#FootSoldiers: It’s a bloody affair, but we are all human.

Judaica Ranape works at the Lady Michaelis Clinic in Cape Town where she works hard to ensure the community has access to quality abortion services. Photo by Thom Pierce.

“In 2017 a young girl called *Akeelah showed up at lady Michaelis Clinic one morning to see a Termination of Pregnancy (TOP) nurse. The nurse on duty was busy attending to another patient at the time. While she waited Akeelah  kept shifting anxiously in her seat, eventually she popped her head into the office and asked the nurse if she was going to be long, as she was in a rush. The nurse explained that she had to see everyone in the queue and referred her to the local hospital, if she couldn’t wait. A few hours later Akeelah returned , still  visibly anxious. This time she managed to consult with the nurse. They discussed the option of an abortion and agreed that Akeelah would come back to the clinic.

The next day Akeelah’s aunt arrived at the clinic to enquire about her medical  situation as she had tried to take her life the night before. The nurse did not disclose the reason why Akeelah had come, but just confirmed that Akeelah had presented herself at the facility.

Just as Akeelah’s aunt  left  the clinic , Akeelah  was back again. This time she had a drip needle hanging from her arm and a hospital tag around her wrists – she had  gone to the hospital, but ran away to come back to the nurse.

She told the nurse she was sure that she wanted an abortion. The nurse provided her with the medication she needed to perform an abortion at home, and informed her to call her if she was uncertain about what was happening to her body during the abortion process.

The call never came.

Instead, the aunt returned to the clinic to see the nurse and deliver some news.

Akeelah, had thrown herself in front of a train and died.”

Fourty-eight-year-old nursing Sister Judy Ranape is in tears by the time she finishes narrating this story. She was the nurse on duty the day Akeelah first turned up at the clinic.

It is this harrowing memory that keeps the Cape Town abortion  nurse doing her bit within the corridors and wards of hospitals, and in the lives of people in her community.

Ten years ago, Judy made the decision to become an abortion (Termination of Pregnancy) nurse. A staunch Catholic woman, somehow she navigated a way through her religious beliefs and faced the stigma of being viewed as a person who allows people to take away lives instead of saving them. “I come from a background where abortion Is a sin, it took me sometime before I said to myself, what the heck, I need to help people anyway,” she says   If ever she feels uncertain, she repeats the following mantra to herself “These patients may have chosen whatever, but they are human and above all else, I am pro-human and that also means looking past my own discomforts,”she said.

By April 2019 Judy Ranape estimates she had facilitated around 10 000 abortions – both surgical and medical (dispensing of a pill).  “I never imagined that this is where I would be today,” she reflects.

“The idea of abortion is still very taboo in our communities, people won’t speak honestly about it, and even people in the health system share stigma themselves, I’ve heard of abortion providers not being spoken to at work or being actively avoided,” said Judy.

“When I started my career in TOP, I saw many of my colleagues fail to complete the training course. Many put on brave faces, but were paralysed with fear when it came time to perform the procedure. It’s a scary thing, some woman are screaming in pain, others are desperately fearful, it’s a bloody affair and it takes a lot to be brave and go through with the process of providing a surgical abortion ,” she says.

Judy herself has faced challenges in her own home due to the path she has chosen. Her husband is also a staunch Catholic.

“My family knows about the work that I do, but we don’t talk about it at home,” she says.

Despite sometimes facing judgement and criticism, Judy wakes up every morning to attend to patients who require abortions. “When these woman walk through the door, they usually need two things. An abortion and to talk. Every woman has a story,” says Judy.

Judy quietens for a moment, and tears well up in her eyes. She is thinking about Akeelah again.

“I can’t help but think, that if I had just made the effort to speak to her more, to listen to her, I could have been able to help her.”

After the experience with Akeelah, Judy has become intent on providing a holistic approach to her patients. “It’s important to me that I speak to these women, there is a reason every single one of them come, it’s not just for an abortion.”

Judy has worked with the community of Lady Michaelis to break the taboos around abortion, she speaks openly about it and encourages others to do the same. Initially Judy’s patients would shy away from acknowledging her or speaking to her in public, but now, everywhere she goes, people shout her name and always want to stop for a chat.

“It brings me such great joy, to see people from the community interacting so freely and genuinely with me,” she says.

While access to abortion remains controversial in much of the world, Judy refuses to get caught up in the politics. She is clear that her role is to provide support to her patients and give them the option to make a choice about their lives, after all- her only concern is providing help to those who need it”

“If I don’t do it, who will?,” she grins.

*Name changed to protect identity of the patient and her family.

• Foot soldiers of the health system: It’s election time which means men and women in party regalia take to the streets, podiums, loudhailers and stadiums. Invariably they tell people about all the good and wonderful things they have done or plan to do in the health system. SECTION27’s Nomatter Ndebele and photojournalist Thom Pierce travelled the roads of South Africa in search of the foot soldiers of the health system, the men and women who quietly get on with doing the job and saving lives, often without any acknowledgement.