Ethical and Sociocultural Considerations for Use of Assisted Reproductive Technologies Among the Baganda of Uganda
Total Page:16
File Type:pdf, Size:1020Kb
Georgia State University ScholarWorks @ Georgia State University Anthropology Theses Department of Anthropology Summer 7-15-2013 Ethical and Sociocultural Considerations for use of Assisted Reproductive Technologies Among the Baganda OF Uganda Martha N. Mukasa Georgia State University Follow this and additional works at: https://scholarworks.gsu.edu/anthro_theses Recommended Citation Mukasa, Martha N., "Ethical and Sociocultural Considerations for use of Assisted Reproductive Technologies Among the Baganda OF Uganda." Thesis, Georgia State University, 2013. https://scholarworks.gsu.edu/anthro_theses/78 This Thesis is brought to you for free and open access by the Department of Anthropology at ScholarWorks @ Georgia State University. It has been accepted for inclusion in Anthropology Theses by an authorized administrator of ScholarWorks @ Georgia State University. For more information, please contact [email protected]. ETHICAL AND SOCIOCULTURAL CONSIDERATIONS FOR USE OF ASSISTED REPRODUCTIVE TECHNOLOGIES AMONG THE BAGANDA OF UGANDA. by MARTHA MUKASA Under the Direction of Cassandra White ABSTRACT Anthropological research on the sociocultural outcomes from applications of Assisted Reproductive Technologies (ARTs) for infertility, particularly in sub-Saharan Africa, is greatly lacking and much needed. Narratives from individuals, couples, families, community leaders and members are particularly germane to medical anthropological studies on the intersec- tion of science and technology in the new millennium. With ART applications still in their infancy in sub-Saharan Africa, research of this nature may be of benefit in determining how best to apply ARTs within important cultural frameworks and allow infertile couples and other recipients the opportunity to minimize adverse results. This paper draws upon the- oretical perspectives from anthropology, science and technology studies, ethnographic data from my field study in Uganda, and reviews of literature, to construct theories about how for the Baganda, the proliferation of ARTs could po- tentially change or disrupt cultural notions of power and identity and unseat core notions of kinship. INDEX WORDS: Kinship, reproductive technologies, ARTs, sub-Saharan Africa, Uganda, ethics. ETHICAL AND SOCIOCULTURAL CONSIDERATIONS FOR USE OF ASSISTED REPRODUCTIVE TECHNOLOGIES AMONG THE BAGANDA OF UGANDA. by MARTHA MUKASA A Thesis Submitted in Partial Fulfillment of the Requirements for the Degree of Master of Arts Anthropology in the College of Arts and Sciences Georgia State University 2013 Copyright by Martha Nagawa Mukasa 2013 ETHICAL AND SOCIOCULTURAL CONSIDERATIONS FOR USE OF ASSISTED REPRODUCTIVE TECHNOLOGIES AMONG THE BAGANDA OF UGANDA. by MARTHA MUKASA Committee Chair: Cassandra White Committee: Cassandra White Jennifer Patico Lara Braff Electronic Version Approved: Office of Graduate Studies College of Arts and Sciences Georgia State University June 2013 iv DEDICATION I dedicate this thesis to my late parents Sam and Ethel Mukasa who would have been so proud to have read it. v ACKNOWLEDGEMENTS I would like to thank all the friends and family who helped me through this process. Thanks es- pecially to my sister-in-law Susan Mukasa for the countless hours of conversation on reproductive health, on culture and on social issues in Uganda. Thank you for also providing transportation for me while I was in the field and for introducing me to helpful contacts in Uganda. Without your help I would surely have been lost in more ways than one. Thanks also to my dear friend Josephine Kiyenje for the long distance phone calls from Kenya to give me updates on the attitudes about reproductive assistance among Ugandans in Kenya and to challenge my assumptions with excellent questions of your own. I will always cherish our conversations. Thanks to Namuyaba for your phone calls, your questions, your input and your support of my research. I thank also my sisters Miria and Samantha for their firm support and encouragement. To my brother Kiggundu, I thank you for providing me a place to stay in Uganda, for answering my emails loaded with cultural questions and for going out and finding out all the answers I needed; together we’ve learned a lot about our heritage. I thank my committee members for all the wonderful support and feedback. Thank you to Dr. Cassandra White my thesis advisor for all your en- couragement especially when I was struggling with how to make a thesis out of the data from my limited time in the field. I also thank Dr. Jennifer Patico for taking a keen interest in my research and wanting to get involved and Dr. Lara Braff for providing invaluable feedback and advising me from afar; I appreciate you taking on my research. Finally I would like to extend a sincere thank you to the Department of Anthropology faculty and staff at Georgia State University for the encouragement and support without which I would never been able to complete my studies in the short amount of time it took me. Thank you! vi TABLE OF CONTENTS ACKNOWLEDGEMENTS ............................................................................................. v LIST OF FIGURES ........................................................................................................ vii 1 INTRODUCTION...................................................................................................... 8 2 METHODS AND LIMITATIONS............................................................................ 4 2.1 Formal interviews ................................................................................................ 4 2.2 Informal interview.............................................................................................. 6 2.3 Media analysis ..................................................................................................... 9 3 BACKGROUND AND LITERATURE REVIEW ................................................ 10 3.1 Infertility ............................................................................................................ 10 3.2 The Baganda: A Brief History ......................................................................... 14 3.2.1 The Buganda Kingdom and the Kabaka (King) ........................................... 15 3.3 Kinship ............................................................................................................... 17 3.4 Kiganda Clans and Kinship ............................................................................. 19 3.4.1 Clans and ARTs ............................................................................................. 20 3.5 Female-Male Relations ..................................................................................... 22 3.6 Large-Scale Social Forces ................................................................................. 27 3.6.1 Sociopolitical history ..................................................................................... 27 3.6.2 Repercussions for health management ......................................................... 30 3.6.3 Present state of the kingdom ........................................................................ 31 3.7 Twins .................................................................................................................. 33 3.8 ARTs and Multiple Births ................................................................................ 39 3.8.1 Low-cost alternatives ..................................................................................... 41 vii 3.9 Sociocultural and Ethical Considerations ....................................................... 43 3.9.1 In the News: Ethical challenges ................................................................... 43 3.9.2 ARTs and challenges to clan identity ........................................................... 50 3.9.3 Modern body and mind ................................................................................. 54 3.9.4 Considerations for single females ................................................................. 56 3.9.5 Public responses ............................................................................................ 58 3.9.6 Male infertility and donor sperm stigma ...................................................... 62 3.9.7 Religious considerations ............................................................................... 63 4 CONCLUSIONS ...................................................................................................... 68 REFERENCES ................................................................................................................ 74 LIST OF FIGURES Figure 1 ......................................................................................................................................................... 5 Figure 2 ......................................................................................................................................................... 5 Figure 3 ....................................................................................................................................................... 15 Figure 4 ....................................................................................................................................................... 15 Figure 5 ....................................................................................................................................................... 30 Figure 6 ......................................................................................................................................................