The Anonymous Alien
A friend of mine was having severe pain. She refused to go to the doctor. I couldn’t figure out why, and insisted that she go. She refused. I basically said you are going whether you like it or not, then called around and got a referral to a gynaecologist at a top local hospital in Hyderabad and drove my friend straight there.
Behind (obviously) closed doors, the gynaecologist examined her. After a few minutes, my friend emerged from the exam badly shaken. Once we left the hospital, she confessed that the doctor had been verbally abusive to her, accusing her of sleeping around with lots of men, and that that was why she was having gynaecological problems. My friend assured me this was the last time she would ever see a gynaecologist.
I don’t know what was most troubling for me about this encounter. The doctor’s abusive, judgmental attitude? My friend’s insistence on never getting gynecological care again? Or the fact that, after some questioning, it became clear that my friend hadn’t had a gynaecological exam – no pap smears, no breast exams, no HPV vaccine, no mammogram, no nothing – in over a decade. In fact, she knew practically nothing about these things, and she’s a well-educated woman.
Why such a gap in her care and knowledge? Because the last time she had seen a gynaecologist some ten years earlier, she had been the recipient of similar abuse, and had even then made up her mind to avoid doctors and these health issues altogether.
Now, keep in mind, it is not a trivial decision for a woman to avoid seeing a gynaecologist. A pap smear, for example, can detect early signs of cervical cancer, a fatal disease that is nearly 100 per cent curable if caught early; a breast exam and mammogram can catch breast cancer early and dramatically improve survival rates; and the HPV vaccine can protect against a myriad of venereal diseases and fatal cancers.Any yet, my friend had had none of this care. And had now made up her mind to get none of it in the future.
Was this an isolated case? Or a systemic problem in India? And if so, why? I wanted to find out. I got on the Internet and typed away. Very little hard evidence on rates of quality gynaecological care for women in India, but from what I could see, it seemed that very few women were getting consistent and quality care. Was it the cost? For some impoverished women, perhaps, but overall, the cost of these tests and vaccines in India is very low, so I doubt that’s it.
The more I dug, and the more I talked to people about it, the more it became clear that there were two issues keeping women from seeking proper gynaecological care; ignorance and abuse from physicians. The former is nearly ubiquitous; there seems to be little education on reproductive health in India, and, in many places, discussions about reproductive health are even taboo. And as to abuse, from my informal survey of female friends, practically all of them had encountered a physician who had abused them at some point over gynaecological issues. For many of them, this abuse had stopped them from seeking additional care.
What’s the solution? Maybe call these dreams, but here are the right steps:First, women who are abused by physicians need to write an appropriate letter to the head of the medical facility where they were treated. One letter won’t do much, but if LOTS of women write, things may start to change.
Second, medical leaders need to take the lead on this, and start re-educating doctors about their obligations to patients, about putting patients first, and about dropping their own pre-judgments of women and their sexuality.
Third, reproductive education needs to become a part of the India public school system. I realise there are strong religious and political forces aligned against this, but really, how much weight should we give to the opposition when the lack of reproductive healthcare for women is causing tens of thousands, perhaps hundreds of thousands of women to die young.
And fourth, and this is my really big dream, wouldn’t it be incredibly if Sonia Gandhi, the president of the reigning political party herself, who just happens to be a woman, came out and got vocal about this issue? If she really challenged the abusive doctors and regressive hospitals and outdated education system on this issue, things could change.Now I think that would make every woman in the country a little healthier.
A foreigner’s observations on living,working, surviving and thriving in India.