06 October 2014

one doxycycline pill a day still does not keep the doctor away.

We’ve been sharing a lot of contemplative posts lately: how we feel about our faithsome of the awesome work Michael's doing, and what it feels like to not fit in, even in the expat community. But for today, I thought I’d take you through a “Day in the Life” post again, like I did when we were in language school.

Instead of going through one of our normal days, I’d like to take you through a “Sick Day.” These are the not-so-fun days.


Let the games begin!

6:25AM - The alarm goes off. It’s Monday. Michael heads outside to bid our night guard farewell and I make the bed. I want to start the day off right, so I decide to do a little workout: circuit training, an ab workout, and some stretching. 

the office doubles as our workout room. looks like your average gym, right?
7:30AM - I’ve finished working out and I’m feeling abnormally tired. “I did stay up later than usual,” I think to myself. “And I haven’t worked out that hard in awhile.” I hop in the shower. 

not much to look at, but great water pressure.
8:15AM - I help Michael make his way out the door. This means corralling Noli, dragging her to a chain to be hooked up so she doesn’t bolt out of our yard, removing the two locks from our gate, and opening our gate so Michael can pull the truck out. Phew! Then, I do it in reverse. 

noli, generally unamused.
8:40AM - After eating yogurt, granola and half a banana as breakfast, I remember I need to run to the market to grab a few things for dinner this evening.

9:10AM - I return from the market and find Noli has killed a lizard. Not again! Instead of eating them, she tries to get them to play with her, even after they’re dead. (She’s not the brightest bulb on the tree.) I grab a shovel, scoop up the poor lizard, and throw him in a creek outside of our house, all while making sure Noli remains in our yard. Not a simple task, as she loves to burst outside of the gate like a rocket whenever we open it!

many of these have given their lives in service to our yard.
9:20AM - Three hours after getting up and I’m ready to leave the house! Tanzanian life moves slow, but even slower than you’d think! I close the windows and curtains, lock up the house, and start my walk to the daladala, which shouldn’t take more than 15 minutes. I feel a little lightheaded leaving the house, but don’t stop for long, as I’m already late.

9:35AM - I get to the daladala stop to find three are there, competing for passengers. The conductors, known as konda, try to talk to you to find out where you’re going and convince you to get on their daladala. It’s quite annoying, especially in the morning. I do my best to ignore them and beeline to the one I want.

the infamous daladala.
10:05AM - I walk about ten minutes from the daladala stop and reach the main office of Shalom Care House. 


10:15AM - I walk into the office and sit down with Witness, the office secretary, to work on putting together a website. As soon as I look at the computer, my head starts to pound. I’m starting to wonder if I’m more than just tired.

10:47AM - I get a text from Michael that he’s at the hospital, getting tested because he hasn’t felt well all day. Not a good sign. The first time I had malaria, Michael found out that he also had it within a matter of days. It’s not unknown for married folks to get it at the same time. The thinking is that if we spend a lot of time together, the same mosquitos are also spending time with both of us!

11:43AM - Michael reports that his lab results came back positive. He has malaria. Insert worried face.

1:19PM - I decide I have to bail on the rest of work. I’m heading to the hospital, which with a ten-minute walk and another daladala ride, shouldn’t take more than half an hour.

1:55PM - I roll into C.F. Hospital, the nicest hospital that Mwanza has to offer. It’s pretty busy, which means this could take awhile. I hand the receptionist my file card. I go to another desk to pay another receptionist. It costs the equivalent of over $9 to see a doctor at this hospital, which is really expensive for a Tanzanian, but luckily, our health insurance will cover my entire visit. I take a seat nearby so I can make sure she’s really looking for my file.


2:10PM - A nurse comes to inform me that my file has been found. She takes me into a room labeled “Emergency Room,” but no worries. They just put their check-in equipment in the same place as the Emergency Room. This makes sense, no? They take my temperature, blood pressure, and weight. Nothing strange there so I return to the waiting room while my file gets passed to one of the three doctors on duty.

2:11PM - I watch the seats nearest to the doctor’s offices like a hawk. Those are prime real estate. As soon as you can nab one of those seats, you can slip into the doctor between patients. I know, I know, this would be “budging” in America, but here, it’s all fair! If I waited for the doctor to call me in, I could be waiting for hours, which I’m not willing to do.

2:19PM - Ha! I’ve found a seat near Door #1.

2:30PM - The next patient comes out of Door #1 and I decide this is my chance. The doctor inside of Door #1 calls out a different patient’s name but I go in anyway. I play the foreigner, act confused and tell him my name. He informs me my file must be in another office. Dang!

2:37PM - I switch to Door #2.

2:44PM - The next patient comes out of Door #2. Again, he calls out a different patient’s name, but I zip in. The doctor says he has my file and informs me he’s already called my name. Riiiiight. Once I start describing my symptoms, I switch from Kiswahili to English. Most of the doctors know pretty good English and when you’re sick, you don’t want to bother with another language. The doctor appears to be my age and continues to get off-topic, asking where I live, what kind of work I do, and informing me about his work outside of C.F. Hospital. Annoyed, I don’t wait for his advice and ask him to write me a slip to get tested. This means I’ll submit urine, stool, and blood samples to see if I test positive for any of the “normal” diseases here. The big ones are malaria and typhoid.

2:55PM - Lab slip in hand, I go back to the first desk to pay the second receptionist so that the lab will give me all of the containers I need for my various samples. This is the most expensive part, costing over $30. Annoyed, I realize I don’t have enough cash on hand. (Absolutely everything in Tanzania is paid for in cash.) I know of a reliable ATM nearby so I’m out the door.

3:10PM - Cash in hand, I pay the receptionist. She stamps my lab slip and I walk down the hallway to the lab. She hands me a paper bag with two containers in it. I head outside to a separate building that just houses the bathrooms. No details necessary here.

3:20PM - Back in the hospital, I hand the lab nurse my paper bag and she tells me it’ll be a 40 minute wait. I immediately set an alarm on my phone, so I know when to pester her again.

playing the waiting game.
4:00PM - My alarm goes off. No one from the hospital has approached me about my labs. Annoyed again, I go back to the lab to find the nurse. As soon as she sees me, she informs me my lab results are already with the doctor. “What the heez? Why didn’t you tell me that earlier?” I want to ask her but it would be of no use. I head back to Door #2 and wait for the next patient to come out.

4:07PM - I sneak into Door #2, again. The doctor tells me he doesn’t have my file. “It must be with another doctor,” he says. I barge out of his office.

4:08PM - Increasingly frustrated, I head right into Door #1, even though there’s a patient inside. Hallelujah, she has my file! She opens it up and finds that Doctor #1 (behind Door #2) failed to write down any notes so I have to tell her all of my symptoms again. I have malaria and a staff infection. (Neither are scary, as I got the same diagnosis back in May.) She writes a prescription and I head to the pharmacy.

4:14PM - The pharmacist writes the amount I owe for the medication on the prescription. I bring the prescription to the receptionist once again for payment. There goes another $13. She says she doesn’t have change, a common occurrence here, so I have to search around in my backpack to find the exact amount.

4:25PM - I pick up my medication from the pharmacy and I’m out the door. Freedom! I’m tired and still have that headache but I’m thankful to know what’s wrong. I’ll start the first round of medication after dinner.

4:38PM - I grab a daladala in town to head home. Thank God it’s not too crowded, so I’m able to get a seat.

5:20PM Home sweet home! After two and a half hours and over $50 later, I’ve received a diagnosis.

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I want to underline that the experience I’ve described here is the best treatment you can find in Mwanza. Most Tanzanians could never afford a facility like C.F. Hospital. Instead, they use a small local maabara, laboratory, in their neighborhood. It costs far less but the results are notoriously bad. Most laboratories struggle to stay afloat so the care of their equipment and the cleanliness of their instruments is sub-par. You’re also not able to consult with a medical professional. True, I was exhausted at the end of my day visiting the hospital, but I knew that without the health insurance and money I possess, it could have been a lot worse. There is so much need in Tanzania for quality health care. When I’m sick, I’m only reminded of how large the gap between the rich and the poor truly is.

Now you know what our days look like when we’re not feeling too great! Any questions? Does it match up with what you expected? For our friends living the expat life, I’ve love to know what your healthcare looks like as well. Here’s to hoping we stay malaria-free for quite some time, if only so we don’t have to return to the hospital again!

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