wednesdays women's days

i've started spending more time in Maame Vic's office, listening and watching while her and sophie diagnose patients. it's interesting, and has turned into a hub of experience.

"instead of bending like this" sofie bends down from her waist and touches the ground "you should do this." she lets her knees drop down and picks up a book, then straightens her legs. vic translates to use your knees not your back and the patient explodes into a look as if he has just seen God. he is in utter amazement at this new way to move. "thank you thank you" he says, nodding and bowing as he leaves the office.

it's the simple things.

but on some morning's, on this particular morning, it was far from simple. a young mother was sitting by the side of maame vic's desk, explaining her symptoms. she had a wiggly cheerful infant in her arms (who was not yet 4 months) but the woman lacked energy. she was complaining of fatigue, vomiting, and stomach pains.

"sister akua, can you get down for us please?" maame vic was motioning me off the exam bed, the young lady needed my spot to lie down and have her body checked. i jumped down and moved out of their way. she lifted her shirt and they palpitated her abdomen. then vic asked her a series of questions.

"we should send her to the laboratory to complete a pregnancy test." vic said, opening the door for her to head over to kingsley. then she shut it. "her baby is niiiiicce, a nice child!" she concluded. "but you see, these women come to me because they don't suspect they are pregnant. they think these symptoms are because of something else. either they don't suspect or they pretend to not know and hope i will tell them it is something else."

we sat for a small time and then the woman reappeared. kingsley was walking behind her, with his usual sneaky grin. "the test is positive" he said "it is positive for pregnancy. her child is sooo young and she has already gotten pregnant, truly wonderful." he meant that word to actually mean; full of wonder, not "great".

the woman sat back down in her chair. she hadn't understood what kingsley had said, because he didn't tell her in twi so vic waited a professional moment before she relayed the results.

positive pregnancy tests innately make me happy, so when i saw the look on the woman's face i had to readjust my initial excitement. she hung her head low and froze. she seemed to suddenly forget the child in her arms, and let the baby flop about. i walked over and held the little girl.

the energy in the room got thick and i felt my throat tighten. i swallowed the lump that was going to burst into congratulatory praise and instead sat in the uncomfortable moment, not really sure what to say, i focused more on looking at the baby's face. it was really cute.

ma vic looked at sofie and i and said "she is not yet 22 and has a 3 year old and her small child here. it's too bad. and you see her? she's crying. it's too bad. this child will suffer."

the girl had dammed her tears up, but occasionally one or two burst through. then she'd bury her face for a second in her handkerchief and give it a long slow tired wipe.

"your mother is crying." vic told the 3 month old.

it was the only thing that was uttered for minutes, while we all sat through vic's heavy sighs and head nods. then she broke the silence by telling the woman to return with her husband, for some family planning counseling and to see Ma.

then she left, more depleted than when she had come.

when the door had fully closed, sophie broke through, opinionated and abrupt.

"THAT IS SUCH SHIT!" she yelled. "the men have all the fun and leave the women with all the suffering, and the work. this is such shit."

although, her british accent even made "shit" sound nice, i was a little embarrassed that she had cussed in front of Maame Vic. i had only heard nanakwame and sakola use profanity once at the dinner table, so i had grown unaccustomed to it, but it felt appropriate in some ways because the moment was heated.

"no, it really is shit. pregnancy is such a high risk." she held up her fingers to explain the first of the risk factors. "african women are at a much higher risk when they become pregnant. first, because of malaria. they lose all their acquired immunity when they become pregnant, so there is that. second the risk of abortion and third the actual delivery. everything is riskier here, it just is."

maame vic interceded "i asked her to bring her husband back here the day after tomorrow. i will give them counseling. as for these people, if the husband says he doesn't want the baby she will have an abortion, but if he says he wants it she will by all means have the child. but you see, there is the danger of these illegal abortions they do. women will bleed profusely and die, so i have told her to come to the clinic. when i explain this to the husband they will then know. it is not advisable to give yourself an abortion."

i thought of konongo hospital and the screams. i thought of senam's neighbor and close friend in Ho, a girl of 22 who had just died from this. it was all too common.

"...but often times they don't come until weeks later for something other than antenatals and they tell me their pregnancy has just gone." she shrugged her shoulders. "they come if they don't die."

after a deep breath, and a careful delivery, sofie said "first off, i don't agree with abortion as a form of birth control, how so many women in the west use it. they just get pregnant and say 'oh whoops! guess i'll have an abortion. they do that 4, 5, 6 times. i can't stand it when they come into my office and i see that. take some fucking responsibility for your actions. but i do believe in legalized abortion, and this is a perfect example. in situations like this the risk factors are too high. that woman clearly doesn't want her child. if she goes and gives herself an abortion, because it is illegal, she could die. there needs to be facilities that are safe and legal. people need to be able to have abortions without dying."

there was an awkward silence, begging for someone else's opinion to come and keep the conversation flowing.

i wasn't ready to take a stand on the abortion talk, because i didn't know what side to stand on. personally, i knew what i would do, but i was still digesting the complexities of society, of life as a village woman, and more specific... of this last patient who just left. what would it be like to have no control like that? to be so young with 3 children? she would surely have double by the time she hit 30. how could she afford that?

but when i thought of her stopping what had already been started, of terminating the life of a living baby, i felt weak and sad. it made my gut hurt. i wished for some type of solution.

i wondered what the reasons were that this woman didn't want to be pregnant; there could be so many.

vic continued "many women, they don't want to get pregnant so they won't fornicate. they think if they fornicate, by all means they will become pregnant, so they prefer not to."

"that's a hard ultimatum for a lifelong relationship." i said. i spent a brief moment sympathizing with both sides, male and female. a life spent with a wife who doesn't want sex, or a life spent feeding, cleaning, raising, birthing and loving a family that only keeps growing. since it mostly isn't the woman's choice that wins out in the end i began to feel really upset. the lack of choice was so apparent.

"but as for the men, if they want to have sex the women don't have a choice." she said.

"why don't they just use some form of birth control?" i wondered. i knew it wasn't that simple, but i still had to ask.

"as for Depo (provera) the men think once their wives are injected they won't fear the pregnancy, instead, they think their wives will go around fornicating with other men because they won't be able to become pregnant. that is what they think. so they don't want them to use it."

"oh, really. hm."

"women have got no say in the matter!" sophie said "it's so frustrating."

"vic, do you think women have sex for pleasure here?"

"the couple has to communicate." she said. "they have to know the right time to fornicate, know when her last menses was and then she can tell her husband 'lets wait it's too risky at this time.' then when they choose the correct time they can feel free."

"but even then" sophie said "that method, it is still unreliable. there have been studies that show some women actually ovulate while they bleed. so that won't work. they need to come in to the clinic for birth control."

"they come!" vic said. "they come."

"but they don't!" sofie said. "there are thousands of people out there and comparatively, they aren't coming. i haven't seen anyone since i've been here, come in for family planning."

i had only seen a handful.

"they come in during the night." vic said. "as for the village, people will talk. not everybody thinks birth control is okay, so many of the ones who want it, they come to me in the night. they tell their husbands they have a headache, then they take the 6,000 cedis (80 cents) and come for their injection in the night. so you see? they come, but you are right, not too many. mostly the muslim women come."

"well more women should be coming. we need to educate them and let them know about family planning."

the conversation was turning from a sense of dread into being proactive, i could sense it. when ideas are shared and people care enough collaboration become a beautiful soup. start with something basic, add some ideas, season with each others feedback, let it simmer, think a bit, add some more input, stir our brains together, and let it cook for just a while longer.

"i know! on outreach days we should do a family planning talk and let the women get their birth control then." sofie said.

"ummm, but in that case, they will always be expecting US to come to THEM. that is how they are. if we bring the birth control to them they will wait for us to return, they won't come to the clinic. perhaps we should do it here."

"here would be good. but we have to decide upon a day and do it weekly. maybe fridays?" sofie said, quickly correcting herself "oh no no, fridays are market days. howabout thursdays?"

"everybody will be preparing for the market, going to farm."

"wednesdays?"

brains were thinking, then a collaborative "YES!"

"okay, we'll have our women's day on wednesday's. hey! wednesday women's day!"

we all laughed.

vic said "i will go to town and talk to the churches, that way everybody will know to come on wednesday's. and i'll go to the mosque."

i was a bit confused. "will they support you?"

"oh you see, the women they meet in the week. the presby's meet on tuesday evenings, and the methodists meet on thursdays. the muslim women gather together on friday's, so it is like that. i will go to the women's groups and tell them about women's days, tell them to come to our talks. but when the men find out they won't allow their women to do family planning, so instead we won't mention it. we can talk about breast examination, cervical cancer, the importance of going for check-ups, and then... at the end... we will spend a lot of time educating them on family planning."

sofie left the room and in less than 5 minutes had all the staff gathered outside the office, including me and vic.

"we have to do these things when we think of them, or else we'll just sit around saying 'next week' 'next week'." vera, efreeyeh, kingsley, secetry, watchman, ma, vic and i were all crowded around. "so this is it. we've been talking in the office and have decided we need to prioritize. women in the village really need to know that we offer birth control at the clinic, and they need to be educated about their choices. so starting this wednesday we are going to do 'woman's days' where all this will take place. what time do you think we should do this?"

after a short time we all decided upon the morning, and everybody was excited.

we disbanded in unity and empowerment, saying...

"we have to let people know, spread the word!"

it was nice to be ignited by passion again.