Paper short abstract:

Based on 12 months research with rural Malawian men whose lives have been shaped by infertility and sub-fertility, this paper will examine the way uncertainty is produced and trust tested in the confluence of repeated, often unsuccessful, treatment seeking from hospitals, herbalists and churches.

Paper long abstract:

Life for men in Chilumba, a group of lakeshore villages in a patrilineal region of northern Malawi, is characterized by a continual search for cash whether by piece-work, fishing, or if you get the chance - salaried employment. Yet men say that a man with a child becomes valued in a way that is unmatched by any other status or wealth he may accrue. Dealing with infertility as a man, and as a couple, is a public shame and personal torment, although thus far research has tended to focus on the more visible impact of infertility on women. Based on 12 months ethnographic research with men whose lives have been shaped by issues of infertility and sub-fertility, this paper will examine the way uncertainty and trust are produced and handled in the confluence of repeated treatment seeking from the District hospital, herbalists and churches, with their varied offers of sperm counts, STI diagnosis and sexual and reproductive history-taking, medicines, adultery, and prayer. Men's search for fertility treatments is plagued by the low perceived efficacy, high risks and dangerous side-effects of both 'English' and 'African' medicine, and challenges to their Christian faith. Set within a broader configuration of the way infertility is perceived as a lesser problem in resource-poor health care systems in sub-Saharan Africa, this paper presents an exploration of the way trust in health professionals, healers, relatives, and between spouses may be tested to extremes.