When I look around my workplace and find a sea of male faces I ask myself, where are these women? What happened to them? ? Did they drop out or were they pushed out?
In most medical schools in Nigeria, there is a common saying, that girls make the better students and boys the better doctors. As sexist as this statement seems, it is the reality for most. The cultural landscape of the country often limits women from reaching the peak of their careers. The average Nigerian woman, albeit educated, is expected to prepare for family and place the needs of the family ahead of hers. This extra pressure to be the main carer in the family, to cater to her husband and children impacts her opportunity to pursue her career and hone her skills. Although, some women manage to balance this cultural pressure with their educational and career goals it is an obstacle for many.
According to a study published in the Journal of the West African College of Surgeons in 2017 (AA Abolarinwa and RI, 2017), more women gravitate towards lifestyle friendly surgical subspecialties like plastics and paediatrics surgery, over specialties like Neurosurgery due to a lack of family support structures. For women who give birth during the course of their residency program, there is usually the problem of extending their training and strained relationships with their trainers as they balance family pressures with their work in what is still a male dominated field. Even discussing these issues can create backlash, just writing this could put a strain on my training in Nigeria…
In a sector that is supposed to cater to the physical, social and mental needs of patients, the Nigerian health sector falls short at attending to these needs with its female professionals. Most health care facilities do not provide child friendly options to help in the navigation of motherhood. Although, in theory there is a period allocated for maternity leave, most facilities do not follow through effectively or help support new mothers balance child rearing and work. Exclusive breastfeeding which is taught to all is difficult for most women in the health sector. There is not enough time to breastfeed a child on demand or up to eight times daily when on the job. This is due to the high demand placed on them, especially women in the residency programs to deliver without regard for their physical, reproductive and mental health.
There is also the tradition of referring to a married female doctor as Dr. Mrs rather than the generic Dr. title that is given to their male colleagues, as well as the confusion on whether to keep their maiden names or not. You see, in Nigeria, married women are generally accorded more respect than unmarried ones. Doctors and patients are guilty of this. This tradition does not recognize skill or expertise, rather, the presence or absence of a wedding ring.
This gender imbalance also takes the form of microaggressions like female doctors being referred to as nurses, even when they are dressed in their ward coats and scrubs. I remember a colleague from another school complaining that while she stood with her male counterparts during rounds, a male patient referred to her as ‘Aunty Nurse’. This is a common occurrence with female doctors. It is almost as if the job of a doctor is for a man, while that of a nurse is for a woman, it is not uncommon for a male nurse to be chosen over a female doctor.
From the groping by patients to suggestive statements from their male colleagues and superiors. Sexual harassment is another ongoing issue for female Nigerian doctors, making a hard job even harder. A a female doctor friend of mine had a male patient say they’ll only allow a female doctor to examine him if she allows him to do the same. This type of harassment is common and female doctors are often forced to take it in their stride and treat it as a hazard of being a woman on the job as there is no effective structure to tackle this issue. With almost no help from HR or superiors victim blaming is rife when female doctors do come forward to report harassment. Being asked questions like ‘what did you wear?’ and ‘don’t mind him, you know how men are’ leading to superiors and colleagues sweeping complaints under the proverbial rug and deterring others from coming forward.
I believe that women in the Nigerian health sector are as skilled and capable as their male counterparts, But the cultural landscape of the country greatly affects them. They lack a support system and structure to allow them to follow their dreams and blossom in their chosen field. There are more women in medical school than there are in practice. So when I look around my workplace and find a sea of male faces I ask myself, where are these women? What happened to them? Did they venture into less demanding professions despite the number of years put into their training? Did they drop out or were they pushed out? It is a sobering reality.
Unfortunately, there seems to be no solution in sight. Women have to keep adjusting and fighting these issues till they find a place for themselves. This is because if a Nigerian woman says she is not willing to get married, there would be talks of her getting lonely and living with cats. They would say she is arrogant, stubborn and cannot keep a man. Some would label her a failure, and all these societal pressures and cultural expectations have an impact on her mental health, on her work, on her choices.
Laws have to be put in place and enforced concerning women in health care. Laws that protect them from harassment and provide a good support system for them in the workplace. Cultural reorientation and revision is important. Men, particularly husbands, have a role to play in easing these burdens on women.
Women are humans and have desires, aspirations and feelings. If a man can venture into Neurosurgery, then a woman should be able to. Support systems like childcare, clear anti-harassment rules, or husbands helping around the house more would greatly reduce the burden on women. Because women can have it all, afterall men do.
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