Village Sick

What happens if you get really sick in village? This is a question that crossed my mind a few times before I even got on the plane to Tanzania let alone saw my village's health facilities. Early this month I finally got to experience second hand what it's like to have a serious illness in a remote part of a third world country. My poor partner has had Malaria at least 3 times since the start of the program. She had Malaria so many times in her life she knows the symptoms all most immediately and almost always diagnosis and treats herself for the illness with out ever seeing a doctor. Many Many Tanzanians do the same. Although us Westerners can't imagine treating ourselves without consulting a doctor, the health service situation here can be so poor that people would rather not waist hours waiting to see a doctor only to be told what they already knew. The other influence toward independent diagnosis and treatment is the fact that pharmacies do not require prescriptions here to obtain ANY drugs. You can get anything over the counter here. Think of the possibilities! But Devota was not gleefully buying up painkillers and downers like I can imagine some westerners do here. She just treated herself for Malaria and apparently did not take the adequate dose to kill all the parasites because they came back while we were in village, with a vengeance.

When we first got back to village she told me she was not feeling well but she didn't say she had treated herself for Malaria in Dar during the holiday. She said it was nothing and she just needed to adjust to the weather change from hot Dar to cold Igula. Then one night she calls my cell at 3am for her room next door. I go in the room and she is burning with fever, sweating and crying. She can't even get out of bed. She says she needs some cold cloth for her head and chest. I soak some hand towels in our water basin, put them on her and give her some Ibuprofen. She eventually falls asleep. The next day she says the fever is gone but she thinks she has Malaria again. She doesn't want to go to the hospital and test because our village Lutheran Mission hospital is a miserable place, always packed with people and it always takes hours to see a doctor. She decides to just get some more anti-malaria's and treat herself again. But the next evening the fever returns. She texts me at 6pm while I'm in a neighboring village at 30 minutes away. She says her fever is back and she needs to go to the hospital. I start walking home as fast as I can. There are some men in a truck. I recognize them from the village. They are cat calling me from the window. I go up to them and he smiles and continues talking. I say in Swahili "Stop. Listen. My friend is very sick. She needs to go to the hospital. We live near the Catholic Church can you take me there and then take us to the hospital?" All the man says is "Lets go". We pick up Devota. She's crying again and can barely walk. By the time we get to the hospital it's dark and there is no one in the reception area. Fortunately, I know the matron of the hospital and she is still in her office. She gets Devota in with a doctor rather quickly. While Devota is waiting for me to find the matron, the men who drove us get out of their car and start asking Devota for money. They are asking for 5,000tsh, which is exactly 10 times the normal price for a Dala Dala ride. I come back and tell the guys to piss off because I thought they were just doing us a favor and I'm angry they are bothering Devota and asking for so much. Then while we were waiting to see a doctor the men followed us into the women's ward and wouldn't leave. I went out there and said "What do you want?" The man rubbed is fingers together signalling money. I say " I'm sorry. My friend is very sick. I thought you were giving us a ride to help us. I have no money for you." They just laugh at me and didn't leave until a nurse came out and yelled at them to leave.

Devota was admitted into the hospital that night and put on a Quinine IV drip for 24 hours. The student nurses who first came in to put her IV in were literally piercing her skin trying to get the needle in over and over again. They used the same needle each time they pierced and must have contaminated the needle because a week later Devota got an infection in both the veins the IV was placed in. It wasn't until an experienced nurse came in and took over that the IV was put in correctly. The old nurse was wearing a Badger Rosebowl sweatshirt over her uniform because it is so cold at night and the hospital doesn't have heat.

We paid extra so Devota could have a private room. However the accommodations were still really poor. There were cockroaches everywhere and the one toilet she had to share with the 50 plus other women in the ward was the worst I've ever seen, and I've seen a lot of disgusting toilets. The next night she was still on the IV drip and had to stay. The nurse forgot to give her her evening does of fever reducer and her temperature got so high she became delirious. She was speaking non sense, couldn't open her eyes and would laugh and then cry. I ran and got the nurse to ask that they take her temperature and give her some panadol. The nurse took her sweet time and even thought it was funny that Devota laughed when the nurse put her hand on her forehead. I said "she's laughing because she is delirious with fever! Give her the meds!" Her temperature was 103. I was scared and frustrated. I had never seen anyone delirious with fever. And in village Devota and I are all we've got. It was my job to take care of her, to make sure she was taken care of in the hospital. It was one of the hardest things I've ever done to stay composed and not scream and yell at those stupid nurses.

The IV worked, she was feeling better the next day and we got to go home. She had 5 days worth of quinine pills to take after the IV and she didn't feel 100% for another week after that. She's now on antibiotic meds to get rid of the infection the IV caused. But besides that she is healthy. The men who gave us a ride showed up at our house a week later drove up on our lawn and demanded the 5000tsh. I was alone in the house and got scared they were going to come back and try to hurt us or intimidate us again so I went to the new police station in Ilembula right way. The police tracked down the men easily in such a small village. The police scolded the men for trying to charge so much, but not for coming to our house demanding money. We came to an agreement that they would never come to our house again and I would never ask them for a ride again. Like that would ever happen! The whole sick in village experience just showed me how much we take for granted in the states. When it comes to our health we expect everything to be done for us by highly trained experts who never make mistakes. But that's not the reality for most of the world. Weather in the hospital or out its always the same: fend for yourself.