Before I was an activist and an author, I was perhaps the most frustrated medical doctor in South Africa.

I grew up in Qwaqwa, a rural town in an apartheid-era Bantustan, now called the Free State. 

Because of the unjust conditions of the racist regime, I had no choice but to fight for survival; I didn’t choose activism, activism chose me. 

Today, I may be a rebellious Catholic, but when I was growing up I spent my school holidays at the monastery visiting the nuns.  

At the convent, I could choose one of two activities. I could do the stations of the cross (a 14-step Catholic prayer practice which commemorates Jesus Christ’s last day on Earth) for hours each day. Or, I could do something which I still think was the best decision of my life – I could help the nuns take care of the elderly. 

This experience made me want to be a doctor for as long as I could remember.

Women are people, not a collection of organs and ailments

At medical school we were biomedically trained. In practice, the conditions we worked under meant we didn’t have time to consider the wide range of experiences patients had and how those things affected their health.

Often you’ll hear public health experts say that women need to know that early detection of breast or cervical cancer can save their lives. 

But what does it take, practically, for a poor rural woman to make numerous visits to a clinic for a screening test? They may have to wait months for their results and even longer to be referred to a specialist for treatment. 

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Many women have to choose between competing needs for themselves and their families. Sometimes it’s about making a decision between putting petrol in the car or buying food for the household. 

I realised that we, as doctors, were being trained to see patients – especially women – as a collection of organs and ailments.

Women were no more than expectant mothers or future caregivers or potential cervical cancer cases.

At no time did we stop to consider that they were individuals with their own stories, desires and aspirations.

Safe abortions save lives

These days, I see the practice of medicine as a powerful tool in the restoration of people’s dignity.

That means understanding the ways in which racism, colonialism, imperialism, white supremacy, capitalism, ableism (discrimination in favour of able-bodied people) and transphobia have multiple and compounding effects. 

These systems of power continue to determine who is seen as fully human. 

That is why in my capacity as the United Nations Special Rapporteur on the right to health, I submitted an amicus (friend of the court) brief to the US Supreme Court when it was considering overturning Roe v Wade, a court ruling that ensured the right to an abortion in the US for nearly 50 years. 

I wrote that abortion rights are human rights. When a pregnant person asks for a safe abortion, they are asking for control over their own body and self-determination of their own future. They’re asking for the ability to continue their education or to earn a living.

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As a proud abortion provider, I am telling you that safe abortions save lives.

I’m worried that the US court’s decision in June to scrap the right to terminate a pregnancy takes us back to a darker time. 

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They are already hinting at a long list of rights that might be taken away too – LGBTQIA+ and same-sex marriage rights, as well as the right to contraception.

The function of freedom is to free someone else

We are truly living in challenging times. I am tired.

But there is one thing that gives me hope: more and more people are practising their professions in service of human rights.

Elected leaders and those in positions of power may not be doing much, but we are a community of doers.

We, the goalkeepers, are leaders at this moment.

And so, I have one request: Add “human rights defender” to your résumé.

The right to health is indivisible and is key for gender equality and necessary for sustainable development, peace and security.

As goalkeepers, we must ensure that people realise their rights and move from surviving to thriving.

As the late novelist Toni Morrison said: “You are moving in the direction of freedom and the function of freedom is to free somebody else”. DM/MC

Tlaleng Mofokeng was speaking at the Bill & Melinda Gates Foundation’s Goalkeepers meeting in New York City on 20 and 21 September. Watch her full speech here. 

The Gates Foundation is one of Bhekisisa’s donors. Find out how they ensure editorial independence. 

​​This story was produced by the Bhekisisa Centre for Health Journalism. Sign up for the newsletter.