COLUMN – Why all these men for female care?

TODAYSwomanBIf there is one thing I can say about my little island is that I feel by the time I die I would have heard all things and seen all things possible on a tiny little island. Something caught my attention over the weekend. The big story was rough sex and the damage it is doing to women and men in Barbados.

The rough sex story was not the kernel for me. What left me absolutely awed was the source of the story –– a gynaecologist who wanted to remain anonymous reportedly because of the nature of the story!!!

The gynaecologist was providing expert explanation in his/her speciality, so I am unsure why anonymity would have been appropriate in the circumstance. Had I been the journalist writing the story, I certainly would not have let the source make a mockery of the news in that manner.

Journalists have become facilitators for the setting up of cloaks of anonymity on the Barbadian landscape. These cloaks hinder exactly the things we loudly voice a craving for: investigative journalism, integrity and accountability in office.

There are many discussions that need to be had in Barbados. Those that pertain to politics have rightly been occupying our attention. The downside of living in a political turmoil, however, is that everybody starts to function in crisis mode. There is no discussion about other issues which need to be analysed and remedied in the society. Everything is focused on the macro issues.

This is how the stability of a society is lost. When there is crisis in the political system the development agenda of the country is suspended. The result is seen in a progressive breakdown in the systemic structure of the society. This is where Barbados is. While we continue to pussyfoot with our political situation, health care, education and family life are other areas are all being eroded.

Sexual health care and choices about sexual expression cannot begin with an article on “rough sex”. This issue begins not with the trauma suffered by body parts and noted in clinics, but with the societal taboo about talking sexuality and sexual expression –– and there is also the matter of women being “incapable of sexual desire”.

The entire society remains unrealistically uncomfortable with talking about sex, while at the same time there are claims the imagination of our people are making sexual desires and exploration explode. The result is that everybody is doing everything with everybody else, but nobody is taking the responsibility that comes with it all.

It makes sense to me that we need to become more comfortable talking about sex. And I wonder if the gynaecologist, who wanted to be shrouded in anonymity, remotely understands that he or she (I suspect it is a he) by his or her was perpetuating the societal taboo about talking sex. That gynaecologist was holding up something he or she should have been actively involved in breaking down.

Sexual responsibility cannot begin at 30, and sexual activity certainly begins long before then. Hence, when children turn 11, I believe there should be a clinic visit added to the child health schedule. This visit should be to ensure that genitals are developing normally, and to begin to sensitize preteens to sexual health care and how to access it.

The next thing that has to happen for women to be able to adequately negotiate sexual health care is the regularization of the anomaly between the age of consent and the legal age to receive medical care. That the anomaly is still present on the law books of Barbados does make us appear a moral society; it makes us appear to be a very reckless society.

Sexual responsibility comes with sexual activity. How can we then be comfortable to enable young people (and specifically girls) to engage in sex, but then deny them access to health care? Perhaps it is time to conduct a comprehensive survey on the mean age at which young Barbadians become sexually active.

Then we will be numerically persuaded that making the age of sexual responsibility and sexual activity the same will not encourage more young people to become sexually active as much as it would encourage them to become sexually responsible in their sexual activity. Young women need to be empowered to get pap smears, treatment for STDs and have access to birth spacing and planning mechanisms.

When Barbadian women are ready to become mothers, they have to make a choice between public and private maternal care. I wish to state unequivocally, as a woman who has experienced both, that public maternal care in this island is far better than and superior to private care. In this case, money has no bearing on receiving the better care.

Let me add this disclaimer, though. I have never experienced the public maternity ward and I have heard both stories of horror and high commendations about the ward. I chose to have my first three children cared for by privateobstetricians/gynaecologists. By the last one I was absolutely frustrated and disillusioned with the long waits and inadequate visits in the private maternal care sector. I chose public maternal care for my last pumpkin, and I was more than pleasantly surprised.

The first thing that struck me was the thoroughness of the “booking”. I had a head-to-toe examination that included questions about my diet and general health, a scalp test (yup), mandatory blood work and lab tests, including HIV. The HIV testing in the private sector was optional, but I agree with mandatory testing for all pregnant mothers.

I was heartened by the maternal care space in the public sector. Women were caring for women. No male doctor/female patient boundaries and barriers to negotiate. No power struggles about whose body, whose desires to follow or whether I was asking too many questions or not.

The midwives in the public system are good at what they do. Very good! They are one of the hidden treasures in Barbados –– their system of care one of the few things that work effectively. Midwives are an underutilized unit that need to be given far more autonomy in the provision of health care for females.

There is absolutely no reason why midwives can attend to normal pregnancies in the clinic up to 36 weeks, but cannot continue to attend to those women from 36 weeks to postnatal care (with minimal involvement of consultants as necessary).  The bottlenecks and long waits in the antenatal clinic at the hospital can be avoided.

There is so much to say about sexual health care and access to sexual health care by females in this island! However, there are six posts of obstetrician/gynaecologist (at the Queen Elizabeth Hospital) in the public health care system. Only five of these posts are filled, and by all men. That takes away the choice of attending from Barbadian women, not only in maternal health (at the QEH), but any other service under the band of female medicine in the public sector. In 2015???!!!

Until there are more liberated, aware women incorporated in setting the agenda for female medicine in Barbados, much of what needs to be said about the issues will not be. I was bitterly disappointed in, but not surprised by the gynaecologist who could not talk about rough sex under his or her name and title. I was also bitterly disappointed with the sensational manner in which such a serious subject was broached.

Women in Barbados do lack the knowledge, and in some cases the power, to negotiate sex safely. There are several issues which need to be discussed, and sensationalism has no part.

Why would there be only male consultants in public health care? What does it mean when a trained specialist can only talk speciality anonymously? When will the women of Barbados fight for their issues to be brought to the forefront?

If gynaecologists are seemingly squirmish about talking sex, is it any surprise young women find it difficult to negotiate with partners about sexual health and safe expression? Pfffttt . . . !

(Marsha Hinds-Layne is a full-time mummy and a part-time lecturer in communications at the University of the West Indies. Email:

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