A PROFESSION WITH SHARP DOUBLE EDGED SWORD

KWABENA ABRAH
Bioethics Blog Entry
UHSA 2006

A PROFESSION WITH SHARP DOUBLE EDGED SWORD

Introduction and Comparison
An OB-GYN (Obstetric and Gynecology), a branch in medicine that used to be, to my knowledge, a lucrative specialty field for many physicians in the western world, is probably losing its attraction because of increased in liability insurance and malpractice lawsuits.
Nonetheless, on the other side of the world, especially in some of the countries in sub Saharan Africa, it is rather the opposite. Both old physicians and those fresh from medical school are craving for this special branch of medicine, because this is where the money lies.

Supposedly Job description and discussion of some African Gynecologists
In some part of Africa, not only does a childless wife or woman is always get blamed for being the cause of her infertility, but also she does not command respect and dignity in the society in which she lives. She is as well treated among her kinsmen, and husband’s family as a “worthless being”. For an idea that men as well could become impotent and sterile, is of little knowledge to some of the African societies, especially those in sub Saharan.
In order to avoid emotional harassments, humiliations and embarrassment from the above three categories of people (society, kinsmen, and husband’s relatives), the women with infertility problems in this part of the world, try on tooth and nail to have their own biological children. Finally, they have to seek medical help from gynecologists who also cross-trained in infertility. The women or the couples have no choice, but to pay huge sums of money as exorbitant charges for the treatment of infertility.
One would have thought that the job description of a gynecologist is to perform a noble task such as the one stipulated above and the likes. They are also expected to treat incomplete, threatening and spontaneous abortions. Not to ignore other disorders like prolapsed cervix and uterus, removal of fibroid tissues from uterus, fallopian tubes and ovaries (total hysterectomy). Included are palp smear, and other diagnostics, which identify illnesses or disorders that are related to or associated with female genital and reproductive organs. Another important job that is supposed to be performed by or expected from a gynecologist is assisting child delivery (labor) and caesarean sections.
Besides the supposedly job description for some African gynecologists, there is another distinctive booming business of which I have termed and abbreviated “The Black-Market Commodity” (BMC), and “Real Gold Mines” (RGM) that raises an ethical question, which puzzles the public. As a matter of fact, it is on this side of the coin where many riches are acquired within a short period of time through illegal means. The said health professionals contribute to the termination or destruction of healthy pregnancy that poses no life threat to the host. There are some doctors who offer services in hospitals that are operated by their governments, and use the instruments and equipment belonging to the public to perform this unlawful act (aiding in criminal abortion).
People do wonder if the law allows these gynecologists to destroy healthy fetuses on one hand by means of causing criminal abortion, and the other hand to help infertile women become biological mothers.
In fact, the answer to the question is a big “No”: because they are not licensed to perform any none life-threatening abortions since almost all the countries in this region have laws against criminal abortions, irrespective of who is performing it.
However, as the laws are not strictly enforced; and also the easiest way for a gynecologist or a physician to become rich overnight, many of African gynecologists and even other physicians are engaged in this unacceptable and dubious transactions. To make it worse, some women in this part of the world show no remorse to submit themselves to this practice, and so criminal abortion is rampant over there.
I can set an example of a small town where I used to work as health care personnel. Even though there is no absolute or written records, yet based upon my own observations, investigations and hypothesis, a town with a population of about 30,000; one in every five women had either once or twice, or more terminated healthy pregnancy (criminal abortion) with the help of a gynecologist or a physician.
In some parts of Africa, by mere mentioning of the word abortion, sounds like pronouncing the word murder. Abortion takes to mean an offensive term, which sends a signal of indignation to the people around: thinking that it is an operation or a kind of intervention to end a pregnancy by removing a healthy embryo or fetus from a womb. At times, the procedure is badly done and leads to the death of both mother and embryo, which is quite unfortunate. As a result, in some areas, it is a taboo to hear the name “abortion.” It is quite uncomfortable and difficulties for someone to bring the word abortion in casual conversation. Hence, when another name was coined for abortion, it became widely accepted in this small town and her surroundings. The name “APPARA”, which was coined by the writer of this article, became popular and the people in the nearby towns and villages embraced it with whole heartedly. I believe the new name is still in use in those areas, and probably it has spread to the other nearby regions. I won’t be surprise to hear that the new name has spread to the entire nation and has completely replaced the old one, criminal abortion.

Defense and view points from Gynecologists and other Doctors
On the other hand, the gynecologists and physicians arguable protect their positions of engaging in this offensive business; saying that Africans have many forms of crude and unsterilized method of getting rid of unwanted pregnancy, which most often, caused a lot of health complications even resulted in death of most of the teenage girls and young ladies. They added that sometimes adult women are not exempted from being victims.
For that reason and many, they deemed it more appropriate, and healthier to offer the women more sanitary means of treatments. Moreover, these health care providers stressed that by tending to the women’s needs, they are in a way preventing premature death among the reproductive aged women, and also adding to their freedom of choice; therefore, women will have more autonomy over their bodies.
What is more, the physician emphasized that their services to their patients are not for their selfish reasons, but they are proper medical care providing to their patients to alleviate both their physical and mental suffering as well as social and economical hardships.

Summary
There is no doubt about the work of African gynecologists and/or general practitioners as a life-saving job. However, I do not side or agree with those gynecologists and physicians, who do not only practice to destroy healthy fetus for monetary gain, but also justify their deed by convincing the public that they are saving the lives of desperate young ladies who are facing difficult life-choices. I feel the self justification and self-defense by the gynecologists to cover-up their deeds is not the proper way to show compassion pertaining to women reproductive issue. To me, there is no reason to claim to save the life of young women at the expense of innocent fetuses, and my only position is that it is only done for financial reasons. For; almost every person that I know especially the Africans, believes that a human is formed the moment conception had taken place.

Conclusion
I want to conclude with the following stand point.
The work of gynecologists as well as physicians will be that of divine blessings if only they are to save lives and to restore health, but not to aid in destroying the seed of mankind.

The authenticity of this article
The writer of this article had served in various hospitals in sub-Saharan Africa and therefore, the contents of this article are based on his experiences of twenty-two years of working as a healthcare provider.

Reference:
For any question, contact the writer.
Thanks.