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Vasectomy: Why men are afraid of surgery

 Dr Douglas Stein of No-Scalpel Vasectomy International with a patient at the Family Health Options clinic, Nairobi. [Elvis Ogina, Standard]

When Samuel Gatenjwa wanted a contraceptive method, he and his wife made a major decision and settled on vasectomy, a procedure that sends shivers down men's spines.

Mr Gatenjwa's decision on March 23, 2004 contradicts the long-held perception that the use of contraceptive as a family planning method in Kenya and other African nations is a burden largely shouldered by women.

Pills, implants, tubal ligation, diaphragm, ovulation calendar, and female condoms are methods women use in their duty to ensure the earth is not literally filled, as is described in the book of Genesis 9:1.

Men’s role in family planning has been limited to the use of condoms and withdrawal during ejaculation, which has been smooth sailing for them.

Not until the introduction of vasectomy did the script change and attention shift to who between husband and wife should bear the burden of family planning.

Gatenjwa said he did it out of love for his wife, who was suffering due to the side effects of using other methods of contraceptives.

“For a variety of health reasons, my wife and I would not be in a position to bear more children hence the operation was necessary,” he said.

Unlike Gatenjwa, most men shy away from vasectomy, regarding it as a method that could robe them of their fertility and pride, and bring shame upon them in society.

According to a 2013 UN report, only 0.1 per cent of men in Africa had entertained the idea of vasectomy, with South Africa and Namibia leading with 0.7 per cent and 0.4 per cent coverage against 18.9 per cent of women who were sterilised. Only 0.1 per cent of Kenyan men had a vasectomy.

Peter Omondi said he could not contemplate the idea of having his sperm tubes cut or sealed to permanently prevent him siring children, no matter how much he loved his wife.

He dismissed vasectomy as being for the people who idealised Western culture, saying he would rather stick to the old natural methods of family planning.

“That method sounds and feels like castration. I cannot have that. There are many other ways to control the number of children and I prefer withdrawal,” said Mr Omondi.

David Omwoyo and the pride of a man in society was having an unlimited number of children provided he had the resources to look after them.

Mr Omwoyo said in the eventuality he divorced his wife or tragedy struck and his children died, he would need to sire other children.

“I am an African man and my fertility is my pride. I cannot even bring myself to think of the idea. What if we separate with my wife, marry another wife or, God forbid, I lose the few children I have? I will need to sire other children.”

Paul Oloo, a master's student at the University of Liverpool, said vasectomy was a short-term remedy to controlling population, but had a vast long-term effect on a nation’s manpower.

Mr Oloo said a country's GDP was based on the working hours and the work force, both of which depended on the manpower.

 Limited manpower

“The GDP is determined by a 24-hour economy and workforce, all of which depend on labour that depends on the population of a country. So if there is limited manpower, it will be an expensive affair for a nation’s economy.”

Fauzia Kidusa, who works in the media, said she would not advise her man or anyone to have a vasectomy because it was against God’s intended purpose of creation.

Ms Kidusa claimed that those who chose vasectomy were tampering with nature and that it would eventually hit back.

“There are other natural methods men can adopt. Vasectomy is against God’s plan of creation and it will end up backfiring in the end.”

However, Bakari Mohamed, a court clerk, said men should help shoulder the burden of family planning instead of leaving it entirely to women.

“I think it is okay for men to have a vasectomy if they feel they are satisfied with the number of children they have. It is a good to shoulder the burden since their partners sacrifice by carrying and giving birth to children,” said Mr Mohamed.

Evelyn Wamboi, a sales executive, said men should help their spouses if they decide to stop having children.

Ms Wamboi said women faced many health side effects when they used certain contraceptive methods.

Charles Ochieng, a vasectomist at Family Health Options Kenya, said most men shied away from vasectomy because they did not understand the procedure.

Dr Ochieng, who had a vasectomy after siring two children, said some men, out of ignorance, thought that after a vasectomy, they would put on weight and become sleepy and lazy (hypersomnolence).

“Most men equate vasectomy to castration of bulls where their genitals are cut off and one remains like a woman. On the contrary, vasectomy does not prevent a man’s ability to enjoy sex and one can still erect and ejaculate normally but the semen will not contain sperm.”

Gatenjwa said despite the operation, he ended up making his wife pregnant a year later and has sued the hospital and the doctor.

A man who wished to remain anonymous told The Standard that his vasectomy had failed.

According to African Population and Health Research Centre, few vasectomies fail and in very rare cases, the duct spontaneously reconnects.

The report said one in every 500 women had an unintended pregnancy after their partners' vasectomy.

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