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?”

Mental Health Begins With Medical Students

Every few months, the mental health of doctors/medical students makes it to popular media. It seems like these spikes in attention occur, and everyone shouts YOU SHOULD CARE FOR YOUR DOCTORS! and then we write blogs and we tweet and we make youtube videos and eventually we go back to work, and nothing has changed.

I think we are the missing link. And by “we”, I mean qualified doctors. And also, you, the older doctors. Continue reading “Mental Health Begins With Medical Students”

[Book Review] Incarceration Nations

dreisinger_incarcerationnationsI don’t know how much time the average person spends thinking about prisons. It usually crosses my mind when I have a patient who is brought from prison – which happens a lot less now that I’m working only with kids. Every once in a while there will be a report of a jail break, and in high school we had a few debate topics around prisons (This House Supports The Right To Vote For Prisoners, etc). Every year at the anniversary of my aunt’s murder I think about prison, and wonder whether her murderer is still incarcerated.

Besides that, prison doesn’t cross my mind too often, and I’d wager it’s the same for those who don’t work with inmates, or don’t have a close relative currently imprisoned.

Baz Dreisinger’s Incarceration Nations dares to coax us from this comfort in a multi-national exposé of prisons around the world, and the justice/punitive systems within which they function. Continue reading “[Book Review] Incarceration Nations”

The Safe Working Hours Wristband Campaign is Missing the Point – Here’s Why

If you’ve been paying attention, working hours of doctors (especially junior doctors) have been getting some good airtime over the past few months. The Province of the Western Cape has committed to actively reducing maximum continuous working hours for doctors to twenty-four, the HPCSA has promised to “look into it” (not that we have too much confidence there), and our biggest representative, SAMA (South African Medical Association) has come out in our support.

One of the things to come from all this is the launching of an armband campaign. This has its origins, I believe, from a similar campaign in the UK – although I have not been able to find any source to this link.

608772084 Continue reading “The Safe Working Hours Wristband Campaign is Missing the Point – Here’s Why”

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]”

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”