Infertility Turns Congo Women Into Outcasts

BRAZZAVILLE, Congo â€”  The Congolese have a traditional saying that underlies much mockery and tears across the country: “An infertile woman is like a fruitless tree that should be chopped down.â€�

For Celine Kimbembe it meant the end of her marriage.

“I was chased out of the bedroom after five years of marriage by my husband’s parents,� said the 32-year-old high school teacher in Brazzaville, the capital. “My crime, in their eyes, was my inability to have children.�

Her story has become worrisomely common in Congo and elsewhere in central and western Africa, where sexually transmitted diseases, botched abortions and poor health care are rendering more and more women infertile.

In Congo, at least 21% of the women cannot bear children--the world’s worst rate--and some experts put it as high as three of every five women. The infertility rate is about the same in neighboring Zaire, 17% in Central African Republic, 14% in Zambia, 12% in Cameroon.

By contrast, about 6% of women are infertile in the United States and Japan, which are on the high end of industrialized nations. Most nations in other parts of Africa have rates in line with international norms, says the Population Action International, a research group in Washington.

“When you start getting into that 10% to 20% range, you’re talking about really, really serious problems,� said Sally Ethelston at Population Action.

In a culture where women are valued for the number of children they bear, sterile women in Congo find themselves ostracized, going from church to hospital to traditional healers in search of a cure.

Beatrice Atsono-Ngatse, 57, married and divorced five times, says she tried everything--even sleeping with a clergyman.

“One day, a minister took advantage of me by convincing me that a few sexual encounters with him would help my sterility,� said Atsono. “I’ll never forget this shameful scam, which never ceases to amuse my current and sixth husband, who accepts my condition.�

Women’s health care has never been a high priority in Africa’s patriarchal societies, which generally forbid abortions and frown on birth control. Prenatal care and family planning programs are scarce, and treatment for sexually transmitted disease is too expensive for most.

Fertile women in sub-Saharan Africa bear an average of 6.4 children each, the highest rate in the world, according to UNICEF. In many western and central African countries, the average is more than seven per woman.

Women who do not want to get pregnant turn to contraceptives, but birth control pills often are fake or poorly made and folk methods are ineffective. When they fail, the women obtain illegal and dangerous abortions that can cause scarring and infertility.

Doctors say the infertility problem is compounded by girls being pressured to become sexually active as they approach puberty, mainly by men seeking virgins who do not pose an AIDS threat. Younger girls are more susceptible to infections that can lead to blockage of the Fallopian tubes.

For Pauline Nkondani, 43, not having children has left her feeling empty inside--and without a husband. In most of Africa, an unmarried, childless woman is considered a disgrace.

“Not to have a child, for me, is a real curse. God took away three-fourths of my life. I feel an emptiness that nothing can fill,� Nkondani said, wiping away tears.

Like most childless women in Congo, Loise Kenge is superstitious about her infertility.

“It was just after a dispute with my maternal aunt that I began to have difficulties. That last time, she declared that I would never bear children,� said Kenge, 38.

Dr. Robert Koubaka, an obstetrician-gynecologist at the Central Hospital of the University of Brazzaville, scoffs at beliefs that spirits can either cause or cure the problem.

He puts the sterility rate at 3 in every 5 women and blames at least 70% of cases on infections or scar tissue caused by disease or botched birth-control efforts.

As an accountant, Kenge makes good money--$400 a month when a typical government employee in Brazzaville earns $150, but a man she once lived with refused to marry her because she could not have children.

“In the compound where we lived, there was this fruitless papaya tree. My ‘mother-in-law’ used this tree to make fun of me. Sometimes she would joke and order girls to cut down the tree because it was unproductive,� Kenge recalled.

“Despite my good job, I feel an emptiness. Even a husband wouldn’t be enough to console me.�

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Infertility in Sub-Saharan Africa

Percentage of infertile women in sub-Saharan Africa: Burundi, Benin, Ghana: 3% Liberia, Senegal: 4% South Africa: 5% Burkina Faso, Guinea, Mauritania: 6% Kenya: 7% Mali, Nigeria: 8% Sudan, Niger: 9% Ethiopia, Madagascar, Malawi, Rwanda, Somalia, Tanzania, Uganda, Zimbabwe, Cote d’Ivoire, Sierra Leone, Togo: 10% Chad: 11% Angola, Cameroon: 12% Mozambique, Zambia: 14% Central African Republic: 17% Congo, Zaire: 21% Source: Population Action International, Washington; Associated Press