In America, going to the ER was an all day process. Unless you had a bullet in head, you could expect to wait in the ER waiting room for about 3 hours before getting you vital signs taken and moving to one of the hospital rooms. At that point, you get really excited because, you're in the hospital bed, it must be almost your turn, right? Wrong. It takes another 2 hours of rolling around in the hospital bed in a silly johnny, with your bum hanging out, calling the nurse every half hour to request one of those warmed up blankets and pain meds, until finally: 5 hours after arriving at the ER, you get seen by a real doctor. And the real doctor sits with you for 15 minutes, asks you questions and then determines a series of tests to run, then hands you over to a lab tech, nurse, or intern. Your tests get run, you see the doctor for another 15 minutes to talk about your plan of treatment, and then you're done. 6 hours in the ER for a total of ½ hour with the doctor. Sound familiar.
That used to annoy me, as I am sure it does everyone else. I've heard complaints that doctors have too many patients now-a-days, that nurses are overworked, that patient care is no longer a priority. And, it's true. Ideally, everything would run smoother. Ideally, you wouldn't have to be dying to be able to see your doctor on short notice. But, that being said, let me tell you about my hospital experience in Tanzania.
So, I have been really sick this last week. Like 102.5 F, swollen/painful glands all over my neck – to the point where I could barely move my neck, headache, chills, not sleeping at night, the whole 9-yards sick. After 4 days of being miserable, and more neck lumps popping up, I called the PCMO and she suggested that I go to one of the PC approved hospitals. The closest one is in Mbeya town, about a 2 hour bus ride from my site. Being on a bus in Tanzania when you're sick is miserable.
When I first arrived at the hospital (which by American standards is a small clinic), I was actually pretty impressed. I registered at the front desk, and the woman actually spelled my name correctly and then I got my BP taken by a nice old mama and then was asked to wait for the doctor to call my name. It was a same, familiar process that would happen in the States.
I waited for the doctor for maybe 15 minutes before my name was called and I entered his office. His office had a sink, a desk, and two chairs. Nothing like an American doctor's office. There was really nothing there that would enable a complete physical evaluation to occur. I explained to him what was wrong, told him about my fever (which I was even nice enough to convert into Celcius), about my very painful swollen glands, about how I had pain medicine that I was taking to reduce the swelling and be able to move, about everything (he didn't speak English, and my Swahili actually held up pretty well). He then felt my swollen glands very roughly, even after I had stressed how much they hurt and diagnosed me with “inflammation” and “pains of the neck”. And that was it. No temperature taken. No tests. Nothing at all medically competent. It was the biggest waste of time of my life. And the kicker: he prescribed me an antibiotic and then three different types of pain medicines (even after I told him I already had some). Even doctors want to rip of the white people. I didn't get any of the prescriptions. The PCMO recommended a different antibiotic which I could get at a local “duka la dawa”.
So moral of the story: the 6 hours spent in the ER is at least a productive 6 hours. You get a knowledgeable doctor to give you a real diagnosis. You get tests to prove that diagnosis. You get medicine. Even though you only see the doctor for half an hour, there are nurses, interns, heated blankets, magazines, and real proffesionals to fill up the 5 ½ hours that you are not seeing the doctor. Here, you see the doctor for 5 minutes, and come out no more knowledgeable than when you went in. Except that he's given you the names of 3 different brands of medicines that do the same thing.
I'll take the knowledge.
the end
10 years ago
