As many of you know, I decided to dedicate my professional life to women's health. I could go on and on about reproductive rights, period education, maternal health and family planning for hours. While that is not fun for people who get stuck on planes next to me or my uber drivers, I cannot be stopped. I have decided to travel to Eldoret to explore the context of women's health in a lower/middle income country to add another component to my women's health passion: women's global health!
**As a disclaimer to ALL of my posts, including this one, these are my opinions based on limited and personal interactions. It is important to realize that my experiences do not apply to all Kenyans, their communities or their culture.** A life lesson - look at everything critically, question everything, and explore it for yourself.
Below is the front of the Riley Mother & Baby Hospital that houses the labor and delivery ward, the antepartum ward, postpartum ward, OB ORs and the NICU. There are also some OB triage rooms at the front and a state-of-the-art US machine for the new MFM fellowship.
I have spent *almost* a month on the OB and GYN wards at MTRH (Moi Teaching and Referral Hospital) and I have experienced every emotion, every day. Frustration over the system, anger over the lack of resources for patients, complete fear in the OR, devastation over suicidal mothers, happiness when chatting with registrars, and the incomprehensible joy when women are handed their babies for the first time. I chose OB/GYN because I love to feel all of these emotions. But here, there is this tangled, sticky web underlying every experience. One that can't simply be unraveled by more ventilators, more staff, more money. This is the complicated web of female inequality. *SIGH*
While we have been battling inequality in the states for years (hug your women), Kenya as a whole has been lagging behind. In fact, this is a common theme among most lower/middle income countries. There are many policies and organizations trying to combat this, such as micro-finance loans for women, period education, access to clean menstrual products, education/literacy programs for women, etc. However, it appears we have a ways to go until we permeate the culture as a whole.
I have seen several examples of male dominance since being here. One such example shook me to my core. In rural villages there is this concept of a male "beader". This concept, brought up nonchalantly by the most strong and intelligent female registrar during a grand rounds, is one that many urban/educated Kenyans seem to ignore. A "beader" typically describes an older, respected man in a rural village who gets to essentially call dibs on a newly menarcheal woman. Woman, however, is not the best word because in actuality, these "women" are typically 10 or 11 years old. Often, these children do not know why they are bleeding or what it signifies. Period education is routinely ignored and pushed under the rug. In fact, some children/teenage women get hospitalized or die from abnormal uterine bleeding/hemorrhage because of the stigma surrounding menstruation. So not only are they coping with the confusion of their first periods, these children also suddenly get raped by respected village men. We have seen pregnant, 11-year-old patients from this method. Often, the beaders do not assume paternity and leave the women and her family to raise the infant alone.
The "beader" concept is the most severe example of male dominance I have seen thus far. Most instances of female inferiority is through lack of decision making without male approval. Some women won't even get an early dating US without their husband's approval. While this seems minor, this makes it hard to counsel women appropriately and gauge their understanding and wishes.
To end on a positive note, like the US, urban settings are seeing more and more educated women. In fact, Moi University has more female medical students than male. YAAAS queens. Let's keep that up.
^Happy pics of our Consultant/MFM fellow representing post-placental IUD for family planning, embroidered on his WHITE COAT (can I get one??) on the left.
Me about to scrub into my crazy first c-section (huge smile under that mask, trust me) on the right.
Okay I have ranted enough and am emotionally drained. Feel free to What'sApp me, instagram DM me or get my international number if you want to hear some more incredible/insane/beautiful/devastating stories from my trip thus far.
With love to you all,
Rebecca
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