I met a woman on the maternity ward of a hospital in Papua New Guinea, and I can’t forget her story. In the sticky morning air we rattled the old trolley through the crowded wards, feeling the bellies of soon-to-be mamas and interrogating the frazzled mamas, fresh from the labour ward. Thinking about the mothers made it easy to forget about all the tiny lives in each room, some sleeping peacefully under domed mosquito nets, others fretful with fevers and bruised heads from the traumatic journey into the world.
It was day one post partum for this woman, and as she cradled her newborn son we approached her for her post-delivery check up. Are you feeling pain? Big pain or little pain? Are you bleeding? Is the baby feeding? Does he feel hot? When she came to the hospital yesterday bursting at the seams, her blood tests gave away her severe anaemia. With a haemoglobin of 2.8, I was shocked she could walk, let alone deliver a baby. A post-partum haemorrhage could have been the end of her, so it was not an easy day for the midwives. She didn’t bleed, her family donated her some whole blood and she lived to tell the tale. Not everyone is as lucky.
The interrogation continued. What number baby is this? Seven. How old is your biggest child? Five. There was a short pause. Are you having family completion surgery tomorrow? No, doctor.
The female registrar stopped writing notes and looked this woman straight in the eyes. Her monologue that followed was what stuck with me. Even in Pidgin, the message was clear and her passion was clearer. Why are you having children that you cannot feed, and that will be forever competing with each other for everything? Do you want your children to have mobile phones? When they go to school will you be proud that they have holes in their clothes? And what about university, will you be able to sell enough at the market to afford for 7 children to get an education? Every child that you carry in this country is a threat to your life. Your body is tired. Who will feed your children when you don’t survive the next delivery?
She was met with stony silence, downcast eyes and a half-hearted shrug. This woman knew her place, she knew it was not her decision. The midwife informed the doctor that the woman’s husband had not consented for her surgery. There was tittering around the ward, and 10 pairs of eyes look upon her sympathetically. These women knew her predicament well, and knew there was no easy solution. Many husbands believe tubal ligation surgery will result in a promiscuous and unfaithful wife. The law says that only the woman needs to consent to surgery, but the doctors cannot afford to put vulnerable women at risk in a country where domestic violence is endemic.
The registrar sighs, prescribes some post-partum paracetamol and moves to the next patient – she can’t argue with culture.
This woman left the hospital and returned to the village with another mouth to feed and a contraceptive implant in her arm. We can only hope that she will return in 3 years to get another one, and not become another woman lost from the healthcare system in this remote place.
Charlotte O'Leary is the Engagement Director for Torque in 2015. She spent the month of January in Papua New Guinea, learning on the Obstretrics and Gynaecology ward of Kavieng General Hospital, New Ireland Province.