Dear reader, I hope you are doing great and have a minute or two; I’ll need your input at the end of this article. I want to go straight to the point with this one, and I hope you are okay with that. So, this lady would like to have an abortion, she is 29 years old, about eight weeks pregnant, and this will not be the first time this happens if it happens. She has had abortions before, about four; this will be the fifth if it happens. But let me tell you the whole story first.
Tasha (Not her real name) walked into the Outpatient department (OPD) of one medical facility with several body aches and extreme pain that couldn’t let her stay home any longer; I say this because she was home for close to a week with this pain before seeking medical attention. This is a prevalent vice amongst many South Sudanese. People only go to hospitals/ clinics or generally seek medical attention when their pain can’t allow them to sleep at night or when it’s about to cost them something huge, which most times it does.
Back to our story, Tasha was clerked, examined, and found to be with a child, malaria, typhoid, and extreme pain. She tried to process everything she had just heard when given the results. Or was she probably reliving an inevitable ordeal from the past that none of the doctors and clinicians in front of her had any idea about?
On further history taking, she revealed she had had four previous abortions, none of which was induced. So, the medical personnel clerking told her she would be sent for a scan to see whether she had cervical incompetence or to rule it out; this would help her make the right decision. But Tasha had a problem with that. She refused to be sent for the scan. Did she have a different idea? Was it safe to talk to the doctors and clinicians about what was on her mind? I wondered.
By the time I came in to somehow intervene, I had been watching from a distance and noticed her irritation and discomfort. I greeted her, introduced myself, and created rapport. I told her I wanted to help her but would need to understand her situation first. She gave me her book, which had lab results and the information she provided during clerking; I looked through and saw the positive pregnancy, malaria, and typhoid tests, and the different medical histories and other details.
I looked up from the book, leaned forward, and asked her. I didn’t want to advise her; I tried to understand her and see where she came from. Is there a reason you don’t want to do the scan, if you don’t mind me asking, please? Because this is supposed to help you. “I don’t want to go for that scan or even take this medication.” She responded. Help me understand, please; I followed up. “Why should I?” she added as tears began to well up in her eyes. “Do you want us to go inside and talk about this?” I asked, and she nodded. We didn’t go inside; the other doctor and clinician gave us space and left the room.
“Malaria in the first trimester is dangerous; it can make you lose the pregnancy”; I initiated the following conversation after everyone else had left. “I want to remove this child; I am tired; there is no way I can go for a scan without permission. It would be a different problem altogether,” she said as built-up tears rolled down her face. There was a long silence. Her pain was palpable, and her emotions very high. I needed to give her time to let it out. It wasn’t just the physical pain; there seemed to be much more. “Someone shouldn’t suffer this much without help,” she added as she wiped the mixture of tears and mucus off her face, close to her nose, with her bare left hand. Judging from the way things were unfolding, for a moment, I thought maybe she was a single mother without support and that responsibilities had become overwhelming.
“Who do you stay with?” I asked, expecting her to say her mother, father, maybe brother, just any other relative, uncle perhaps? But I was wrong. She told me she stays with her husband, with whom she has four children. I asked whether she could call him and let him know about her diagnosis and the possible complications and that she had been asked to go for a scan. But instead, she seemed much more distressed. Any mention or referral to her husband made her feel uneasy.
“There is nothing I haven’t done or tried to convince him to come to the hospital with me or to give me money to seek medication, but he ignores me and refuses. It has been the same situation with the previous four pregnancies that I lost; he leaves home early in the morning and comes back late, and he won’t listen even when I tell him I’m in pain,” she spoke as she looked down at her fingers as one hand caressed the fingers of the other. She said many things that made me realize the man was very negligent of her health, even when there was clear evidence of a life-threatening illness.
“I am so sorry to hear that. Have you tried to report him to his family, maybe their elders?” I continued the conversation. “Doctor, there is nothing I haven’t tried; last year, I took the issue to the elders and a family meeting was conducted, my father and brothers contributed money for my treatment, and everything was given to him since he is head of the family. I was supposed to seek treatment, especially about losing the pregnancies, but he spent the money instead. He traveled to Khartoum for God knows what and returned with no money. Now I can’t return to my family to ask for more money; what would I say? How will I say it?” It was infuriating to hear her say this.
I asked whether the man had another family that he was probably spending the money on; she said that as far as she was concerned, she was the only wife, and there was no other official woman, but she also added. “In this Juba, one can’t completely say they are the only woman in a man’s life when they (the men) spend the whole day up and about, without you ever knowing the different routes they take”.
I felt terrible for her. Such a beautiful young woman, not just neglected but in extreme pain and expected to find a way to deal with it without inconveniencing others. When I asked her what her husband does for a living, I had already assumed that this must be an uneducated man who is either jobless or does some low-level informal job with minimal income. Still, to my surprise, her husband is a lecturer at a university. A whole learned man!
Overall, during our talk, I resisted the urge to tell her what to do because, more than anyone else, she was the only one that knew and felt the pain of being in her shoes, and she was the only one that could come up with a decision that could help her. I only listened and asked questions. Hoping that by having her talk, some things would make more sense as they came out and became more evident. By the end of our conversation, she wasn’t crying anymore and asked for the pharmacy location where she was to pick up her antimalarials. I showed her, praying that her best interest was at the forefront of her decision.
Do you remember when I said I would need your input? Yeah, it’s about time. You know, women in this country continue to suffer life-threatening events because our bodies belong to everyone but ourselves; one woman must wait for her husband to consent for her to get a scan, and another has to make sure the man is fed and his clothes washed in this Juba heat even when she’s sick and barely able to sit upright in bed.
Men often use their positions of power to manipulate, violet, and abuse, and somehow, women must bear the consequences, for which many women have paid with their dear lives. So here is my question: what would you do if you were in Tasha’s shoes? Who is to blame for whatever is happening, and how would you solve Tasha’s problem if it were possible for you too? (Whatever solution you come up with, if you look carefully, there is a Tasha somewhere in your life, identify them and be their beacon of hope).