May 14, 2012
Jean Chamberlain Froese on Ugandan health care: Women and children lastBy Jean Chamberlain Froese
As a Canadian obstetrician working in the developing world, I’m reminded daily of the superior health care available to men here compared to the health care available to women. Sadly, this discrepancy is often supported and perpetuated by well-meaning international donors.
The profound injustice hit me when I was visiting a local health-care facility in Uganda — I hesitate to call it a hospital, but it does offer obstetrical care for pregnant mothers and can, when strained to do so, perform cesarean sections for mothers who need them.
I met Helen in the delivery room at this facility. She was a Ugandan mother-to-be who had been in labour for nearly two days with no progress or chance to deliver naturally. After careful assessment by the local midwife and doctor, the obvious decision to do a C-section was made. Now the only thing that stood between Helen and a safe delivery was the $60 that this government health facility required from her — after all, she needed to pay for the gloves, medicine and anesthesia required to surgically deliver her baby. Her alternative was to hop on public transit — in this case an overcrowded minivan — and risk a two-hour drive followed by numerous hours of waiting at the national referral hospital, where she would queue up behind the many other mothers trying to access free services.
As director of the Save the Mothers program and a qualified doctor, I couldn’t just stand by and watch. The delay in moving to another facility would mean certain death for the unborn baby and probably significant injury, if not death, for the mother. I reached into my pocket and pulled out the Ugandan cash; Helen could now receive the medical care she urgently needed.
I was relieved to see that within an hour, Helen was operated upon and a healthy baby boy was born. But as I approached the operating room, I was shocked at the commotion outside. There were 10 men waiting — all lined up in a row, clutching their medical files with sheepish looks on their faces. They were scheduled for male circumcision — an approach to reducing HIV/AIDS transmission that [perhaps] shows some benefit in decreasing men’s susceptibility to infection. It was a procedure the men could access for free and one that was advertised nationally with billboards and radio campaigns. These operations took up nearly all the space in the operating theatre and the attention of the medical staff — at least three times more of whom were assigned to one man’s care than were assigned to Helen’s. This injustice stung me.
There really is a distinct difference in the care available for men versus women in the developing world. Male procedures that potentially reduce HIV/AIDS receive unlimited and sustained international support, while health interventions to categorically save mothers’ (and their babies’) lives still take a back seat — or a small corner of an operating room in Helen’s case.
Shouldn’t the women who are risking their lives to deliver the next generation at least receive the same free health care as the men who want to reduce their personal chances of HIV/AIDS acquisition? Don’t their lives count as much as those of men? If that operating room in Uganda was any indicator, the current answer is no.