This is a country where a woman’s
fertility is of paramount importance. If she marries and has no
children, then often she will be left behind or the man will take
a second wife. She is not a respected member of the community
if she has no children. If a man has children with one wife, he
usually does not bring those children into the second marriage,
but expects his second wife to produce children. This is a country
where sexually transmitted diseases, including HIV, are at an
epidemic level. Sexually transmitted diseases can cause infertility
and cervical cancer. Fifty-nine percent of people living with
HIV/AIDS in Malawi are women.
I saw a woman yesterday who had come to the hospital to “buy
blood” because she had no donors. She had been told that
she was severely anemic and needed a transfusion. She sat in the
chair and wept when we told her no one could “buy blood.”
I felt that her anemia was not so bad that we could not treat
it with iron. I learned that she was divorced because her husband
had beaten her. She showed me the scar on her face. She had had
five children, three living. What concerned me was the knowledge
that women who are beaten by their husbands have a 48 percent
greater risk of being infected with HIV. I did a gynecologic exam,
and it was obvious that she had a terrible infection. I asked
her if she had lost weight and she had. Through translation, she
was asked to be tested for HIV. She returned with her results,
which were positive. We treated the infection and the anemia and
asked her to follow up in a week.
The last woman we saw today was 34 years old. When she was 18,
she had a stillborn baby and was left with a VVF. She had surgery
then, but now was complaining of leaking urine. She walked with
a limp, the result of nerve damage during labor. Dr. Rijken started
to examine her but she was writhing on the table in pain. We discovered
that she had a large stone in her vagina as a result of her unattended
condition over the last 16 years. Her health booklet notated only
the last two years of medical visits. I discovered that during
those seven or eight medical visits, she persistently complained
of lower abdominal pain, but instead of anyone ever examining
her, they would diagnose her with pelvic inflammatory disease
(PID) and prescribe certain antibiotics. Over time, she was labeled
“known PID case.” PID is not a chronic condition like
hypertension or diabetes; it is an acute condition, cured with
antibiotics, and it is the result of one or more sexually transmitted
diseases. This young woman was so disabled by this vaginal stone
that she was physically unable to have sexual intercourse.
I was so enraged by this insulting dismissal of this woman’s
suffering that I went from clinician to clinician, showing them
the notes in her health booklet. “This is a crime against
women, “ I said. “It’s a wonder how she can
have any confidence in the medical establishment.” She sat
in the chair as Sue explained that she would do a surgery tomorrow
to remove the stone. She looked afraid and was sitting, leaning
to one side to ease the pain. She had only a younger brother who
had accompanied her to the hospital.
We had no turkey today, but we are thankful for much. We are
thankful for all the abundance we should not take for granted
as privileged human beings who come from a land of plenty. We
are thankful that we are able to be of service to those who have
so much less. As women, we feel a kinship with these women who
walk for miles with their babies on their backs and loads on their
heads, who work in the fields, who care for their sick, and who
can still laugh with us, despite all their hardships. They deserve
so much more and it is always our privilege to feel we have given
a little to them.
Happy Thanksgiving,
Charlotte
The 2005 Mission Yearbook for Prayer & Study, p.
337 |
