Vasectomy in Kenya

Here is the truth: the idea of a vasectomy is alien in my country, unknown to most Kenyans and out rightly repulsive to many. This is the obstacle we face in trying to build a movement here, but we face it without fear because we know it is the right thing.

When I had my vasectomy 8 years ago, my youngest son, Tyler was just 1 month old. In the past, I had noticed that my wife's health deteriorated greatly with implant usage and that is why I made the decision to get a vasectomy after the second born. Today, my wife is happy and, mostly worry free because she carries no foreign objects in her womb and no external hormones flow in her veins. I love my wife and this was the truest gesture of kindness and love I could offer her.

As a young man growing up in the remote village of Yadhwelo in Homabay County, I lived in extreme poverty. My entire education was funded by well-wishers and generous relatives like my uncle Paul Nengo, a man of lean means who offered all he could to see me excel in my education. Uncle Paul was not a well-educated man, but he knew, as do all Kenyans, that a good education is key to success in life. My father too was, and still is a man of little means.

Life was hard for him, but his situation was even further complicated by the fact that he was polygamous with many children. In our community polygamy is considered a status symbol as it is considered a sign of wealth. On the other hand, providing the children a high quality life in terms of education, health care and parental love, sadly, was considered irrelevant and the idea of limiting one's fertility for the sake of quality of life was considered ungodly. That is the world I grew up in.

When I became of age I wanted to be different. My dream was always to have just a few children that I could take care of comfortably. I wanted to be the one who controlled my family size. I believed that holding this power in my own hands was a truer sign of manhood than putting the burden on my wife.

When I arrived at Moi University in Eldoret to prepare for my medical degree, I felt disillusioned when I realized that the family planning clinics were run by men but that it was only women who were being served. I was concerned by the large number of women who showed up with all manner of complications related to the use of contraceptives, the side effects mainly included but not limited to break through vaginal bleedings, migraine headaches and vaginal discharges.

When I started out in medical school in Eldoret, our instructors talked to us incessantly about all the birth control options available for women, but there was nothing comparable for men. In fact, we never even explored the possibility of involving husbands, or offering vasectomy as an option, even when their families were complete. This is what I was taught in medical school.

It was in my 6th year, when we were given log books from the ObGyn Department and were supposed to observe, assist and perform 10 tubal ligations on women. There was absolutely no emphasis at all on vasectomies. I knew from the beginning this was wrong as a vasectomy is simpler, cheaper and so much less invasive than opening a woman’s abdomen. But it takes two to tango and for a long time, there was no dancing going on in Kenya.

I would ask myself, ‘how come everything is biased against women’? I knew from the very beginning that the situation had to change. And I committed to beginning to make the change, even if it meant that I had to do it all by myself.

In 2007, I joined Marie Stopes international as a resident doctor in Kisumu. At that point, the situation was the same. Men were not offered options or expected to be part of family planning. That year, I attended to many women who had developed complications during pregnancy and childbirth. These conditions included severe bleeding after delivery, hypertension in pregnancy with convulsions and obstructed labor, puerperal infections and septic abortions. Some of these cases even ended in maternal deaths.

I know and it is still the case that Kenya has one of the highest maternal mortality rates in the world with 360 deaths per 100,000 live births. This is just wrong. No, vasectomy cannot prevent all these deaths but men who have had vasectomies know very well that it can go along way in alleviating the suffering of some of these women. When I hear that men are resistant to getting a vasectomy I think what kind of a man would rather let his wife risk death?

In 2009 I was featured in a national newspaper about my vasectomy and was shocked that even fellow doctors had little idea about it. A senior doctor even asked me if I had been castrated. That is how ignorant many of my colleagues are about a procedure that is very simple and safe. This ignorance of the danger taken on by women motivated me to found a group to educate people about vasectomy and later offered correct and accurate information on vasectomy through a website. The website has administrative tools to offer information about vasectomy service. On the site, patients get counseled, book their appointments and can even offer their consent. The only part of the vasectomy that needs hands on attention is the vasectomy itself. The rest you can do online!

In the hope of being able to offer an excellent vasectomy, I travelled to Florida to learn the latest vasectomy techniques from one of the world's best vasectomists, Dr Douglas Stein. Doug is the founding director of the Florida Vasectomy and Reversal Center. Through Doug, I was introduced to the President of No Scalpel Vasectomy international, Dr Ramon Suarez, who has proudly shared the story of doing his own vasectomy in the 1980's.

In May, 2012 we organized the first vasectomy camp in Busia, a small town on the border of Uganda. Working with Doug and Ramon and local promoters, we performed 53 vasectomies in 3 days, the highest recorded number in the country's history. On the last day of our vasectomy camp, Jonathan Stack, renowned filmmaker and two-time Academy award nominated filmmaker, Jonathan originated the idea of World Vasectomy Day. Patients had come from Kenya, Uganda and Tanzania and doctors from the USA, India and Kenya.

WVD started out as an international event and now four years later we are larger then ever and I have hope that what started as a simple idea might actually bring real change to our country. I am proud to be part of World Vasectomy Day and confident that the seed that was planted here will continue to grow into a positive and powerful agent of change that makes a real difference both in Kenya and in the entire world.

#WorldVasectomyDayKenya2016 #DrCharlesOchieng