376

Round the World

From our CorrespondentsTranskei

UNHEALTHY DIETS

"Hooray, hooray, hooray. Mum has made it a canned fruit day."Rising earlier than usual, I heard on the radio the end of the farmingprogramme and the latest slogan of the Fruit, or maybe it was theCanning, Board, promoting its products to "the Black population".No equivocation about income groups or social classes. Blacks arestill, in the minds of many South Africans, a special group ofunsophisticated shoppers. So we have shelves full of canned fruit,canned vegetables, biscuits, and sweets. Moreover, chemical soapsand one glutinous skin application (all heavily advertised) result in astream of scratching children and skin lesions among our

outpatients.The many excellent magazines in English and Xhosa are doing

their best to combat the trend to unhealthy eating, but it is a hardjob, since the public is heavily addicted to such foods (as are the malepopulation to tobacco). One result is an outpatient departmentdominated by large numbers of grossly obese women with

dyspnoea, joint pains, hypertension, and diabetes. Children,especially the town ones, munch continuously and are heading inthe same direction. The waste in medical resources is vast, but themost disastrous effect is, as always, on the poor. A two-portion canof fruit costs between 70c and Rl, the same price as a pack ofprotein-packed beans that would last a week. And, as elsewhere,many of the poor are dispossessed of the little land they have, so thatcash-cropping entrepreneurs can grow the fruit to be canned, to bepromoted, &c.

United States

DOMESTIC BOMBERS: ATTACKS ON ABORTION AND

CONTRACEPTIVE CLINICS

AMONG the victims of terrorist bombings in this country havebeen abortion clinics and offices of the Planned Parenthoodorganisation. It is a wonder that so far the anti-abortion bombershave not killed anyone, for some of the bombs placed, or sent bymail, have been big enough to kill. There have recently been 50bombing and arson attacks on abortion and family planning clinics,and several persons are in prison for these attacks. PlannedParenthood of New York City took a full-page advertisement in theTimes denouncing such activities; and it used the term "right tolife", commenting adversely on lapel pins, in the shape of a stick ofdynamite with a slogan "have a blast", issued at a conference of anorganisation aligned with the Right to Life Committee, which seeksto appropriate this phrase to the exclusion of its use by others. Theharrassment of the clinics by supporters of the Right to LifeCommittee can hardly be denied.The Committee has reacted vigorously to the advertisement,

asking for an apology, which was not forthcoming, and for freeequal space for a reply. It is issuing legal threats. It has, however,publicly denounced the violence (for the first time, according to theknowledge of the executive director of Planned Parenthood of NewYork City). When these crimes happen it is usual for such

organisations as the Right to Life Committee to issue statementsdenying any connection and dissociating itself from the action. Butwhat the committee and its various prominent religious supporterscan hardly deny is the vituperative language used by the anti-abortionists, language so extreme that it might well be expected tolead unbalanced supporters to commit such crimes. A decrease inthe violence of the language used and in the vigour of the behaviourof some supporters at demonstrations would do more to give creditto the denunciations and lessen the risk hinted at in the headline tothe advertisement "Today the Clinics, Tomorrow the Churches".The public wants neither clinics nor churches to be burned orbombed.

In England Now

INSTEAD of falling asleep in the balmy temperature of that circularchamber wherein Mrs Wendy Savage’s obstetric practice is underscrutiny, I grew more and more fascinated as the afternoon wore on.My visit was paid on the fourth day of the official inquiry, which isbeing held in London N 1, near Old Street, and is expected to last amonth. I thought I would hear Mrs Savage defending her

professional competence with all the pioneering zeal that has cometo be associated with her. Instead, I heard Prof Jurgis Grudzinskas,Mrs Savage’s head of department at the London Hospital, render atortuous definition, in the face of relentless cross-examination, ofthe term "trial of labour".

Professor Grudzinskas, who initiated the proceedings wherebyMrs Savage was suspended by Tower Hamlets Health Authoritynearly ten months ago, was just as much on trial as Mrs Savage. Sowe heard Professor Grudzinskas, understandably reluctant to

categorise himself as a high-tech interventionist obstetrician doctor,circle round and round a clear exposition of how he would havemanaged the labour of one patient, a small woman who had had onechild earlier by caesarian section.A trial of labour, the professor was eventually persuaded to state,

tested the ability of the woman to deliver her baby normally, inclinical circumstances that permitted immediate action shouldcomplications arise. A trial of scar, on the other hand, was quiteanother matter, he added. And how long labour should be allowed tocontinue, with evident progress, adequate emergency back-up, andno fetal distress, was yet another. For close on two hours, MrsSavage’s barrister tried to lead Professor Grudzinskas into outrightcondemnation of her management of the case. Had he objections tothe duration of labour, the back-up available in an emergency, or theuse of oxytocin? But Professor Grudzinskas’s evasiveness exhaustedeveryone without clarifying the reasons for disagreement. Exactlyhow he would have managed the case was not clear.

* * *

THERE is a long track to the cottage. A dog yaps from a derelict car;chickens scratch the yard. In the one downstairs room there is avenerable stove, a churn of stream water, a guitar hung on a nail, anda small boy being read fairy stories by a neighbour. Upstairs,Mummy is in her 14th hour of labour and now, says the midwife,"fully dilated".Beyond the window the mountain stretches brown and barren for

ever. Mother’s pains are infrequent. She’s tetchy at the midwife’sexhortations and with her man for rubbing the wrong spot of herback. Time passes. Nothing happens. Dusk creeps up, cold andbeautiful. Mother walks, squats, tries all-fours. "Oh this wretchedbaby!" She complains. The midwife mentions hospital: twentymiles and a world away.

I’ve been given-or remembered-few words of obstetric wisdom.The wisest were: "Leave be". Birth is a natural process. So we

persuade the mother on to her side, cradled by her man, to rest. I jointhe little boy for Peter Rabbit. Shortly comes a hearty cry ofprogress. "I can’t deliver her like this,"the midwife confides. "Whyever not? When I was a lad most mothers were delivered in the leftlateral pos..." No time to explain: here’s the crown and mother’spanting concern that those downstairs make the finale in time. Theydo-thanks to the cord twice round that baby’s neck. The mostjoyful of sounds, a first cry, banishes our nightmares. Fingers arecounted, orifices peered into, the hasty thump of her new heartsounded, and then Naomi is returned to the breast.Leave be. The chickens are at roost, the dog and the day asleep. I

have a conceit that I’m for righting things that do not happen"naturally" and that the occasions when I’m not needed are buthappy accidents. Nature knows better. It teaches doctors they mustnot seek to justify themselves by making crises where none, inNature’s perspective, exist. It is a hard lesson for us to learn: "Leavebe".