Tales & images from life as me…

TIA Tales – hospitals & health care

OK so in a hospital, which shall remain nameless, there is a death every Friday in a private life support room. No one can work out why. To be fair the generator doesn’t always work (hmm good huh!) so power fluctuations could have explained it but the timing is just too similar, too regular.

After four or five people crashing, despite being attached to machines that should stop them doing that, doctors become suspicious. They begin to keep an extra eye on the room on Fridays. Finally, one doctor observes a cleaning lady entering… She calmly unplugs the machines, plugs in her vacuum cleaner and proceeds to hoover the room! Two minutes later she replaces the original plug and leaves, with the alarms all pinging behind her as she closes the door! Mystery solved.

Healthcare here in Tanzania is a brilliant subject for a TIA Tale, there are just so many insane stories it’s hard to believe, and with doctors here on strike because they are paid as little as one to three pounds for being on call all night, it’s also topical.

As the story above illustrates many people who work in the hospitals here have no training or understanding of what is going on around them, however there are those who are working incredibly hard to change things. So, whilst the stories I have to share are too good to ignore for this blog, I will start by saying that these stories of lacking resources and total incompetence do not reflect all our doctors or every hospital. In fact, I have written pieces for local magazines in the past about the amazing people who are leading the way and changing things – but they’re for another day. Right now, we’re interested in laughing at murderous cleaning ladies! Having said that, as I wrote this piece I also found it hard to be flippant the whole way through, there are too many heartbreaking stories that go alongside each silly one. So forgive me there is some disturbing material in here, and there are some serious bits this week.

OK so you need to start by imagining the sort of hospitals I’m talking about, if you don’t live here it’s a bit of a leap. They are generally huge concrete buildings without a computer in sight, just rooms of files and it’s rare that they can find yours so chances are if you see two different doctors neither will ever know what the other said. Outside one of largest hospitals is a coffin shop, I think that kinda says it all. Often people coming to hospital here expect to die. They just associate the two.

One of the biggest problems is misdiagnosis, and that’s largely down to the fact that doctors here like to blame everything on malaria! Seriously Mwanza has to be skewing the world statistics because about nine out of ten of the cases diagnosed are not malaria at all. Put it this way a friend of mine recently had to take a child to the hospital (people often go direct to hospital here, bypassing doctors’ surgeries) because he got a fly in his eye – she’s a teacher and the parents insisted, ridiculous, but still they went – they explained about the fly and the doctor’s response “No, no, no, but I think he has malaria!”

The clinics make money from the sale of the medication so it works for them. Also they use tiny glass slides to see the malaria in the blood, they then give you a count as to how many cells (or whatever, I don’t know the technical stuff!) are in your blood. Now, they’re not that careful about cleaning these little glass slides so literally hundreds of people are told you have a ‘two count’ (very low) and must take the meds – they may well have had a two count, but they were probably someone else’s!

My partner had it for real a while ago though. I was away so the poor thing took himself to the hospital. They diagnosed malaria and said he was bad enough to warrant a drip (usually it’s just tablets to fix it) so he needed to stay… They then packed him off home to bring clean sheets, food and water so he could survive the next few days! Man it makes you miss the NHS!

It’s alright for ex-pats of course, who can afford to take a few days off work and feed themselves etc but there are actually people who starve to death in hospitals, especially babies and young children if their parents are not there or are not able to provide food. One of my friends runs an incredible charity that rescues many of these babies and makes sure they do get fed and helps to track down their families and support them through the tough times. It’s called Forever Angels Baby Home, do take a look at their amazing website www.foreverangels.org – it’s one of the charities where I can honestly say that every penny reaches the kids and families and they’ve rescued hundreds of babies, finding them homes and new beginnings where needed.

So, back to the health care system (if you can call it a system) – death rates, as you may imagine, in local hospitals are high. But the hospitals have no morgue, because they have no cold storage. They insist that every body is taken care of by a family member or friend. This is carried out to the extreme that when a young girl went into the hospital experiencing a miscarriage late into her pregnancy and lost the baby, it’s body was wrapped in a blanket and placed under her bed whilst she was unconscious for two days. They simply saw it as her responsibility. It’s 30 degrees here every day. Horrific. Yet not considered shocking or strange here at all.

I recently got up close and personal with some of the hospitals here due to a broken foot. All I needed, initially, was an X-ray. There are several places that do it so we were pretty hopeful. Ha! How naïve!

First stop: “Sorry the radiologist is not working today”. Second stop: “Sorry the machine is not working today.” Third stop: “Sure no problem”. So we wait… and wait. Then we ask if the radiologist is coming today “Oh yes, but his daladala has broken down” (that’s a form of public transport here, there’s a picture of one in the driving TIA Tale I think) “will you pay for a taxi for him?” Brilliant! OK so we agree to pay his taxi and he arrives, finally.

I am wheeled, in an old garden chair with wheels attached, up a slope which must be about 50 degrees. Terrifying, especially when I also consider I will have to go down it! Anyway, we go in and he prepares the X-ray. My friend (Kate, aka Katron, a Mwanza legend when it comes to health care and thank goodness because I wouldn’t have known…) is in there and he is about to take the X-Ray when she pipes up “hand on, I need to leave, and shouldn’t Mel be wearing this protective led apron thing?” Hmm, safe!

Next step, we wait for the X-rays. They come back black! It appears I have no bones in my foot! We tried again and then decided I’d had enough radioactivity for one day, I would have to fly to Dar es Salaam for a proper assessment.

I head for a lovely local doctor in order to at least get some pain killer and get strapped up for the journey. “A splint,” he says, “we definitely need some sort of splint, and crutches” and he sends his assistant off with some money to get what we need.

An hour later she returns… with a wrist splint that is definitely not going over my increasingly swollen ankle and I’m not letting anyone try! “No problem we can make do!” says the doctor, and before I know it I have a cereal box and a whole heap of pink elasticated bandage holding my foot in place! I looked ridiculous. Oh well, it did the job.

To cut a really long story short I finally make it to Dar (having been told off on the plane for resting my foot on their aeroplane pillows!) and get an X-ray which is slightly out of focus, but they insist it won’t matter. The conclusion? Not broken. Phew!

A month later I am still in a lot of pain. Luckily I happen to be heading to the UK to renew my passport so I pop in to A & E. Yay NHS – An MRI scan picks up not one but five breaks and I return to TZ in a leg brace! Hmmm.

So, as you can imagine, everyone here becomes a quasi-doctor and self-diagnoses. You can buy just about anything over the counter here – including morphine (not that I’ve ever decided I need that! – so we often bypass the system and just opt for DIY healthcare! It’s surprising how much knowledge you gather (my safari med kit is awesome – Coops knows!).

Your turn…

Any terrifying travel traumas involving doctors or hospitals? As always – please do share!

Thanks for all your comments on the building piece, I love hearing what you think so please do let me know.

Next week – watch out for a brand new poo story!


6 responses

  1. 3lln

    For fair warning, I don’t like hospitals so when I do go it is always bound to be serious. Whilst one month to my IGCSEs, I started to experience fevers before bed and lost my apetite completely. One night I got a slightly higher temperature than normal and the next morning it was deicided I was to be taken to the doctors. As you might have guessed, they tested for everything but only found Malaria – surprise, surprise. I got medication for it, of course.
    Two weeks to my IGCSEs, I feel horrible. I am ill and sick all the time and and can barely get out of bed one morning. Back to the doctors it is for me (obviously different ones) and tested for everything again.
    Turns out I didn’t have malaria (not anymore if I did, at least!). But I did have enough typhoid to kill a child, amoeba and an infection of some form. I had to revise in bed for few days.
    My story of hospitals 🙂

    March 15, 2012 at 3:08 pm

  2. Ms D.

    I know exactly what you mean by everyone being a quasi-doctor! I never get any other diagnosis but Malaria or Typhoid! Now that I have learnt what malaria and typhoid parasites look like, I normally insist on taking a look down the microscope at my blood sample! More often than not, I don’t have what they claim!

    I spend a week in Nakuru’s local hospital. Each day I was assigned to a different part of the hospital and while in the operation theatre, I noticed how the surgeon would upturn an empty crate of coke bottles and climb on to it get a better view of the patient! ( I can imagine Coke desperately wanting a photo of that and captioning it with something like, ‘we save too…life’s good!’ )

    Anyway, It breaks my heart to acknowledge the little resources and ability present in all the hospitals. But on the brighter side, at least we can count on the staff to come up with creative solutions to some of the problems, like the crate and in your case, the cereal box! Hope your leg/foot is much better now.

    March 15, 2012 at 8:31 pm

    • Great story, will never look at a coke crate quite the same way again! – life saving apparatus! Please keep adding your responses, I always enjoy reading them.

      March 19, 2012 at 9:59 am

  3. carriepots

    Brilliantly expressed Mel!

    March 18, 2012 at 1:39 pm

  4. Kate

    Hi there Mel.. Katron here! Great piece yet again… But also a stark reminder of the shocking state of health care provision in much of the world. Being back in the UK certainly has it’s downsides – the weather most notably! But whenever I hear anyone moan about the NHS I really down have to hold myself back from a full on lecture… Nearly let a woman in the bus queue have it the other day, she thought it terrible that the menu when she was in hospital didn’t have enough choices for vegetarians! I have so much admiration for those trying to help improve health care in places like tz. I remember well the comments of one expat doctor working in the big concrete monstrosity you refer to. To make the decision to go home to his family would very often mean someone may die, but long term, if he was to retain any sanity and therefore be able to continue to make a difference, he needed time with his family… Now those are decisions most people will never be faced with… Sobering.

    March 19, 2012 at 5:29 am

    • Wow, it’s amazing what people find to complain about when they’ve got it good! I’ve just been interviewing volunteers from the states at Bugando Hospital for an article I’m writing and, as you say, I have so much admiration for what they do. Thank goodness for health care professionals all over the world! Thanks for the comment, adds another angle again x

      March 19, 2012 at 10:02 am

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