Monday, March 22, 2010

Fiction: "Sandy's Clinic - Part 1"

It was terribly hot and Sandy tried to sleep. She could hear the whispering in the room next door. Two of her kids were asleep, the third was with Joe - tending to the beans and feeding the guinea pigs. At least it was shady out there - in here it was as hot as a sauna.

The whispering became more energetic and Sandy had an uneasy feeling that the whispers were intended not just to avoid disturbing her and the two little ones, but to conceal something afoot.

The nurses had been acting strangely lately, looking away when she walked up, talking evasively. Naively she continued to trust them, believing that they shared the same passions that she did, and were equally selfless in their intentions.

Sandy believed passionately in natural childbirth and the importance of having support for new mothers. Her work with disturbed children had convinced her that adequate support in those first early years were critical for a healthy start. For the past two years she had poured all of her energies into developing a small clinic, where women could access important pre-natal and post-natal services. In this country town such services did not exist - the closest being many hours away in the larger metropolitan city. Perhaps foolishly she had also poured in a substantial inheritance from her aunt. There were no guarantees that it would be returned - unwisely perhaps, she trusted that she would continue to influence the clinic’s direction, and her entrusted funds would eventually be returned.

Having the three children at the same time and being so heavily involved in the clinic was not easy. But being a community centre, children were welcome and easily accommodated. Most of the other volunteers worked for one or two days a week, complaining that they needed time to cook, clean and look after the house. Sandy somehow managed to fit it all in - although her house was never spotless, it was still tidy and relatively clean. From early morning till she dropped into bed at night, she organised the family meals, supervised the clinic, championed the cause politically and kept the kids occupied with activities.

Joe had initially been very supportive. But he was easily influenced. He worked in the city, and most days had coffee in the same café with the doctor’s association. Joe listened - initially protesting against their continual complaints. Soon he became silent, confused. Recognising an opportunity, the doctor’s began shouting Joe coffee, gave him tickets to the soccer and turned his head by praising him in public. He found it harder to actively defend Sandy against their angry tirades. He began to be more confused as to what she was really trying to do.

In reality the city doctor’s association were convinced that Sandy was depriving them of their social importance. The clinic‘s nurses were solving problems that previously had been dealt with by doctors alone. The number of patients making the long journey into the nearby country town had dropped, and this was affecting the doctor’s income. For the first time, local nurses were questioning the automatic requirement for all pregnant women to travel hundreds of miles to the closest city hospital, the high rate of ceasarian births at the convenience of the doctor and the lack of pre and post-natal assistance.

The provision of exercise classes and support groups at Sandy‘s clinic, along with midwifery classes and better dietary advice had increased the number of natural births. The post-natal support at the clinic also ensured that parents were given adequate support in the difficult days immediately after birth - there was less stress in these young families and consequently less illness.

The town’s doctors though were full of self-importance. They were used to being consulted, revered and never questioned - on community issues as well as politics. Elected as leaders of most of the local associations they did not realise how arrogant they had become. They certainly did not appreciate a nurse with limited education challenging their right to dictate the kind of birth their patients should have.

Sandy was unhappy that so many women - healthy and with no apparent complications - had been sent far away to the city hospital. They were absent for weeks sometimes, their other children struggled without them and the fathers had no choice but to leave them in the care of older children at times in order not to lose their jobs. It was also an unnecessarily expensive way to give birth.

Sandy had never been someone to sit on the sidelines. Her parents always told her that she was reckless. Her parents had ’normal’ jobs, jobs that did not follow them home - with all the associated stress of a community project. Her parents had never championed a cause and had little understanding of the commitment that it demanded. “Leave this type of work to someone else” they would tell her. But Sandy did not know any one else who was prepared for this type of work. It needed someone who was passionate, an entrepreneur, willing to sacrifice a lot of time and effort - and maybe a little crazy as well.

One of the children stirred and she quickly went to him and tied him into the baby pouch. She felt the afternoon breeze finally stirring and opened the window, gently moving the lace shading her son’s cot. He sighed and she paused, watching him for a few more moments.

The crowd outside was growing. Sandy had no idea what was going on. She pushed through, excusing herself as she went. Outside the clinic - a small rented brick building, gaily decorated with signs and pretty flowers, was one of the city doctors, addressing the crowd of neighbours, media and some locals gathered in front of him. He was standing on the low wall at the entrance eyeing and working on all members of the crowd.

"I’m not a gynocologist” he was saying, “but I can assure you that this clinic is not safe. It should not be run by nurses - they do not have the training, they are risking the lives of the mothers and risking the lives of the children who come in here….”he said, raising his voice and jabbing the air each time he mentioned ‘risk’.

Sandy felt panic rising in her throat. She ran back to the house and found the clinic’s committee members - who had been whispering outside of her room - looking dejected and slightly guilty. Her son was now awake, rubbing his eyes as he held on to her skirt.

“Do you know about this?” demanded Sandy of the nurses.

There was an uneasy silence. The committee looked from one to the other - Susie tried to explain, but fell silent again. There was the sound of cheering outside.
“It’s hopeless..” volunteered Jane. “You can’t win - haven’t you seen the papers today?”

She held out the newspaper from this morning. In bold print across the top of the page was sprawled - “Clinic a health risk”, citing quotes from the Doctor’s association.

“Why are they doing this?!” exclaimed Sandy looking from one to the other. “You know the clinic is not a threat. You know that this clinic will make life so much easier for the women here….” her voice trailed as she realised that they were shuffling their feet. Something else was going on here.
Joe came in through the back .

“What’s going on next door? When did those doctors arrive in town? They’ve decided to support you at last have they? As if…” he smiled sardonically.

There was a knock at the door, and the Chairman of the clinic - a small, squinty man who smiled a little too much, a little too falsely, appeared behind the screen. His open-necked shirt was crisp despite the humidity.

“Pardon me” he said - without really seeking permission, With a confident air he pushed open the door and came inside.

He cleared his throat. Outside thunder began to rumble, and drops began falling on the dispersing crowd.

“We - that is the new committee of the clinic - have decided that the clinic should be overseen by our notable doctors who will work in a full and professional manner for the benefit of the mothers in this town.” He paused, drew a deep breath as the sunlight faded and the room dimmed in the growing storm, raised his voice over the thunder and announced “Your services will no longer be needed. You have been outvoted. The previous committee met last night, and after much discussion, they resigned. A new committee of doctors has now been voted in. These good nurses will now be employed by the Doctor’s Association at appropriate salaries.“

He paused, smiled and nodded briefly towards the nurses huddled in the living room. “We have now taken possession of the building”.

Sandy was aghast. She now understood that the volunteer nurses had been offered good wages - something hard to turn down. They did not realise that the clinic as it was would no longer exist, that the services she had struggled to provide would most certainly be scrapped, and the clinic itself would become a small medical referral centre - with no input from the patients, and serving the doctor’s rather than the local women. Almost certainly there would be a few poorly trained overseas doctors brought in to run minimal services.

She sank heavily on the back steps. Rain was running under the verandah, and pouring from the gutters. Through her mind ran the thought that it would be much easier to simply accept the inevitable and give up. There seemed little opportunity to fight such a co-ordinated attack. If she walked away now, she could spend more time playing with the kids, cooking their favourite foods and the house could finally be spotlessly clean. She could rest and have more time to read, grow herbs and definitely her stress levels would drop.

It now seemed unlikely that she would ever recover her the inheritance from her aunt. It had been entrusted at a time of goodwill as an unsecured loan, when the clinic was still a great ideal, and such funds could not be found elsewhere. Her family would never understand that the clinic would never have begun without it, that it was necessary and was loaned in a genuine spirit of generosity. How naïve she had been!

Alternatively, she could fight for her clinic - mobilise the women to reject the doctor’s takeover, and publicise some of the clinic’s success stories through more supportive media. Maybe with the help of a lawyer she might be able to fight it. Only last week a benefactor had offered to raise money for the centre - perhaps she could make a counter offer to the nurses. There were certainly plenty of other volunteers keen to assist the centre, and its loss would be keenly felt by the women and their families. She was torn in two - what should she do?

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