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Fighting infertility stigma in Malawi

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ZUZE—Things have changed

By Memory Chatonda:

Linda Bingisa, a visually challenged woman from Chikamakuka Village, Traditional Authority (T/A) Chakhadza in Dowa District, recalls vividly how she lost her first blissful marriage because she could not conceive.

Sitting on a dusty veranda of her house, Bingisa explains that, for two decades in wedlock, she vainly sought help from traditional healers in an attempt to conceive.

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As the result of her childlessness, she was subjected to ridicule and discrimination by community members including some of her in-laws.

“I became a laughing stalk in the whole community. As a result, I could not participate in any development activity. My in-laws hated me for not bearing a child,” Bingisa says.

Her situation further subjected her to physical and emotional abuse perpetuated by her husband, who could not stand the mockery associated with her childlessness.

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“One day, he openly told me that he had found another woman to marry. This is how I lost my marriage,” she recalls, emotionally breaking into tears.

Bingisa is not alone in such circumstances.

Loveness Haji, 39, from Ndimbula Village, T/A Nkaya in Balaka District has had an almost similar experience.

She says she fails to have a second child after trying for almost five years.

“Our first child is seven years old and we have been trying to have another one, to no avail. We have been taking different concoctions to help in conception but nothing comes out positive. Currently, we are hopeless because we feel we shall never have any more children,” she says.

Bingisa and Haji are among many people in Malawi and the world associated with primary and secondary infertility.

The World Health Organisation (WHO) says infertility is the disease of the reproductive system characterised by failure to achieve a clinical pregnancy after 12 months or more of having regular unprotected sex.

Among other factors, according to WHO, infertility is caused by age, low sperm count in men, fibroids of the womb, extreme weight gain and excessive alcohol consumption and physical and emotional stress that result in amenorrhea (absence of periods).

A recent study by WHO estimates that 48.5 million couples worldwide were unable to have a child.

Out of them, 1.9 percent of women aged from 20 to 44 who wanted a child were unable to have their first live birth (primary infertility) while 10.5 percent of women who had previously given birth were unable to have another after five years of trying (secondary infertility).

Although, in Malawi, there is no clear picture of the prevalence of infertility, a clinical study done at Kamuzu Central Hospital’s Gynaecology Outpatient Department estimates infertility at 6.2 percent, with primary and secondary infertility standing at 11.9 percent and 20 percent, respectively.

Similarly, another study conducted at Queen Elizabeth Central Hospital (QECH) indicates that infertility affects up to 17 percent of reproductive-age women with primary infertility rating at 45.6 percent while secondary infertility is at 54.2.

Dr Bernadette Zuze is an obstetrician and gynaecology specialist at QECH in Blantyre and sheds light on infertility and some of its social implications.

She describes infertility as a huge burden, saying couples with the condition face problems such as divorce, stigma, discrimination and psychological and physical abuses.

In view of this, Merck Foundation, in collaboration with African First Ladies, is carrying out awareness campaigns to encourage people like Bingisa and Haji to seek medical attention in time to increase chances of bearing children.

Merck Foundation Chief Executive Officer, Rasha Kelej, says the campaign also aims at addressing stigma of infertility by sensitising communities to “say no to infertility stigma” and also to raise awareness about women’s role in society which is beyond being a mother.

Echoing Kelej’s sentiments, Zuze testifies that following the campaign, a number of people with infertility conditions are now seeking early diagnosis in hospitals unlike in the past when most suffered in silence.

“Previously, you would see couples seeking help after suffering for four or five years but now, things have changed. For instance, the 2020 study on Infertility at QECH indicates that 65.4 percent females and 2.9 percent males of age ranging from 28 to 32 years came to seek medical help in time,” she explains.

Zuze stresses that some infertility-related problems are treatable only if the affected individuals seek medical help in time.

Bisinga is one of them. Today, she is carrying a five-month old pregnancy.

“I was motivated by the message which I heard through my cell-powered pocket radio to seek fertility services from Dowa District Hospital and, today, I bear the testimony,” she says.

Speaking during an interface with Merck More Than a Mother awardees at Sanjika Palace in Blantyre, First Lady Monica Chakwera committed herself to stepping up efforts to encourage more people associated with infertility to seek clinical consultations in time.

“We will continue to work closely with Merck Foundation and stakeholders to define the right strategy to build healthcare capacity, empower women with infertility and support girls’ aspirations in education,” Chakwera said.— Mana

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