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Infertility: Tales of exploitation and death among Nigerian women

By Sunmola Olowookere

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Temilade (not real name) is the third wife of Baba Ogunje, a popular herbalist in the Ijoka axis of Akure. She was married off to Baba at the tender age of 18. Then, she fell sick and nearly died. She was brought half dead to him. She was cured of the strange ailment after spending a month in the herbalist’s house. Her family claimed that it was the herbalist’s skills that brought her back from the land of the dead.

Therefore, when he predicted that she would be attacked again unless she was given out in marriage to a powerful man who would be able to ward off evil attacks around her, her family was quick to beg Baba Ogunje to do the honours.

Temilade became the herbalist’s wife and had a child for him. Trouble reared its ugly head when Baba got a younger girl as wife about five years later and the girl had three children in quick succession.

Although the third wife, Temilade became jealous and felt her position was threatened. Rather than discuss the issue of delay in getting pregnant with her husband being an herbalist, a friend took her to a traditional fertility clinic where she was given some powdered substance in improved sachets. A week after taking the product, she began to pass watery stool. She complained to the friend and she assured her that it was the herbs working.

Alas! She passed out inside the toilet on the third day. By the time her body was discovered, it was  too late as she was already  long gone. She was buried in the evening.

According to sources, her family chucked it up to the death that had been haunting her for decades.

Infertility; greatest fear of married African women

Many women are confronted with the challenges of infertility, barrenness, and seeking a male child. The business of treating infertility in women, either by orthodox, spiritual, or traditional means, is a thriving business, especially in Nigeria.

According to statistics by WHO, the fertility rate in Nigeria is estimated to be 5.4, implying that the average woman can expect to have that many children during her life. Yet, many Nigerians experience infertility.

The greatest fear of a typical Nigerian married woman is to be infertile. This is because African society is fixated on fertility in its women and does not look kindly on anything otherwise.

   Chelsea Polis of the Guttmacher Institute, a think-tank, and her colleagues estimate that 31 percent of Nigerian couples fail to conceive a child after 12 months of unprotected sex—a rate at least as high as in the West. In a country where a woman’s worth is defined largely in terms of her ability to bear children, there is a growing market for fertility treatments of all kinds.

 Clergymen’s unwholesome practices

In a large church in Akure along Ondo road, Prophet James (not  his  real name) is popular among his ilk and he is like a demi-god among his congregation. Extraordinary and strange practices are rampant in the ministry, yet he is growing his church business in leaps and bounds. Many people especially youths looking for means to travel out of the country thronged his church. Also, women seeking the fruit of the womb flock to his church.

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During special programmes in which he called the women facing such challenges “expectant mothers”, he mixed his saliva with tea and started to serve it to the women that answered his altar call for the fruit of the womb.

For those that he especially favoured, he spits out rightly in their mouths with the belief that it worked faster than the one mixed with tea. It was observed that none of the women expressed reservations or irritation at the unwholesome practice. Whether out of fear or desperation, no one could tell. He backed up the strange practice with claims that Jesus used saliva in the Bible.

Another female prophet situated along Oda road, Akure washes the women’s private parts with soap and water, not minding the health hazard. She claims that the washing is to remove any embargo hindering the women from getting pregnant.

According to a source in the church, some women have gotten pregnant after the washing. However, the source who is a female minister under the ministry could not give a percentage of those who got pregnant out of the number of women that subjected themselves to the bath.

 Ayoola Janet revealed to The Hope how an Islamic cleric told her that he would help her to conceive by having sex with her, claiming that he was divinely endowed to carry out such acts.

    The woman who said she had been barren for 15 years admitted that she was tempted to try it because she was desperate by then. She said she was saved by the fear of being discovered in the future and had refused his overtures.

   So the pastors, alfas, and the traditional healers thrive. In Ondo, another town in Ondo State, Prophet Okanlawon Moses who operates a white garment church sees between one and three new clients per month. He charges N50,000- N100,000 naira for treatments that include saying prayers over water, which infertile couples then drink. He also uses herbs.

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    When Richardson Ajayi created the Bridge Clinic in 1999, in vitro fertilization (IVF) was still a novelty in Nigeria. He had to fly in doctors and send blood samples abroad for hormone analysis. Today the technology is widespread, and private IVF clinics are popping up in several wealthy cities of Nigeria.

    According to a gynecologist, Mercy Okpara, the fertility clinic business is buoyed by the fact that many Nigerian women struggle to conceive because they have been harmed by sexually transmitted diseases such as chlamydia, or by infections picked up during unhygienic abortions or previous deliveries.

“Another reason is that some others have infertile partners. One study of 246 couples seeking fertility treatment in a Lagos hospital found that 52 percent  of the men had a low sperm count or another problem that made it hard to conceive”.

She lamented that few men, however, will countenance the idea that the problem lies with them. “To many Nigerian men, infertility is “a one-sided thing”. The notion that barrenness is a female malady is so strong, she says, that many women are obliged to pay for treatment out of their own pockets. They often turn up in her clinic in their early 40s, because it is only at that stage of life that they have amassed enough money.

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Women have good reason to spend their savings. One study in Kano, a northern city, found that 38 percent of women seeking fertility treatment in a hospital had been physically or verbally abused. Just 7 percent  of pregnant women said the same. Other women are abandoned or displaced.

Okpara observed that many men in childless marriages will remarry and that it is only after they fail to impregnate their second or third wives that they seek medical help. As a result, almost all the men who enter the clinic turn out to have fertility problems.

Medical treatment can be expensive, especially when both partners have problems. A single IVF cycle in a fertility clinic is said to cost around N1million  but is far out of reach for the average Nigerian. Because so many clients are in their 40s, treatment is often unsuccessful.

The gynecologist says that many infertile couples could have been treated fairly easily and cheaply had they sought help earlier. But many are unaware of the science of fertility, and neither the Nigerian government nor aid agencies have tried hard to educate them.

According to the World Health Organization, there are annually 350,000 maternal deaths in sub-Saharan Africa, with obstetric hemorrhage as the most common cause of death. Although maternal mortality can be reduced by healthcare interventions such as the provision of family planning, maternity care, and access to safe abortion practices, it is not happening in rural areas. Previous studies in rural communities indicated the importance of medicinal plants in their primary health care system.

However, no survey has been done in this region to document the medicinal plants used to treat various gynecological and obstetric problems.

 Like the case of Temilade, who  was buried without any investigation into the cause of her death. No autopsy was carried out. Yet her husband claimed that she was affected and weakened by the fertility concoction powder discovered among her belongings.

Tale of exploitation by ineffective fertility clinics

The experience of Fadekemi Olokunola, a teacher resonates among Nigerian women about the importance placed on having a male child. She told The Hope that she became worried that her husband might seek the arms of other women when she gave birth to four girls in succession. She narrated how she was introduced to a fertility clinic in Ibadan by her friend who claimed that the clinic s had several success stories in helping women actualize their dreams of having a male child.

Fadekemi said that she took a loan of two hundred thousand naira and registered at the clinic where she was taken through a series of treatments and was also given drugs that would enhance the conception of a male child.

She described how elated she felt when she became pregnant and was confident that it was a male foetus that was growing. She was also encouraged to  start buying male clothes as an expression of faith.

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Alas! She gave birth to a female child again and decided to let the sleeping dog lie.

Dangers posed by fertility drugs to users

An In Vitro Fertilisation specialist, Dr. Abayomi Ajayi, wrote about the dangers inherent in the usage of fertility drugs He said that people most times mix virility with fertility and explained that while some drugs can help a man’s libido, there are no drugs that can help his fertility. 

Ajayi stated that fertility drugs in tablet form are the most abused type by men and women alike, because people do not understand the dangers of abusing fertility drugs.

“This is because most of these drugs can be easily purchased or sold over the counter without any proper investigation or prescription by a qualified doctor. It is so bad that women with blocked tubes still go to buy this type of fertility drug for ovulation induction. People use it anyhow because it is commonly available. One cannot treat what one does not know anything about.

 A proper medical test has to be done to ascertain the problem first. Fertility drugs should never be used without a doctor’s prescription and supervision,” he warned.

“They should be properly monitored to see the effects. The doctor must scan continuously to see that the drugs are producing eggs. There is no specific time frame but the doctor needs to be sure that she is not producing too many eggs. Also, the woman can produce more than one egg and more than one embryo. The doctor should be responsible enough not to replace too many in IVF,” he said.

While agreeing that fertility drugs have helped a lot of women to have children, he noted that the major causes of infertility in most parts of the world are either the woman’s tubes are blocked or the man’s sperm count is bad. He said that these two things are not amenable to drugs.

He further urged that patients must have a good assessment before taking any kind of drug, including ovulation induction drugs.

 “I have seen many cases where the man is the problem. He has a low sperm count but the woman is still busy taking fertility drugs. For such women, they are not likely to get pregnant in that type of situation.

“About 60 to 80 percent of women who take these tablets will ovulate if their problem is that they are not ovulating. But the side effects include having a slight headache and what we call hot flashes. This happens when a woman is in a well-ventilated or air-conditioned room, but still feels a sudden heat flow inside her body that later disappears. It is transient.

“Also, this effect could be most frightening for some people who, after using this tablet, could have ovarian stimulation, where the woman produces too many eggs. And that could range from mild to severe the majority of women who use the tablets would have the mild one.

It has been reported that some people have had severe hyper-stimulation from taking the tablets. That is why the injectable drug is more dangerous”. He warned.

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