By Christelle Nathalie Ghomsi
My name is Christelle Nathalie Ghomsi. I am a young Cameroonian general practitioner, who obtained a medical degree in 2017 from a private university in my country. I am an aspiring neurosurgeon with a special interest in neuro-oncology. However, I still need to get into residency. This is an account of my struggle to pursue neurosurgery in my country.
The African family unit extends beyond the father, mother and siblings(1),(2). Aunts, uncles, cousins and grandparents have a say in the upbringing of children (1). While these family members can provide great moral support(3), it can equally be a source of frustration since these family structures can also be prohibitive for young women(4). In my tribe “Bamileke”, women are defined primarily by their ability to maintain a house and give birth. Women who are educated and financially independent are not desirable, because in our patriarchal system, women are not supposed to argue with their husbands. In addition, some women do not have a say on to whom and when they will get married because their parents arrange their marriages. To make matters worse, the payment of expensive dowries by grooms legitimizes the concept of wife ownership(5).
I can recall last year during a call at the emergency department, a woman arrived with burns on her face, inflicted by her husband. He had scolded her while pouring hot served food on her face and told her “You are my property, I bought you so shut up”. This behavior is supported by African governments who are sanctioning the notion that women have achieved as much as they possibly can and now ought to slow down. The woman who survived Female Genital Mutilation or early marriage or violence and tries to take her place in the public sphere will quickly meet a glass ceiling called “˜African culture’(6). It is therefore difficult for a woman to make personal choices in life, especially one as ambitious as pursuing surgery even neurosurgery. These are considered too demanding and not adapted for a woman.
Thus there are no surprises that in Cameroon, out of 22 neurosurgeons, only 3 are women. Despite the fact that female medical students are competing with their male counterparts in licensing exams (7), This is unfortunate and the lack of mentors and role models is a major barrier for aspiring female neurosurgeons.
In my quest to become a neurosurgeon, I faced the same barriers as any other girl of my tribe and age. When I told others about my dream most discouraged me and proposed that I should search for a less demanding specialty. I felt disheartened because around me I witnessed firsthand the pervasive effects of this culture and seen brilliant female medical students and friends choose a different specialty or ever give up residency all together. While I respect their sacrifice, I firmly believe that every woman should be able to make a choice based on her wish and not on what society demands.
Fortunately, my nuclear family has been encouraging and patient, and, I am grateful for their support. My passion for neurosurgery began in my third year of medical studies. Although I loved the brain and field of neurology as I grew up, my real interest for its surgical aspect started with a lecture given to us by a young resident neurosurgeon in 2013. This lecture was on the management of traumatic brain injury. It felt like a revelation and from that moment, my passion and motivation grew bigger and bigger. I chose a neurosurgical theme for my final thesis. Though the research was tough and arduous, the reward was worth it. During the same year I began an internship (though not obligatory) in a neurosurgical department. It took a toll on me physically and on my relationships but the passion, determination and prospect of becoming a neurosurgeon kept me going.
At the end of the academic year, I had managed to do both successfully: my thesis and internship. The next logical step was to get my mentor, the head of department, to support me in getting into a neurosurgery residency program in order to fulfill my dream. Surely he would help me with a letter of recommendation or ideas on a few residency programs. When I went to meet him, I told him what I had in mind and I waited for his answer. He looked at me and said “I don’t have a plan for you.” My ears started buzzing, my head was spinning, my heart pacing, my breath was heavy and I felt like there was a truck on my chest. I felt disoriented, lost, abandoned and betrayed. How could he? He who had supervised my thesis, he who had seen me work day in and day out in the ward. He went on and proposed that I should have a child first and practice 2 years as general practitioner before coming back.
That night was the longest in my entire life. I shed tears until I felt dehydrated, yet it did not relieve me. Somehow, things kept going downhill and I became depressed. Discouragement and deception slowly drew their way into my heart. I became disgusted by our African culture and system that wanted to draw me away from my dream.
This year, things changed. I met some special people, Ulrick Sidney and Dr Esene who coached me and gave me a newfound hope. They talked to me about other amazing women in neurosurgery and their accomplishments; Dr Claire Karekezi, Pr Julie Pilitsis… Their stories and YouTube videos(7, 8) encouraged me to keep fighting and to keep my head high. Now, I believe I can do whatever I want so long as I put in the effort.
My story highlights the role of models, mentorship and storytelling(9). We need more visibility from African women in surgery both online and offline. For example it will be great if we could have more regular videoconferences organized so as to share experiences and challenges. Equally, more female surgeons need to participate in mentorship programs like that of the Gender Equity Initiative in Global Surgery(9, 11). We need opportunities and exposure. But the most important thing that is needed to change the future for all African children is the eradication of poverty. And one of the ways to do that is through education. That is how you truly liberate a person. But education needs money, which is why education has to be free for those who are from disadvantaged backgrounds. We also need more positive role models for young women. African girls need to see a girl that looks like them making it in the world and in that way they can see that it can be done,” said Dr Lindiwe Sidali(10). This is not just about me, it is about all those women who have been told what they can and cannot do. I am determined, full of energy and wisdom to pursue my mission. I look like a surgeon and you cannot tell me otherwise.
References
1. Values of the family in African culture. | POPLINE.org [Internet]. [cited 2019 Mar 28]. Available from: https://www.popline.org/node/345620
2. The Traditional African Family – Mwizenge S. Tembo [Internet]. [cited 2019 Mar 28]. Available from: https://wp.bridgewater.edu/mtembo/articles/the-traditional-african-family/
3. The Strength of African Culture in Managing Family Crisis in a Globalized World [Internet]. Available from: https://www.omicsonline.org/open-access/the-strength-of-african-culture-in-managing-family-crisis-in-a-globalizedworld-2332-0915-1000197.pdf
4. “African Culture” is the biggest threat to the women’s rights movement – By Patience Akumu – African Arguments [Internet]. Available from: https://africanarguments.org/2015/03/09/african-culture-is-the-biggest-threat-to-the-womens-rights-movement-by-patience-akumu/
5. Marriage and family – Bamiléké [Internet]. Available from: https://www.everyculture.com/Africa-Middle-East/Bamil-k-Marriage-and-Family.html
6. “African Culture” is the biggest threat to the women’s rights movement – By Patience Akumu – African Arguments [Internet]. Available from: https://africanarguments.org/2015/03/09/african-culture-is-the-biggest-threat-to-the-womens-rights-movement-by-patience-akumu/
7. Joining the ranks of Neurosurgery: My Impossible Dream | Claire Karekezi | TEDxEuston | SuperNewsWorld.com [Internet]. Available from: https://www.supernewsworld.com/Joining-The-Ranks-Of-Neurosurgery-My-Impossible-Dream–Claire-Karekezi–TEDxEuston-7516568.html
8. So, you want to be a neurosurgeon | Julie Pilitsis, MD,PhD | TEDxAlbany – YouTube [Internet]. Available from: https://www.youtube.com/watch?v=hVhEpTDNPic&t=1s
9. Gender Equity in Global Surgery: Mentorship Model – Google Slides [Internet]. Available from: https://docs.google.com/presentation/d/1958mD6-JeEqXYdQXQCSJbdiHplat89coqb4YnbNF9R4/edit
10. Lindiwe Sidali, from cattle herder to South Africa’s first black female cardiothoracic surgeon – Face2Face Africa [Internet]. Available from: https://face2faceafrica.com/article/lindiwe-sidali-from-cattle-herder-to-south-africas-first-black-female-cardiothoracic-surgeon
11. Women in Surgery 2018 EART | Mission: Restore [Internet]. Available from: https://missionrestore.org/women-in-surgery-highlights-from-the-2018-eart/
12. Holman L, Stuart-Fox D, Hauser CE. The gender gap in science: How long until women are equally represented? Sugimoto C, editor. PLOS Biol. 2018 Apr 19;16(4):e2004956.
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