Hospital Visit

It goes without saying that if you spend 6 months in Africa after having gone 20 years without spending more than a couple of weeks outside of the same small town, you will probably get sick. In all honesty I’ve been lucky- I made it through a full month without getting anything worse than a nosebleed.

I hadn’t been feeling so hot this past weekend. Well, that may be a poor choice of words- I hadn’t been feeling so great this past weekend. It started on Thursday afternoon, just the normal sick feeling- headache, congestion, stomachache, sore tonsils, and that horrible achy feeling that makes your skin crawl when you move or touch things, including the bed, the covers, and air. However, the normal sick feeling doesn’t feel so normal when I can hear the voice in my head taunting, “Malaria! Ebola! Sleeping Sickness! Zombie Virus!”

By Friday morning, I legitimately felt like I was dying. So when I finally succumbed to Mama Kawishe’s most guilt-producing looks of sympathy and agreed to go to the hospital, I had to brace myself just a little bit. She was comparing my symptoms with those of malaria, and was convinced that I had contracted the disease. I was too, a little- it is a practice in futility to try and avoid all the mosquitoes, because they’re everywhere, and if my memory serves, the malaria medicine isn’t a 100% prevention guarantee.

My first thought was that since malaria is a blood disease, the test to determine malarial infection would be a blood test. Despite my dad’s and Papaw’s most furtive attempts to turn me from needle-fearer into future-surgeon, I still cringe at the sight of a needle. And if they just hurt medium-amounts in America, surely in Africa they’re the size of bamboo shoots?

Upon arriving at the hospital (TMJ, a privately-owned place in Kawe), we parked the car and walked into the outpatient waiting room, which is also the inpatient waiting room and also the emergency room.

Literally the very first thing I saw upon walking up the ramp into the building was a gurney being pushed out to a large van by two nurses. A white sheet covered the body on the stretcher almost completely, although a pale, sallow white arm was exposed. Aside from seeing an open casket once, this was the first time I’d ever seen a dead body in real life, and as I was already nervous this didn’t help at all.

We entered the waiting room, which was hot and humid even with the open doors and presence of several oscillating fans. We were instructed to wait in a long line to present name and insurance information and be given further instructions, and Mama Kawishe, being the gracious and kind host mother she is, told me to sit (read: collapse) on one of the chairs in the waiting area while she waited in the line for me.

The room smelled like dust and tension. It had the same décor of the Titanic- marble floors, eloquently designed ceiling tiles- but it was obviously old, outdated and in need of maintenance. The whole place had a tinge of yellow to it, as though smokers lived there. There were a lot of people waiting, crowded onto the red plastic chairs, and in the middle of the waiting area there was a bored and irritable-looking nurse sitting with a stethoscope and pressure cuff, her feet propped up on the scale in front of her.

She was painting her nails a poisonous green color and watching the overhead TV, which was repeating movie trailers for “Unstoppable”, “Stone” and “Due Date”, all movies I am now interested in seeing (or perhaps it was just the effect of seeing such a plethora of mzungus on the screen). Every once in awhile a prevention ad for malaria and tobacco use would pop up, or else an ad for a nearby boutique.

By the time I was adequately sure I knew the film progression by heart, Mama Kawishe was at the front of the line and we were soon directed into a small room just off the waiting area.

A young Arab woman sat at the desk in the room, and to my relief she spoke English with a fine American accent. In most situations I wouldn’t care about the language or accent with which someone spoke, but when I’m asking about needles and sterilization I want to be perfectly sure that I am heard correctly.

She asked about my symptoms, medical history, prescripton drugs, and other routine subjects, and then she examined my mouth and ears.

“It’s probably not malaria,” she said, setting down her shiny-ear-looking-thingy and pulling some prescription papers out of a box on her desk, “but I want you to get a blood test to be sure-“

I whimpered a little.

“-and I’ll order a blood pressure test-“

I thought of the irritable-looking nurse outside.

“-and then you just bring the results right back to me and we’ll see what’s wrong.” She handed me two prescriptions, one that just said “BS” and one that just said “BP”, and a little purple object a little larger than a pen cap. Upon further examination I realized it was the needle with which I was going to be stabbed momentarily, encased in protective plastic.

I went and sat tentatively on the edge of the chair next to the irritable-looking nurse, who waited a full fifteen seconds after I sat down to draw her eyes from the TV screen and acknowledge that I was there and in need of her stethoscope-wielding services. She (grudgingly, I thought) strapped the cuff on and, after inflating the thing to painful capacity, took her time in getting the stethoscope to my arm and releasing the air in the cuff. I could see the veins on the back of my hand starting to pop up, which almost never happens, because I think my veins like to stay hidden where needles can’t find them.

After the nurse scribbled a large fraction onto the note that said “BP”, and looked at the other one and pointed me down a long corridor, where a faded yellow sign hung from the ceiling and said “LAB”.

At the door to the lab, I waited until I saw someone that looked professional enough to give my “BS” paper to. A young man in jeans and a button up T-shirt took it and steered me into the lab room, plopping me down into a chair and taking from me the purple needle-holder.

A large man appeared at the door, leaning against the door frame and blocking the exit.

The men inside the lab room bustled around, looking into microscopes and arranging tubes with yellow or dark red contents inside them. The lab was a sunny room, although it had the same old and yellowing feel that the waiting room had to it. Had you removed all the people, it could be the sort of place people use in horror movies about abandoned hospitals (the movie Session 9 comes to mind, if anyone is interested in that sort of thing).

No sooner had I sat down than the man grabbed my hand and started attacking my finger with the cotton swab. I remembered the size of the needle I’d handed him and my exact thoughts were, “NO WAY IS THIS GUY GOING TO STICK THAT NEEDLE UP MY FINGER. I’d rather have malaria, thanks.” (To be fair, these were the thoughts I had about polio, yellow fever, typhoid, tetanus, and influenza when I had to get those shots from the health department before my trip).

He put the needle in a sinister-looking blue thing that at the time looked like it should be used to tranquilize bears at a zoo. My faint request that he put on some plastic gloves went unheard, though when I looked around the room I couldn’t even see a box of them.

He brought the death-needle closer to my hand and I literally pulled my hand back and looked him dead in the face.

“What is going to happen here?! What are you going to do?!”

He just grabbed my hand back, and said “No pain! No pain!” very fast, and jabbed my finger with the blue thing.

I’ll be honest, it didn’t hurt a bit, it was just one of those spring-loaded needles they use to type your blood at a donation site, but I had braced myself for pain akin to having my finger removed with pliers. In my defense, I think it was really unnecessary for them to hand me a two-inch-long needle when all they needed was the 1/8^th of an inch at the end, and then let me sit there and fret about it for ten minutes.

The man wiped my blood on a little clear plastic plate and gave me a cotton ball to stick on the end of my finger. I sat outside the lab room on a red plastic chair next to a set of very young twin girls (both holding cotton balls to their fingers) and their rather large mother. I grinned at the twin next to me.

“My finger has a heartbeat,” I said to her, smiling, knowing fully well that she couldn’t understand me. She looked at me a little funny and mumbled “Sijambo” and turned back to her mother. If my mom had been there, I know she would have probably snorted and laughed, because Elf is one of her favorite movies. I didn’t eat the cotton ball, though.

It took about twenty minutes to get my lab results back (doodles, I thought, because I couldn’t read the writing; way to perpetuate a stereotype, doc) and then I was back in the Arab doctor’s office.

“Your blood test came back negative for malaria, although you did have a high nerophlosmopippydoopedoodah count-“ (whatever that is) “-which does indicate an infection, so I’m going to prescribe you some antibiotics, and some anti-histamines for your congestion, and some painkillers…-.”

She handed me a sheet with the prescriptions on it, we thanked her, and we left. The pharmacy is conveniently located in the waiting room, which I think is another thing America needs to seriously pick up on.

The entire visit cost me about $18 (25,000 TSH), and that’s without medical insurance- mine isn’t accepted in Tanzania except for emergency visits. To put this in perspective, though, $25 is a good half of what most people get paid in a week in Dar Es Salaam. Additionally, this particular hospital is privately owned and operated, and is in quite better shape than a government-run hospital, which would be cheaper but also less safe and less efficient.

The Arab doctor explained to me that while the building doesn’t look very nice, they do their absolute best to make sure that their treatments and equipment are completely sterile, and they don’t re-use needles. She told me that that much can’t be said for all of the hospitals in Dar, though, and some of the more rural hospitals will lie if you ask whether their equipment is sterile.

All in all, though, I had expected a lot worse. It was an overall positive experience and I will be using TMJ as my regular hospital in Dar, when I inevitably get sick again or get mauled by a hippo.

Next time: Discussing a topic of your choice! I’ve had a few suggestions already, but feel free to comment and suggest more.

Oh, and I'm fine now, by the way. :)

Love you Mom and Dad J Eli, excellent job on your Silver Key in the art show- I’m so proud, I hope you never give up the artwork! Miss you tons Nana and Papaw, I love you so much!

Kwa Heri,

Emily