Siobhan O'Grady On World Vasectomy Day on Nov. 18, doctors in Nairobi performed free vasectomies behind a screen on stage. The event aimed to encourage more Kenyan men to opt for the procedure instead of relying on their wives to carry the burden of birth control.

Last Friday, more than 100 men received free vasectomies at the Kenya National Theatre in Nairobi. In a country where masculinity is measured by the size of a man’s family, the number of men opting for the sterilization procedure is small – but growing.

NAIROBI – George Mbogah grew up in rural Kenya, one of 25 children born to a man with four wives. As a child, he dreamed of attending university and escaping the poverty in which he was raised. But he knew that would never be possible: His mother was his father’s fourth wife, making him one of the youngest in his family. If his older siblings never attended university, he certainly wouldn’t be able to, either.

So when he married his wife, Ruth, they had a lot of conversations about the kind of family they wanted to have. Both agreed: A big family with little money would only perpetuate the cycle of poverty they had experienced as children.

“We were so many, and my dreams were shattered,” Mbogah said in Nairobi last week during World Vasectomy Day, an international health fair intended to raise awareness about male involvement in family planning. “I didn’t want the same for my future child.”

For the first 10 years of their marriage, the couple used different birth control methods to avoid having children. And during that time, they fielded endless questions from extended family members about why they were so hesitant to get pregnant. Finally, they decided to have just one child – a daughter they named Avallenedah.

But when Ruth resumed birth control after their daughter’s birth, her side effects were worse than ever before. She tried seemingly every option, including pills and a hormonal implant inserted in her upper arm, and the couple tried condoms. But they all made her miserable: her back ached, her legs swelled and her period became irregular. “It was painful for me seeing her experience those symptoms,” Mbogah said. “Marriage is not one-sided.”

The new father began to question why it was Ruth who always had to bear the burden of birth control, and visited a few Kenyan doctors to see if there was an option available for him instead. All of them said his only choice was a vasectomy – an irreversible operation that prevents the release of sperm during ejaculation. The doctors urged against the surgery, repeating to Mbogah that if he were to go through with it, he would never reproduce again. But that was exactly what he wanted, so he boarded a bus and traveled 20 hours to a hospital run by the nonprofit sexual healthcare organization Marie Stopes International (MSI), the nearest one to him that could do the surgery.

He said the procedure was painless: After the 10-minute surgery, he walked back to the bus station to head home.

But Mbogah is a rarity among Kenyan men, one of only a tiny percentage who have opted for a vasectomy, which is still considered controversial in a culture where many believe their masculinity is tied to how many children their wives bear. That belief has contributed to Kenya’s rapid population growth, with the country’s population nearly quadrupling to more than 40 million people over the past five decades. According to a 2014 Demographic and Health Survey, only 38 percent of Kenyan men claimed to even know what a vasectomy was. Mbogah said that when he told family and friends about his surgery, they were horrified and told him he would be castrated and never enjoy sex again.

Faustina Finn-Nyame, Kenya country director for MSI, said that many of the men she consults worry they “won’t be able to satisfy their wives, they won’t be able to ‘feel like a man’ anymore, they won’t have the same vigor as before, and so forth.”

But health professionals say all empirical evidence points to the opposite. “You will have more sexual libido because you won’t be anxious” about accidental pregnancy, said Finn-Nyame.

Still, MSI performs only around 300 vasectomies in Kenya each year, compared to thousands of tubal ligation surgeries, a surgery that prevents women from becoming pregnant.

The organization is attempting to reach more men in Kenya by working through church groups and other community outreach programs to debunk misconceptions about vasectomies and encourage the surgery to become normalized.

“Women have always carried this burden [of birth control], so of course it would be nice in an equitable environment for a man to play a very critical role in this life changing and live-saving, I would say, decision,” Finn-Nyame said. “I would encourage all men to stand up and show this act of love.”

And if the turnout at World Vasectomy Day in Nairobi was any indication, Kenyan men are becoming more open to the procedure. Dozens of men lined up at the Kenya National Theatre to receive vasectomies behind a screen on stage. Their operations were then live-streamed as part of an international event urging men around the globe to opt for the safe and simple procedure.

Ahead of his surgery, Eric Ouma, 38, said he decided to participate after watching his wife suffer from the side effects of birth control. The couple has four children, only two of them planned. Ouma realized that he could be the one to stop his wife’s headaches, irregular periods and heavy bleeding. “I’ve heard about vasectomies since high school,” he said. “I’m not scared.”