Gynecologists in Egypt: No singles allowed

Puberty is a period characterized by myriad questions and issues for girls, with its assortment of symptoms and hormonal changes, making it a natural course of action to seek guidance from a gynecologist. In Egypt, though, this simple doctor’s visit is forbidden. An OB/GYN clinic remains the realm of married women alone. A girl or young woman may suffer from chronic pain on a daily basis, but the hegemony of customs and traditions will prevent her from saying it. Asmaa Gaber, 30, tells Raseef22, “motherhood was the price I paid for heeding my fear of society, and my compliance to my family’s intolerance towards any issue that had to do with ‘honor’. I was 13 when I got my period; it came for the first two months, then stopped for the following six, before continuing again irregularly. I often felt bloated and dizzy, and at times I would have headaches.” She adds, “I would live in continuous fear for days. I squeezed my brain for any memories of inadvertent wrongdoings that may have caused my period to stop. I doubted myself, fearing everything, to the point that I arrived at the idea that I may have been assaulted while I was asleep or drugged. A million thoughts and fears passed through my head, and I never expressed them to anyone.” After three years of a continuously irregular period, Asmaa finally decided to tell her mother about her symptoms. “I began to think it was due to a bodily deficiency or to some disease, so I decided to speak to my mother. At that point, she said that there was no need to visit a doctor and stir up scandal among our acquaintances. From that point on, my psychological well-being suffered immensely, and I stopped caring about what happened to me, until a friend of mine who was a nursing student convinced me to visit a doctor,” Asmaa says. She then told her mother, who admonished her for telling her friend, and forced her to call her to make sure she would not tell anybody else. A few days later, her mother took her to see her aunt, an older woman known for her experience in such affairs. Her aunt proceeded to tell her that her symptoms were normal, advising her to drink hot liquids during her period. Asmaa continued on this prescription, which slightly alleviated the pain, but it nonetheless continued until she was married. “Shortly after I got married, my husband decided that we should visit a doctor due to delayed pregnancy. There i learned that the irregularity of my period was the reason I was not getting pregnant. I went through many treatments, but never once got pregnant during my entire marriage, which has now lasted more than nine years,” Asmaa continues. Oftentimes, girls or young women prefer silence over the trial they would undergo at the hands of their families or society, if they choose to reveal their symptoms. In many cases, they may suffer from minor, easily-treatable issues, but negligence often exacerbates the problem. According to physician Nahed Gomaa, who specializes in obstetrics and gynecology, customs and traditions often deprive girls from seeking treatment. While some mothers have become more attentive to such issues and the necessity of seeking medical help in these cases, they nonetheless ensure that appointments are booked under their own names, rather than that of the ailing daughter. “I have long tried to convince mothers that there is no shame attached to girls visiting a specialist due to late periods or infections, or any other symptoms, but I was met with intolerance, and always with the response that, over here, it is shameful for a girl to visit an OB/GYN before marriage,” Gomaa says. She further notes that many collegiate women often come to her clinic under a pseudonym, fearing for their reputation and ‘honor’. If that fear were not enough, the gazes of other patients in the clinic at an unmarried young woman awaiting her turn between them is enough to make any girl hesitate a thousand times before taking such a step.

‘Their Delusions of Honor Killed Her’

Countless girls have paid the price for compliance with customs and traditions, though each with their own set of calculations. Intissar El-Saeed, head of the Cairo Center for Development, recalls one such case: “A father recently killed his daughter out of suspicion that her bloated stomach was caused by an extramarital pregnancy. After the autopsy, it was revealed that the girl suffered from a blood clot on her uterus due to a late period, along with a number of other health issues. This girl paid the ultimate price because of regressive ideas.” El-Saeed further notes that Egyptian society is in constant need of awareness-building, as well changing their perceptions about women, to see them as agents rather than subjects. Often, mothers resort to pushing their daughters into resorting to bad practices instead of encouraging them to seek medical help, such as sitting in a bowl of water and disinfectant to ‘treat’ infections or pains in the bowels and uterus. This could eventually cause girls and young women to develop tumors, as it kills the naturally-occurring bacteria inside the vagina. Another issue that is commonly taken lightly is excessive discharge, whereby it is often treated as a regular healthy symptom, without heeding any changes in color or smell, which could indicate the existence of an infection. Additionally, symptoms such as chronic headaches, excessive hair loss, knee pains, irritable bowel syndrome, and the appearance of hair around the nipples and stomach (at times a symptom of polycystic ovary syndrome) are often treated as run-of-the-mill common occurrences. Heba, 20, experienced one such symptom, and chose to endure her pain in silence, rather than face the violence of her father’s and brothers’ reaction. “Two years ago, I noticed an unusual excess of discharge, which had a bad smell. I also occasionally suffered from intense lower-back pains for whole days at a time, repetitively, even long times after my period was over. I could no longer wear certain clothes, such as trousers, and my skin was constantly affected by this discharge,” she says. Heba could not tell her family members, as they would not have allowed her to visit a doctor. Even if her mother had agreed to accompany her, without telling her father and brothers, Heba feared that the doctor might say something that would call into question her previous actions and arouse her mother’s suspicion. This might lead to her family preventing her from going to college. “I could not go alone, as we live in a small town and I could have run into one of our relatives or acquaintances at the doctor’s clinic, which would cause them to speak ill of me. And if such talk reached my father and brothers, slitting my throat would not be a sufficient punishment,” she continues. Heba concludes that, “there’s just one thought that continually preoccupies me: what if I have a uterine tumor and I just don’t know it yet?”