Global Day for Safe and Legal Abortions

4e1359d8e206b850346e738d142216cdThe young woman left my consulting room after protracted counselling, with a completed J88 (a medical report of assault), a prescription for anxiolytics and pain medication, and a referral to a therapist. She was six weeks pregnant, but would not be for long. Her husband had inserted misoprostol tablets in her vagina, without her knowledge or consent. She was already in the throes of uterine cramps.

***

07cc7967ffd26d872fce5dafe4e3bd86The smell of blood permeated the ward I walked into that morning. Twelve beds with twelve women, who would be discharged that day and replaced by twelve more. And again. And again. Some women did not meet my eyes. Some looked angry. Some resolute. But the teenagers implored me with their big doe-eyes, waiting for me to pull back their sheets and discover the expelled products between their legs.

The night staff regularly refused to help the patients admitted for pregnancy termination. “It’s your mess. You clean it.” Many women would lie helplessly at night, groaning in unrelieved pain, with no assistance from the nurses sworn to care for them.

I was just an intern. I did my best. But maybe I should have done more.

***

4457445e1daf992adfbc37a6aa68a7e0An unidentified woman stumbled into the labour ward. Her long skirt was sticky with blood. She was diaphoretic, and breathing fast. She was weak with low blood pressure. She would not – could not? – speak.

“I think… I feel… bone shards?” the registrar reported on the vaginal examination.

An informal abortion gone awry. We will never know who did it, and the woman will never find justice. Abortion deaths were common in the days before legalisation. Our elders in medicine remember them well. These days, we are not meant to see women die from septic abortions. But that night, we did.

***

Today is the Global Day for Safe and Legal abortions. I feel like this protestor: I can’t believe we still have to protest this shit. How hard is it to leave women’s bodies alone? How hard is it to back off, and respect our autonomy?

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I am tired. Tired of hearing how women must run from pillar to post to find a facility that will help them, because so many healthcare workers choose to “conscientiously” object. Conscientious my foot.

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A very important report; worth reading. Click the image.

And I think that instead of suggesting a list of things readers can do, I’ll name just one:

Talk about it. 

Even just with your closest friends. If you can, talk to your colleagues. To family. Say the word out loud: abortion. Break the silence. You don’t have to have had an abortion to believe in choice and safety. Your voice is just as loud.

Say it.

I believe in the bodily autonomy, safety, and right to choose of all womxn. 

I believe that legal abortions are integral to the health of communities. 

Statistically, abortion is an everyday part of life. The sooner we start treating it that way, the better.

 

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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.  Continue reading “Doctor. Counsellor. Freedom Fighter.”

Are We Secretly Our Own Worst Enemies?

If you’ve been reading South African news, you’ll know that at least 300 interns and community service doctors stand to be unemployed next year, due to a lack of funded posts at accredited institutions.

Perhaps you read about our inhumane working hours last year.

Perhaps you have read about the overflowing hospitals where patients pile up in the corridors.

These are not new problems, we just hear about them more because doctors and patients have phones with cameras, and social media accounts.

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Continue reading “Are We Secretly Our Own Worst Enemies?”

What If Slavery Never Fell: Underground Airlines [Book Review]

I’ve been on a bit of an alternate-history kick recently, which has led me to believe that it is possibly one of the most challenging genres an author might tackle. Call it the Butterfly Effect or Domino Effect or just plain Jenga, but changing a single event in history causes a cascade of changes, and if the author misses even one of those, the book loses its believability.

23208397Underground Airlines by Ben H. Winters is an alternate reality in the present day where slavery was never outlawed in the USA, and is still practiced in four major states. It is a horrifying thought and an important topic in light of current race-relations in the USA and much of the world.

World-building is important in alternative-history fiction, but must be subtle. If the world is different to the way we know it, the reader must be able to understand why that is. Winters did this fairly well, in referring to trading sanctions which, for example, result in CDs not yet reaching American markets. Continue reading “What If Slavery Never Fell: Underground Airlines [Book Review]”

If You Plan To Spend Mandela Day At A Hospital…

Although I believe that community service should be a habit rather than an annual event, I am a big fan of Mandela Day. I’m a child of the 90s, after all, and my first hero was Nelson Mandela. There’s nothing quite like a day where the whole nation reaches out to one another to build morale. (And it’s not just for South Africans!)

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Public hospitals are a popular venue for community service, which is not entirely a bad thing because many of our patients truly fit the description of being disenfranchised.

But every year, my colleagues and I find ourselves a little annoyed by many of the people who arrive to do their bit. Here are some pointers if you intend to visit a hospital this Mandela Day – or any other day. Continue reading “If You Plan To Spend Mandela Day At A Hospital…”

Too Little, Too Late?

You might remember that we lost an intern colleague in South Africa a while ago, when she was in a fatal car accident after a long overnight shift. It was a big accident involving other vehicles, with at least two other people requiring ICU care.

One of them recently succumbed to her injuries, and the victim’s family members have made it known that they intend to sue* the Department of Health.

Most of my colleagues seem very happy with this. The government must be held responsible for the consequences of working their young doctors to exhaustion.

But part of me feels so very embittered. For years now we have asked nicely, and loudly, that our hours be addressed. Continue reading “Too Little, Too Late?”

My Evolving Opinions About Doctors’ Working Hours

I started working on this post two days ago. Since then, I have received news of a colleague who died in an accident while driving post-call. She went to my alma mater and graduated last year, and though I did not know her personally, my heart breaks. A country with a shortage of doctors has lost a young doctor who was just starting in her career. She was well-loved, and we will all feel her absence.

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 * * * Continue reading “My Evolving Opinions About Doctors’ Working Hours”

Threatened By The People We Serve

A few weeks ago, the community around one of the hospitals where I work picked up their torches and pitchforks (well, sort of) and protested again. I’ve written before about South Africa’s protest state of mind, and about working during a riot.

As it stands, when this specific community protests, they protest right outside the hospital. No matter the reason for protesting, they block all entrances to the hospital and threaten anybody who tries to circumvent them.

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Police told us to turn around. We called our superiors. They told us to come to work. Continue reading “Threatened By The People We Serve”

On Poverty and Health: The Obesity-Conundrum

rich man poor man slimmer man fatEver since I started running (and enjoying it), I have been intrigued by the sociology and economics of health and fitness. It coincided with my “coming of age” in medicine, so to speak, so it has been in interesting and ongoing thought-experiment.

I want to address some pertinent falsehoods about health and fitness, and why the disenfranchised have such a hard time of it. Right now I intend to write a two-part series, but who knows.

Quick disclaimer: I would never suggest that being a student-on-a-budget is comparable in hardship to living in poverty. All the same, being a student on a partial scholarship and a heavy student loan certainly did teach me a little about struggling financially and its effects on health. Continue reading “On Poverty and Health: The Obesity-Conundrum”

Fifteen Lanes by S.J. Laidlaw [Book Review]

25893705Writing an “issue book” for young adults can be dangerous. Writing an issue book that incorporates diversity and a non-Western setting can be disastrous. It can be shallow. It can be whitewashed. It can be a pity-party. It can be subtly racist. Issue books are hard to write because we all have unwitting biases, and they can reveal themselves in our writing, despite our very best intentions.

Fifteen Lanes by S.J. Laidlaw is nothing like that.

Besides being teenage girls in Mumbai, Noor and Grace seemingly have nothing in common. Noor (which by the way is one of my favorite names!) is the eldest child of a prostitute. She was raised in the red-light district of Kamathipura. Education is her refuge, but she lives in constant fear of following the fate of her mother. Continue reading “Fifteen Lanes by S.J. Laidlaw [Book Review]”