It’s babies until the wombs are empty

"Our men believe we are continuous givers of life so, in our lifetime we should exhaust all the children in our stomachs,” says Stellina Ngale, 32.

A reproductive health field worker in this area is rare. Family planning adverts on radio and television are rarer. Brochures won’t work because of low literacy levels.

Welcome to Turkan Tokol’s household in Daaba, Isiolo, where terms such as contraception, condom and child spacing are bizarre intrusion on cultural integrity and therefore no-go areas.

Tokol’s has three wives and 23 children. The owner 20 cattle, 100 sheep, 56 goats and one camel is not very rich by local standards but he wouldn’t think of a keeping a smaller family.

In his book, family planning is a sign of weakness for the Turkana man and a sure way of losing respect by women.

“Requesting my husband to consider one of the available modern methods is a ticket to a beating and later shunning by the community,” says Jacinta Ipaki, one of Tokol’s three wives.

Last year, the government promised to strengthen male involvement in the provision of rural health services including family planning.

But until it happens, the women in this community will be in the firm grip of a tradition that has no quarrel with women giving birth yearly.

Never mind the resultant malnutrition and an increase in childhood diseases.

One of Kotol’s wives, Stellina Ngale, 32, confirms that any form of artificial contraception will attract reprimands from her peers and husband.

“Our men believe we are continuous givers of life so, in our lifetime we should exhaust all the ‘children in our stomachs,” she says, her gaze fixed on the ground on the ground too shy to comment further in the presence of her husband.

Having read her body language, Tokol joins fellow men in a nearby manyatta where in every man’s hands is the ekicholong — the Turkana wooden stool.

Here most men spend the day seated in small groups outside their manyatta or leisurely lying on the ground, their necks supported by the ekicholong.

The women and girls prepare meals and fetch water and firewood while the boys mind the livestock.

If the residents of Daaba village were to talk to talk to Prof William Stones, the chairman of Aga Khan University Hospital Department of Obstetrics and Gynaecology, he would advise that the most favourable spacing for children should be at least 24 months.

“This gives the mother time to rest and further reduces the risk of poor nutrition due to early cessation of breast-feeding,” he says.

“Both mother and child have ample time to rest and bond during this time,” Prof Stones added.

The gynaecologist warns that the growth rate of children born in rapid succession is poorer compared to those born two or three years apart.

The health of the mother is also at risk due to the strain of the deliveries which may sometimes lead to complications like obstructed labour or a ruptured uteri.

Stellina is a mother of seven and has never been to any formal school. With the prevailing drought, she cannot feed all her children.

Young women with no education are more than three times as likely to have started child bearing by age 19 than those who have secondary and higher education, says the Kenya Demographic Health Survey.

Stellina gave birth to her first child at 17 years, she tells us as her year-old son runs to her side chuckling in a manner to suggest it is suckling time. Another baby, her second last born, is crying on her left demanding the other breast.

But the breast is empty.

A cup of tea for each of her three girls and four boys is all she can offer for breakfast this morning.

Stellina’s second co-wife Jacinta Ipaki, 29, recently gave birth at home to her eighth child.

“We practise natural family planning where the normal spacing between the children is one year, at least until the last born takes his or her first steps,” says class standard three drop-out Jacinta who favours the natural method of family planning and is our translator.

However, Stellina says the method is unreliable because of the high levels of illiteracy, which it difficult to get the safe days right.

According to their husband, Kotol, it is culturally unacceptable for the women to take any modern contraceptive.

“Children are a symbol of wealth just like the goats and cattle. How is modern family planning a better option?” he protests.

“In good times, we have plenty of food and milk to feed the entire household so the number of children has never been a problem apart from this drought”.

Then he lays the law.

“If other women want to limit the children they have that is okay but not in my household”.

His father had more than 20 children and fed all of them, we are reminded.

As is the case anywhere in the world, children are an asset in this community. Girls translate into wealth when the suitor comes calling.

“If I do not have many girls I will not be respected by my peers because they are source of wealth. Boys serve as protectors of the home and also carry the family name, ensuring continuity of my home and the clan,” he explains.

A bride will fetch at least 50 head of cattle, we are told.

Girls learn about motherhood and midwifery when they make fertility dolls known as ikoku which means child. Keeping one, it is believed, ensures fertility.

The women in this community also give birth at home thus from an early age the science of midwifery is taught to married women who watch as others give birth.

“We do not go to the hospital before giving birth, to give birth, or after giving birth because it is very far leave alone the Sh20 you pay for the admission card,” says Jacinta. To fill the service gap, birth attendants known as ng’akimak or nakithidonak come in handy.

The qualification for the birth attendant is that she must have reached the end of her child bearing. This ensures she has had at least 15 years of experience thus increasing the chances of handling difficult deliveries. Deliveries which no man must witness.

“When the labour pains become intense we send away the children and the men,” says Jacinta.

The husband could asked to buy a blanket that can only be found in Isiolo 50 kilometres away.

He must never watch his wife in pain during delivery.

But this year husbands face a different kind of pain— the drought.

“We will live on boiled water from the village well if there is no porridge,” says Jacinta. But it gets depressing such when, according to Jacinta, “babies suckle empty, sagging breasts that give them a soothing effect, a consolation that the milk will be back soon.

They fall asleep for a few minutes before they are awakened by hunger because there was no milk in our breasts”.

But hope is eternal.

A mother of seven, Leu Naupa is eight months pregnant with her youngest child only one and a half years old.

She is due next month and hopes the traditional birth attendants will assist her to deliver safely.

 “My seven babies were delivered safely so I do not foresee the current one having any complications,” she adds.