Dr. Karim Oubedat is more than just a vascular surgeon, who runs the Men’s Clinic International in Gaborone; he is a storm trooper of the male sexual revolution in Botswana.
In a society where men are taught to cope with staff and just get on with it from an early age, a Male Clinic seems like an oxymoron, like plastic glass or open secret. Batswana men have not had the same long-term relationship with doctors as women (smear tests, contraception, antenatal care etc). “I’m only here because the Mrs/my partner/daughter forced me to make an appointment” is a common testestorone charged refrain. Dr Oubedat is changing all that.
And the plot thickens: Dr Oubedat’s clinic treats men’s sexual problems. This throws away the rule book of being a traditional man ÔÇô the first rule of being a real man is that you are not allowed to talk about it, that was until the Men’s Clinic opened its doors in Gaborone recently.
Indication are that a sexual revolution is in the offing, cutting a wide swath across Botswana’s male demography. “Age is not a factor when it comes to male patients who seek treatment for erectile dysfunction, premature ejaculation or low libido.” Dr. Karim Oubedat says men as young as 17 years come to the clinic looking to find permanent solutions for their sexual impotence. The doctor has patients who are 90 years old. “Sex is still important at 90 years, as long as one still feels fit. Race, profession or background is not a factor based on those seeking treatment because his patient comes from all walks of life.
This clinic for men is part of an international chain of clinics specializing in men’s health problems. They can be found in Africa, New Zealand, Australia and Canada. Thus far in Southern Africa the clinics can be found in Botswana, Lesotho and South Africa. The doctor reveals that before the clinic opened in Gaborone Batswana men would travel to South Africa to seek this type of medical attention. “As medical practitioners we are not allowed to advertise ourselves as per Botswana medical council regulation. However, it is allowed to inform the public regarding the benefits and the service we are offering.”
There are currently 88 such clinics in South Africa alone. Dr. Oubedat hopes to establish, with approval from the Ministry of Health, another clinic to cater for the northern part of Botswana as they are receiving patients from as far off as Sua Pan and Kasane. The Gaborone Mens Clinic was officially incorporated by the Ministry of Health in June 2011 to the doctors’ private licence. When it was being established, small portable offices where used for patients consultations. The patients however started to demand more privacy and a bigger space. Now it operates from a Medical Centre on Independence Avenue; Plot 223 in Gaborone. Dr. Oubedat as a vascular surgeon deals with diseases affecting the arteries and veins (vessels). Originally from the Czech Republic he relocated to Botswana with his wife in 1999. He started working for the government at Princess Marina Hospital; and then moved to Gaborone Private Hospital (as a consultant surgeon) where he practised until 2008.
In December 2008, he was involved in a tragic car accident. He was returning from Christmas shopping in SA driving back to Botswana with his wife and year and half-old-daughter, when the tyre burst and the vehicle they were traveling in overturned. His wife passed away, she died at the scene; and his right hand was left paralysed. Fortunately his daughter survived and is now six years old. Due to the injury on his hand he was unable to continue his surgical duties. Despite the tragic circumstances, he progressed with his medical profession via this clinic, where he is now able to continue to use his expertise and vast medical knowledge to the benefit of the community. In one day the clinic receives around 10 patients; 5 are usually new patients. “Females have gynaecologists; and men also need attention- that is why we have this clinic,” explains the doctor.
Men have a reputation of being reluctant when it comes to health matters. When compared with women, they are seen as less proactive towards their health. The doctor reiterates this point by clarifying that men are ‘shy’ when it comes to their health. “Men are very shy, especially in Botswana,” he adds. Sexual satisfaction involves two people; it is therefore highly encouraged for the man to bring his partner when seeking consultation. The partner also helps to explain and clarify the problem as to the lack of sexual fulfilment. If both partners are sexually content then they do not need to seek the specialist. “Sex is not a sport, where there is competition. It’s all about mutual satisfaction,” emphasises the doctor, hence the partner is allowed and welcome to join the session, however the focus of the consultation and the treatment is directed to the men only. “There are instances where the partner, or wife, will call the clinic on behalf of her husband or boyfriend. This is not encouraged because consent and consensus is needed,” advises the doctor.
There are various conditions such as weak erection, premature ejaculation, low libido or impotence that men bring forth to the doctor. Before giving any treatment he assesses the patient, goes through his medical history to see if there are any other diseases which may be underlying factors to his problem. Vascular ultra sound scans are conducted to determine whether the vessels are fully functional, that they are allowing the blood to flow accordingly. Diseases such as Diabetes, Hypertension and HIV/AIDS are known to cause complications to the vessels.
“HIV/AIDS affects the immune system and it also affects the vessels and leads to what is called HIV Vasculitis or the inflammation of the vessels.” A patient with Diabetes may also exhibit the same complications. “I know of a patient who went for 6 years with no sex because he couldn’t have an erection due to HIV/AIDS,” shares the doctor. He also helps patients who are HIV positive and have partners who are HIV negative. “When you cannot get an erection it is difficult to use the condom. You cannot put the condom on without satisfactory erection. It makes life difficult. In this case we do various tests and see which treatment is appropriate.” The most common erectile dysfunction that the local clinic deals with is that of a weak erection, or an erection that does not last long.
Apart from diseases, a person’s lifestyle can lead to a weakened erection. It is advised that men should exercise moderately and stay fit. They should reduce their stress levels as prolonged stress can have an adverse effect on the sex life. They should eat healthy foods (balance diet) and cut down their smoking, drinking and use of drugs (illegal drugs). “Partners should get in the habit of talking to each other about their problems. Not just sexual problems, they should talk about everything about their lives with their partners. Many problems can be avoided by talking to each other,” adds the doctor. Sex is an intimate act which is why the doctor is not able to apply the same medical intervention to all individuals. What makes one couple happy will not necessarily make the next couple happy. The critical factor here is communication between partners; speak up and seek help.
Sex is a part of every day life to the point where people tend to forget that apart from sexual pleasure, sex also serves a biological purpose; that of making children. That is why the clinic also provides counselling to men who have been emotionally or psychologically affected by the inability to get it up.
There are myths that people believe to be true. The doctor knows that numerous men worry about the size of their penis. The fear that one’s penis looks too small or is too small to satisfy their partner during sex is a common fear. “But a number of studies have shown that most men who think their penises are too small actually have normal sizes,” says Dr. Oubedat, who also clears out that it has been scientifically proven that size does not contribute to sexual satisfaction. “Women are much more interested in a man’s personality and or their looks rather than the size of his penis. However, there are medical conditions like micropenis which requires specialized medical help,” shares the specialist.
Another major myth is that a penis can be easily enlarged. Penis-enlargement products and procedures are easy to find. Men’s magazines, and the Internet are full of advertisements for pumps, pills, weights, exercises and even surgeries that claim to increase the length and width of one’s penis; as has been claimed by various dubious adverts which are usually placed by mysterious ‘traditional doctors’. “There is very little scientific support for any nonsurgical methods to enlarge the penis. And no reputable medical organization endorses penis surgery for purely cosmetic reasons. Most of the techniques you see advertised are ineffective, and some can damage your penis. So think twice before trying any of them,” advises the doctor.
Another common myth he quashes is that alcohol is a cure for a weak erection or for increasing the libido. “Yes when one drinks alcohol they feel confident initially. But drinking more will have the reverse effect. The penis will fail to get erect.” There is a long list of ‘aphrodisiacs’ or substances such as certain foods and drinks that heighten sexual desire which are also quite popular. On the market, there are various erectile dysfunction drugs such as Viagra, Power One or Mojo. Dr. Oubedat has nothing against the herbal supplements that may help the individual get satisfaction. He does however advise all those who use these pills to seek medical advice prior to purchasing and using them, because they might have side effects which may be harmful. “These pills do work, some better than others. They boost the erection only. However, they are not part of the long term solution and treatment we provide at the clinic,” he adds.
There are cases where the woman will leave the relationship because the man had some form of erectile dysfunction. This is an unfortunate scenario (according to the doctor), because there is no reason why a relationship should end due to this. “Many men have been left by their partners as a result. If couples break up, it is just an excuse and maybe the relationship was never strong in the first place. Couples should learn to go through difficult times together.” He advises women to encourage their partners to seek medical help rather than walking out on them. Usually when the man is not able to get a strong erection, the first thing the woman thinks is that he is cheating on her, or getting sexual satisfaction elsewhere. In this regard the accusation is usually furthest from the truth. On the other hand the man suffering the condition will also start to suspect that the woman is getting satisfaction elsewhere. The critical component here is talking about it to avoid and reduce unnecessary conflicts and suspicions.
The good thing is that there is light at the end of the tunnel. The success rate of the interventions at the Men’s Clinics all over the world is pegged at 80%, says the doctor. Treatment varies between 3 ÔÇô 6 months if the patients’ complication is not due to an illness. However if the complication is exacerbated by an illness such as HIV or Diabetes and Hypertension then it will most likely continue together with the illness. “It is a pity that at the moment there is no permanent cure for HIV or Diabetes. But with the progress in medical science and new researches who knows, a cure could be found one day, maybe next year.
