Transkei woman

There is a huge backlog of unprocessed legal cases here in South Africa. This country is not alone in having that problem; in India it can take fifteen years for a criminal case to make it to court, even something serious like rape or murder.

The ANC led government have recently proposed that one solution to this logjam is to devolve more of these pending cases to the ‘chief’ system (see ‘When you come out of the storm’). This will mean that there will be no legal representation and the traditional male dominated culture will rule. Women’s groups are vociferous in attacking this proposed devolution of yet more power to a local and highly chauvinist authority. They have reasons for their concern.

Women are still largely second class citizens in much of Africa; in rural areas of the Eastern Cape their status is variable but there are many examples of them being treated almost like property.

One in three South African women is said to have been a victim of rape. Some of the cases that occur locally come to Zithulele and there is a set protocol for doctors who have to manage rape cases. Violence is not something that anyone likes dealing with and documenting it in a consultation is traumatic for patient and doctor alike, but the handful of cases that are seen each month are quite likely only the tip of the iceberg.

The hospital notes are sometimes graphic and disturbing. The cheerful young woman sitting in the clinic in front of you doesn’t appear to be psychologically damaged by the previous occurrences described therein which recount that she had a sack placed over her head and was repeatedly sexually assaulted by who knows how many young men. It surely cannot be the case that it is so much the norm that it traumatises less. Tragically perhaps it is that she has so many female friends who can empathise and with whom she can share this horrific experience.

In times past rape was a way to stake one’s claim to a female, as the loss of her virginity made her ‘damaged goods’ and unacceptable to all but her assailant. Here still, in the 21st century, in the Eastern Cape, it can happen that should a young male decide that a particular female is to be his and he gets her to his house and rapes her then a negotiation ensues, adjudicated by the local headman, in which she stays with her new conqueror in exchange for a suitable sum of money paid to her father.

The lack of female empowerment can be shocking. A 16 year old girl was brought into the hospital with a miscarriage. On probing the background and apparent lack of family involvement it turned out that she has a 47 year old ‘husband’ to whom she was sold by her family in exchange for six sheep.

Abduction of girls against their will is a well-recognised phenomenon here. They commonly come from very poor families. If, as sometimes happens, the girl absconds and goes to the police she may not receive the warmest of welcomes when she returns to her family since the sheep have to be returned too.

Perhaps the need to grow up very quickly is the reason that women in the Transkei seem to transform from schoolgirls into mature women in a remarkably short space of time.

When they do get married and go to live in the house of their husband’s family they may become the resident slave, certainly to their mother in law. The giggling girl in coloured school uniform becomes the serious-looking, patient, solid motherly presence dutifully fulfilling her role in her adopted home. Despite the seriousness however these delightful people are on an absolute hair trigger for fun, and peals of laughter accompany most conversations.

Solid is a word that describes Transkei women well. Wherever you are they can be seen clad in their multiple layers of rainbow hued clothing surmounted by the inevitable heavy patterned blanket round their shoulders and each with their own unique knotted turban headscarf. They walk slowly and deliberately, through fair weather or foul, as though made of something denser than normal flesh.

If you are following one of them down a corridor in the hospital you notice more acutely the slow ambling pace and the large amount of physical space they can occupy despite not being of great stature. However much of a hurry you are in it is no use trying to overtake; you may as well slow down to their speed. There are aeons of experience and history in that steady purposeful walk.

The stature and measured pace conceals a remarkable toughness. They are the workhorses of society. One colleague said she would love to see what would happen here if one day all the women went on strike. Everything would grind to a halt.

Like many African women they carry items beautifully balanced on their heads. It is common to see women toting bags of provisions the size of cement sacks in this way (which, incidentally, obviates the need for an umbrella). Faggots of firewood can be seen perched on their heads making them look from a distance like a weird sort of see saw. (The term ‘Faggots’ suggests some small bundle of kindling or twigs but these are big – see photo – some weighing up to 40kg). Realistically it probably is the only way to carry something of this size without a cart.

Within their numbers are some remarkable survivors. In the outpatient clinic recently a stretcher was wheeled into my room on which lay a feisty little sparrow-like and very alert great grandmother, pushed and accompanied by three family members all clearly concerned about her. She had slipped and fallen and had a pain in her knee. It is a long time since I did orthopaedics but the story of pain in the knee sometimes being ‘referred’ pain from a hip sprang to mind and the classic look of the left leg which was apparently shorter than the right and with the foot pointing outwards (‘shortened and externally rotated’) was an easy spot diagnosis of a fractured neck of femur. Sometimes you don’t need an X-ray – which is lucky as we still don’t have them.

I looked at her notes and past record: date of birth – 1922, previous medical attendances – nil. I questioned this as sometimes the actual birthday is very different from that on the hospital records. She produced her own identity cards going back some years, all of which confirmed the date. She was probably also born at home and may have given birth there too so this might be her first ever admission to hospital in 90 years, despite living in a seriously harsh environment through some very fraught political and economic times. Someone should sequence her DNA; she clearly has all the genes you need for survival against ferocious odds.

In 1922 in South Africa, the year she was born, the Rand revolt reached its climax. White miners were striking against the promotion by the mining companies of cheaper paid black workers into traditionally white jobs to offset the fall in the world price of gold. The strike became a national rebellion supported by the Communist Party under the banner “Workers of the world, unite and fight for a white South Africa!” It was crushed by the premier Jan Smuts so violently that he lost the next election. As a consequence white trade unions were recognised and the colour bar reinforced. The mines are still such a major focus of unrest and influence on national politics and there are some curious parallels between then and now.

Sadly this lady’s future is very unpromising. All fractures requiring surgery under general anaesthetic have to be referred to the local orthopaedic centre, Bedford Hospital in Mthatha. They are serial offenders at sending people back without being seen and they are in trouble themselves as their own X-ray equipment has been out of action recently. This lady would probably survive a hip operation as successfully as someone half her age. However she will have to sit at Zithulele in traction until she can be transferred. This can take months. In the current crisis and with the resulting backlog of cases, it will be hard to persuade surgeons there that someone of 90 should be prioritised.

This tough old bird has probably flown for the last time

2012-11-21 12.41.352012-11-21 12.43.13

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