Health, Care & Crisis
By
For girls who are, like me, from Hanover Park – a small township in Cape Town infested with gang violence and poverty – the world can seem incredibly small. It is like being within a society, within a bubble, that very little of the outside world seems to penetrate and reach. We are all born in the community day hospital, raised in the community and go to school because it is a legal requirement. Before it was a legal requirement, many did not finish even primary school, especially girl children.
Generally speaking, even then, the chances of escaping and experiencing life outside of the bubble seemed impossible, and almost laughable to even consider. You are bound to duty, poverty and Black tax. Tertiary education is seen as an aspiration for white people, not us – never us. When I was younger, it was not even a conversation – so much so that I did not even know that it was a possibility. After we finish school and try to find a job, the next step, as with the rest of the sacraments for girl children from the Flats, would be to get married, and have children – ideally in the order specified. If you switch the order up, you will raise eyebrows and be judged severely by everyone – from the priest to the neighbourhood drunkard and even the community moms.
Your worth as a girl child is seen in key things – respectability, European beauty standards, your ability to perform wifely duties and, lastly, the functionality of your womb. Even as a child, your mind is filled with ideas of motherhood, and how it is a blessing to have children. Your job is to be fruitful and multiply while relying on God to make a way. This concept always made me laugh internally although I never verbalised it – having children and relying on God to provide for them. It sounded strange to me, considering how so many people and their children were living in poverty – I didn’t understand it, and thought maybe there was a special number of children you had to have before the whole making a way thing starts to kick in. There is no margin for error, no wiggle room, no negotiation... And woe to those who are not fruitful and who do not multiply, because surely ... surely ... they are cursed by the Almighty with lifelong spinsterdom?
Sexual and reproductive health is taboo. We don’t talk about it at all, so it does not exist, right? You are better off assuming babies come from the mountain because asking questions about them is shameful. We don’t talk about our genitals or sex organs, we use euphemisms, even as adults, and there are no conversations about why some people’s ovens don’t work as they should, apart from the occasional community skinner about how so and-so’s husband ran off, apparently justifiably, because so-and-so’s oven was not working. Women’s worth is in their ovens and their ability to make dough rise without mishaps. And yes, by oven ... I do mean uterus.
To add insult to injury, there is no situation wherein it is justifiable for women to walk out on their marriages, even if the reason is something their husbands could control – unlike infertility. As a woman, you are then instructed to carry your cross. I guess it is as the saying goes on the Cape Flats: ‘Meat is meat and a man must eat.’
In the middle of winter in July 2014, when I was 19 years old, I was rushed to the hospital on my GP’s orders – he was not entirely sure what was wrong with me but knew it was dire enough to give me a letter to be seen at the emergency room at the local hospital. I was feeling feverish, nauseous, exhausted and had extreme pain – especially on the right side of my body. The nurses and hospital staff took pity on me because I looked like I was near death because of the pain. I was immediately admitted and spent the night and early morning undergoing a series of tests and scans to get to the bottom of what was causing my strange symptoms. I was then informed I was not allowed to eat – not that food was even on the agenda in that noisy, smelly and overcrowded ward. Soon thereafter, I was told that I needed to have an emergency surgery as they had located a mass on my right ovary from a scan. I was terrified and had no idea what to expect or what it could be – I had never had any kind of surgery before.
I woke up, groggy from the anaesthesia, and was back in the enormous post-surgery ward. It seemed that everything in there was in various shades of white – white linen, white uniforms, white walls. The light was unnervingly bright to me and, suddenly, my doctor appeared out of nowhere, leaning over the railings of my hospital bed. She made no attempt to prepare me, sugar-coat or even check that I was fully conscious before she started to speak. She stopped speaking, or I stopped listening, I may have slightly blacked out again and then I heard her say ‘you have endometriosis, really, really bad. It is unlikely that you will ever have children.’ I don’t remember responding, or acknowledging what she had said, and felt myself slipping back into an anaesthesia-induced stupor as her face faded away in my mind’s eye.
Even through the numbing effects of the anaesthesia, I felt a heaviness – the feeling of despair and hopelessness had already started to creep in. My entire world shattered around me, as I lay in my hospital bed attempting to physically recover while being torn apart emotionally and psychologically. It felt brutal, disheartening and inhumane. The doctor’s bedside manner, in retrospect, is one of the coldest, most violent experiences of my life. She let me know my life, as I knew it or imagined it, would never be the same again with about as much empathy and emotional range as someone ordering a coffee. I don’t suppose the need for counselling or proper emotional support is important for girls like me…
Want to read more? Nadine Dirks’ Hot Water, published by Jacana Media, is available at all good bookstore and online.