Of those newly diagnosed with HIV in UK, over 10% were under 25 years.
“We are offering all newly registered patients the chance to have the test.”
“But why?” he asked again, suspiciously.
“It is regarded as good medical practice to do this. People who have HIV or Hepatitis may not show any signs until the disease is very advanced. If any of the tests are positive, then the person can benefit from treatment and specialist support much earlier on.”
“I don’t want to do any test,” he replied, “I know its because I am Black that you want to do the test. They are always targeting us. They are all racists.”
I was speechless for a moment at his outburst.
That’s not the case,” I hurried to reassure him, “HIV is prevalent in Africa…”
“You see, that’s why you want to do it…because I am from Africa,” he cut me short. He picked up his car keys from the table and stood to leave.
Why do you think Dike reacted like this?
After Mma left, I sat thinking. It all started coming back to me. It must have been like eighteen months ago or more that Mma and her children had come to register at the surgery having recently moved into the area from Africa.
She had told me then that they had come overseas due to her husband’s job. He worked with one of the oil companies, she said, and he had been posted abroad for four years.
She was a linguist with excellent command of Chinese and German and was hoping to get a job teaching these in one of the academies. A very pleasant woman, I recall thinking.
Her children were aged twenty-two, twenty and seventeen. The first had been due to get married in a few weeks.
Dike came to register almost six weeks after his family came. He had only come because his boss had insisted he needed to be registered with a surgery while in the UK. A complete waste of time, he told me.
He fidgeted while I went through my new patient’s routine. I was used to men feeling that coming to see the doctor was unnecessary.
Blood pressure check. Height check. Weight – a little overweight but nothing that a bit of exercise wouldn’t shift.
“Do you smoke?”
“Just when I am out in the rigs.”
“How many a day?”
“Ten sticks a day.”
“Have you ever considered stopping?”
“Maybe one day,” he glanced at his wristwatch. “Are we done now?'”
“Almost. I would like to offer you testing for blood borne viruses like HIV, Hepatitis B and C.”
“Why?” he asked surprised.
Would you have HIV and Hepatitis tests even if you believe you are not at risk??
“No doctor, I really don’t want to go down the condom route. There is just no way I could rely on condoms again. So please, as he doesn’t want to be sterilised, just tell me what I need to do to get sterilised. I’m the one who has gone through the abortions and the child bearing. I think I am the one who will have to provide a solution to this since he is not willing,” she ended, gesturing at Baako.
“Eh..I didn’t say I am not willing. I’m just….”
“It’s okay, don’t worry. You can keep your manhood,” said Amina.
“Female sterilisation is getting your tubes tied and that means that when an egg is released from your ovaries, it cannot meet up with a sperm that has traveled up the vagina. If the egg cannot meet the sperm, no pregnancy can result.”
“How do you tie the tubes then?” asked Baako. “With a belt or what? Sorry, just asking,” he laughed when Amina threw him a scathing look.
I noted how relaxed he was now the pressure was off him.
“There are two ways of doing it. We could make tiny cuts on your tummy and, through them, find your tubes with special cameras and then cut and tie them or use clips to occlude them. That way you will only have very tiny scars. They’re barely visible. The other way is by passing special flexible tubes up your womb from your vagina. A tiny spring is inserted into each fallopian tube which then occludes the tubes. Both methods are very effective in preventing pregnancy. I must add that these are permanent methods of contraception.”
“So what if we want to have more children?” Baako asked.
“More children!? What are you saying? I thought we had agreed to stop?”
“Eh…but you never know…we may change our minds…”
“Then this method is not for you,” I replied.
“Doctor – please carry on,” said Amina.
“As I always say: ultimately the decision is yours and we are just here to help. Hopefully you can both decide on a method that is mutually acceptable. Sterilisation does carry a small risk of failure. If that happens and a woman falls pregnant, then it’s likely to be an ectopic pregnancy. That’s a pregnancy in the tubes rather than in the womb.”
“You hear that!” exclaimed Baako.
“It’s a very small risk. I must add that there are many women who have had ectopic pregnancies who have never been sterilised. One last thing – sterilisation can be reversed but it’s not always successful.”
“Doctor, I’ve thought about it and that’s what I’d like to do. What do I have to do next?”
“No!’ said Baako. “I don’t want you to get sterilised.”
“What!” Amina was annoyed.
“Yes doctor, what do you call a woman who is sterilised? A man?”
“What worries you about your wife going forward with this procedure?” I asked gently.
“It’s just so permanent eh! And also won’t it affect…”
“Affect what?” Amina asked.
“I don’t know… please let’s go back to condoms. Doctor, you were going to tell us about condoms. Just tell us about that. Forget all these permanent methods. I don’t want to hear about them.”
“Okay, then, let’s talk about condoms.”
Baako and Amina had already decided that their family was complete, which was why he wanted Amina to have an abortion. What do you think about Baako’s attitude? Why does he oppose his wife’s sterilisation?
WHO figures for female sterilisation are as below:
Dominican Republic 47%
South Korean 24%
Just like male sterilisation, the concept of female sterilisation is yet to be established in Black communities.
Should we be promoting it??
Consider that the maternal mortality rate (i.e the number of women who die at childbirth) is 840 out of every 100,000 live births in Nigeria
and 790 in Zimbabwe compared to 12 in U.K.
The issue of unplanned pregnancies must be tackled.
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