Chapter 3: Testing Boundaries

The boy talk, "Forget HIV. No need check. I don see HIV rash picture online, my own no resemble am. No need check HIV."

He dey form Google doctor. Naija boys sabi look online, dey use am argue for clinic. Sometimes e dey funny me.

I insist, "Abeg, check the two, make sure."

I use my softest voice, because if I press too much, e fit vex go house. For Naija, patient na king, even when e dey wrong.

But the boy stubborn, snap:

"Abi na because you wan chop my money you dey order all these test? No need HIV—just check syphilis."

He dey vex.

I dey used to this—Naija people dey always suspect doctor dey find how to chop extra money. E dey pain, but you go just laugh inside.

The girl try calm am, dey pull shirt: "No worry, just do the two test. Na just test, no be say you get am. No go take time."

She dey beg am with eye. For Naija, sometimes na woman dey get sense pass for relationship wahala.

The boy vex more:

"I no dey do HIV test! If Dermasol work, I for no even do syphilis test. Two months ago, when my eczema come, doctor talk make I check syphilis. The result negative—nothing dey."

He dey hold onto old test like say na vaccine. Many people here believe say once you test once, na forever immunity.

Since patient no gree, I just agree: "Oya, make we do syphilis first."

Sometimes, you go allow patient win small, so dem go still dey come hospital. If you force, dem go run go chemist next time.

I order syphilis markers: VDRL, RPR, and TPHA. I write am bold for form, so lab people no go mix sample. For Naija, if lab result lost, dem fit accuse you of theft.

Small tip for syphilis test: To know if syphilis still dey spread or need treatment, check VDRL and RPR. If two turn negative and remain so, syphilis don cure.

Small medical matter: Most people no dey understand all these numbers. For Naija, you must break am down for patient like say you dey teach JSS 3 Biology.

TPHA go remain positive for life—just mean say you don get am before. If dem don diagnose you, no need check am again.

I write small explanation on the paper for reference. If lab call tomorrow, at least I fit remember the story.

The boy carry test slip, waka go do blood test, dey vex.

I watch as e waka go, step heavy like person wey lose football bet. The girl waka behind am, dey beg with low voice. For waiting room, dem go sit, dey avoid each other eye. Outside, generator dey roar, and from corridor, the faded wall paint and malaria poster dey look tired, while hawker dey shout "Gala! Gala!" from distant gate.

As I see the clear syphilis rash for the boy body, I look the girl, fear grip me.

For my mind, I dey worry say the thing fit don reach her, and from there enter family wahala.

I dey worry say she fit get am too.

Because for Naija, if woman catch am, na she go first carry name, even if no be her start am. Na so society be.

I ask, "When last una do?"

I dey ask gently, because this kind question fit cause quarrel, but na my work.

The girl blush, pause, answer, "Four weeks ago."

She dey shy, hand start shake small, and she press her bag tight for lap, eye dey dodge my own. She no wan make her boyfriend vex more. For here, woman dey always get that extra shame when doctor dey ask about private matter.

"Una use protection?"

I dey try know if condom dey involved. For Naija, some people dey reason condom na only for belle.

She glance at her boyfriend, hesitate, then say, "I dey always tell am use condom, but no be just to prevent belle?"

She look me with innocent eye. For my mind, I dey pity her—many people no know the full reason for condom.

Chai, I think say everybody sabi say condom dey prevent STD.

I remember back then for university, even some lecturers no sabi say na STD condom dey block pass.

I explain, "E dey help well well. Condom no be just for belle, e dey block like 99% of STD—HIV, syphilis, gonorrhea, all those ones. If una no use protection, risk high."

I talk am like elder brother, no like doctor wey dey form Oyinbo accent.

"So, if I use protection, risk still high?"

She look confused, voice low.

"E still dey, but small," I say, using my hand to show small gap, so e go enter her mind. For here, action dey help words sometimes.

Even if una dey use protection, if una dey share towel or toilet, syphilis fit still spread.

For Naija, house dey crowded, and towel sharing plenty. E fit be small, but e dey cause big wahala.

Plenty people think say na only sex dey spread STD.

I remember aunty for church wey say she catch infection from office chair. All join for our local wisdom.

But syphilis different from HIV. Syphilis dey spread pass, even daily contact like towel for same house fit carry am.

E shock many, but na true. Na why we dey always warn people, make dem dey careful for hostel and crowded house.

But na unprotected sex still be the main way.

If you dey run skin-to-skin, risk na number one.

With protection, risk drop well.

But only God fit guarantee 100% for this matter.

I continue, "You don notice any sign of syphilis, like painless wound or rash like your boyfriend own?"

She dey reason am, dey look down. For my mind, I dey hope say she never see anything. Na small hope wey doctor dey pray for.

As she pause, I see say the medical talk don plenty.

Sometimes, too much explanation dey turn patient head. For here, e better to ask direct and no overload pikin brain.

I just advise make she check—quick thing, if she get wound, e go help intern learn.

I talk gently: "No be say you get, but if you fit allow, make I check. E go help us clear mind, plus my intern go see real-life case."