Goat cream contraceptive: Method leaves experts with more questions
Scientists brush it off and even frown at its mere suggestion, but Turkana women swear by it. Their men know nothing of it, assuming that it is only used for cooking, oiling their skins and animal hides, or mixing with milk and blood to make a delicacy gulped down by warriors.
Goat oil is what it is, and women in Turkana County have used it to address their reproductive health challenges, particularly for birth control, once they are done having children. They may not have evidence from clinical trials and life-long experiments that the scientific community wants, but you can’t argue with their indigenous knowledge that has served them for years with results that show the goat oil works.
This is what the women of Lolupe Village in Turkana County swear by, vowing to keep at it even as county health officials ask them to give it up in favour of modern contraceptives. They use it without their husbands’ knowledge, because men don’t believe in any form of birth control, be it traditional or modern.
Goat oil served 50-year-old Lobukre Kakalel, when she was done carrying pregnancies and pushing out babies after 15 years of childbearing. She was married off as a 15-year-old, and one of the first pieces of advice she got from her mother-in-law was that if she ever used “those family planning methods pushed by the government” she would never have a baby when she was ready. The older woman warned that modern birth control methods had chemicals that weaken and destroy the womb, and told her that when the time came to stop popping babies, she would give the younger woman a solution.
Now 35 years later, Lobukre believes that modern contraceptives will give you cancer and she says it with such conviction, it’s almost impossible to argue with her. She even has an example – a woman who lost her womb after defying traditional wisdom and turning to daily pills to prevent pregnancy.
Such are the myths and misconceptions that health workers and Ministry of Health officials have to deal with, as they try to promote modern contraceptives to further push down the birth rate that stands at four children per woman. According to the Kenya Demographic Health Survey of 2014, women who want to avoid pregnancy but are not using contraceptives cite opposition to contraceptives by their husbands or partners, perceived religious prohibition, fear of side effects and other health concerns.
In Turkana, where the average woman gives birth to seven children on average, and where only 10 per cent of women of reproductive age (15 to 49 years) use any contraceptive (whether traditional or modern).
And so Lobukre began her days as a married woman. Her husband, a pastoralist would be away for prolonged periods, in search of pasture. And each time he came home, the couple would get intimate. And each time they got intimate, she would get pregnant, giving birth to five children in quick succession.
“He would leave me just when I was about to give birth, only to return in time to impregnate me again,” she recalls.
On the one hand, she was happy that she was fertile and had fruits of the womb to show for it, but on the other, feeding her children and taking them to school, and footing their medical costs was becoming more of a burden with each additional child.
“He never left us anything to eat. I struggled with my children all by myself until I realised that enough was enough,”
So at the tender age of 38, six years after about three per cent of women turn to the modern solution of tubal ligation, to shut off the womb for good, she turned to the trusty old goat cream.
Condoms were never an option since the couple had never come across them, and they had no idea how to use them, not forgetting that the man would probably reject them. She has not had a child ever since she used the goat oil.
While scientists are wishy-washy about endorsing the oil, they acknowledge that scientific studies on indigenous knowledge could shed some light on how methods like goat oil work to prevent pregnancy. And it’s not in the smell, that would repel the man, thereby making intimacy improbable (this writer took in a whiff of the cream made like butter from goat milk and it smelled rather delicious, so if anything, it would only make the woman smell more attractive.)
“It could be that the oil is not stored appropriately, meaning that bacteria grow in it, and when applied, the bacteria destroy the fallopian tubes,” posits Dr Joachim Osur, the director of reproductive health at Amref, who urges more research into it.
In another part of Lolupe Village, we meet 44-year-old Ajukwony Samal Aukot, a mother of 10 who had her first child at 16. She had a child every year after that, without an option of delaying pregnancy and spacing the births.
Again, it was a case of having a pastoralist for a husband, who would go out to look for pasture and water for their herds, followed by a return home to make his wife pregnant, before heading off to look for pasture and water again.
The man wanted as many children as the eggs in Ajukwony’s ovaries would allow, but after a decade at it, she had grown tired and wanted out of baby-making. An elderly woman she confided in told her that goat oil was the answer.
“I have used it for six years now and I have never conceived since I started using it,” she says.
The method which has been in use for years is not recommended for younger women, but only for those who have their desired number of children. This is because once you use it, you can never turn back. The results are irreversible.
“This is only for older women like me,” Ajukwony says roaring with laughter, “if a young girl touches it, she will never get pregnant. She will never give birth.”
The milk is put in a gourd and left undisturbed for four nights. If someone touches it, it won’t work. On the fifth day, the cream is boiled in a sufuria and left to cool. The naked woman uses a stick to administer droplets of the cream in the mouth four times.
Then she swirls the container with the cream round her body four times while chanting “Don’t give me a child, shut my womb.” After that she applies the cream on her hair and all over her body which is adorned with traditional beads.
“We talk to the oil and tell it to fulfil our requests of not having more children and our forefathers hear us,” says Ajukwony.
The cream is then mixed with the faeces of a donkey, then placed in the goat’s shed where it remains for four days, and nobody and nothing is allowed to touch it.
“This is enough to shut off your reproductive system for good. I am living proof that it works. My husband is always at home now, so we have sex more often. I have never used any modern contraceptive and have not been able to get pregnant for six years,” she says with confidence.
“Once you swallow or touch this this, you cannot conceive. It has worked for many women over the years,” she adds.
Interestingly, Ajukwony serves as a community health worker, attached to the nearby Lolupe Dispensary, where she advises younger women to use modern contraceptives to space births. However, because their husbands are against birth control in any form, the younger women plan their families behind the men’s backs.
“Our men are adamant. They can’t accept birth control. They want you to give birth, but they don’t consider the struggles of raising more children than you can afford in these modern days,” says Ajukwony.
She has helped many women to embrace modern methods, though it hasn’t been easy.
“Traditionally, our community valued children. They are seen as a source of wealth,” she says, adding that men chase her from their homes when she goes visiting, claiming that she is against the wisdom of their forefathers.
In one home with seven children, the man of the house told his wife that he needed at least 20 children from her, to make up for the resources he spent when he paid bride price for her. The woman went behind her husband’s back and got a modern contraceptive method to space her children, on Ajukwony’s advice.
Although, uptake of modern contraceptives is improving in Turkana County, the numbers are still rather low at 18 per cent, against the national average of 59 per cent, with some parts of the county, like the northern side having an uptake of one per cent. Counties with high poverty levels like Turkana have little or no access to contraceptives, and this in turn contributes to poor health indicators for mothers who can’t space births and their children.
Dr Gilchrist Lokoel, Chief Executive Officer at the Lodwar County Referral Hospital, says that culture has made it difficult to penetrate some places even after putting up 158 health centres to improve access to the family planning commodities.
“We are a traditional society that is patriarchal in nature and men don’t support family planning. They say it is a ploy to sterilise women,” says Dr Lokoel, who notes that goat oil’s efficacy has not been documented, the way lactational amenorrhoea and withdrawal method (other traditional methods) have, even though they are not as effective as modern methods. He suggests that the oil might work through the placebo effect, but adds that research would yield better conclusions.
Turkana has the eighth highest birth rate with 47.9 births for every 1,000 people, more than double the rate in Kirinyaga which has the lowest birth rate at 21 births per 1,000 women. A Kenyan woman now gives birth to an average of four children, though women in rural areas have one child more than their urban counterparts. The number is higher than the global average of two children but lower than Africa’s average of five children.
While more than half (58 per cent) of married Kenyan women use modern family planning methods, five percent use traditional methods. Injectables are the most widely used modern method (26 per cent), followed by implants (10 per cent) and the pill (eight per cent).
Eighteen per cent of married women are considered to have an unmet need, which means that they would like to delay pregnancy but are not using contraceptives. Kenya hopes to achieve a modern contraceptive prevalence rate (women of reproductive age –15 to 49 years – using contraceptives) of 66 per cent by 2030 and 70 per cent by 2050. Josephine Kibaru-Mbae the director general of the National Council for Population and Development, notes that trends indicate that Kenya is likely to achieve its 2020 target of 58 per cent prevalence of modern contraceptive use this year. This has been attributed to increased public awareness and education on the use of modern contraceptives.