A Secret Problem

In the midst of all the chaos, sometimes, good things happen.

A call from a patient made me extremely happy. I smiled throughout the day and was thankful for the umpteenth time for my profession. The ability to help people in need, altruistically, is for me, the ultimate source of happiness.

Mariah* had been referred by a colleague who happened to hear from the hospital the grapevine that I was interested in such cases. Sexual health is not something that is commonly discussed by doctors in this part of the world, yet, ironically, it is the topic most commonly heard blaring from the speakers at every marketplace in Arewa.

I met Mariah a year ago, at her insistence, alone in a consulting room after my normal clinic hours. She had a complaint she felt was peculiar to her alone; inability to have sexual intercourse. She had been married for six months but had not been able to achieve penetration due to the excruciating pain she felt. Her husband had taken her to several hospitals where she was examined and found to be physiologically fit, however, their dilemma persisted.

Her husband was getting increasingly frustrated and saying hurtful things to her. Her self esteem waned as she constantly doubted herself and was having crying spells. It did not help that she could not tell her secret to anyone. Upon further questioning, she revealed that she had been raped at the age of ten by an older cousin. She had vague memories of what happened but recollected that she had told her mother who told her never to repeat the story again.

Mariah therefore, put the episode behind her and assumed she had forgotten about it, that is, until her wedding night. All attempts by her husband proved abortive as her body refused to relax and allow him to penetrate. Her husband thought she was married to a ‘djinn’ and a marabout was called to intervene. Several beatings and prayer sessions later, the only thing that she had to show were numerous bruises and a sore body.

Vaginismus is a term which refers to involuntary contraction of the walls of the vagina prior to sexual penetration. It is a condition most commonly associated with victims of sexual assault like in this case, but can also exist in people with no significant past sexual history. It is not commonly talked about, but yet very common among young women in these parts. It is also difficult to treat as it involves psychological and clinical interventions.

My decision to delve into these muddy waters stems from the outrageous stories of women I have heard, that sometimes deprive me of sleep.

A woman I know who suffered from vaginismus, told me of how she was taken to the village barber (wanzami) who made an incision (cut) on her vagina to open her up. She was held down by four hefty women as she endured this act of barbarism. Additionally, this act of terrorism (because that’s what it is) was done seven different times! She would be cut, then it would heal (by fibrosis) and then cut again, heal again and so on. Until the husband gave up and divorced her.

It is almost as if we intend to make a mockery of ourselves in Northern Nigeria. In hospitals, we shy away from these patients, yet the thing we most excel at, that thing which we export to the southern part of the country and sometimes even outside the country is our expertise in ‘Maganin mata’ and ‘Maganin Maza’. These aphrodisiacs or concoctions that we have no inkling as to their contents are sold by both men and women who proudly display their wares and scream from their microphones during Friday prayer. Society will hail you for consuming ‘maganin mata’ but will frown at you for seeking medical help for a sexual disorder, because then you are telling your secrets to an outsider; and that is forbidden, a no-go area.

One of the key ingredients in the management of this case was couple therapy. Before then, however, I needed her to tell her husband about the rape. She was adamant at first, but I made her realise it would only help her husband understand her plight. Fortunately, he loved her enough to understand. I asked him to read up on her condition and to give her the necessary emotional and psychological support she needed. The weekly dilation procedures were accompanied by tears (on her part) and wrist sprains (on my part). Several times she would call me crying, at the point of giving up and I would counsel until my voice was hoarse. My middle name may very well be ‘Perpetual’. I perpetually love challenges!

This Lockdown has its advantages and disadvantages. Whether it’s videos of couples dancing for each other or the numerous challenges on twitterville, there is certainly no lack of entertainment.  But what I am most grateful for, is that it afforded the time for Mariah and her husband to reach the last stage of our treatment- which is actual penetration. I was so happy the morning she called crying, that she had done the deed. Yes, that deed we take for granted, is someone else’s Everest.

That day, it felt like all was right with the world again.