It is amazing how much you can learn in as little as a week. Full immersion in a culture and its language can teach you many new things. With these new things, there is a period of excitement and total acceptance. I describe this as an attitude of “look how different this is, perhaps even better than what we have at home!”. Slowly, new things bring new challenges. These challenges might test your beliefs, leading to the uncomfortable attitude of “look how different this is, perhaps this needs to change”. And from there you may teeter back and forth between excitement and initiative until you have reached your final opinion.
In my last half of this week, I had the chance to visit Pumwani Maternity hospital. While it is normally a very busy hospital, with over 60 deliveries per day, there was recent litigation which lead to a serious decline in numbers of women visiting the hospital. We have heard a vast array of gossip surrounding the controversy. The most common explanation surrounded around the appalling disposal of twin stillborns of whom the parents were given the bodies of two entirely different children when they came to claim them. This in turn lead to a strike amongst nurses, and a decreased capacity for patients. While this is the most popular explanation, I will admit we have received a few reasons for the hospitals recent issues. It seems that there is more to this than I might understand, especially from the hospital’s point of view. The media here can be quite hard to trust. Just recently, Ingrid had been looking at a newspaper with one of the clinic workers, and they noticed one of the photos was very blatantly photo shopped to superimpose a rhino beside two locals. It is a reminder that news and media, in all countries, is a business and one should be very careful as to what they state as truth and fiction.
Besides this media frenzy, Pumwani was overall a very valuable experience. This is not only because I was able to observe C-Sections and deliveries, but also because I learned more about the culture and the health practices in Kenya. I found that because I was working closely with women and in a somewhat high stakes environment, I learned more about how women are perceived in Kenya. For example, things may be more difficult for you if you are unmarried, a single, or very young mother. While this applies throughout many other countries, I will admit the prevalence of this belief is much more engrained in the culture and more debated than in Canada. One of the most discussed news I had heard in the clinics was of a wealthy businessman, Dr. Njoroge, who is 54 years of age and unmarried by choice. For a greater part of a week I would hear various conversations and even debates on the radio about this man and his marriage status. By popular consensus, if you are single and past a “certain age” (I believe is around 35) in Kenya, you will be questioned as to why you are not married. I myself was even questioned by some of the nurses at Pumwani as to when I would start having babies (because 25 is SO old!).
This also relates greatly to how single women were treated in Pumwani. In one incidence, I was observing the encounter between a clinician and a single, young woman who had lost her baby. Instead of regret, the health care worker expressed relief. I was so aghast. The young woman was clearly distressed about it, she was crying and very upset, and the clinician did not seem to express much sympathy for her. In order to get a better idea of why I saw this, I asked a few people about this incident. One good explanation was that the regular staff at Pumwani are currently not there due to the strike. Other explanations centered around the extreme poverty and undue suffering a child might be exposed to when brought into the world with a single parent in Kenya. Legislatively, with abortion being illegal in Kenya, women also are expected to have a lot of responsibility surrounding their Family Planning (contraceptives). The government does an excellent job promoting Family Planning and offering it at a very reduced rate. Oral contraceptives are pennies, Depo-Evra, Norplant, and IUDs are freely given to whomever at a very reduced price, if not for free. This might explain the onus society places on the mothers however, it was still very hard for me to see health care professionals behave in such a way towards women.
From the perspective of our medical system and culture, women are very much independent, given many choices and encouraged to support their children, even under strenuous conditions. We have better social supports, through welfare and resources for women here in Canada, but a good portion of this attitude could be due to our cultural perception of single moms. For example, when I think of a single mother, I think of a strong woman, who had to coordinate her life to care for her children, while working at the same time. I think of a woman who may have made sacrifices to be a single mom, but has persisted nonetheless. Now this might be my cultural perception of a single mom, but it is certainly not the case for all single moms either.
Therefore, It is different for everyone. Each person has their own experiences and each culture has their own social constructs. At Pumwani, I was finally becoming aware of these differences when hearing people speak about single mothers, or marriage. I am happy to say that despite this brief experience, I have also seen some pretty impressive women empowerment at the SWOP clinics thus far. I have also good conversations with female clinicians who have placed education before parenting or have worked while being a single mother. Based on these conversations, it does seem as though things in Nairobi are beginning to change. For now, we will await the future and let this serve as a reminder of the inequality women face every day in this world and the difficulties of changing this due to it being tightly engrained in the cultures they are born in.
I hope this was helpful in showing one of the differences in culture I have seen so far. I would really like to hear others opinions on this as I am still trying to process this myself. Let me know!
-Susan
tembointheroom 