Before Naeemah Abrahams’s name was attached to more than 90 public health research publications, she worked as a nurse. She saw things in the hospitals of Cape Town that stiffened her resolve for justice.
There was a certain disdain for the disenfranchised built into the public health system of 1980s South Africa. She was often left in tears by it: “I felt like I was not allowed to care.”
Her difficulties as a nurse were compounded by the expectation that she would grow inured to people’s pain, that she too would soon practise the contempt built into the system.
She remembers watching patients who came to the hospital drunk be treated with open disdain by healthcare workers, who sent them to the back of the line or left them to queue outside in the cold. It weighed heavily on her.
“I realised I didn’t want to be part of a system that tells me that I should not care about a person because he’s drunk or because he’s black,” she says. “I thought, I can’t continue to be a nurse in this system — I’m going to be changed by it.”
So, she took a break from the hospitals for a year to pursue a qualification in community health and then returned to work at the Red Cross Children’s Hospital in Cape Town. There, at last, Abrahams was allowed to show compassion. She felt like she could indeed care.
By 1989, Cape Town was poised delicately between hope and despair. The apartheid regime was in its final days. Rumours of political assassinations and detentions were rife. But the promise of change was stubborn.
Abrahams had already been in trouble for her political activism. Municipalities refused to hire her.
For years, the message from the “underground”, from the structures of the banned ANC in exile, was for people to equip themselves with knowledge to ensure the new state that would be built had a ready bank of expertise. It was from there that she was inspired to take a position as a fieldworker working under the tutelage of a surgeon at the South African Medical Research Council (SAMRC) in Cape Town.
She hated it.
Women get beaten up sometimes. It just happens
In the background of Abrahams’s home in Pinelands many, many years later, there are the tell-tale sounds of a household slowly waking up to a mid-December morning. Abrahams is a mother of two, married to someone she describes as “much cleverer” than her, and she’s devoted to her family.
She’s deeply appreciative of the people who have helped her chart a successful course in epidemiology — it’s more than she ever thought she would want, more than she dared to imagine she could be. She had thought she just wanted to be a nurse — and even that was quite a feat for a woman from a working-class family in Cape Town in those days.
Sitting in an armchair in the living room now, looking out of the glass doors to the small garden, Abrahams breathes deeply. She appears perfectly at ease, content.
But she shudders slightly at the memory of her first job at the SAMRC.
The job was meant to allow her to be able to do something about injustice. All the talk was about the new state that would have to be built soon. And healthcare would be integral to that.
Her supervisor, however, was obsessed with guns.
He would begin every morning regaling her with stories about his gun collection. There was no escape. In the trauma units where she worked, she was surrounded by the lingering effects of gun violence.
“My hatred for guns started there.”
Years later, she would publish papers that show guns play a significant role in violence against women in South Africa, particularly in the killing of intimate partners.
It was there in and among the victims of gun violence, in her first job as a researcher, that she began taking note of the evidence of violence against women. To most others, it was unremarkable — a phenomenon that was not questioned.
Women get beaten up sometimes. And sometimes, they ended up in the hospital. It just happened. The implications were not widely considered to be worthy of deep reflection, especially by epidemiologists.
“There was this woman with a blue eye who I encountered in the trauma units that nobody enquired about.”
Abrahams is pensive — almost as though she’s once more weighed down by that memory.
But she trudged through that job — she never grew to like it — until epidemiologist Salim Abdool Karim, who also worked at the SAMRC, encouraged her to apply for another position.
She wasn’t sure she was suited to the job but she applied anyway. And she got it.
‘Violence, violence everywhere’
Things were much better in her new role, as a junior to researcher Rachel Jewkes.
At first, the pair set out to focus on reproductive health and contraception. “We started off with abortion work,” Abrahams says.
But there was a troubling pattern emerging in their conversations with women.
“Violence. We came across violence everywhere. We go and speak to teens about pregnancy, we come across violence. We go speak to nurses, we hear about the violence on patients.”
This informed a new trajectory.
Her master’s thesis involved speaking to men about their abuse. In many ways, it was groundbreaking work. Few people had considered talking to the perpetrators.
Finding out from men about how and why they abuse would go on to become the subject of her PhD thesis as well.
In the meantime, the SAMRC was building a world-class women’s health research centre.
“I truly believe we became well known as leaders in the field of violence against women globally, having built the field here in South Africa as well — although our policymakers don’t always take note of us.”
Her work on intimate-partner violence has explored a range of topics such risk factors for perpetrating intimate-partner violence; femicide; health sector responses to gender-based violence; sexual assault services; prevention of HIV following a sexual assault; HIV stigma; mental health and gender-based violence as a risk factor for health outcomes.
At the heart of her research lies a key finding – men can be engaged about their violence. And a key recommendation to help society stem the violence — believe women.
This is what Abrahams has devoted herself to for more than three decades – assembling and analysing numbers in order to change the lives of the people behind them. She is now the director of the women’s health team she joined and helped to establish.
“There is no such thing as gender-based violence research without some kind of activism [built in],” she says.
Progress has often felt achingly slow, she says.
It is hard to believe violence against women in South Africa is falling when the news is still full of stories about women assaulted or killed by their partners. But change is happening.
Earlier this year, Abrahams and her colleagues released a study showing that femicide — when women are murdered — has declined rapidly and dramatically in South Africa since the 1990s. Indeed, since 1999, when the unit first started researching the subject, the rate has halved.
“There is good news there,” Abrahams says. “I think we can celebrate a little.”
That kind of understatement is typical of Abrahams, a PhD scientist, and the first woman in her family to finish high school, but who still describes her academic and career trajectory as having been “in the right place at the right time”.
Portrait of a modest trailblazer
Abrahams never intended to be a trailblazer. She never paused to think she was breaking barriers.
But attending lectures for her master’s qualification at the University of the Western Cape, with a 10-day-old baby, Abrahams was always remarkably different. She is unaffected by what she’s doing, no matter how impressive it may be. She just does it — if she didn’t go to lectures she would fall behind with her studies. So of course she took her baby with her. She didn’t think anything of it. It was just practical. She’s guided entirely by the strength of her convictions to lend a hand to others.
For her family, Abrahams is a bulwark against the grief, worry, illness and isolation that sometimes punctuate our lives and a source of strength, understanding and guidance for her community.
Naaemah Abrahams is indeed a product of her time. A product, as well, of place — a city teeming with contradictions. She is indeed a product of the people she’s met along the way. She claims to be lucky but she overstates her luck. Although she is lucky, in the way all successful people are, she is also unique.
She hasn’t stopped caring when many others have long grown weary. She proves most emphatically — in herself and in her work — that sometimes the only thing necessary for the defeat of evil is for good women to do something.
This story was produced by the Bhekisisa Centre for Health Journalism. Sign up for the newsletter.
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