Infertility: Why Africa is a state of 'bareness amid plenty'

In many cultures, childless women suffer discrimination, stigma and ostracism. For example, Ann, my client was banned from attending her father-in-law's funeral.

Kenya is one of the countries in the "African infertility belt" that stretches across central Africa from the United Republic of Tanzania to the East to Gabon to the West. In this region, a phenomenon described as "barrenness amid plenty" refers to the fact that infertility is often most prevalent where fertility rates are also high.

The stigmatisation can be extreme in some countries, where infertile people are viewed as a burden on the socio-economic well-being of a community. Stigma extends to the wider family, including siblings, parents and in-laws, who are deeply disappointed for the loss of continuity of their family and contribution to their community.

This amplifies the guilt and shame felt by the infertile individual. The cultural misconceptions and the emotional burden, especially for women, is often unbearable.

Infertility is a global problem, particularly in developing countries. It is estimated that one in three couples is affected in countries within Central Africa, according to a report. Infertility is common in gynaecological clinic consultations in Kenya.

In Africa, the woman's place in marriage remains precarious till confirmed through child bearing. A woman has to prove her womanhood through motherhood. The man also has to confirm his manhood in the same fashion. Children are viewed as a source of pride, strength and economic fortune for the family, a man's wealth and strength being equated to his progeny.

Infertility, therefore, entails a loss of something that though previously non-existent, is thought to be tangible and therefore impacts negatively on a couple's mental and social well-being.

Infertility constitutes a crisis in the affected African family. The attendant emotional, psychological, cultural and social burdens rob the couple of self-belief and esteem. The societal expectations place on such couples unimaginable pressure and tension. Infertility may even lead to isolation and neglect of the affected couple.

When a couple is unable to reproduce, the man may divorce his wife or take another wife if they live in a culture that permits polygamy, further worsening the problem.

Many notions exist as to the root cause of infertility. Taken generally, the female is held responsible for virtually all cases of infertility. The men folk are hardly blamed for infertility. The woman can sometimes be humiliated, isolated, derided, abused and rebuffed.

Most infertile women in Africa have to ensure all that. They go to varying lengths visiting orthodox medical practitioners, herbalists, traditionalists and spiritualists in search of solution. Such women need to worry less as assisted reproductive technologies are becoming available, accessible, acceptable and affordable.