Men Contraception: Spiral Taboo wrapped with myths and misperceptions

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By Yasir Habib Khan

A brawl erupted at Ali Town, vicinity of Raiwind, some miles away from the residence of PML-N rulers in Lahore. Furious gathering were shouting at Bilal Ahmed (social worker) saying “are you gone mad. How dare you to talk about male contraception.” “Better to get lost before agitated people lose their cool and kill you as you have committed an unapologetic sin,” gathering fired salvo.

When asked Hassan Nauman, 40, one of the outrageous’ mob, violently utters that getting the message across about “condom or other contraceptive” are off-limits in social, cultural and religious circles. “We are honorable community. We neither share such private matter even with close family members nor in public,” he asserts in tantrum.

Bilal Ahmed, since the day horrendous incident happened, vanished from the area to ward off public meltdown.

Milieu of taboo on male contraception is order of day in Pakistan. Under social pressure and conservative setting, people deem haram (forbidden in Islam) to chat on birth control devices used by males. Even mass communication networks in public and private spheres—shy away making discussion on it. Through there is some space to discuss women contraceptive measure for spacing child (temporary or permanently) but when it comes to male steps to prevent conception, all hell breaks loose.

Surprisingly married and unmarried folk know about condom, its shapes and somehow utilization. They are displayed and are sold out in pharmacy outlets irrespective of fact how minimum they are used. Since society terms it steamy matter that foment vulgarity and promiscuousness in sheer contradiction to injunction of Islam, government have been pulling the plug on various awareness campaign targeting male groups.

Two years back, an 50-second clip to encourage male to use condom in a bid to stop burgeoning birthrate as a part of national drive was launched, conservative folks upped in arm branding ad as immoral and unsavory to social fabric. Government regulatory body had to put it off air soon after people poured in more than 1000 complaints in a week.

2Meanwhile, Population Welfare Department Punjab (PWDF) has held in abeyance next five-year plan 2015-2020 comprising social awakening for birth control, male contraception and others.

Out of 100 million population of Punjab, merely less than 1 percent use condom, Dr Amjad, incharge of Male Contraception Cell, Population Welfare Department Punjab reveals. Despite various motivational programmes, he says, making male cognizant of fact that male contraception is safe and healthy, no headway is sight.

“During conversation with couples, men clearly put birth control liability on the shoulder of women. Venting unwillingness, 99 percent males are found fearing contraceptive methods on ungrounded reasons. Some believe male contraception leads to loss of sexual power and hinder erotic pleasure,” Dr. Amjad expresses. Department has deputed, he mentions, officers in 34 districts of Punjab to instill sense of protected sexual life. People seldom visit them and most of the time Male Contraception Cells bear deserted look, he speaks loud and clear.

Owing to traditional hush-up on contraceptive measures and lack of sexual education, Pakistan’s population has alarming growth of around two per cent a year and it is likely to increase to 343 million people by 2050.

A random survey lays bare the fact that families predominated by males least bother passing on youth basic information how to spend protected marital life. “Neither our forefathers told us anything nor we should let them know about contraceptive.” Hammad Akbar, 60, responds the query.

“Who is destined to come to world, will surely come and unnatural interference is tantamount to visitation of God,” he goes on saying.

Shying to discuss on condom, Ghalib Ali, aged 24, businessman at Gulberg, says he knows about condom but lacks knowledge to use it in befitting manner. Though he is going to wed next week, Ghalib says, he has not proper counseling on how to intercourse if desire “birth spacing”.

Myths and fallacies regarding condoms use and vasectomy (permanent male sterilization) lie in physical, sexual, psychological, socio-cultural and religious settings.

The leading myth amongst male and female youth is that use of both condoms and vasectomy beget impotence in males. So much so, condoms are believed to inflict infections, backache and headache in males. Some youth claim that vasectomy is designed for prisoners only.

According to Health Ministry condoms are 97 percent effective if used correctly and only 80 percent effective if used in erratic way.

As compared to 30 percent married Pakistani women who adopt contraceptive, percentage of men using family planning is dismal, a bleak disclosure made by Pakistan Demographic and Health Survey, 2007.

Social scientists hold opinion that even with minimum margin, elite and liberal class in urban culture makes some deliberation on condom’s pros and cons. However when it comes to talk on male sterilization (permanent) called vasectomy, it becomes a taboo for them, they add. People have, they comment, firm belief that permanent method of contraception is strictly prohibited in Islam.

Poor literacy rate and limited knowledge of Islamic teaching are the stumbling block in the way of mass mobilization of contraception issues. Pakistan literacy rate ranges between 28 to 45 percent in terms of rural and urban stretches and contraceptive prevalence rate (CPR) is 30 percent. Iran literacy stands at 85 percent with CPR at 74 percent. With 91 percent literacy, Turkey has 65 percent CPR rate. Literacy rate in Indonesia and Malaysia revolves around 92 percent and CPR rates are 60 percent and 61 percent respectively.

In a country like Pakistan where the Family Planning decisions are still taken by the man of the house and the mother-in-law, particularly in the under-privileged and rural setup where Family Planning is direly required, the eventual result is more kids than the family can manage and in turn, more children than Pakistan can possibly care for.

6Family Planning and Contraception is Islamic Countries: A Critical Review of the Literature published in Journal of Pakistan Medical Association shedding light on the smothering issue says that low usage of contraception in the rural areas of Pakistan correlates with the level of isolation, poverty, illiteracy, and to a large extent, religious misinterpretations/misconceptions. Almost 25 percent of couples who desired family planning services are not receiving them for a variety of reasons of which religion could be one, especially in the rural remote areas where the media is still not reaching and influencing mind-sets.

No wonder that a number of Islamic countries efficiently mobilize local clergy and obtained desired results on family planning programmes.

Pakistan and Afghanistan

It is documented that it is mostly religious leaders who are against FP services and that involving them proactively in community education is extremely important to promote contraception use. Even in Afghanistan, the involvement of communities along with local opinion and religious leaders has made the promotion of FP practices in rural Afghanistan possible. Dialogues with opinion leaders, clinic staff, and household members helped in understanding cultural norms and taboos in order to innovate and test FP services in a local context. Updated contraceptive information supported with Islamic ideology and the mobilization of religious leaders helped in achieving the goals of the programme.

Middle East

In Iran, decision-makers including ministry officials and religious leaders met with technical experts and collectively agreed that the country could not adequately feed, educate, house, or provide jobs to its citizens at existing levels of population growth. Faced with these facts, they took action and developed a population policy that was incorporated into the country’s development plan. Family planning programmes were strengthened as a building block for poverty reduction and the achievement of national development goals. Religious leaders have also played their role in removing community fears about contraception methods. This is the most unique and impressive approach adopted by FP programmes in Iran.17 Social stigmas such as men’s negative behaviours towards permanent contraception, were addressed through consultative sessions with ulema.

In Egypt, the Grand Mufti, the country’s most authoritative interpreter of Islamic law, issued a religious decree in favour of contraception, thus allowing the establishment of birth control clinics in Egyptian cities. He declared that the earliest followers of the Prophet (pbuh) practiced contraception with the knowledge of the Prophet, who did not forbid it.

Europe

In Turkey, religious leaders have a positive attitude towards contraception. The integration of religious leaders in reproductive health programmes and education on FP issues was prioritized to attain desirable fertility rates.

Pakistan has already missed millennium development goals (MDGs) set for 2015. Having recognized that Islam is still the mainstay in the debate on male and female contraception in country, religious leaders, ulema, scholars, think tanks, and even local clergymen should be disseminating the correct information and actively engaging in advocacy for the promotion of birth spacing diluting the myths and misperception about male conception.

Yasir Habib Khan is an investigative journalist. He is fellow of US-Pakistan professional partnership program for journalists. He can be reached at yaseerkhan@hotmail.com or @yaseerkhann