I had barely had the time to stretch my legs after booking another patient for Antenatal care in our hospital, when another figure darkened the doorway.
Booking is exhausting- you have to ask a plethora of questions, most of which the patient doesn’t have answers to. But I was new on the job and eager to impress, so I didn’t mutter any obscenities under my breath as I greeted her with a smile.
She was clearly uncomfortable. Her eyes were shifting frequently. Too frequently. It is considered rude in African culture to keep eye contact when a respected figure or older person is talking with you, but this was beyond courtesy.
She asks again in a shaky voice
“Can I come in”
” Yes, please, come in ” I say, gesturing to the seat opposite me.
She sits gingerly, and we begin to talk, her voice barely above a whisper.
“I had a pregnancy test done today…” She trails off
“I take it that it came out positive”
She nods silently, afraid to utter the words.
So, I launch into the algorithm. I ask if she is married, she shakes her head no. She is speaking very little now, clearly emotional.
I ask what support system she has at home. Her parents are long dead, she explains, but she lives now with her aunt, whom she says simply cannot find out. She helps her out in her business. I nod slowly, realizing she probably peddles consumables for her- placing her life and safety at risk on a near daily basis. It also strikes me, that she is a couple of years older than I am- she doesn’t know this of course, but is still hoping to get into the university and one day live her dreams. I briefly ponder on how much potential is lost to scarcity of opportunities in this part of the world and I secretly hope she doesn’t give up on her dreams.
I ask what level of support she anticipates from her partner and father of the “baby” and this is where she loses it. At first she doesn’t understand.
“I think he will support me” she says
” I mean, how much can you count on his support, assuming you decide to go through with the pregnancy and give birth to the baby?”
Her eyes go wide- in surprise, or fear, or both. She obviously hasn’t really thought this through.
Then she hides her face and starts to cry. I tell her there is nothing to be ashamed of and that my job, what I do for a living, is to ensure that she is ok. This seems to calm her down a bit. She goes on to explain.
“Now, he still supports me, but I don’t know about later…”
I nod as if in understanding.
“You see, the man- he is married. So, he doesn’t want his wife to find out about anything”
“Have you two talked about this?”
“You know now, he doesn’t really want to talk. He is keeping a distance, so his wife doesn’t suspect anything.”