“Not once, not twice; but on many occasions. My wife suffered series of spontaneous abortions and later, she was not getting pregnant at all. All her dream was to have her own child. Sadly and unfortunately for her, when we finally had our child, she could not live long to enjoy the fruit of her labour—she died a year and a half later. I raised the boy myself until I married my present wife a year later.” These were the words of Mr Krampah (not real name), as he narrated the struggles he and his late wife, Nana Ama (not real name), had gone through in their desire to have their own biological child.
“My wife never lived a happy life until she had her own child. Every day presented a new cause for her to be sorrowful—it was a constant sorrow. I could feel her pain in my heart,” he recounted, pausing momentarily to reflect on his past. His near-red eyes blinked incessantly.
For him, living in a village as a married man or woman without a child is nothing more than giving people the reason to constantly mock you.
You are reminded of your childlessness in every quarrel. He said his wife nearly attempted suicide over a comment about her childlessness passed by someone she quarreled with. “I remember she wept that whole day and throughout the night. I wept myself,” he said, adding she did not even eat the evening preceding that night.
In Mr Krampah’s house
I got to know about Mr Krampah’s story when I discussed a story idea on infertility with a friend. As soon as I mentioned the concept of the story, my friend said he knew a certain man in their village who suffered to get a child and that I could interview him for the story. I told her I was interested in interviewing him. Unknown to me, Mr Krampah was my friend’s uncle.
She told me she would call him and give me feedback in the following day, which she did. My friend called on the following day and told me Mr Krampah had agreed to grant me an interview. I was both sad and happy at the same time when I heard that he had agreed to grantingme the interview. I was sad in the sense that I was going to remind him of his past; I was also happy because I was going to get information that could help many people.
I spoke with him on phone to book a date that we could have the interview. With the aid of my friend, we went to see Mr Krampah in his community in the Akwapem North Municipality in the Eastern Region. It took place on the afternoon of Sunday, June 5, 2021, and we started at 4:40pm.
He was making “kenten” (basket) with palm branches when I got to his compound. He lived in a two-bedroom house with his new wife, Madam Efya (not her real name). When we got there, she was peeling cassava in a bamboo-made kitchen a few metres away from the buildingfor the preparation of their evening dish (fufu). Madam Efya is the mother of three of the four children of Mr Krampah, a nine-year-old boy,a seven-year-old girl and a five-year old boy. The eldest child, Akwasi (not real name) was 12 and the issue between Mr Krampah and his late wife, Nana Ama.
He married Madam Efya in 2009 after the death of his first wife, whom he married for 13 years before they had their first and onlychild, who is now 12 years old. Mr Krampah, 52, was then 27 and his wife, 24.
Having welcomed us to his house and also heard about our mission, he sighed and managed a quick smile. He called his wife and told her about our mission. She also welcomed us and went back to continue what she was doing.
Discovery
Mr Krampah usedabout 50 minutes we spent on his compound to give us a chronological account of his battle to have a child. His story is that of pain, struggles, frustrations, and above all, his firm belief and faith in God.
“I married early because I was a leader at my church and I’m still a leader at church. Apart from being a leader, I was very hardworking and had everything a man would need to marry,” he said. He continued that in their village, once you marry, the next thing people expect from you is a child. “But for us, our story was different. For almost 13 years, we never had a child. My wife never had a sustained pregnancy for more than two months. Our childlessness was a big challenge for us because the frustration and back-talks were too much,” he said.
Mr Krampah said he had many farms with different crops and hiswife too was very hardworking. He said they did everything together, explaining that she supported him in all his farm work—weeding, spraying and harvesting. He extolled the qualities of his late wife, adding that even when he was not around, Nana Ama would do everything in his absence. For him, they all picked their farming skills from their parents.
“We were both born and grew up in the village, so farming wasn’t a new thing to us. All our parents were farmers and so we were brought up to farm,” he explained.
Mr Krampah said he could not fathom why they faced difficulty in having a child. He never believed that his wife was infertile or at worse, barren, unlike what some of the villagers believed and so stigmatised her for. His conviction was based on the fact that his wife became pregnant on many occasions except that she suffered recurring miscarriages.
“It was not the fact that she was infertile or barren. No! She became pregnant on many occasions but they did not last long before she lost them,” he defended his wife, adding that at some point, she was having issues with her menstruation —it came at different times she did not expect.
According to him, they tried several herbal medicines but the condition did not change. They also went to some health facilities in the municipality and other places but the result was not different.
Shocking revelation
For Mr Krampah and his wife, they only became aware of the real problem preventing his wife from having a sustained pregnancy that will lead to childbirth when some white doctors came to their community with a non-governmental organisation to do free health screening.
“My wife attended the health screening and explained her condition,following which the white doctors asked her to go to Accra for some other tests. It was from those tests that they told her she had accumulated in her body some toxins from the pesticides we use in our farms,” he said.
He said it was revealing and strange at the same time to him because he never thought the agrochemicals they were using on their farm could be the reason for their childlessness.
“I was seriously confused when my wife told me what the doctors had told her. I couldn’t doubt it because we did the spraying together and even before we married, she was helping her parents to spray their farm,” he said.
Mr Krampah said his wife was put on some drugs and a treatment plan to get out the toxins in her body. For him, her wife was asked not to do the spraying again and that she should also thoroughly wash foodstuffs such as tomatoes, pepper, okra and garden eggs she harvested from our farm before cooking them.
According to him, the doctors told her that until all the toxins would be flushed out of her system, she could not give birth.True to the doctors’ word, after a year’s treatment, she conceived and carried the pregnancy through the months, leading to the birth of their son, Akwasi. But unfortunately, she lost her life two years afterwards.
Pesticides and fertility
Pesticides are used in agriculture and public health to control insects, weeds, animals, and vectors of disease. They are substances or mixtures intended for preventing, destroying or controlling pests. In spite of their usefulness, pesticides have adverse health effects on human beings. They can affect fertility in both men and women, particularly when one is regularly exposed to them
. For instance, pesticides can reduce the semen quality in men.
A 2006 study titled: ‘Pesticide exposure: the hormonal function of the female reproductive system disrupted?’ looked at the potential effects of exposure to pesticide on reproductive health. It found out that “Pesticides may cause reproductive toxicity through several different mechanisms—direct damage to the structure of cells, interference with biochemical processes necessary for normal cell function, and biotransformation resulting in toxic metabolites.”
Similarly, information sourced from biomedcentral.com indicates that pesticide exposure in women may lead to decreased fertility, spontaneous abortions, and ovarian disorders, as well as disruption of the hormonal function.
Exposure to pesticides, according to some studies, may affect many body organs, including the reproductive system.
Even though many of the most toxic pesticides have been banned or restricted in developed nations, farmers in developing countries such as Ghana continue to use them. And with Ghana’s high illiterate farming population, where many farmers, like Mr Krampah and his late wife, hardly read and follow instructions or wear protective gear before using pesticides on their farms, they could only become vulnerable to infertility.
Infertility
Infertility is a major health condition around the world. The World Health Organisation (WHO), for instance, states that infertility affects up to 15 per cent of reproductive-aged couples worldwide.WHO demographic studies from 2004 shows that in sub-Saharan Africa, more than 30 per cent of women aged 25 to 49 suffer from secondary infertility, the failure to conceive after an initial pregnancy.
Infertility is defined as the failure to conceive after a 12-month period of regular unprotected sexual intercourse. This condition is further subdivided into primary infertility (couple that never ever conceive before) and secondary infertility (couple that has conceived before but now failing to fall pregnant again).
In sub-Saharan Africa, for instance, the prevalence rate of infertility is very high and with many women in sub-Saharan Africa. Therefore, going into agriculture and using agrochemical products such as pesticides may put many of these women at the risk becoming infertile.
Women farmers
In Ghana, for example, women contribute largely to agriculture by providing labour for weeding, planting, harvesting and processing of agro-products,making them play 70 per cent role in food crop production in the country. Sadly, as women go about their work on their farms, they expose themselves to harmful substances such as pesticides, which interfere with their fertility.
Available statistics indicate that in Ghana, women constitute about 52 per cent of the workforce in the agricultural sector with many of these women being illiterate, thus limiting their ability to access and adopt best practices that protect them against agrochemical use on their farms.
The use of agrochemicals are recognised as a significant factor in enhancing the ability to meet food sufficiency, despite its continuous and excessive use is harmful and detrimental to humans.
Aside women farmers unduly exposing themselves to the dangers of pesticides, they also eat produce contaminated with these agrochemicals.
A study by the Harvard T.H. Chan School of Public Health, titled ‘Pesticides in Produce liked with Reduced Fertility in Women’, pointed out that eating fruits and vegetables with high amounts of pesticide residue in them may reduce women’s chances of conceiving and bearing children.
Experts speak
Mr Maxwell Antwi, an agrochemical dealer based in Accra, shares the view that in Ghana, the incidence of misuse of agrochemicals such as pesticides is relatively high due to low awareness of the safe use of agrochemicals, particularly pesticides.
He said a large proportion of farmer population in Ghana was unfortunately illiterate and did not always use any form of standard protective clothing while applying agrochemicals such as pesticides.
He expressed the concern that “most of the farmers are not aware of the long-term chemical and physiological effects associated with improper agrochemical handling.”
Mr Antwi said, for instance, that many farmers, after pesticide use, did not change their clothes or properly washed their hands with detergents before handling food.For him, unsafe handling of pesticides aggravates farmers’ dermal exposure and can result in “systematic poising”.
Dr Daniel Ansah, a Gynaecologist with Anton Hospital in Accra, also affirmed that women who had been exposed to pesticides had decreased fertility, spontaneous abortions, stillbirth, premature birth, low birth weight, developmental abnormalities, ovarian disorder and disruption of hormonal function.
He said some pesticides interfered with female hormonal function and may lead to negative effects on the reproductive system by way of disruption of the hormonal balance necessary for proper functioning.
This, he explained, was because pesticides comprised a large number of distinct substances with dissimilar structures and diverse toxicity which could expose pesticides in ovarian cycle, leading to infertility.
Recently, Dr Ansah said, a study conducted by a group of scientists (Farr et al 2004) to examine the correlation between pesticide exposure and menstrual cycle characteristics observed that women who worked with pesticides suspected of being hormonally active had a 60 to100-percent increased odds of experiencing long cycles, missed periods, and intermenstrual bleeding compared with women who had never worked with pesticides.
He has, therefore, advised that women trying to conceive should avoid working with pesticides on their farms or limit their intake of fruits and vegetables associated with high pesticide use.
Way forward
As the maxim goes, a stitch in times saves nine. Therefore, practices such as wearing protective clothing, washing of hands with soap as well as immediate change of clothes after use of pesticides must be upheld.As we try to fight infertility and its related stigma in Ghana and, by extension, Africa, let us encourage our women farmers to observe some safety with regard to handling agrochemical products on their farms.
BY BENEDICTA GYIMAAH FOLLEY
