August 26, 2007
Prof George Albert Omore Magoha, a leading surgeon in this part of the world, is a highly complex man.
You can tell it from the professional organisations he belongs to: the Erectile Dysfunction Advisory Council (Edac), the International Society of Impotence Researc for real men.
Away from administrative duties at the university, Magoha attends to men who struggle with medical complications many prefer not to talk about.
But those complications could make the difference whether a man leaves a generation behind or his kind ends with his death.
Magoha recalls when he was growing up in Yala Gem, Siaya District, it was not uncommon to hear villagers wailing to mourn the sudden death of an old man in the neighbourhood.
When he asked what caused the death, he would be told the old man could not pass urine at the hour of need, however much he tried.
In Magoha’s village, like in any other African society, the idea of a man failing to pass urine was the stuff of myths and taboos, discussed in low tones and only among adults who equally did not know what was going on.
It is life in this world of strange deaths that pushed Magoha into the field of medicine, which few have pursued in Africa.
Highly private man
No wonder Magoha’s clients come from as far as the Democratic Republic of Congo (DRC), Burundi, Tanzania, Uganda and Somalia. Of course Kenyans also visit his Nairobi Hospital clinic.
Magoha describes himself as ” a highly private man”. Students and even some staff at the University of Nairobi agree that Magoha is indeed “a very private person”.
Whether it is the love for privacy that pushed the surgeon into this branch of medicine or it is the profession which pushed him into embracing privacy is hard to tell.
What is clear is that in the line of duty as a medical doctor, Magoha handles highly private and sensitive sicknesses of men.
Magoha is an urologist by. “In very simple terms,” he says, “a urologist is a human plumber.”
He describes it thus: “The plumber deals with human water pipes which transmit urine and seminal fluid, and the organs that feed and supply these pipes.”
In complex terms, Magoha says, a urologist is a fully trained general surgeon with a fellowship diploma or Master of Medicine diploma in general surgery.
But the urologist specialises in urogenital diseases in the kidney, ureter, bladder, prostate, urethra, penis and testes among other parts.
The urologist also manages infertility and erectile dysfunction (erection problems) particularly in men.
As urologist, Magoha has been at the forefront of cutting edge research in cancer of the male genital tract, cancer of the prostate gland, cancer of the penis, testicular cancer, torsion of the testes (twisted testes) and, above all, male erectile dysfunction.
The names sound strange and distant. But in the privacy of clinics and hospital wards, the names stand for real diseases men struggle with daily as they struggle to, as Magoha says, “keep their houses in order”.
Marriages have broken because men have “failed to rise to the occasion” at the critical moment. People have also died because they are unable to pass urine when they are pressed.
Recognized globally
Yet until fairly recently, there was little medical interest in these complications in the East African region. In the villages, marriages broke quietly or after the women exploded with the news that their men could not perform. The explosion would quickly be buried by hushed murmurs and blame passed to the witch in the next home who was bent on ruining people’s families.
When the sexual virility drug Viagra hit the market about eight years ago, few people knew there was a Kenyan brain behind the research and marketing of the wonder innovation.
Magoha was the Kenyan brain behind the drug and he had long researched on the problem of Male Erectile Dysfunction quietly since he graduated from the University of Lagos about 30 years ago.
“I started seeing patients who had a problem they were not very comfortable talking about. I wrote some paper on the problem of Male Erectile Dysfunction and published it in an international journal. Pfizer, the manufacturer of Viagra, picked my name from the Net,” Magoha told The Sunday Standard in an interview this week.
In the inaugural lecture the Vice Chancellor gave recently, he defines erectile dysfunction as “the persistent inability to achieve and maintain an erection sufficient for satisfactory sexual performance”. It is “not the occasional difficulty that may be experienced by men every once in a while”.
In the village where Magoha grew up, there was a plant, locally known as Ogombo, that was popular with men. The men chewed it to deal with their libido problems.
His research have told him that the men in his village were wrong as they confused libido with erectile dysfunction. The libido can rise, but it will not cure erection problem.
Around 2000, the American Biographical Institute recognised Magoha as “most admirable and whose excellent performance in the field of urology will be recognised globally in 1,000 World Leaders of Scientific Influence as a permanent record for research, history and inspiration”.
The specialist in the cancer of the penis, prostate and testes has never turned away a patient at his clinic at the Nairobi Hospital even if the client could not pay.
He has turned down generous job offers at home and overseas because of his commitment to the work he’s doing at the University of Nairobi. “. . . . because I know this is where I’m needed most as a professional training doctors and surgeons for this country and this part of Africa”.
Internet Pharmacy - Buy Pharmacy at reasanoble prices.Internet Pharmacy provides confortable and easy way to order pharmacy via internet.In the 1990s, Pfizer Laboratories, then planning to launch Viagra, approached Magoha for professional advice because he was the East and Central Africa’s representative in Edac for Africa, Middle East, India, Pakistan and Turkey. He still holds this position.
He worked with the Pfizer team on how to approach the cultural barriers that stood on Viagra’s way. He also advised fellow doctors on some of the side effects of the drug before it was launched in Nairobi in October 1998, and in Kampala two months later.
It is Magoha who later lunched the drug in other countries in the region. In 2003, he was in Accra, Ghana, to launch another virility drug, Cialis.
Viagra, Magoha says, came with a number of medical and cultural complications. How was it to be sold in Africa where people do not talk openly about sex and where the erection problem is regarded as a curse and not a disease?
Traditionally, Magoha says, inability of men to “rise to the occasion” has been called impotence. But that is not the case. Men with erectile dysfunction retain other functions like sexual desire and the ability to achieve orgasm or ejection. It affects up to 152 million men worldwide and is tied to age.
About 39 per cent of men aged 40 years and above experience the problem. The numbers of sufferers rise to about 70 per cent among those aged 70 years and above.
The dysfunction can be mild, moderate or complete, Magoha says.
At 70 years, complete dysfunction is recorded in 15 per cent of men, moderate occurs in 34 per cent while mild affects in 21 per cent.
This according to Magoha, makes erectile dysfunction one of the most common diseases among men.
Yet the stigma around this condition makes it hard for men to see doctors over it.
“Most patients do not consult qualified doctors and other health workers. They prefer to consult the traditional medical practitioners and healers because of the stigma and socio-cultural barriers, myths and taboos associated with erectile dysfunction,” says Magoha.
It was around 1990 that the professor came to know that erectile dysfunction was a silent problem among men.
Often, a patient he had examined for other problems would, on reaching the door, turn and say, “anyway doctor I have another very small problem”.
“The ‘very small problem’ would eventually turn out to be persistent inability to achieve and maintain erection sufficient for satisfactory sexual performance,” Magoha says.
The lack of confidence by the patients resulted from the stigma, myths and the feeling of guilt and embarrassment.
It did not help that the most efficient cure — injection of the penis with alprostadil — remained very unpopular with African men in this locality.
“The main reason for this was fear of needles and self-injection, pain and the lack of privacy from the partner who invariably had to know that the sexual process had to be preceded by a penile injection,” Magoha explains.
“In African tradition, this demoralises the men as it tends to imply that they are not men enough,” he adds.
In those days, men treated this problem as an affair between them and the doctor at the worst. They kept their wives away. However, this has changed in recent years.
“Now some come with their wives. The surprise has been that some show up with bottles of wine as a form of appreciation. That is very rare with Kenyans,” Magoha says.
“Usually, it is the wife who delivers the wine in appreciation,” he adds.
Administration and teaching have confined Magoha to seeing just about five patients every week. Most of the patients, some of whom travel from far, say they picked his name from the Internet.
A tablet of the new virility drugs like Viagra costs $10 (Sh600) and usually, the drug comes in a mandatory package of two tablets for a start.
“Those who can afford come and pay for it. Unfortunately, the disease, just like the other diseases afflicts both the poor and the rich. Sometimes these drug companies give us free samples. I give these to desperate cases who cannot afford,” Magoha says.
“In dealing with erectile dysfunction, we are just reorganising your own systems in the body. There is a chemical in the body we rejuvenate so that it does not die too early,” he explains.
A tablet of Cialis, Magoha says, can stay in the system for up to three days.
“Since we are not animals, sex is not something you go for everyday. It is, therefore, not a question of how many tablets you require. All the same, a packet of two will cost you Sh1,400. It is a reasonable price to pay for keeping your home intact,” Magoha says.
The VC has also researched and published extensively in diseases affecting the male genital tract including the prostate and testes. He has researched on cancer of the penis and dismisses as “rubbish” the belief that people who are circumcised do not contract the disease.
“Those who survive are those circumcised at very early age, at around one month. But if you observe basic hygiene and stay clean, there is no reason for you to contract cancer of the penis,” he says.
Magoha got invitations to meetings during the trials on Viagra. The first meeting was in Cape Town, followed by others in Dubai and Cairo.
His role was to advise fellow doctors on safe use and cultural limitations that faced Viagra in Africa, the Middle East and Asia.
The professor confesses that Viagra “sells very well” in Kenya, despite the fact that it costs over Sh600 per tablet.
“If you want to put your house in order you just work out how to accommodate the price in your budget even if only for one evening in a month,” he says.
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