By Memory Kutengule Chatonda
The news that he was diagnosed with an infertility condition ignited shock and hopelessness in the life of thirty-nine-year-old Ben Mkangano.
“I felt that having the condition could mean I would never have a biological child in my remaining lifetime,” complains a resident of Semu Village in the area of Traditional Authority Chigaru in Blantyre.
Before the medical diagnosis, Mkangano, who operates a hardware business at Lunzu trading centre, explains that he and his wife had stayed in a blissful marriage for about eight years without having children.
During the years, he says they made several efforts, including visiting traditional healers, so that his wife could conceive, but to no avail.
The couple, however, found solace from one of their distant relatives, who encouraged them to visit the hospital for fertility test.
“After a thorough medical examination was conducted on both of us, I realized that I was the causal factor of childlessness in our marriage because I was diagnosed with a low sperm count; I was immediately put on treatment,” says Mkangano.
The story of Mkangano is just a case in point in the district. Christopher Matchado, 37, from the area of Traditional Authority Kapeni, shares a similar narrative.
He says he was diagnosed with an infertility condition after he and his wife failed to have children for nearly six years.
Infertility condition in men is defined by the World Health Organization (WHO) as the inability of a male to make a fertile female pregnant for a minimum of at least one year of regular unprotected intercourse.
WHO estimates suggest that approximately one in every six people of reproductive age worldwide experiences infertility in their lifetime.
During the recent Merck Foundation health media training which was done on the sideline of this year’s Merck Foundation First Ladies Initiative summit in Dubai, fertility specialist Dr. Edem Hiadzi from Ghana said, in the male reproductive system, infertility is most commonly caused by problems in the ejection of semen, absence or low levels of sperm, or abnormal shape (morphology) and movement (motility) of the sperm.
He further stated that the condition occurs in males aged between 20 and 45, and that males are solely responsible for about 20 percent of cases and are a contributing factor in another 30 percent to 40 percent of all infertility cases.
He added that infertility affects a substantial number of men and couples trying to conceive and has an impact on their families and communities, both socially, psychologically, and overall well-being.
This speaks volumes to the life that Mkangano and Matchado went through because of their condition.
According to Mkangano, his family experienced stigma and discrimination from people within their place of living.
“Our neighbours and even some of our relatives laughed at us for not having children. They called us sarcastic names like ‘Gocho’, ‘Ogwa Mpapaya’ to emphasize and describe our condition.
“This mostly affected my wife to the extent that she could not participate in any social gatherings like weddings, engagements, and other development meetings taking place in our area,” he says.
Equally, Matchado recalls experiencing stigma because he was unable to impregnate his wife for nearly six years.
“I am a Primary School teacher and it has always been hard for me to work in an environment where all my colleagues have children. Sometimes, when I try to shout at children in class, I end up being rebuked by my friends as well as parents of the children,” he says.
The Ministry of Health says male infertility is a significant concern, but there is no proper study to establish the prevalence of the condition in Malawi.
Ministry of Health spokesperson, Adrian Chikumbe, attributes the situation to the failure of men with the condition to report to health facilities for medical assistance.
“There is a lot of stigma towards people with this condition, and as a result, most men with the condition shun the hospital because they don’t want to be known,” he says.
Fanuel Lampiao, Professor of Reproductive Physiology at Kamuzu College of Health Sciences (KuHeS), concurs with Chikumbe that men shun fertility testing.
He, however, is quick to indicate that in recent years, he has seen an improvement in men seeking help when they are faced with problems of failing to achieve pregnancy.
“In our case, on average, we process about 10 to 15 samples in a month, and the most common conditions that we see when men come for semen analysis are low sperm count, poor sperm motility, and hyperviscosity,” he says.
Prof Lampiao underscores the need for massive awareness to sensitize the public that male infertility is treatable only if the affected seek medical care in time.
“If the man has low levels of sperm, or he has no azoospermia (no sperm in semen) and has some sperm cells in the semen, yes they can be able to have a baby with medication and some with assisted reproductive technologies such as intrauterine sperm injection (IUI), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI),” he says.
Awareness that male infertility conditions are treatable is very important to encourage men like Mkangano and Matchado to seek medical care in time.
This is the reason Merck Foundation partnered with influential first ladies in Africa and Asia to raise awareness about the infertility condition in both males and females, and also fight against stigma and discrimination associated with it.
Currently, Chikumbe says, the Ministry of Health is making strides in raising awareness about the condition, which is done through different strategies.
“We know Infertility comes from a multitude of causes, including Infections, for example, sexually transmitted infections, and lifestyles such as smoking and excessive physical factors, hormonal imbalances, as well as stress and anxiety.
“As such, we have included reproductive health and rights issues in our health talk booklet, which health workers are using as a reference to deliver messages on infertility issues, Youth Friendly Health Services, and others,” he says.
Today, Mkangano and Matchado hope for renewed moments someday, having followed all the medical advice and other health education tips on infertility treatment.
