“How far along are you in this pregnancy? How many kids do you have?”
“Fourth month...three babies.”
“Do you speak English?”
“What language do you speak?”
“Does your belly hurt?”
Fadhuma shook her head. She looked like she was about twenty-four or twenty-five years old, with dark skin, a glowing face, and sparkling eyes. She had applied her eyeliner with utmost care, almost like an artwork, without any smudges or overflows, eyelashes nicely groomed with mascara and her eyebrows shaped like an arch.
A Hijab covered her head, with no glimpse of even a single strand of hair. Even in this touch screen age, she carried an old-fashioned flip phone with its slim ear-piece tucked into her Hijab. Her lips were lightly painted. The colour of her lips and the mascara paled against the brightness of the eyeliner and the Hijab, which had an odd brownish purple colour.
The mobile phone’s speaker was on and her husband Hassan was at the other end of the line. He interpreted my questions in English into Sanghaali language for her.
I asked her, “Fadhuma, what brings you to the hospital?”
“I’ve been vomiting all day and my belly hurts.”
“Are you hurting right now?”
She shook her head.
“Not this belly, but this one,” she showed her protruding abdomen.
“I have to examine you to find out what’s wrong.”
“No, not possible. I want a lady doctor. Interpreter, interpreter,” she screamed with impatience. The operator had paged the hospital’s Sanghaali interpreter as soon as Fadhuma arrived but she hadn’t arrived yet.
“Fadhuma, there are no female...sorry, lady doctors here today. I am the only doctor here who can examine you. I’ll not look down there. I’ll check if the baby is alright. If I sense that there is a problem, we can get Dr Radhika. Were your first three deliveries normal or did you have caesarean sections?”
Fadhuma did not respond to my question right away.
The husband and wife conversed in Sanghaali for five minutes. I continued with my examination. It was a full-term pregnancy. On her lower abdomen there were horizontal surgical scars. I suspected that her previous deliveries were all done by C-sections.
I held the probe soaked in gooey gel against her abdomen and looked at the baby on the ultrasound monitor. The baby was breech – its head was up. Fadhuma’s contractions were very unsettling for the baby. I figured that the chances of a normal delivery were slim.
Fadhuma had not replied to my question yet. She was still talking to her husband.
I asked again, emphasising each word, “the...first three... deliveries...were by...cesarean section...right?”
She spoke with her husband again for a few minutes. I didn’t understand any part of their conversation.
“No,” Fadhuma’s husband spoke cautiously over the mobile. “What?” I asked, a little surprised at the delayed response. “The first three children were delivered normally. No surgeries.”
Fadhuma made a futile attempt to conceal the scars on her lower abdomen.
“This one?” I pointed at the scar.
Fadhuma was embarrassed. Her husband intervened quickly, “That...that...there was a growth in her tummy and that mark is from when they took out the growth.”
I decided not to say any more. I called Radhika, the hospital’s Obstetrician, on her mobile and gave her a quick summary of what had transpired so far.
“Let me guess, the husband and wife are refusing cesarean section, right?”
“I briefly raised the possibility of a C-section. I didn’t say it was one hundred per cent necessary. I think the baby is breech. I also think that her previous deliveries were all by cesarean sections. But both the husband and the wife deny this. They insist that the children were delivered normally. Fadhuma”s husband is not here in the hospital. She does not speak any English. He is interpreting everything over a speaker-phone. I am waiting for the hospital”s interpreter. She should be here anytime. Fadhuma is demanding a female doctor. She says that if we cannot provide that service, she will leave against medical advice.”
“Welcome to my world. This is what I have to deal with every day. This has been these people”s jig-and-dance now- a-days. No matter what, they insist that they will not get a cesarean done. Apparently, ‘cutting the belly open’ and taking the baby out is against their cultural beliefs.
There was another Sanghaali patient of mine who complained that we do unnecessary surgeries all the time, only to make money! None of them have health insurance. Neither the hospital nor I make a single penny by treating them. And if something goes wrong, I have to deal with these ‘Human Rights’ and ‘Patient Rights’ groups. They come chasing you at the drop of a hat. Guru, don’t try to be a hero. I will come and take over.” Her tone made it clear that she was getting a bit antsy.
“Hurry up, Radhika. What if Fadhuma starts to deliver here in the emergency room?”
“Don”t worry. If she delivers normally, all you have to do is watch. If she needs a cesarean section, no one can convince her to have one, not even her good Lord Allah!”
“Trust me on this, I have no idea. Just hold the fort. I will be there as soon as possible,” she hung up.
Excerpted with permission from Hijab: A Novel, Guruprasad Kaginele, translated from the Kannada by Pavan N Rao.
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