Dr Rasha Kelej and Prof Koigi Kamau
“I ask myself every day. Who I am in this world? Is this the life I was meant to live? There was no one to love or help me,” Grace Kambini says.
Grace, popularly known as Mama Chips, now 57 years, got married out of societal expectations, where women are expected to get married to earn respect from the community she hails from in Kenya.
But after nine years of marriage, she realised that she could not get pregnant after trying several times.
When her condition did not change, her husband and his relatives’ attitude changed towards her as they started abusing and insulting Grace, a treatment that extended to her home where she was assaulted often.
“I remember asking my husband, how long I will continue to live this misery. He replied, ‘You refuse to leave my house as if your parents are dead, if they are dead you should ask them to open their grave so you may join them. You are of no use to me,” Grace recalls.
Although Grace is no longer with her husband, she says, “Every time I remember his insult or talk about it, I feel faint and out of breath.”
Noonkipa Enole Mpalush is a 55-year-old childless Maasai woman who lives in the heart of Kenya, in a village called ‘Elder’.
Her husband also left her 15 years ago because she could not bear children.
She was constantly put to blame and the finger pointed at her over the fact that she could not bear children.
She says she went through very traumatic situations during her marriage, as she did not get much support from her husband.
Noonkipa says she tried everything, from saying prayers together with her age mates, to going to the hospital and even seeking help from traditional healers but nothing worked.
“Being an oppressed infertile Maasai woman is the worst thing that can happen to anyone,” she reveals.
In some cultures, like the ones Grace and Noonkipa hail from, childless women still suffer discrimination, stigma and ostracism.
An inability to have a child or to become pregnant can result in being greatly isolated disinherited or assaulted.
This often results in divorce or physical and psychological violence like in the cases of Grace and Noonkipa.
Africa’s Infertility Status
According to the World Health Organisation (WHO) data, more than 180 million couples in developing countries (which is one in every four couples) suffer from primary or secondary infertility; the inability to get pregnant after 12 months of unprotected sex.
The WHO data indicates that infertility is one of the conditions affecting reproductive age group between 20 to 45 years, however, it is not given the needed attention it deserves because of the high fertility rate mostly associated with Africans.
Pauline Wanjiku Kibui, a Kenya embryologist, says research has shown that infertility in Africa is caused by infections in over 85 percent of women compared to 33 percent worldwide.
She says untreated sexually transmitted diseases (STDs) like chlamydia and gonorrhoea, acquired from unsafe sex and complications from unsafe abortions and some lifestyles contributed to – some extent- infertility in women.
“Cancer or HIV patients may also find it difficult to conceive, for instance, besides the negative impact that HIV has on your body’s immunity, it can also affect your body’s ability to produce hormones required to fall pregnant, or lead to early menopause- the stage when monthly periods stop and you cannot fall pregnant,” she explains.
She adds that a central difficulty associated with infertility is that it can transform from an acute, private distress into harsh, public stigma with complex and devastating consequences.
Professor Koigi Kamau, chairman of the Kenya Fertility Society, says although male factors contribute to about half of all cases of infertility, women are overwhelmingly perceived as being the party responsible for a couple’s infertility, thus, disproportionally having an effect on them.
Explaining further, Prof Kamanu indicates that due to the cultural background that man cannot be infertile, women are often blamed for a couple’s inability to conceive.
“But, as men are core to reproduction they are also the core to infertility problem,” he states. Adding that the burden assumed to fault the woman should be a thing of the past.
Prof Kamau points out that although most cases of infertility in men are not preventable, the combination of keeping healthy and avoiding environmental toxins may help.
“Avoiding drugs and smoking, exposure to high temperatures and industrial environmental toxins, as well as eating a balanced diet and maintaining a healthy weight helps improve fertility in men,” he indicates.
The United Nations (UN) Universal Declaration of Human Rights states that access to adequate comprehensive reproductive health services, including infertility care, is a basic human rights regardless of the economic circumstances in which individuals are born into.
A declaration, the Chief Executive Officer (CEO) of Merck Foundation, Dr Rasha Kelej, has been working for in the past year through the flagship initiative, ‘Merck More Than an Mother’.
‘Merck More Than A Mother’ initiative aims to empower infertile women through access to information, education, health and change of mindset.
It, thus, defines interventions to break the stigma around infertile women and raises awareness about infertility prevention and management.
In partnership with academia, ministries of health and international fertility societies, the initiative also provides medical education and training for healthcare providers and embryologists to build and advance fertility care capacity in Africa and developing countries.
Dr Kelej is of the strong belief that no woman should suffer stigma because of infertility.
She says now is the time for a change in mindset about infertility, which research has shown affects a high number of people in silence.
“We at Merck want to lead the change in the narrative about infertility and lead the discussion that would bring about prevention, no stigma and better treatment options for couples. From today, let’s talk about infertility until it becomes normal thing to talk about,” she adds.
Dr Wanjiru Ndengwa, a gynaecologist and IVF specialist in Kenya, says there are various treatment options for infertility, including simple lifestyle changes like losing weight.
She says other treatment options include intrauterine insemination, ovulation inducing and in-vitro fertilization.
Empowering Infertile Women
Dr Rasha Kelej, who is also the president of ‘Merck More Than A Mother’, explains that it is very important to empower infertile women through improving access to awareness and fertility care so they can bear children as part of their human rights.
“We have initiated a cultural shift to break the stigma around infertility on all levels; by improving awareness, training the local experts, building advocacy in cooperation with decision makers and by supporting childless women in starting their own small business.
In case they can no longer be treated as in the case of Grace, ‘The Empowering Berna’ project will contribute towards empowering and re-building their lives.
It’s all about giving every woman the respect and the help she deserves to live a fulfilling life, with or without a child,” Dr Kelej mentions.
‘Merck More Than A Mother’ has helped Grace to stand on her own feet by building a small local kitchen and cafeteria for her, where she has expended her chips business she does for a living, hence the name Mama Chips.
Through the support of ‘Merck More Than A Mother’, Grace will also be enrolled in the Kenya Chamber of Commerce- women in business body to help her network with other entrepreneurial women, thereby, giving her a platform to generate even more businesses.
“My suffering and stress life is over, now I am a new person. I can now walk with my head up knowing that I have a great business that will sustain me. I am very happy with this programme and I WISH THAT Merck can continue helping many other desperate people in this world,” Grace says.
Noonkipa was also supported with two cows to enable her to become a productive member of society.
Each cow can produce six litres of milk per day so with two cows, she will be able to make around (Kshs 600) per day.
“Now my life has changed with the help of Merck, I am happy and proud because I can support myself. Now I am more than a mother,” Noonkipa says standing proudly besides her cows.
From Jamila Akweley Okertchiri, Nairobi, Kenya