Infertility is not a death sentence- Merc Foundation CEO Dr Rasha Kelej

Dr Rasha Kelej.

Most people only know infertility, but don’t understand what exactly it means. Mind sharing more light?

First, there are two types of infertility; primary and secondary. Primary infertility is when a couple hasn’t fallen pregnant after at least 1 year of trying, without using birth control methods.

Secondary infertility is the inability to become pregnant or to carry a baby to term after previously giving birth to a baby. The two are caused by almost the same factors.

Based on your experience, how can married couples enjoy their relationship even when they have no kids?

While most couples have a desire to have children, being unable to bear a child due to certain medical reasons should not hamper their relationship. They should know infertility is not a death sentence. It is a condition that can be prevented or managed.

Further, it should not be a blame game. They should work together to fight it. In fact, I tell couples, it should bring them closer. For example, if it is the wife with the problem, the husband should be supportive and accompany her to all the clinic visits.

When women have infertility issues, most men resort to remarrying. But this is not the case for women, why?

In many cultures, women are solely blamed for failing conceive. They are treated with a lot of disgust and in some cases, face violence.

Most women are not aware that in 50 per cent of infertility cases, the man is the one with the issue. And I agree, most men prefer to remarry, not knowing they are the ones with the problem.

On the other hand, the women can’t get married again since they have already suffered a lot of stigma. She will give up the fight. This is of course, unfair and incorrect.

I once met a man from a remote village in Uganda, who married 35 times, not knowing that he was infertile! We need to create a culture shift and sensitise communities about this sensitive issue.

Be honest, why is the society so harsh on childless couples?

Because they perceive infertility as a condition that can’t be treated or prevented. Unfortunately, women suffer the most. It is considered bringing shame to the family, which is not the case. Bet it has do with our obsession with kids.

The poor seem to be more fertile and happier than the rich; why is that?

This information is not true. There is no data to verify this claim. Infertility affects both the rich and the poor, men and women. Infertility does not discriminate.

What are the major causes of infertility?

Some African traditional, cultural and religious practices combined with low resource environment are linked with higher levels of non-genetic and preventable causes of infertility.

Further, untreated sexually transmitted diseases (STDs), unsafe abortions and female genital mutilation. Further, poor nutrition and exposure to smoking, leaded petrol and other environmental pollutants.

What about in men, what is the major cause?

For men, it is mainly attributed by previous genitourinary tract infections, though it doesn’t apply in all cases.

Before walking down the aisle, couples go for HIV testing. Would you advise couples to go for fertility test before committing to marriage?

 Fertility or infertility should not be a reason to commit or not commit to a marriage. Couples should support each other if they find out they can’t have kids. It is a shared responsibility.

Why is adoption not popular in Kenya especially for infertile couples?

Adoption is a great option. While the practice of adoption has started to take shape in Kenya, the social perception of adoption needs to change as it is a big barrier. We have so many orphans and offering them that parental love is an amazing journey.

What are your thoughts on fertile couples who chose not to have kids?

It is a personal choice. However, both parties should agree. Also, a couple should not decide to have a child because of societal pressure.

There are women who swear by certain foods to determine gender, single or multiple births; is this medically proven?

Eating a balanced diet and maintaining a healthy weight will boost fertility. I am not aware of any scientific literature supporting food to determine gender of the baby, or single/ multiple births.

 What has been the lowest moment in your advocacy journey and as Merck Foundation CEO ?

During my visit to Uganda, a few years back for a community awareness campaign, I met many infertile women. Listening to their stories and how they have suffered was heart-breaking.

That was the lowest moment. I decided to create ‘Merck more Than a Mother’ campaign and I was lucky that Merck supported this idea with all kind of resources because they also believed that it is not fair to leave these women suffer this injustice.

They also believe in the need to empower them and create a culture shift to break the stigma around infertility and build fertility care capacity.

What do you consider your greatest achievement since the launch of ‘Merck More Than a Mother’ campaign?

 Merck Foundation has as many as 10 First Ladies to be ‘Merck More Than a Mother’ ambassadors in their countries such as Botswana, Republic of Burundi, Central Africa Republic, Chad, Ghana, Niger, Sierra Leone, Gambia, Guinea Conakry and Zambia.

This speaks volume about the work we are doing. This year, they will be 17 First Ladies. This makes me very proud that we all join hands to break the stigma of infertility.

Merck Foundation is making history in many African countries where they never had fertility specialists or specialised fertility clinics before ‘Merck More Than a Mother’ intervention, to train the first fertility specialists such as; in Sierra Leone, Liberia, The Gambia, Niger, Chad, Guinea and Zambia. 

Other achievements?

Merck Foundation has also supported the establishment of the first ever Public IVF centres in Rwanda, Ethiopia and Uganda.  I did not reach my greatest achievement yet. The sky is the limit.

The views and opinions expressed here are those of the author and do not necessarily reflect the official policy or position of