Vasectomy brings villagers satisfaction all round in Boyolali
Leony Aurora, The Jakarta Post, Boyolali, Central Java
There is nothing unusual about Kaligentong village, Ampel district, which lies six kilometers to the east of the foot of Merbabu mountain, Central Java.
Like other modest villages in the country, Kaligentong is blessed with clean and fresh air. Brick houses are everywhere, with chicken running around and dogs sprawling in the unkempt yards. Smiling villagers stare at passing cars.
Perhaps nobody can find Kaligentong on a map, but beyond its simplicity it serves as a model for the country's family planning movement.
Along with its neighbor Ngagrong, Kaligentong is dubbed "vasectomy village", due to the extraordinary level of male participation in the birth control program.
In Kaligentong, 173 men have had vasectomies since 1975, 40 of whom are still in their prime. They account for 5.8 percent of married men aged 15 to 49 who are using contraceptives in the area.
Vasectomy is far from popular in Jakarta, with an average 0.1 percent of the male populace resorting to it.
Latest data from the National Family Planning Coordinating Board (BKKBN) shows that 0.7 percent of 38.4 million couples in the country choose male sterilization. Other methods of family planning are much preferred, such as the pill (13.2 percent), intrauterine device (IUD, 6.2 percent), injections (27.8 percent), implants (4.3 percent), condoms (0.6 percent) and female sterilization (3.7 percent).
Vasectomy is a simple procedure designed to block the passage of sperm. Nowadays, doctors use a no-scalpel method, in which a doctor makes a tiny hole to tie and cut the vas deferens, or sperm tubes. A patient will have to refrain from strenuous work for five days and use condoms for 12 to 15 acts of sexual intercourse to clear the tubes of any remaining sperm.
"The procedure is finished in five minutes, and since there's no medication used, aside from common antibiotics to prevent infection, there are no side effects," Budiadi, an obstetrician and gynecologist, asserted.
Indonesia has succeeded in curbing its population growth from 2.32 percent in the 1970s to 1.49 percent in 2003. However, this still means that every year four million new citizens have to be taken care of.
Ngagrong could be proud of a record 211 men who opt for vasectomy, but Kaligentong still shares the honor for breaking the myth that men cannot or will not take part in the family planning program.
For some the reason to join the program is very simple.
"My wife was afraid of undergoing a tubectomy," said Harjo Sutarno, a 63-year-old man with five daughters.
They were waiting for a boy, he reminisced. "But after five girls, well, I felt that was enough," he said with a smile.
Sutarno had the operation in 1976, following in the footsteps of two leading men in his village: former village chief Suratman and a prominent Buddhist leader, Harjo Suwiryo.
Sutarno had the operation in Semarang, a favorite place for many as they could enjoy some recreation as well. The operation can also be performed in Pandan Arang hospital and the newly opened Primary Clinical Training Center (P2KP) in Boyolali.
Sutarno now chairs an organization for men who have undergone a vasectomy in the village. Established in 1983, the group is called Paguyuban Priyo Utomo Keluarga Sejahtera (the Association of Prime Movers for Prosperous Families).
The club has now 35 members and gathers once every selapanan, or 35-day month according to the Javanese calendar. They hold an arisan (a draw in which members contribute to and take turns at winning an aggregate sum of money) and a discussion.
"We also promote vasectomies at weddings and other public meetings," said Sutarno. The approach, he said, worked much better than seeking information from family planning field counselors, because it came from first-hand experience.
Tri Sunasri, the current head of Kaligentong village, however, said many men declined to have the operation for two reasons: they still wanted to have more children or they could not afford it.
"The procedure is free of charge if they register with the BKKBN, but they cannot afford to take the mandatory five-day rest," she said. "Many work as becak (pedicab) drivers and a daily income is very important to them."
Suratman, 46, underwent the operation in 1993, three months after his third daughter was born because his wife, Harjani, did not feel comfortable using contraceptives.
"My neighbor told me of some women who still got pregnant even after using the coil (IUD) or the pill," said Harjani. "Another neighbor became sick quite often after she used the coil."
When asked about how vasectomy had affected their marriage, Harjani smiled and said, "Everything is OK."
Some men even admitted to having a better sex life.
"It's just a psychological reaction. Because they feel safe in performing it, the action itself becomes more satisfying," said Budiadi.
For Suratman, the most important thing is that his family can have a better life with the money he makes from being a worker and a farmer.
"All I want is that my children have more education than I did," said Suratman, who is an engineering vocational school graduate.