Sunday, October 27, 2013

Lagos community where men don’t use condoms


The use of condoms is strange to many men in Makoko, a densely populated slum where the majority live in wooden shacks built on water.

Following his pleasant discovery earlier in the day, Hueze Huesu, in his 50s, couldn’t wait to get home later that night. He felt like a school boy preparing for a first date.
He was excited about exploring the world of sex with a ‘rubber.’ “Nobody had told me about condoms until I heard from some people that it prevents pregnancy and sexually transmitted diseases,” he said.
However, his excitement was deflated when he tried to explore his discovery with one of his wives that night. He said, “For the first time, I tried to use it when I wanted to sleep with my wife but she bluntly refused. She said she was not a prostitute and queried why I wanted to use a condom when we have been married for years and never used one.”

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Since then, Huese, who has 10 children, has never tried to use a condom with any of his two wives. “I have never believed in the use of condoms anyway. This has not stopped me from having sex regularly. The woman knows the sign when the man is about to ejaculate or reach orgasm. So she has already even enjoyed it more than the man before he withdraws,” noted Huese animatedly.

Like Huese, many Egun people in Makoko, as well as Oko-Agbon and Ago-Egun communities in Yaba Local Council Development Area, Lagos, do not like using condoms due to their long held traditional belief in the old practice of coitus interruptus, also known as the withdrawal or pull-out method during sexual intercourse.
For centuries, this has been used as a method of birth control worldwide.
The history is not lost on the Egun people whose forefathers migrated from neighbouring Francophone West African countries like Togo and Benin Republic, as well as from Badagry, Lagos. This age old practice has been transferred to the current generation, where most of the people speak their local Egun dialect and sometimes French. Their major occupations are fishing and farming. Only a few understand English and the residents, whose maj live in wooden shacks built on murky waters oozing with an unpleasant odour.
“The use of condom means nothing for us here as Egun people. We don’t like using condoms because we know ourselves, both women and men; we don’t go outside or sleep around. It’s those people who go outside sleeping with different people that contact such diseases like HIV,” said Lowato Luke, one of the traditional chiefs in the area.
Luke, who has two wives and 12 children, gleefully boasted that he had mastered the withdrawal method and understands his wives’ ovulation cycles. “I know the particular times to have sex with my wives, even if they are breastfeeding and I want to have sex with them, I know how to do it to prevent another pregnancy,” he said. Like Huese, he also claimed that his wives enjoy the sex more than he does. “But if you use condom, it won’t be that enjoyable. I have never used a condom,” he noted.
It is the same case with Kirianko Goi, in his 40s. “I don’t believe in the use of condom because I never heard that from my father. It’s not for me to say whether I will advise my children to use condom or not. If the young boys and girls want to have sex, they won’t tell you. This generation is clearly different from that of my father and mine. But if I’m in a position to do so, I will advise them, it is my duty to advise them,” he said.
Goi’s nephews, two young men in their 20s, one married and the other unmarried, giggled intermittently during their uncle’s brief condom talk. But they declined comments when asked if they use condoms during sex.
Many of the men who spoke to our correspondent in the community expressed their aversion to the use of condoms during sexual intercourse and were insistent that their women enjoyed it that way.
Twenty-five-year-old Bernadette Sato, who has two children, agreed. She does not like condom. “We don’t like using condom. But if we don’t want to get pregnant, we know how to do it by ourselves; it pays us more that way, because we don’t like using condom. I was told in a hospital in Cotonou, Benin Republic, where I gave birth to my first child, that people who don’t want to get pregnant can use condom. Sometimes, I use a family planning drug before and after sex with my husband to prevent pregnancy,” she said, noting that many of her friends also don’t like condoms, while some claimed it could bring about disease. “I don’t know the type of disease, but I just don’t like condom during sex,” she added.
Pipi Olorunwa, who has been married for 12 years and has six children, gave an insight into the female perspective. She said: “Although there is no official report that says condom is bad; personally, I don’t like it because God did not create it. Those who created it did so because of the level of immorality in the world today so that they can enjoy themselves. There are several methods to avoid pregnancy. A couple can have sex without the wife conceiving.
“I also don’t like the chemical and odour from condom because I believe the chemicals used in preserving the condom could cause problems and is harmful to the body. Although I didn’t get the information from a medical expert, but everybody does according to their belief. I don’t use any drug either to prevent pregnancy. I just do it the natural way with my husband.”
“We don’t use need it or any other contraceptive because we understand how to do child spacing,’’ noted the head of the traditional chiefs in the area, 55-year-old Mr. Francis Agoyon Alashe. When probed further, he gave a timeline of the spacing among some of his 14 children as proof. It showed a two or three-year gap among them. “My children are well spaced. Some of them, including the twins, were born in 1984, 1986 and 1989. I stopped having children in 2003,” he explained, adding that he still had sex with his wives during those period without childbirth because he had ‘planned it carefully with the withdrawal method.’
“Of course, the woman enjoys it. It’s a matter of agreement between the man and the woman. We don’t like using condoms as such because we want flesh to meet flesh. If a man is too anxious during sex, he will ejaculate on time, but if he can control his excitement, he can take longer minutes,” he explained.
According to Agoyon, the use of condoms could even have ‘negative effects.’ “We believe using condom could bring disease on its own. This could happen when the sperm goes back into the manhood. We call it ‘foon’. Then, to urinate will be very difficult,” he said.
However, a medical doctor, Dr. Kareem Jamiu, punctured holes in Agoyon’s statement. “That’s not true. It’s not medically possible. But there is what is called ‘retrograde ejaculation’, where the sperm goes backwards to the bladder instead of forward. Normally, when a man wants to ejaculate, the bladder neck closes so that the sperm can easily flow forward. But if the bladder neck muscles are weak or relaxed, then it means there is a problem. Some causes of retrograde ejaculations are complications from diabetes, a malfunctioning bladder sphincter, as well as some STDs. But in a normal male, the bladder neck is normally so tight and so the sperm cannot go back,” explained Jamiu, who once worked with the Doctors Without Borders/Médecins Sans Frontières during their intervention programme in Makoko, Oddo and Badia communities in Lagos State.
The MSF team, comprised foreign doctors supported by Nigerian medical staff, worked in these areas for over two years and established a health centre, until they left in 2012.
Despite the lack of information, knowledge, and awareness about the consequences of unprotected sex, there is a general low rate of STDs and HIV/AIDS in the Makoko communities, noted Jamiu, who confirmed to our correspondent that the people in the communities really don’t like using condoms.
He said: “We tried talking with them but it was difficult getting the message across to them. When you tell them about it, they just laugh about it and say they will try.
“From our experience with them, their way of preventing pregnancy is coitus interruptus. Most of the males that had STDs patronised traditional healers, while the females sometime came for treatment, although the rate of STDs or HIV/AIDS was not as widespread as feared. I don’t think there was any difference between the rates in Makoko when compared with the general population or with people who live in different settings. Sometimes, there were 11 cases of HIV in a month, sometimes 12. The community also recorded low figures in malaria and cholera cases,” he explained.
“We have special herbs to cure STDs like gonorrhoea and other types of diseases,” said Huese. “It is an Egun secret,” Agoyon replied when probed about it.
This surprising trend may be due to what is medically termed ‘herd immunity’, Jamiu noted. “When a group of people are exposed to something too frequently, they tend to develop a general immunity to it,” he explained.
According to Vaccines Today, an online publication, “Herd immunity is a form of immunity that occurs when the vaccination of a significant portion of a population (or herd) provides a measure of protection for individuals who have not developed immunity.”
“I think that’s what happened in Makoko. The rates of diseases were not really as bad as envisaged,  Jamiu said.
Another medical doctor who worked with MSF, Dr. Valentina Edoro, echoed Jamiu’s words. “There were isolated cases of STDS, but not high. The number was not something that needed any special intervention. When the women came for family planning; we found out that they don’t discuss it with their husband. We needed to bring the men on board during discussions on family planning, but it came about much later when we were about rounding off the project,” she said. Edoro added that many of the men in Makoko said they didn’t enjoy sex with condoms because they believed it decreased the pleasure during sex.
However, she pointed out that the withdrawal method may not necessarily be effective in preventing pregnancies and STDs. “This is because the pre-ejaculation fluid from a man’s penis may contain sperm, which means that the man may still has enough sperm to make a woman pregnant,” she said, noting that the women were less conservative about family planning than the men.
“Surprisingly we also discovered that their children were healthy and they breastfed for longer time, malnutrition was not a problem. Yes, they had a lot of chest infections because of their environment and they smoke. But they were healthy, despite their environment. I was also surprised about the low rate of STDs because they don’t protect themselves with condoms. They don’t marry outside the community, I don’t know if that is a factor,” she noted.
Conservatism, illiteracy, lack of awareness, traditional beliefs, environmental factors, high risk sexual behaviour and poverty may be some reasons for the widespread practice of unsafe sex among people in the community. There is also a high rate of teenage pregnancy there.
Their claims asides, SUNDAY PUNCH gathered from some of the residents that, despite their marital status, a few of them still had sexual affairs outside the community.
“Today, girls are getting pregnant more and giving birth. Sex is more common in Makoko among the young boys and girls. They like it. All they know in this settlement is sex. You see young girls of 13, 14 years, who have had sex. And when they are brought to the elders, they would claim that they are husband and wife. We deliberated some cases last Sunday, Monday and Tuesday. We had cases of rape in the past but it is very rare. Nowadays, some of these young girls spend their mothers’ profits from her trade to get boys to have sex with them,” Agoyon said. Most times, a traditional marriage ceremony is quickly conducted between these young, consenting lovers. It doesn’t cost much to have one in Makoko, a traditional wedding ceremony could cost between N10,000 and N150,000, Agoyon said.
This developing trend may change the status quo in the community in terms of population growth and rates of STDS.
This is the more reason why, beyond the changing perspectives, Jamiu said people in communities such as Makoko needed more enlightenment about the use of contraceptives such as condoms, considering the social and economic effects such population increase in slums areas would have on the country.
According to recent World Bank statistics, Nigeria, with a population of over 160 million where majority live on less than $2 a day, has the seventh highest birth rate in the world. The report stated that Nigerian women give birth to an average of six children within their childbearing years.
“Their educational awareness and knowledge of contraceptives is very poor in Makoko. I can’t comment on how it works for them. But if the communities can be provided with standard education, it will help change their mentality and way of life, because you can’t dislodge them from there. That’s where they are comfortable to live in. It’s more of a rudimentary life. They have some brilliant children where during interaction with them, you know they can be better. Education is what they need,’’ he noted.
Although the older generation still holds strongly to the sexual practice of their forefathers, the younger generation of Egun people seem to be drifting away with the current of modern times, while in the murky waters surrounding their communities.
Remi Goka, in his 30s, who was evasive about his marital status, said he used condoms whenever he was with his girlfriends. Like he put it, he didn’t know if they had other sexual relationships outside. “But I go for tests regularly. I have many of my friends who use condoms,” he said.
His friends, whose ages ranged from 18 to 30; Hunkarin, Yomlomnun Monday, Keyebo Richard and Djisou Honsou, who had his name tattooed on his arm, all agreed. They all use condoms also. Goka agreed that sex among young people was now a common way of life in the community.
“Yes, there is a difference between my generation and the older one because we are more enlightened about the issues. We have a larger population now. It’s a thing of choice,’’ he noted.
With an increasing population, especially of women and children, poverty, poor living conditions, lack of education and basic infrastructure and services, the increasing rate of unprotected sex in Makoko communities is a worrying trend, especially as the general dislike for condoms hasn’t changed much with the younger generation.
“They live in a kind of cocoon.  For them, it’s a way of life. The men go for fishing; the women go to the market and come back. From what I have observed, there are no special values being handed over. So, it goes on like a cycle. The young boys grow up to impregnate their women and it just goes on and on,” Edoro noted.

-ARUKAINO UMUKORO/PUNCH

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