As the prevalence of the challenges of infertility rises among men and women, there is a growing trend in Uganda towards Assisted Reproductive Technology. This shift has led to the establishment of numerous fertility clinics in Kampala, offering hope to couples seeking to conceive.
Assisted Reproductive Technology involves the fertilization of a woman’s eggs with a man’s sperm in a laboratory setting, bypassing the need for natural intercourse. One of the commonly employed techniques is Invitro Fertilization (IVF), where eggs are extracted from the woman’s ovaries and fertilized in a controlled environment.
The resulting embryos are then transferred to either the woman’s own womb or that of a surrogate mother for further development. Dr. Edward Sali, the Director of Women’s International Hospital in Kampala, has identified three primary reasons why some women opt for surrogacy. Firstly, certain health conditions such as uncontrolled diabetes, uterine fibroids, or scarring can prevent women from carrying a child themselves.
Secondly, there are cases where a woman’s uterus has been surgically removed or when she is born without one, making pregnancy physically impossible. Dr. Sali also acknowledges that some women who focused on their careers or studies, choose surrogacy as a means to have children while dedicating time to their professional pursuits.
Uganda registered its first surrogate child back in 2005. The biological mother was a woman whose uterus had been removed without her consent during an operation more than five years earlier. Dr. Sali, the doctor behind this birth, has since performed over 1000 such procedures in the country.
However, religious leaders hold opposing views and caution against what they perceive as immoral behavior, fearing potential negative consequences for society. Clerics and scholars from the Catholic, Anglican, and Muslim faiths, which together constitute a significant portion of Uganda’s population, express their opposition to surrogacy.
Rev. Fr. Joseph John Ssenkaali, the Assistant Judicial Vicar of the Kampala Archdiocese, emphasizes that the teachings of the Catholic Church unequivocally condemn the use of Invitro fertilization and the involvement of a surrogate mother in any capacity. Fr Ssenkaali, an ardent scholar of the canon and catechism, said that the reason for this is that these practices violate the dignity of the child, who has the right to be conceived by the loving union of spouses, as well as the dignity of the marital union.
“A key Church instruction, on respect for human life in its origin and on the dignity of procreation, notes that marriage does not confer upon the spouses the right to have a child, but only the right to perform those natural acts, which are per ordered to procreation,” Rev Fr Ssenkaali noted.
Ssenkaali’s argument is in line with the teachings of the Catholic Church as outlined in the Catholic Catechism, specifically number 2376. The catechism states that techniques involving a third party, such as the donation of sperm or ovum or the use of a surrogate uterus, are considered gravely immoral- and therefore sinful.
“These techniques (heterologous artificial insemination and fertilization) infringe the child’s right to be born of a father and mother known to him and bound to each other by marriage. They betray the spouses’ “right to become a father and a mother only through each other,” the catechism reads in part. In his view, Fr. Ssenkaali says that certain couples mistakenly hold the belief that they possess an entitlement to a child, regardless of the means of conception, a notion he regards erroneous.
He emphasizes that it is not obligatory for every married couple to have children, as children are ultimately seen as blessings bestowed by God.
Fr. Ssenkaali suggests that individuals who desire to have children should explore medical procedures that align with God’s will and do not violate moral principles. If these attempts are unsuccessful, he advises against resorting to immoral practices, as they are considered sinful.
Ssenkaali, however, emphasizes that in cases where individuals are naturally unable to conceive, it is crucial for them to disclose this information to their potential spouse when entering into a marriage union. He asserts that keeping such significant information hidden can potentially lead to the nullification of the marriage.
Likewise, Rev. Canon Captain William Ongeng, the provisional secretary of the Church of Uganda, emphasizes that marriage was intended by God for one man and one woman, excluding any other relationship. When a couple faces infertility, Canon Ongeng encourages them to trust in God’s will rather than go against the doctrine of marriage.
Dr. Abdul-Hafiidh Walusimbi, an expert in Islamic law says, surrogacy goes against the principles for the protection of the institution of marriage making it impermissible in Islam. He explains that Islam aims to protect five fundamental needs: faith, life, family, intellect, and property.
Surrogacy falls under the category of family, and Dr. Walusimbi identifies preserving one’s lineage as crucial for safeguarding the family. He makes reference to verses five, six, and seven of chapter 23 of the Holy Quran, which emphasize the importance of believers in safeguarding their chastity.
“Those who guard their chastity except with their wives or those ˹bondwomen in their possession, for then they are free from blame but whoever seeks beyond that are the transgressors,” reads the Holy Quran in part. According to Dr. Walusimbi, there are two reasons why surrogacy is considered impermissible in Islam.
Firstly, the two women involved do not have a marital relationship (and cannot since in Islam marriage is between a man and a woman), yet under Islamic law, children should result from a marriage. Secondly, it causes a question as to who the biological mother of the child is: the owner of the ovary or the surrogate mother who carries the child in her womb.
During the process of surrogacy, the surrogate woman is allowed to live a healthy life just like any other pregnant woman. There is even no restriction on whether or not to have sex. This, Dr Walusimbi says opens another room for error in case an unnoticed miscarriage were to occur, and yet the woman is sexually active and hence able to conceive.
But, Dr. Sali says that surrogate mothers are closely monitored and subjected to health check-ups every two weeks to monitor the progress of the pregnancy. Further still, there is no inherent connection between pregnancy and continuing to have sex after pregnancy. He says that once an egg is fertilized, the baby cannot be altered in any way by incoming sperm.
Dr. Walusimbi suggests that the only practical method within Islamic teachings for assisted childbearing, where the mother does not physically carry the baby, is through the fertilization of an egg that grows in an artificial womb. By utilizing this approach, the concerns and conflicts associated with traditional surrogacy can be avoided, as the pregnancy and development of the fetus occur outside of a woman’s body.
Although the topic of surrogacy and assisted reproductive technology is relatively new in Uganda, it has been a subject of discussion in other parts of the world, particularly in Western countries, for several years. In these regions, the practice has sparked substantial debates regarding bioethics and religious considerations, leading to discussions on different procedures, treatment methods, and related issues.
In a recent development, Sarah Opendi, the Tororo district woman member of parliament, requested permission from Parliament to introduce a Private Member’s bill aimed at establishing a legislative, institutional, and policy framework for the practice.As the prevalence of the challenges of infertility rises among men and women, there is a growing trend in Uganda towards Assisted Reproductive Technology. This shift has led to the establishment of numerous fertility clinics in Kampala, offering hope to couples seeking to conceive.
Dr. Abdul-Hafiidh Walusimbi, an expert in Islamic law says, surrogacy goes against the principles for the protection of the institution of marriage making it impermissible in Islam. He explains that Islam aims to protect five fundamental needs: faith, life, family, intellect, and property.
Surrogacy falls under the category of family, and Dr. Walusimbi identifies preserving one’s lineage as crucial for safeguarding the family. He makes reference to verses five, six, and seven of chapter 23 of the Holy Quran, which emphasize the importance of believers in safeguarding their chastity.
“Those who guard their chastity except with their wives or those ˹bondwomen in their possession, for then they are free from blame but whoever seeks beyond that are the transgressors,” reads the Holy Quran in part. According to Dr. Walusimbi, there are two reasons why surrogacy is considered impermissible in Islam.
Firstly, the two women involved do not have a marital relationship (and cannot since in Islam marriage is between a man and a woman), yet under Islamic law, children should result from a marriage. Secondly, it causes a question as to who the biological mother of the child is: the owner of the ovary or the surrogate mother who carries the child in her womb.
Dr. Walusimbi explains that Islamic scholars have concluded that motherhood is determined by the owner of the womb, which differs from the concept of surrogacy. This view is based on the understanding that the woman who endures the pregnancy and gives birth is considered the mother in Islamic law.
During the process of surrogacy, the surrogate woman is allowed to live a healthy life just like any other pregnant woman. There is even no restriction on whether or not to have sex. This, Dr Walusimbi says opens another room for error in case an unnoticed miscarriage were to occur, and yet the woman is sexually active and hence able to conceive.
But, Dr. Sali says that surrogate mothers are closely monitored and subjected to health check-ups every two weeks to monitor the progress of the pregnancy. Further still, there is no inherent connection between pregnancy and continuing to have sex after pregnancy. He says that once an egg is fertilized, the baby cannot be altered in any way by incoming sperm.
Dr. Walusimbi suggests that the only practical method within Islamic teachings for assisted childbearing, where the mother does not physically carry the baby, is through the fertilization of an egg that grows in an artificial womb. By utilizing this approach, the concerns and conflicts associated with traditional surrogacy can be avoided, as the pregnancy and development of the fetus occur outside of a woman’s body.
Although the topic of surrogacy and assisted reproductive technology is relatively new in Uganda, it has been a subject of discussion in other parts of the world, particularly in Western countries, for several years. In these regions, the practice has sparked substantial debates regarding bioethics and religious considerations, leading to discussions on different procedures, treatment methods, and related issues. In a recent development, Sarah Opendi, the Tororo district woman member of parliament, requested permission from Parliament to introduce a Private Member’s bill aimed at establishing a legislative, institutional, and policy framework for the practice.