Is there life after vasectomy?

By Collins Vumiria

RICHARD Kato is a father of 11 with an expectant wife. He believes the child she is carrying will be a boy, his heir. “My wife and I kept hoping to get a second boy and that was how we got seven children,” says Zabron Barintuma, a farmer in Mbarara.

Kato and Barintuma are among thousands of men for whom the mention of family planning leaves a bitter taste in the mouth. For them, having babies will only stop when they have the ‘right’ number and sex of children.

“We have six children and when we get the seventh we will close ‘production’,” says Cornelius Zavuga, of Kamwokya.
The 2006 Demographic and Health Survey puts Uganda’s fertility rate at about 7 children per woman.

This number is high and the health ministry promotes family planning, as a way of reducing the fertility rate. Family planning methods include pills, condoms, intrauterine devices and injectables.

For a permanent end to child bearing, there is male sterilisation or vasectomy and tubal ligation for women.

However, for many men, sterilisation is a no-go area. “After that cutting I don’t think one can sustain an erection,” says Kato. “You can’t risk it! If you quarrelled with your wife she would tell people you were castrated and are not a man any more. Manhood is seen through the ability to impregnate a woman,” Barintuma said.

For Zavuga, the ability to have babies is a weapon: “If my wife became indisciplined, I would make another woman pregnant and then she would cool down.

Besides, I have heard that having a vasectomy would make having an erection in the future a problem. Why should I disable myself?”

What is male sterilisation?
According to Dr. Arthur Sebukko of Fort Portal Regional Hospital, sterilisation, or vasectomy, is “a permanent contraceptive method that prevents sperms from getting to the urethra and out into the male organ.

It involves an operation where tubes known as ‘vas deference’, which carry sperms from the testicles, are tied and cut.”

Dr. Sebukko emphasises: “It does not interfere with the manhood or sex life of a man, apart from inhibiting the transfer of sperms to cause pregnancy. The potency is retained.”

Dr. Sebukko says in the last 12 months, he has carried out only two vasectomies. Data from the Population Reference Bureau, indicates that in Uganda, only 28,000 men have undergone male sterilisation.

Dr. Sebukko says during a community outreach, they registered about 100 cases of tubal-ligation, (tying the female tubes), but only two vasectomies.

Ironically, Ssebukko says some men were discouraged by their wives who told them they “should not tamper with their (wives’) properties.”

Amon Mulyowa, a program officer at the Young Empowered and Healthy initiative, notes the importance of involving men in family planning. “We should not think of family planning as the responsibility of women alone,” he said.

Mulyowa said his organisation was piloting a male involvement project. “We tell men to give their partners transport to health centres, remind them to take their pills and to have vasectomies once they have the number of children they can support.”