• HealBridge

One of the more predictable things about this work is that a woman arrives needing help with housing, money and a lawyer, and turns out to have a health problem she has been carrying for years.

Not an injury. A tooth that has been broken since 2019. A lump nobody has looked at. Blood pressure that has never been measured. A pregnancy that ended badly and was never followed up.

It happens because there was never a safe time to go, or no money that was hers, or permission was needed, or every hour was accounted for. It is worth treating as its own piece of work rather than as something to get to eventually.

Why it accumulates

• No money of her own, and a request for it that has to be justified.
• No unobserved time. A clinic visit takes half a day and has to be explained.
• Not being allowed to attend alone, which makes some things impossible to raise.
• Everyone else first. Children’s fees, children’s medicine, his health.
• Avoiding examination because of marks.
• Being told it is nothing, for long enough to believe it.
• Not knowing it is abnormal. A great many women assume constant pain, exhaustion or heavy bleeding is ordinary because it has always been theirs.

What to get looked at

If you can only do one appointment, it should be a general check with somebody who can then refer you. But these are the things that most often turn out to matter.

Anything from an old injury. A shoulder, a jaw, a knee, a wrist, a nose. Old fractures that healed badly can often still be helped, and hearing loss after a blow to the head is common and rarely mentioned.

Head injuries. Repeated blows to the head matter, and so does anything that caused loss of consciousness. Headaches, memory difficulty, dizziness and concentration problems are worth describing rather than attributing to stress. So is any history of pressure on the neck, which is worth mentioning even years later.

Reproductive health. Untreated infections, pain, heavy or irregular bleeding, complications from a birth or a termination, and anything since. Obstetric injury from childbirth, including incontinence, is treatable and specialist centres do it — women live with it for decades believing nothing can be done.

Sexual health. Testing matters, particularly where sex was not consensual or where he had other partners. It is a routine request and it does not require an explanation.

Teeth. Almost universally neglected, frequently painful, and a real barrier at job interviews, which is a reason to treat it as practical rather than cosmetic.

Blood pressure, blood sugar, weight. Cheap, quick and easy to check, and the things most likely to be quietly wrong.

Eyes. A great many women have never had a test and cannot see well enough to study or work comfortably.

Mental health. Sleep, anxiety, panic, low mood. What trauma does physically and why symptoms often worsen once you are safe are both relevant, and neither is a character problem.

How to have the appointment

1. Write the list before you go, worst first. You will forget in the room, and appointments are short.
2. Say at the start that there are several things. It changes how the time is managed.
3. Say how long it has been going on, honestly, even where it is years. Nobody is going to tell you off, and duration changes what they look for.
4. Mention old injuries and their cause if you are able to. You do not have to give details, and “some of these are old injuries from violence at home” is enough and changes the examination.
5. Ask for it to be written in your notes. A dated record made by an independent professional is useful later, whether or not you ever use it.
6. Ask what it costs before agreeing to tests, and say if you cannot afford something. There is often a cheaper route.
7. Ask to be seen alone if anybody came with you.
8. Ask for a female clinician if you would prefer one. It is a normal request.

The part that is hard to say

Many women find the physical examination itself difficult in a way that has nothing to do with modesty, particularly where there has been sexual violence.

You are allowed to say so. “I find examinations difficult” is a complete sentence and requires no explanation. You can ask for a chaperone, ask to be told before anything happens, ask for it to be done in stages across appointments, and stop at any point.

A clinician who responds badly to that is one to change rather than one to endure. What clinicians are asked to do is written for them and sets out the standard you are entitled to.

Money

Cost is the reason most of this is postponed, and there are more routes than people assume.

Government primary health centres are cheap and handle a great deal. Teaching hospitals have social work departments that know what support exists. Some conditions have dedicated free or subsidised programmes, obstetric fistula repair among them. And medical care is one of our six programmes — it covers consultations, tests, medication and transport, which is frequently the part that actually blocks people.

Ask us rather than deciding you cannot afford it. The cost is often smaller than expected and it is a straightforward thing for us to cover.

The children

Get them checked too, and expect a similar backlog: immunisations missed, teeth, eyes, hearing, and untreated skin conditions.

Eyesight is worth particular attention. A child who has been struggling at school for two years is quite often a child who cannot see the board, and it is the cheapest problem on this page to solve.

One thing worth hearing

Women in this position frequently apologise for taking up an appointment, or say that others need it more, or wait until something is unbearable before going.

You are not being greedy by having your blood pressure taken. Years of being last in the household is a habit rather than a fact about your worth, and this is one of the more concrete places to start unlearning it.

Questions people ask

If you need help now

If you are in immediate danger, call 112. To talk to HealBridge, email us at hello@healbridge.org, or use the form on our contact page. Every page on this site has a Quick Exit button at the top right, and pressing the letter E three times does the same thing.