­lar fam­ily plan­ning method. Few men were will­ing to go through the mi­nor op­er­a­tion, while their women thought that men who un­dergo vasectomy may not have an erec­tion any more, or worse still, may be­come im­po­tent,” the re­port stated.

WHAT PRO­CE­DURE EN­TAILS

A vasectomy is a sur­gi­cal pro­ce­dure per­formed on men in which the vas def­er­ens (tubes that carry sperm from the tes­ti­cles to the sem­i­nal vesi­cles) are cut and tied.

Once cut, the se­men will no longer con­tain sperms, so con­cep­tion can­not oc­cur. The tes­ti­cles con­tinue to pro­duce sperm, but they are ab­sorbed by the body.

Be­fore the pro­ce­dure is done, the physi­cian will first as­sess the pa­tient’s gen­eral health to iden­tify any po­ten­tial prob­lems that could oc­cur. The doc­tor will then ex­plain to the pa­tient what the pro­ce­dure en­tails.

Af­ter that, the pa­tient will sign a con­sent form stat­ing he un­der­stands the in­for­ma­tion given to him and gives the doc­tor per­mis­sion to per­form the op­er­a­tion.

“The pro­ce­dure only takes 15 min­utes. It is done un­der a lo­cal anes­the­sia,” vasectomy spe­cial­ist Charles Ochieng’ said.

Dr Ochieng’, who prac­tises at Wi­nam Safe Par­ent­hood Ini­tia­tive (Wispi­vas), has con­ducted more than 1,000 pro­ce­dures. He said af­ter the pro­ce­dure, the pa­tient is not al­lowed to strain him­self by do­ing any hard labour. He is also ad­vised not go have sex­ual in­ter­course un­til af­ter 72 hours or when he is com­fort­able to re­duce any chances of the wound be­ing in­fected.

TUBAL LIGATION

Dr Ra­mon Suarez, who is among the five doc­tors who will be car­ry­ing out the va­sec­tomies at KNT, cau­tioned men not to opt for a vasectomy if their part­ner opts for tubal ligation.

“The fail­ure rate of a vasectomy is 2 per cent, and if it fails, the worst that can hap­pen is get­ting your spouse preg­nant. How­ever, if tubal ligation fails, your spouse may die,” Suarez said.

Tubal ligation is a sur­gi­cal pro­ce­dure for ster­il­i­sa­tion, in which a woman’s fal­lop­ian tubes are clamped to pre­vent eggs from reach­ing the uterus for im­plan­ta­tion.

Both Suarez and Ochieng’ doc­tors added that va­sec­tomies are rev­ersible but very few men opt out of it.

“Vasectomy is not for peo­ple who still want to have chil­dren. This is one of the sim­plest fam­ily plan­ning op­tions be­cause the process of di­vid­ing the tube is fairly sim­ple com­pared to the process of re­vers­ing it,” Suarez said.

“In Kenya, men are said in­volved in fam­ily pan­ning mat­ters be­cause the gov­ern­ment has not been cre­at­ing aware­ness about vasectomy. That is why most of them think that it is cas­tra­tion.” Ochieng added.

SEARCH FOR AL­TER­NA­TIVES

Women have more than 10 dif­fer­ent types of fam­ily plan­ning meth­ods while men have two: con­doms and vasectomy.

A study pub­lished in the Jour­nal of Clin­i­cal En­docrinol­ogy and me­tab­o­lism shows that sci­en­tists are try­ing to come up with male-equiv­a­lent fe­male con­tra­cep­tives like pills and IUDs.

A hor­monal pill for men is in the off­ing af­ter re­searchers said that the in­jectable drug is 96 per cent ef­fec­tive.

Out of the 320 who took part in the study, only four of them got their wives preg­nant. The trial, how­ever, ended pre­ma­turely af­ter some men com­plained of de­vel­op­ing some side ef­fects to the pill, such as mood swings, mus­cle pain, acne, among oth­ers.

Ochieng’ noted that the roles of men in fer­til­ity and fam­ily plan­ning should not be over­looked, as it is im­por­tant in the con­text of rais­ing con­tra­cep­tive preva­lence and re­duc­ing level of fer­til­ity.

1 /RHODA ODHIAMBO

1. Zachary Ka­giri, one of the men who will un­dergo vasectomy to­day at the Kenya Na­tional The­atre.

2. Jonathan Stack, founder of World Vasectomy Day.

2

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