Doctor. Counsellor. Freedom Fighter.

She was a healthy young woman who came to see me for a “complete check-up” before a holiday overseas. Although I tend to think “complete” check-ups are somewhat overkill, they do present a good opportunity for health promotion and disease prevention. As one does, I asked about sexual history and family planning. She hesitated just a split second before answering, “Well, my only partner is a woman, so I don’t have to worry about pregnancy scares.” And then, we moved on. 

 * * *

As much as this encounter seems every day, that was the first time that a patient volunteered their sexuality without being prompted. I marked it a Very Important Day.

 * * *

8245c2f7b79d445bad550d7a04e192b9This Freedom Day, when South Africans commemorate the birth of a new egalitarian democracy, I remember those who fought for freedom so that we may reap the benefits of their struggle.

But I also remind myself that many – in this country, and beyond – are free only on paper.

And I remind myself that healthcare workers have swaying power. We have access to podiums. We have clout in policy discussions.

And we have a horrible history of turning a blind eye.

 * * *

He fell from the ninth floor
He hanged himself
He slipped on a piece of soap while washing
He hanged himself
He slipped on a piece of soap while washing
He fell from the ninth floor
He hanged himself while washing
He slipped from the ninth floor
He hung from the ninth floor
He slipped on the ninth floor while washing
He fell from a piece of soap while slipping
He hung from the ninth floor
He washed from the ninth floor while slipping
He hung from a piece of soap while washing.

Chris van Wyk, In Detention

 * * *

So today, I think of those who live in the ravages of war. Those who live under a modern Apartheid. And those healthcare workers who toil with them, to bring relief to the oppressed, and sometimes lose their lives with them, too.

Today I think of those who are not free to express their sexuality and gender preference. Those who have been hurt for it. Those whose doctors have aided in their systematic erasure. Those who have been subjected to conversion therapies.

Today I think of those who are not free to exercise control over their bodies. Those who are pinned down. Those who are denied choice in reproduction. Those who rely on dark alleyways and metal hangers to maintain a semblance of freedom, and often pay for it with their lives.

Today I think of those who walk 5km to the nearest (hopefully clean) water. The young girls who miss school at every menses. The children who queue to use a single pit latrine during their break. Those who have been found drowned in those same pit latrines.

 * * *

Today, I consider the many freedoms that exist on paper only.

You may consider this more apt for Human Rights Day, but in my mind, freedom and human rights are two sides to the same coin.

Just as my patients are not healthy if they are depressed, just as they are not healthy if they are afraid; just so, my patients are not healthy if they are not free. Nobody is.

Today, I think about being a doctor. I think about the privileges that affords me. And I realise: doctors have a responsibility to make up for the sordid history of our profession; for the many times our community has benefited the captors instead of the captives.

I do believe that we have a responsibility to fight tirelessly for the freedom of all under our care – whatever form or shape that fight may take.

Happy Freedom Day, South Africa.

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2 thoughts on “Doctor. Counsellor. Freedom Fighter.

  1. I think about this so often. A lot of my work is with with HIV positive patients, some of whom are gay, lesbian or transgender. And I worry that we are not doing enough to advocate for these groups. As I talk to women freely about their reproductive options, I worry about our damaging policies surrounding women’s bodies. I worry about what I am allowed to say, but I worry far more about what will happen if I d on’t speak.

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