Kwame looks completely normal, bouncing around the compound of the orphanage at Kwao Bondzie, a sprawling neighbourhood in the outskirt of Kasoa in the Central Region.
With thick-black hair, white clear eyes and shy smile, Kwame has the features of any two and half-year-old, until the diaper is pulled off.
Life has pelted Kwame with stones since birth. Born a hermaphrodite to a mentally-ill mother and a run-away father, he was rejected by a church because the cost of taking care of him and his eight-year-old sister had become a burden.
Under his diapers lay an organ that looks like a sexual organ that is lost between that of a male and female. He has an un-descended scrotum with a tiny penis with a hole.
To add to his woes, he also has hernia.
Pains and cost
Kwame’s guardian, who is also the Founder of the Royal Seed Home/School at Kasoa, Mrs Naomi Esi Amoah, told The Mirror that sometimes, his pain could be harrowing.
“Sometimes, the place swells and it gets itchy. It gets so bad I cry for him. We sometimes have to be in the hospital for about a month, going up and down.
But all hope is not lost for him as his guardian said specialists at the Korle Bu Teaching say the prospect of making him a complete male, were bright.
The doctors say he needs three surgeries, the first of which is scheduled for July this year. But the cost of the surgery put at almost GH¢20,000 is beyond the means of the orphanage, which is burdened with taking care of 74 other children and accommodation challenges.
Mrs Amoah said the Department of Social Welfare at Awutu Senya East Municipal brought him to the orphanage.
What is hermaphrodite?
A hermaphrodite (or inter sexed person) is someone who has some or all of the primary sex characteristics of both genders (for example, a penis and a vulva).
A true hermaphrodite is someone who has both ovary and testicular tissue. The genitalia can vary from completely male or female, to a combination of both or even ambiguous looking.
According to medical experts, Kwame’s specific diagnosis is rare, but being born with a blend of female and male characteristics is surprisingly common: worldwide, up to 1.7 per cent of people have intersex traits.
Prof. Hesse speaks
A Pediatric Surgeon, Prof. Afua Hesse, told The Mirror that “the actual cause is often times not known but occasionally, there may be genetic factors. It is passed on in the family. It is believed that there may also be environmental factors that may be causing it.”
She, however, stated that the important thing is the early diagnosis.
“It is very important that as soon as they are born, the genitals are examined and if the problem is noticed, it should be referred for specialist’s attention because some of the conditions come lead to other conditions that could be life threatening. That would need specialist attention,” Prof. Hesse, who is also the President of the Accra College of Medicine, advised.
She confirmed that it was common for such children to have hernia.
Asked about the possibility of surgery that could make Kwame a normal male or female, she said, “It depends on what the cause is. Some of them are expensive because you need to do genetic determination to assess whether it is genetically male or genetically female.
“That would then guide the direction of treatment with other things as well including what the parents say.”
Prof. Hesse said, “The fact that there was just one hole where he passed urine did not make it female”, adding that “It is a whole spectrum of abnormalities that can be related.”
Elsewhere, especially in Europe, there is growing moral and legal debate as to children with such conditions should be allowed to make their own decisions about their sexual orientation when they grow up, with Malta taking the lead to legislate on that right.
Others also hold the view that normal life could become a problem for such children as they grow.
But Prof. Hesse said, “Normal life does not depend on your genitals. He can have a normal life. However, the functions that depend on your genitals may be limited in what you are able to do.
“If he has an abnormal curved small penis, he may not be able to urinate standing up. He may have to sit down and urinate like a lady. That does not mean he has a female organ.”
From church to orphanage
A Social Worker who has been involved in Kwame’s case, Ms Freda Oppong, recounting the toddler’s journey to the orphanage said a church drew the attention of the Social Welfare Department almost two years ago to Kwame, his 10-year old sister and their mother’s plight.
“We had a call from a church that two children were vulnerable and their mother is mentally challenged, so we should come pick the children.
“When we went to pick them up, we realise that there had been a surgery on Kwame but it was infected. Because the mother was mentally challenged, no medication was applied. We took the boy and his sister and brought them to the orphanage.
“Mrs Amoah has been taking him to the hospital for some time now to ensure that the infection is healed but she complained that there is no money for the surgery. People don’t give money to orphanages. It is mostly food and toiletries.”
Fears of stigmatization
Ms Oppong is, however, worried about the stigma of the condition if Kwame grew without medical attention.
“He is just a two-year-old boy who would grow up in an orphanage where the children bath together, eat together and sleep together. Other children will realise that what he has is different from what the others have.
“The stigma alone will kill him. He will not survive. How will society treat him? He may even end up killing himself. I feel such pity for him. When we met, I cried the whole day. I could not sleep because I know what our society will do to him.
“He lives in an orphanage. The mother is mentally ill. We don’t know the father and we don’t know where he comes from,” she said in near tears.
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