
Workplaces must wake up to the harmful invisibility of endometriosis
In a country grappling with gender equity, rising workplace absenteeism, and the push for inclusive labour policies under the Basic Conditions of Employment Act (BCEA), endometriosis remains an overlooked crisis, one that silently undermines South Africa's efforts to create humane, productive and equitable workplaces.
'You don't look sick,' is a phrase women with endometriosis hear way too often at work, at home, in doctors' offices and sometimes from themselves.
In conversations with others navigating endometriosis, a recurring theme emerges: the overwhelming burden of managing pain in silence, often while trying to meet workplace expectations. Many speak of being expected to justify absences long before receiving a diagnosis, as if their health problems were inconveniences rather than legitimate concerns.
These experiences show how invisible endometriosis remains in the workplace, not just in terms of physical pain, but also the stigma and lack of accommodations that quietly shape career trajectories. And behind that invisibility lies one of the most debilitating and misunderstood health crises affecting working women today.
Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus. It affects roughly one in 10 women globally. That's millions silently battling chronic pain, fatigue and infertility. In South Africa, where access to specialist care is uneven and healthcare resources are strained, many women face even longer delays in diagnosis and appropriate treatment.
Research shows that it takes seven to 10 years to get a diagnosis. During that time, many women are gaslit, misdiagnosed or dismissed. The consequence? Careers cut short, dignity eroded, jobs lost and health quietly sacrificed on the altar of workplace performance.
This structural mismatch between what employees need and what workplaces demand creates a dynamic where women feel pressured to mask their pain to avoid stigma, job loss or being labelled as unreliable. This is especially damaging in sectors where sick leave is tightly controlled, or in precarious work environments with little room for flexibility.
The unpredictable nature of endometriosis flare-ups makes consistent attendance and productivity difficult. Missed promotions, unfair performance reviews, or job losses are not
uncommon. This undermines employment equity, not only along gender lines but also class and health lines.
At many workplaces, 'diversity and inclusion' is reduced to a wellness day or a motivational speaker. But for employees doubled over in pain, that kind of tokenism is not support, it's avoidance. Chronic illness remains the elephant in the boardroom.
South Africa's progress toward workplace transformation, through broad-based black economic empowerment and equity laws is commendable. But to be truly inclusive, policies must also account for the experiences of those managing chronic, often invisible health conditions such as endometriosis. This gap signals the need for a more intersectional approach to workplace equity.
A framework for change
To end this cycle, here is a four-part framework South African workplace can adopt immediately
1.
Policy reform:
Recognise chronic illness in HR and organisational policies. Review BCEA provisions in relation to long-term, fluctuating conditions like endometriosis.
2.
Flexible work options:
Enable remote work, adjustable schedules, and rest breaks during flare-ups, especially important in South Africa's mixed rural-urban labour economy.
3.
Manager education:
Train supervisors to replace scepticism with empathy. Awareness reduces stigma and improves productivity.
4.
Support systems:
Create access to mental health resources, safe disclosure channels, and peer support groups. These are low-cost interventions that are effective.
I explore this framework in detail in my recent article which you can read
When flare-ups hit, routine tasks become mountains. Without proper support, women are forced to choose between health and income. For South Africa, where high unemployment, youth joblessness and gender inequality already intersect, this is an unacceptable trade-off.
Endometriosis is not just a medical condition, it's a workplace issue. One that demands recognition under policies and labour codes, and inclusion in discussions around productivity and well-being.
If we claim to care about transformation, dignity, and decent work, we must move beyond superficial gestures. It's time to stop brushing off pain that doesn't show on a scan and start building workplaces that are compassionate, inclusive, and prepared for reality.
Endometriosis is real. Women's pain is real. It's time our policies, leaders, and workplace cultures responded like it.
Zimkhitha Juqu is a researcher, published and cited author interested in gender, health equity and workplace inclusion.
Hashtags

Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles


Mail & Guardian
a day ago
- Mail & Guardian
Poultry sector recovering, prices not expected to increase
South Africa's poultry sector is recovering from a devastating outbreak of bird flu and has capacity to meet local consumer demand. (Madelene Cronje) South Africa's The department of agriculture rolled out mass inoculations earlier this month to protect the industry from highly pathogenic In 2023, millions of birds had to be culled, hampering production and driving up poultry and egg prices. The inoculation campaign kicked off with the vaccination of 200 000 broiler breeders at poultry producer Astral. The birds represent 5% of the company's total breeding stock, the department said. Industry experts have welcomed the inoculation drive. 'We had two cases of HPAI in the country, but both were contained and did not spread with minimum losses in terms of production,' said Izaak Breitenbach, the chief executive of the South African Poultry Association. 'We still have an additional one million birds per week slaughter capacity. We currently slaughter about 21.5 million birds per week.' That number reflects normal production levels, which may rise slightly toward December because sales typically increase in the second half of the year. Breitenbach said the industry also has the capacity to exceed this demand if needed 'The industry can cover an increase in demand of about 10% with local production in the short term and probably more in the long term.' Agriculture economists said the success rate for the inoculations will depend on how well future outbreaks are contained. (Graphic: John McCann/M&G) 'There are great expectations that South Africa's recent efforts to vaccinate poultry against avian flu will lessen the likelihood of another devastating outbreak similar to the one that occurred in 2023. Particularly in light of the seasonal influenza outbreak, which usually starts in April and peaks in September each year,' said Thabile Nkunjana, of the National Agricultural Marketing Council. 'However, the initial vaccination is reportedly for at least 200 000 broilers, which is extremely small compared to the size of the industry as a whole. As a result, there is still a chance of an outbreak related to South African poultry production, as well as a current risk of disruptions in the poultry supply, which frequently results in prices that have a negative impact on consumers The layer side of the poultry industry, which raises chickens specifically for egg production, is still producing at lower levels comparable to those before the 2023 outbreak, Nkunjana noted. 'If an outbreak were to occur, the industry would likely experience the same level of pressure as it did in 2023, and egg prices would probably rise once more,' he said. Experts warned that the cost of bird feed could hamper poultry production. Prices have increased on the back of climate conditions as well as international supply. 'Initially feed costs rose when world prices increased sharply in the aftermath of the pandemic and associated supply chain challenges, challenging weather in some key production regions and Russia's invasion of Ukraine,' said Tracy Davids, the executive director for commodity markets and foresight at the Bureau for Food and Agricultural Policy. 'When world prices came down, South African prices stayed higher due to the summer drought of 2024. So, feed costs have increased much more than meat prices over the past five years, making life difficult for all livestock producers, but particularly poultry that use feed very intensively. It's the biggest cost component in the sector.' With feed prices declining and the partial lifting of the ban on Brazilian chicken imports earlier this month, the prospects for the sector are looking positive, Davids added. The ban was implemented after Brazil also reported disease outbreaks, but was lifted to support South African consumers' food security, alleviate cost pressures, and help stabilise the supply chain, said Nkunjana.


Mail & Guardian
a day ago
- Mail & Guardian
Aid cuts, including by UK, undermine progress on fight against superbugs
Antimicrobial resistance silent pandemic that already claims more than 1.3 million lives every year. File photo A recent global economic model warns that antimicrobial resistance (AMR) may cost the world economy up to This escalating threat coincides with a decline in international support for AMR surveillance. The Low- and middle-income countries, including South Africa, are likely to bear the heaviest burden because of under-resourced health systems, limited surveillance capacity and growing barriers to effective treatments. AMR arises when microorganisms evolve mechanisms to withstand the effects of antibiotics intended to eliminate them. As resistance spreads, infections that were once easily treatable become increasingly difficult, and sometimes impossible, to cure. This silent pandemic is already responsible for more than By 2050, resistant infections could reduce global GDP by up to 3.1% and push millions into poverty as a result of the cost of prolonged illness and ineffective treatment. Health systems, especially in countries already facing a high burden of disease, are at risk of being overwhelmed. The But Experts caution that even partial reductions in funding may accelerate the spread of AMR in high-risk regions. Such cutbacks can delay the detection of resistant pathogens, disrupt surveillance efforts and weaken public health responses. The consequences are clear: more infections, higher mortality rates and mounting pressure on already overstretched health systems. AMR does not respect borders. Resistant bacteria can emerge in one location and spread globally through travel, trade and migration. Inadequate surveillance in one part of the world increases vulnerability everywhere. Many low- and medium-income countries face compounded problems: limited access to diagnostics, overuse or misuse of antibiotics in both clinical and agricultural settings, as well as underinvestment in water, sanitation and hygiene infrastructure. Surveillance programmes supported by international aid help fill these gaps by enabling early detection and informed response. Cutting funding now undermines global preparedness just as AMR risks are accelerating. While AMR is a long-term challenge, the window for effective action is narrowing. Delaying investment now will probably increase the cost and complexity of response in the future. According to recent economic analyses, every dollar spent on AMR containment today could save up to $20 in future health and productivity costs. Continued investment in surveillance, laboratory capacity, workforce training and antimicrobial stewardship is essential for all countries and for global health security. Multilateral partnerships, sustained funding, and equitable access to innovation are critical pillars of any effective AMR strategy. What can be done? Given the recent decline in global funding, it is essential to explore alternative strategies to sustain and strengthen AMR efforts. Reinforce multilateral funding: Donor countries should explore shared funding mechanisms to sustain critical AMR programmes beyond bilateral commitments. Strengthen regional cooperation: Regional AMR surveillance networks can improve resilience and facilitate data-sharing, even in the face of international funding cuts. Mobilise domestic resources: Prioritise public health investment in laboratory systems, data infrastructure, and training to reduce reliance on fluctuating aid flows. Promote responsible antimicrobial use: Stewardship programmes in human and veterinary medicine are essential to slow the development of resistance. Invest in research and equitable access: Support for the development and fair distribution of new antibiotics, vaccines, and diagnostics must remain a global priority. AMR is one of the most urgent and complex public health issues of our time. Progress made in the past decade, through global collaboration, investment and capacity-building now stands at risk. At the very moment when stronger action is needed, international funding is contracting. The decisions made now will shape the trajectory of AMR for decades. Reducing support is not just a financial recalibration; it is a choice that may have irreversible consequences for millions of people worldwide. The global community must act decisively to protect hard-won gains, support countries most at risk and uphold the shared responsibility of safeguarding the effectiveness of life-saving medicines. Dr Jose L Balcazar is a senior microbiologist at the Catalan Institute for Water Research (ICRA-CERCA), Spain.


Mail & Guardian
a day ago
- Mail & Guardian
Dreaming in Color, speaking in truth: Africans are speaking up and this podcast is listening
South Africa is a country where silence often wraps itself around pain like a second skin. Whether because of our past or our present struggles, we've grown up hearing the word gqina , 'be strong,' and soldiering on quietly. At least we used to. In 2025, podcasts have emerged as spaces where South Africans can speak their truths out loud. Local listenership is booming: more than who's listening—female-hosted shows have seen a Among the growing constellation of podcasts showcasing African voices, 'There's something profoundly powerful about hearing young African voices speak their truth with clarity and courage. Africa's youth aren't waiting to lead someday. They're already leading. And the world would do well to listen,' Makumbi says. The fifth season of Dreaming in Color , the next episode of which airs on 24 July 2025, journeys through six African countries, from South Africa to Tunisia, threading together voices that are powerful in their differences and united in purpose. Each episode doesn't just try to tell a single story but rather lead a chorus of lived experience. Mental health is one of the central threads tying these stories together. Across the continent, the stigma around depression and trauma still lingers. Vulnerability is often mistaken for weakness, and naming your pain can feel like an act of rebellion. The podcast creates space for those stories to be shared without shame. In South Africa, where youth depression and suicide rates remain alarmingly high, mental health has become an urgent conversation. A recent episode featuring Kenyan social entrepreneur Tom Osborn, helps move this conversation forward by highlighting the different ways that young Africans approaching the problem. Osborn is leading one of Kenya's most promising mental health interventions, one designed by young people, for young people, and rooted firmly in African ways of thinking. Bridging diasporas and dialects From the heart of the continent to the hustle of the diaspora, the podcast travels far and wide. Conversations move between Johannesburg and London, Dakar and New York, carrying accents, anecdotes and ancestral wisdom across time zones. Among the guests is Farah Mami, a Tunisian impact investor and community builder who's creating spaces where women and artists lead from purpose, not pressure. Raised between Paris and Tunis, she speaks to the tension, and the beauty, of living between cultures. Ore Disu, a Nigerian cultural strategist and museum leader, is reimagining restitution at the Museum of West African Art. She's not just asking what should be returned, but what must be rebuilt, supporting young creatives, reviving artisan practices and using art as a bridge between fragmented histories. In South Africa, visual storyteller and arts leader Lekgetho Makola poses other deep questions: Who gets to frame the African story? And who benefits when it's told a certain way? Through institutions like the Market Photo Workshop and Javett Art Centre, he has created platforms where new narratives are possible. His fellow South African, Nwabisa Mayema advocate for women-led, regenerative business models. Raised in the Eastern Cape, her leadership is deeply grounded in matriarchal wisdom and what she calls 'wild womanhood', not the absence of fear, but the courage to act in spite of it. In her Dreaming in Color episode, she challenges Silicon Valley's obsession with unicorns, advocating instead for 'zebra' businesses: collaborative, community-rooted ventures that prioritise sustainability over scale. Every episode echoes what's already happening on the ground. These conversations honour oral traditions, local languages and the beauty of everyday life. They push back against erasure and remind us that storytelling is alive and very well. Dreaming in Color offers stories that challenge, affirm and inspire. In a world that too often flattens African voices into stereotypes or silence, this series does the opposite: it listens with care and amplifies with respect. The series affirms that our stories, however complex, are worth hearing and worth holding onto. Listen to Dreaming in Color , available on and . Episode 1: Semhar Araia, Eritrean-American activist and CEO founder Episode 2: Leila Ben Gacem, social entrepreneur and general director, Episode 3: Legketho Makola, chief operations officer, Episode 4: Tom Osborn, co-founder and CEO, Episode 5: Nwabisa Mayema, social entrepreneur (South Africa) Episode 6: Ore Disu, founding director, the Institute of the Episode 7: Madji Sock, co-founder and president, Episode 8: Feven Teshaye, founder, Episode 9: Farah Mami, president, Tunisia Chapter of the Episode 10: Tijan Watt, co-founder and managing partner,