MEDICAL FORMS

MEDICAL FORMS
Eight years ago when I was joining campus, I was required to fill a medical form. While I don’t remember all the exact details in that medical form, I remember there was a part where I was required to fill if I had undergone any surgeries. I remember that part because I answered ‘no’: a lie. I had had a surgery about a year before but because my father, felt like I would be discriminated against if I said the truth, I had to lie. Thank God it wasn’t some kind of chronic illness that required long term monitoring I had lied about because the result may have been fatal.
Form ones all over the country are reporting to high school. For most, this is the first time they will be away from their homes hence the need to fill that form and list down any chronic ailments that the school should be aware about. Being a doctor, I have had to fill a lot of forms this past week and I have noticed that; apart from most of them being poorly constructed, most parents and their children tend to lie or deliberately omit necessary information.
We are talking about parents who won’t mention anything about their sons or daughters being asthmatics, or epileptic, being HIV positive etc. And this, this actually is a matter of life or death. Then there are those who lie about allergies against popular high school meals like githeri, beans and sukuma wiki..
Lying about being allergic to the most commonly eaten meals in high school isn’t as bad as lying about having a chronic illness. But why would someone who is asthmatic wanna lie that she is not? Here are some of the reasons;
1.Fear of being bullied or discriminated against
2.Fear of being excluded from their favorite sports
I saw a young girl today, who has been asthmatic for about four years now deny the asthma and the inhalers she has been using, except she had conjunctivitis and as I questioned her about her red eyes, she eventually told me the truth. Patients lie to us every time. I mean I have had a twenty something year olds swear to me that she is a virgin even after a positive pregnancy test and an ultrasound confirming a pregnancy. Or a chain-smoker swear that he stopped smoking several years ago even though his breath is reeking tobacco smoke. This young girl lied to me because she loves foot ball and she thinks that she will never make it to the school team if she said the truth.
But is it true that if you are asthmatic you can never be an athlete? Everyone knows David Beckham; the great footballer. But did you also know that he has sufferered from asthma since his childhood? He was even photographed using his inhaler during LA Galaxy’s 5-4 defeat on penalties by Real Salt lake in Major League soccer’s championship game in Seattle in 2009.
Having asthma doesn’t mean that you can’t pursue your dreams about playing football or being any kind of athletes because there are others who have done it despite the asthma. People like Jackie- Joyner Kersee and Paula Radcliffe.
Then there is epilepsy, another chronic illness that a lot of people are ashamed to be diagnosed with. Most people who are diagnosed with epilepsy tend to keep their diagnosis a secret and will even skip their medication just so that other people don’t discover that they are epileptic. But you can live a totally normal life as long as you take your medicine right. Take for example Prince. Remember Prince of Purple Rain? If you haven’t listened to Purple rain then you need to go to you tube right after you are done reading this and watch that piece of beautiful music. Prince was epileptic since his childhood. But that didn’t stop him from being a great musician. The 26th president of the United States of America: Theodre Roosevelt was also epileptic same to very many other people who have achieved so much in life. People like the singer Susan Boyle; we know her from Britain’s Got Talent. Harriet Tubman the famous activist suffered from temporal lobe epilepsy. There are so many great people, people we try to emulate, people whose lives inspire us that suffer from epilepsy but they have been able to live their best lives and offer the world their best.

Prince Rogers Nelson
Prince Rogers Nelson

AFTER BEING DIAGNOSED WITH BREAST CANCER..

January 6th2020

I am seated in one of the consultation rooms in the surgical outpatient clinic, it is a busy morning; the first surgical outpatient clinic in the New Year and the human traffic is overwhelming. Looking at all the people waiting to be seen makes you realize that the world has so many sick people it is scary.

At eleven forty two, a lady walks into my office. I remember the time because at exactly that time, the alarm in my phone goes off and I am startled because a) alarms always startle me and b) I don’t remember setting it…. I mean why would I set an alarm at such an odd hour? Nothing happens at eleven forty two, tea break happens earlier and lunch comes later. I switch the alarm off just as she settles into the chair.

‘So, why are you on follow-up?’ I ask her. It is a question I like asking every patient I encounter who is on long term follow-up. It helps me gauge if the patient understands half of what is going on in their bodies, the mode of treatment they are put on and if they understand their role as patients. (Fun fact- most patients, can’t name the diseases they suffer from, don’t know the names of the drugs they use and don’t carry them to their routine hospital visits because they assume the doctor is supposed to know whatever drugs they are on. Those who have had surgery can’t tell you what the surgery was all about).

Back to my patient, she is here because of her breast….she has had an obvious lump in her breast with skin changes and nipple retraction for the past four months. In that same period, she has only managed to do a mammogram. No biopsy has been taken, no staging images have been done, no counseling, no one has discussed the modalities of treatment with her. we have lost three precious months, why? I don’t know. Meanwhile the tumor has been growing in size (because that is what tumors do, they grow, and spread…

So what was she supposed to do? Most of our patients present a little late because screening is not one thing that we have taken up seriously as a country. Most patients will present with lumps big enough that they can be felt through palpation of the breast. Depending on their ages, they will either be sent for a mammogram or an ultrasound of the breast. Ultrasound if they are less than thirty five, mammogram if they are thirty five or older. After having a suggestive mammogram or ultrasound, here is what you need to do:

1. Tell someone in your family; your husband, your mother, your grown up child or even friend.

2. Get a medical cover if you don’t have one already. The bills that come from having cancer can’t possibly be covered by cash. Medical insurance even though it doesn’t cover everything goes a long way into easing the financial burden that comes with suffering from cancer.

For breast lumps, the next step for your doctor to take after either a suggestive mammogram or breast ultrasound, is to get a histological diagnosis. This is where biopsy comes in.

1. BIOPSY

A piece of tissue is surgically taken from the lump or breast lesion. It is then subjected to histology to confirm the diagnosis of cancer, show the cell types and the hormone status.

2. STAGING

This is done to determine the extent of the disease. Here, the size of the tumor is determined, the organs involved and how far it has spread.

This is done by imaging. In breast cancer, a chest CT scan and an abdominal CT scan or ultrasound are done and reported by a qualified radiologist.

3. TREATMENT

Deciding the modality of treatment depends on the type of the cancer, and the size of the primary tumor and then the stage.

The commonest modalities of treatment include surgery, chemotherapy or radiotherapy.

Whether to start with chemotherapy or radiotherapy or surgery depends on a number of factors; and from here, the team that is involved in your treatment should sit down and discuss how to go about your treatment

The most important thing to note is that it is a race against time and that any time lost may shorten the survival time.

I Have Three Failed Kidneys

Selena Gomez & Francia Raisaa

When people ask me how it started, they almost always expect me to say it started with either diabetes or hypertension. That is normally the story for almost everyone. But diabetes and hypertension didn’t have anything to do with my kidney failure. My kidneys failed because of just a malarial infection. I recovered from the malaria, but my. The doctors were confident it would be for a while, a short one, six months at most. At the end of six months however, my kidneys hadn’t improved. I was on dialysis for like three years, two times every week for three years. It became too much for a lot of people; myself, my family and my employer. I lost my job, I lost friends, I lost most of my family.

Kidney failure may not kill you fast, thanks to dialysis, but it sufficiently reduces your quality of life. The dialysis keeps you alive alright. But you are literally tied down to a life of oscillating between home and the hospital. Every little plan you make about your life has to actually fit in with your dialysis sessions. Dialysis becomes the main point of your existence and everything else becomes secondary.

My brother gave my life back to me. He gave me his left kidney. I was able to go back to work for five days a week from eight in the morning to five in the evening like every normal person. I travelled a little. I was able to become a full time mother again. But that was short lived (sadly) the immune suppressants (the drugs that prevent your body from destroying the donated kidney) became too expensive for me I couldn’t afford them. So I started missing my drugs. Initially just once in a week after I had paid school fees for my children. Then it became two times in two months, then more consistently. My body began becoming puffy; again! So I went in for the tests; and they found that the other kidney, my third kidney had also failed, this time around because of my own immunity.

So I am back on this journey of dialysis two times a week again. Though I have an insurance scheme paying for the dialysis sessions, it is still tough. Sometimes even going to the hospital becomes an uphill task. Before I became sick, I didn’t know I could lack two hundred shillings for bus fare. But then when you have sickness competing with the little money you make, even a ten shilling coin can become rare in your house. You find yourself having to make a choice between putting food on the table for your children and your own health. So you train your body to put up with all the toxins so that your babies can have a meal. It is not healthy but I am a mother and I have to do it.

Angelica Hale
Angelica Hale

PS;
If you watch America Has Got Talent, then I am sure you know Angelica Hale, an eleven year old contestant who is a singer. At the age of four, she contracted sepsis and suffered kidney failure. She was on dialysis for a year and a half. She received her kidney at the age of six from her mother Eva. Five years on, she is healthy, singing her life into money and fame.

Selena Gomez & Francia Raisaa
Selena Gomez & Francia Raisaa

Selena Gomez an award winning record artist suffered kidney failure secondary to lupus. She received her life saving kidney from her friend Francia Raisa in 2017. Almost two years later, she is doing well, great even.

Cervical Cancer

Assuming that we all remembered to include; “taking my healthcare more seriously” in our 2019 resolutions or plans, it is my duty then to impart you with the knowledge that you will need to help you stay healthy.

According to the 2019 WELLNESS AWARENESS calendar, January is the world cervical cancer awareness month. Now cervical cancer is one of the most treatable cancers but sadly our people continue dying from its complications. It is the second leading cause of cancer deaths among women after breast cancer according to the Kenya Network of Cancer Organizations. This is mainly because of the fact that they present to the hospital when it is already in advanced stages, when the doctor cannot do much except just make them comfortable while they await death.
This doesn’t have to be case. We can decide to do better as patients, as a society.

Here is what we need to know about cervical cancer;

The cervix, also known as the uterine cervix is the lower part of the uterus, normally cylindrical in shape, and about one inch long. This is the part that is normally affected by the cancer, before the cancer cells move to the other parts of the body in a process called metastasis.
Unlike other cancers whose causes are still unknown, cervical cancer has almost always been associated with the infection with human papilloma virus (HPV) especially sub types 16 and 18.

HPV IS SEXUALLY TRANSMITTED.

It appears to be common in women who have multiple sexual partners, women who smoke, women with a low immunity (HIV positive), and also women who start sexual relations at a younger age, and those with promiscuous male partners.

After infection with the human papilloma virus, it usually takes about ten to twenty years before the cancer develops. This is good news because it means that if a woman presents at this time to the hospital, then something can be done before the actual cancer develops.
Prevention of cervical cancer;

Well we obviously have to reduce the risk factors; don’t smoke or stop if you already started, reduce the number of sexual partners to one (it is possible right?), dump promiscuous sex partners.

VACCINATION AND SCREENING
If we have any plans as a country to eliminate cervical cancer like the way most countries in the West have, then we need to embrace vaccination and screening as the strategies. If the government is very serious about the delivery of Universal Health Care, then we can do what other countries have done; develop a system of vaccinating our young girls against HPV.
The government could also incorporate screening services and a system to refer patients who have positive pap smears in services provided in government facilities.

VACCINATION:
Cervarix and Gerdasil are vaccines that are available locally and are used against the human papilloma virus which is the causative agent of cervical cancer.
Girls from the age of nine to thirteen are eligible for these vaccines.
Cervarix
Is active against HPV 16 and 18
It is administered in three doses at 0, 6 and 12 months intervals
Can be given to girls aged between eleven and twelve

Gardasil
Active against HPV 6, 16 and 18
Administered in three injections six months apart
Can be given to girls aged between nine to thirteen.

SCREENING
The most common screening method is the PAP SMEARS.

PAP SMEARS
When did you last have your pap smear?
Have you ever had a pap smear?
Do you know what a pap smear is?
Papanicolaou smear or just pap smear is a screening method used to identify pre cancerous cells in women.
Women below 21 years of age do not need screening.
Women aged between 21-29 years will require pap smears every three years.
Women aged between 30-65b years of age, who have had negative pap smears will requitre to go for pap smears every five years.
Women who are HIV negative though require yearly pap smears or as directed by their doctors.

If for some reason you had your uterus removed; complete hysterectomy, then you don’t need to go for pap smears at all.

 

Merry Christmas

HAPPINESS EVERYWHERE….
It is that time of the year when we celebrate the birth of Jesus and the festive mood is present everywhere! Television and radio stations are playing Christmas carols, supermarkets and shopping malls are all decorated in bright colored balloons and glittery lights. There are Christmas trees everywhere, decorated with bright lights that keep winking at us as we walk around, reminding us that it is Christmas.
As everyone else travels to the village to celebrate with their relatives, he (let us call him Mark), Mark lies in the hospital bed unaware and uncaring about what is going on beyond his field of vision. It is two or three months since he was allowed to go home. And for these three months, he has been lying in his bed, trapped in his own body, unable to move any part of his body from his waist downwards.

The doctors found tuberculosis in his spine and put him on medication. But he is yet to get better, and it may be too early to hope for anything because he is supposed to take them for twelve months; yes, one whole year of his life, dedicated to swallowing tablets. For three months he has lain in that hospital bed and waited. Initially, the problem was the hospital bill. But his hospital bill was waived and his family didn’t have to pay for anything. Still, no one came to get him. And so he has been lying on that bed day in, day out. Every time he wakes up and opens his eyes, the first thing he sees is the roof over head. His eyes land on the same spot overhead and he can see it clearly even in the eye of his mind with both of his eyes closed.

Each day is the same in the hospital they are served the same watery tea and three pieces of poor quality bread at seven in the morning. Then the nurses pass around from bed to bed making their beds. At his bed, they pause, change his diapers first, then change his beddings. They also remember to turn him then. If he is lucky, he receives a bad bath once in a while and a change of clothes. Then the doctors pass round and when they reach at his bed, greet him. There is really nothing more they can do. He is already on anti- TBs. They remind the nurses to turn him every two hours and they remind him to feed well. Recently, they add anti-depressants to his treatment. He is depressed. It shows in his face, in his refusal to talk and his poor appetite. And they will call the plastic surgeon to come and look at his bed sores. He has developed large ugly bed sores on virtually every pressure point on his body; over the sacrum, the hips, the heels, the elbows, the cranium; everywhere a pressure ulcer can develop. Sad right?

And today, amongst all these cheer and happiness, I can’t just push his emaciated body off my mind. He keeps popping up and I can’t stop imagining what he was before he became para-plegic; he definitely was a man with goals and dreams of his own. Dreams he has been forced to forget about because well, he is in the hospital and he doesn’t know how to get out. Because what he needs is not just money but someone, people; friends and family. Maybe they will give him a reason to fight, to start feeding and maybe to turn him as frequently as he may need to be turned.

Like Mark, so many patients find themselves trapped in almost ‘useless’ bodies. Either as a result of brain injury from one cause or another, or even spinal cord injuries either due to disease or accidents. You can only pray to never find yourself in that situation. Meanwhile, how about we think about how these people’s lives can be made better? As things stand, we will never have enough nurses to turn these patients every two hours, at least not in the next ten years. But maybe we can buy them a ripple mattress. A ripple mattress is actually a device that can be used to prevent bed sores in patients who are bed ridden. The ripple mattress is sold with an external pump that alternates the pressures in the different compartments of the mattress, allowing for pressure to alternate on the skin.

If you are looking to gift anyone this Christmas season, you can gift a public hospital near you with a ripple mattress…..there could be someone there who could use one.

Ripple Mattress

Merry Christmas!!!

Nyumba Ya Wazee (Part One)

Old patients who have suffered debilitating strokes are the hardest to take care of. These ones need round the clock nursing. After suffering a stroke, most old people never recover fully. They are forced to live with the residual effects of the stroke. These people, will, most of them for the rest of their lives, need help in carrying out virtually every activity of daily living. They will need help with getting to bed, turning, feeding, urinating, pooping, showering, dressing, brushing their teeth et cetera. Most of these people will also need at least two weekly visit to a physiotherapist and regular check-ups by a doctor.

Now most of us have terribly failed our ailing parents and grand-parents. Because we are perpetually busy looking for money to buy food, property, pay hospital bills and repay the Chinese people their loans, we rarely are able to be there to provide this kind of care to them. A few of us try. We employ house-helps to stay with them and do all things on our behalf. But the house-helps soon get overwhelmed. And the fact that old people are stubborn doesn’t help make matters any better. So our old relatives end up staying alone. They sleep on one side for enough days till we are able to squeeze a few minutes in our busy routines to turn them. The result is the big ugly bed sores that almost each one of them has. Some skip meals and their drugs, and physiotherapy.

Photo courtesy/ nation.co.ke

The only thing that we try to do is take them to the hospital when their clinic days are due. But no one stays around to turn them two hourly, to change their beddings, to help them wash up or even to administer their drugs. But when their clinic days are due, we show up in our cars, wash them up and bundle them into the back seats. We march to their clinics and demand to see the doctors, make a lot of noise about delays, demand for lots of tests, get the medication and drop them off in their miserable homes.

Some of us even walk to the hospital and demand that our parents be hospitalized in the best possible sections of the wards. Because we can’t take care of them at home. We want nurses and doctors to keep our old in the hospital and do everything in the hospital. Maybe this works, in private hospitals. Public hospitals are however no place to dump our old. Those places are teeming with humanity and disease causing organisms thrive in the hospital air.

That is why we need to have this conversation about homes for the old and sickly. Instead of pretending to be nice African children, we need to embrace anything that would make our lives easier. How about we admit these old people in professional homes where there are people to take care of them around the clock? How about we admit them there and never worry about them missing their drugs, or overdosing, under dosing or worse still, being found dead alone? We could let them go there then try and visit them as often as is possible.

Homes for the old might not be popular in these sides of the world but we can make them friendly. Have qualified people to see to the needs of these old people. Design nice games for them to play. Arrange road trips for them et cetera.

Rabies

Raise your hand if you have ever been bitten by a dog.
Raise your other hand if this dog that bit you has never been vaccinated against rabies.

Move to the left if the dog that bit you was a strange dog…..

A small boy, about six or seven lay in the hospital isolation room, with saliva drooling down the side of his mouth. Occasionally, he suffered a strong seizure that made his whole body tense and shake at the same time, before slipping into episodes of apparent calm. His mother sat by his side, with hands supporting her cheeks. Occasionally, she would stand and pace the room, raise her hands and place them over her head before finally walking back and taking her place beside her son. He later slipped into a coma, and as we all know, this story doesn’t end well. When he had shown up in their house one evening three months earlier with bite marks and scratch marks thanks to a neighborhood dog, they decided the bite was too small and just ignored it. Three months later, he presented with full blown rabies. (This is a true story).

September 28th is rabies awareness day. Incidentally, yesterday I saw a woman who had been bitten by a dog two days before she presented to the hospital. She was admitted for reasons other than the dog bite. But I had to bring up that “small matter” of a dog bite. She didn’t have money to buy the anti-rabies, she promised to look for the money. Meanwhile, we will just sit back and pray that she gets the money….before it is too late because rabies is real.

Rabies is a viral disease that affects the central nervous system (brain), usually transmitted through a bite by a rabid animal.
Rabies is transmitted through a bite by a rabid animal, usually a dog. In my village, they are called t-nine, or mbwa wa kichaa. Other animals that can transmit rabies include monkeys, skunks, cats, wolves et cetera.
In the unfortunate event that an unvaccinated or a strange dog bites you, please make sure that you seek medical help. Go to the hospital and have the wound cleaned, get an anti- tetanus shot and get a dose of the anti- rabies vaccine. Now ideally, you should get five shots of the vaccine. The day you are bitten is the first time you get the vaccine. That is day zero. Then you should get a repeat shot on day three, day seven, day fourteen and day twenty-eight.

Of course most people rarely get the anti-rabies. The few who get it get a single dose on day zero and never return for the remaining doses. The issue is money constraints. The anti- rabies vaccine costs an average of one thousand five hundred shillings. Public hospitals almost always never stock it and most medical insurances don’t cater for it. So most people who present to the hospital end up skipping it altogether. The question is, if a dog bit you today, would you afford the anti- rabies vaccine right this moment? Maybe we should remind the forty seven county governments that they need to stock anti- rabies …

As a young girl growing up in the village, once in a while, we used to have mass vaccinations. A community vaccination of all domestic animals. I haven’t heard about them for a long time now. People are too broke vaccinating their domestic animals is the last thing on their mind.
Maybe the reason why we are a third world country is because we are still killed by diseases like rabies. Of all diseases that should kill us, rabies shouldn’t be one of them. But it is.

NB; on day zero, rabies immune globulin is administered together with the anti- rabies vaccine.

Living With Lupus

Lupus or SLE is short for systemic lupus erythematosus, a chronic autoimmune disease in which, your immune system fights your healthy body cells! The result is, literally every part of your body, from your skin, your kidneys, heart, lungs, etc are affected. Seal, the Grammy Award winning singer and song writer suffered from discoid lupus, a type that affects the skin, which left his face scarred. Nick Cannon, the AGT host experienced kidney failure due to complications from lupus. There is an estimated five million people in the world with some form of lupus. Despite this, not many governments have dedicated any meaningful relations towards funding lupus. The month of May is dedicated towards raising awareness about lupus.

Once a person is diagnosed with lupus, there is never being free of it. Your life is characterized by periods of flares and remissions during which the symptoms wax and wane. During a flare, your life takes a back seat as the auto antibodies wreck a havoc in your body. Remissions is the time when you take your drugs and suffer the side effects of those drugs, live your life and wait for a flare because it is always coming!
Aside from the physical manifestations of the disease, lupus, like all other chronic illnesses will affect your life financially, socially, and emotionally.
Lupus is an expensive affair! Apart from having to buy drugs that cost an arm and a leg and doing a zillion tests, you also have to pay doctor’s consultation fees on a monthly or two monthly basis. Then there is the cost of moving from home to hospital and numerous other miscellaneous expenditures that don’t apply to persons who are well enough. It is important for me to mention that as much as we encourage all persons to take a medical cover, most people with lupus have to pay for drugs out of pocket because most regular pharmacies and hospitals do not stock these drugs.

Most people are diagnosed with lupus at the prime of their lives; late teenage to twenties, while they are busy trying to be alive and wrapping their minds around the fact that they will be sick for life, their colleagues are making a nark for themselves in the career world! The result is, they give up on their dreams, become under- employed or unemployed. For those who are diagnosed later in life when they are gainfully employed, they may not be able to stay employed because of being constantly absent. Though there are laws that protect employees, some employers will retrench, or sack you at the slightest provocation!
Chronic illnesses always have their effect on marriages and family life. Those that come early in life have a way of separating the sick from their soul mates and lupus is no difference. Love may be strong but not stronger than the constant fear of losing a loved one. One of the consequences of lupus is habitual pregnancy loss and this in itself worsens the already bad situation.

People with lupus may have less friends because they are almost always missing in action. Today they are okay but tomorrow morning they are too tired they can’t move a finger to scratch their scalp! And so they have to cancel a dinner on the eleventh hour and some friends can’t understand that! They miss a baby shower because they convulsed at night and they don’t want to ruin it by convulsing right in the middle of the photo shoot, and also baby showers remind them of their own babies who came out as clotted blood.

Being constantly sick, relying on meds for life, the strain to get enough money for your illness, having very few people who understand your sickness and the lupus itself have an adverse effect on mood. It is therefore uncommon for people with lupus to suffer from mood disorders such as depression! Caregivers and primary doctors should therefore be able to screen for any signs of depression and refer these patients to psychiatrists on time.

It is now possible for people with chronic illnesses like HIV and TB to get drugs at no cost. People with lupus should also be able to get their drugs and tests for free or at a subsided cost. This will go a long way into improving their survival rates and quality of life, because with the proper treatment they can be productive people who will contribute immensely to the growth of this nation. If you see Nick Cannon hosting AGT, you wouldn’t think that he has lupus; a chronic illness that can be debilitating at times.

SEX; FOR PLEASURE OR REPRODUCTION?

A man will pour millions of sperms into a woman’s birth canal, turn on his left side, sleep for hours, wake up, pour another round of five hundred million or so sperms, and sleep like a baby. He will wake up a third time, pour another millions of sperms, then fall asleep and wake up three hours later to leave. And when this time comes, he will leave with hands in his pockets, chest puffed out and a stupid grin on his face. Another one will be whistling contentedly with hands in his pockets while his feet kick every pebble on the way (his way of telling the world he just had unprotected sex).

The woman will toss and turn, then wake up and rush to the chemist for the emergency pill, or she will wake up to count the number of used condoms on the bed side table and try to recall how many rounds you both went, or she will wake up, retrieve her oral contraceptives and confirm that she didn’t by any chance miss her pill yesterday. While she checks her calendar to reassure herself that it is not yet three months since she last had her shot of depo, he will be “hi fiving” and receiving pats on his back for being able to bed that “girl”. While the man goes on with his life without a care in the world, she will be waiting for her period anxiously. That is the only way she can know she is not pregnant for sure.

The same man will tend to react in three ways if by some ill luck that girl gets pregnant; one, he will deny that stomach, “everyone knows you are a hoe or ho, just go find the father of your child.” Two, he will accuse the girl of trapping her “you did this on purpose, kwani you were not on the pill?” Three, he will try to get the girl to abort, give them that little speech of I am not ready and neither are you, raise ten thousand shillings and lead them to some nasty back street clinic, have your baby yanked out of her womb and then avoid them forever. A few however accept and I have to give them that though it leads to unplanned parenthood but hey, the world is too full of dead beats we will take any who is ready to man up and admit that it was one out of the billions of sperms that fertilized that ova.

If there is a chance for men to decide when to have children and when not, by all means they should. If they won’t ‘wear’ the condom, then they can have that pill. Or better still, go for the safest of them all, vasectomy.

Vasectomy is a family planning method that is not for small boys. It is for men who have had their desired family size. During vasectomy, the vas deferens on both side are ligated and tied (done under anesthesia of course!!). This prevents sperms from entering the seminal stream.

Pregnancy is still possible shortly after vasectomy and therefore couples are advised to continue with another complementary family planning method until a semen analysis is done in which zero sperms are found on semen.

A man undergoing vasectomy

It is important to remember that vasectomy will not protect you from sexually transmitted diseases. It doesn’t affect your sex drive also! And the first human vasectomy was done in 1924!