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Discussion on women who had their uteri removed without consultation
Federation of African Media Women - Zimbabwe (FAMWZ)
November 21, 2002

Chairperson: Janah Ncube
In Attendance: Dadirayi Chigoya, Tendai Mandisodza

Chairperson, Janah Ncube, started by introducing herself asked the participants to read through the story in the Daily News. She gave the floor to Foster Dongozi, the journalist who wrote the story. He explained that his report did not highlight all the cases that he had come across. He said that he had left out some of the cases because he felt that the Access to Information and Privacy Act could be used against him for writing such a story.

He said he had left out the case of a woman who, after delivering four children, had gone to have her fallopian tubes tied. After the operation, she could not control her bladder. Foster said he asked to see her card and that is when he realised that the doctor had proceeded with a hysterectomy but the woman did not know about it.

One participant said that the practice of removing women’s uteri was not new as she knew someone who had hers removed in the late 70s without her consent. She also said that she had heard that the uteri are used to make cosmetics.

Another participant wanted to know why the Cuban ambassador was not invited to the discussion so that he could answer some of the questions. Abigail Gamanya explained that it was evident from the story in the Daily News that the Cuban embassy was not going to comment on the issue. She said that was why FAMWZ had asked the Minister of Health and Child Welfare to come as a representative of the government that invited the doctors.

Foster said he was not surprised that the Minister had not come because the same Minister was elusive when Foster tried to get a comment from him while he was still working on the story.

Professor Norman Nyazema was then given the floor. Nyazema said the Patients Charter says there should be communication between the doctor and the patient. He said he was going to be the devil’s advocate and say the Cuban doctors probably communicated that they were going to remove the uteri but the interpreter failed to pass on the correct message. He said that for example, if you say you have a backache, the meaning in vernacular is not the same as in English.

He also said it was important to look at the role that culture plays in communication. He said that when people go to a traditional healer, the patient is not consulted. Instead the traditional healer tells the patient what is wrong with them. This, he said does not work with a modern doctor because the doctor would not be able to tell what is wrong without a proper explanation from the patient. He said that people seem to be afraid that the doctor will say if you know everything, then you must treat yourself. He said that it was important that the patient explains what is wrong and the doctor explains what she is going to do about it so that they meet halfway.

Nyazema said the Patients Charter also talks about competence. He said the Cuban doctors are competent in terms of knowledge of what their job is as doctors. However, he said competence should also be viewed in terms of communication i.e Cuban doctors, who speak Spanish, trying to communicate with a woman who understands Ndebele through an interpreter who speaks English and Ndebele.

Nyazema also talked about the Right to privacy viz a vis the health situation in Zimbabwe which he likened to a factory. He said under such circumstances, the patient ends up withholding or giving the wrong information because everybody else can hear the conversation between the doctor and the patient.

After Nyazema concluded his presentation, the floor was opened for questions and comments.

One participant asked how competent the Cuban doctors were, considering that after four years training, they become specialists compared to the local doctors who spend at least seven years training to be General Practitioners. Nyazema explained that the Cubans were very competent because of that sort of training. He added that Zimbabwe was considering adopting the Cuban way of training.

Another participant pointed out that when we talk about rights, it should not be in the context of the individual but in the context of society. He said the chair should not talk about "my right", but rather about "our rights". He also said he wanted to correct Prof Nyazema’s conception that traditional healers did not ask their patients what was wrong. He also said that there were alternative traditional ways of contraception, like jumping off a certain tree towards the west if one did not want to conceive and then jumping off the same tree going eastwards to reverse the effect.

A participant wanted to know where journalists could get hold of the Patients Charter so that it could be publicised and whether it was a new document. Professor Nyazema said that the former deputy minister of Health and Child Welfare, Ms Hungwe launched the Patients Charter at the Trade Fair five years ago. He said it was available at the Ministry of Health offices as well as at the Consumer Council of Zimbabwe.

One lady wanted to find out from Prof Nyazema how and what women who go the hospital to deliver a child should explain to the health care provider if all they want is to deliver the infant.

Another lady pointed out that she has visited sick relatives in hospital and she had observed that the patients had not gotten any explanation from the doctors regarding what was wrong with them.

One participant said that sometimes it is the attitude of the medical practitioners that makes patients afraid to ask for clarification. She said doctors get nasty if they catch you going through your medical file.

Lydia Zigomo-Nyatsanza of ZWLA said that the case of the women in Matabeleland was just the tip of an iceberg. She went on to say that there had just been a case of a child who was admitted for surgery to correct a sinus problem. The operation was supposed to last fifteen minutes. Complications occurred and 11/2 hours later, the child had been brain damaged.

She said that the women who had their uteri removed without consultation had a strong case. She said if a man and a woman went into a union with the intention of having children, then the doctor removes the uterus of the woman without her consenting, then the doctor has wronged not only the woman, but the man too.

She also said that in the Matabelaland case, there would be three respondents: the government because it invited the doctors, the hospitals that employed the doctors and the doctors themselves.

Lydia said it was important that at least three of the women must be found, taken for medical examination to confirm that indeed they no longer had their uteri and then the class action can start.

Foster said that another NGO in the legal field in Bulawayo had said they would be willing to assist.

Lydia pointed out that for the case to have strength, there was need for evidence, i.e medical reports that prove that the women indeed did not have their uteri anymore. She said it was therefore necessary to take the women for medical examinations. Lydia said her organisation has a budget for such activities.

One participant asked how the medical examination reports could be relied on if it was clear that doctors tend to protect each other. Lydia said that there were some doctors who were for the cause of women and had worked with organisations such as Musasa Project whose services could be enlisted.

Another participant wanted to know if anything could be done to change, not only the attitude of the doctors, but the nurses too. She said that nurses had no right to hold the country at ransom like they were doing. Professor Nyazema said the women could ask to sit on the board that decides on the curriculum so that they could influence it.

The chairperson then asked the FAMWZ Director to give the final remarks. Abigail said she was concerned that the value placed on women’s issues was still much lower than that placed on men’s. She said if it had been men in such large numbers who had lost their manhood, we would not have been sitting and talking about the issue because those doctors would not have been allowed to continue. Abigail thanked all who came for the discussion.

RESOLUTIONS
FAMWZ to collect the addresses of the women who had been affected.

Women’s organisations, ZWLA, WAG, Musasa Project, BLRC and FAMWZ to get in touch with the women in Matabeleland to institute a class action against the government, the hospital where the hysterectomies were carried out and the individual doctors

Media practitioners to get hold of the Patients Charter, simplify the language and then publicise it for the benefit of everybody else

Women’s movement to ask to have their representative sit on the board that decides the curriculum for the training of doctors in order to contribute towards the need for public relations training.

Visit the FAMWZ fact sheet

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