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.

SaveSave

Advertisements

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.

IMG_4084

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.

a4614b35dc2c908084aa434b1fbafe8d

 * * * 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.

fed-up

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”

Learning Through Fiction: Fiji in “Kalyana” [+Infographic]

learn through fictionLast year I made an infographic for Black Dove, White Raven, and although it hardly interested as many readers as I had hoped, it was something I immensely enjoyed doing. So I am thrilled to share a new infographic, this time about Fiji and the novel I read, Kalyana by Rajni Mala Khelawan.

Spanning the early 1960s to more or less the present day, Kalyana tells the story of a young Indo-Fijian girl – her parents’ only daughter, and just a little spoiled. Continue reading “Learning Through Fiction: Fiji in “Kalyana” [+Infographic]”