what's professional in the bush?

As I sit at my health clinic weighing babies, I hear a commotion coming from the birthing rooms.  As the two midwives walk out casually laughing I hear a man violently yelling. Because of the cultural differences (or and unknown inability on my part to read obvious social cues) I have no idea whether this situation is serious or not. I ask the mid ladies what's the dealio and they tell me to go in and see for myself. Had I known that this story ends with me storming out of the clinic wiping away a cocktail of angry-helpless- furious tears I would have…nope, never mind. Sometimes my curiosity leads me to fault. Ok back to the desperate screams from the back room. In the dingy birthing room, I see a young frantic looking woman clothed in nothing but a t-shirt laying on the rusted operating table. I’m sure that she would have gotten up and walked out of the room had a woman- I’m assuming her mother- not have been holding her down. An old man who is either her husband or father (can’t be too sure in this country) is also holding her down also and yelling at her in local language.  Apparently the young lady had given birth two hours before and was torn vaginally (a somewhat normal occurrence during child birth). The tear looked exceptionally grave- I’m guessing- because she was excised (female circumcision) as a young girl. You could still see the scars from her excision. They were holding her down so the two nursed could sew her back up; she was losing a considerable amount of blood. The head nurse (major) attempted multiple times to inject her in the nethers with local anesthesia but she wriggled and squirmed away. He then yells at her saying that he’ll just sew her up without anesthesia. He attempts to sew her but once again she struggles away from him. Mind you, they are being very rough with her. Yelling, cursing, pushing, slamming, and prodding. I’m sure that the young woman is scared out of her mind and extremely vulnerable. They do the “here’s some anesthesia jk I’ll sew you up without it” dance for another ten minutes. Not only is the woman even more terrified and split open, she now has fresh needle/syringe cuts all over her thighs.

At this point everybody is exasperated. The woman pushes away for the hundredth time and the major decides to slop her in the face. The dad/husband feeds off of this and proceeds to slap and shake his daughter/wife. Shocked and disgusted I walk to the table yelling “whoa, hey, don’t hit her!” The major looks at me annoyed and he tells me that he doesn’t have time for this and she has been refusing treatment for hours now. I try to say that hitting her is not going to make her any less scared but I am kindly ignored.

They decide to tranquilize her with two hits of valium. They wait for her to fall asleep, but because she is in fight or flight mode she just lies there whimpering for 15 minutes. I will have you know that one shot of valium knocked me out instantly after my allergic reaction. One of the midwives comes back into the room with a get ‘er done air about her. She walks directly to the woman and with the help of the nurses she pulls her legs into a full split! The woman is screaming and fighting hard at this point. The mom taps out and is replaced by a younger woman. They hold her down and the unnecessary physical abuse continues. The dad, friend, mom, and major have all slapped her at this point. It reminds me of that scene from the film Airplane!, when everybody lines up and slaps the hysterical passenger to try and calm her down. Only this situation is not humorous, it’s real and sad. I chose this time to excuse myself from the room.

I’ve never felt so helpless in my life. Here a woman is being damn near tortured and I couldn't do anything to help her. 1: She needed the procedure. In my small village we don’t have the luxury of foolproof drugs to guarantee the patient feels zero to no pain.  2: Who the heck am I? How am I so bold as to walk into this random country, invited into their hospitals to witness very personal experiences and then tell them how to do their jobs? 3: I didn’t have any constructive input other than violence is bad. Golly Jalysa, what a great contribution, you’ll be a doctor in no time! After I told my mother this story she suggested that I could have asked to speak to the girl alone to calm her down. Not a bad idea but would they have allotted me the time to do so, and would she have understood me? Things that make sense to the average American does not always translate in this culture and vice versa. What would you have done?