Flashback: July
2011
Interviewer for my current position: If
I may be blunt and go off the script for a moment, can I ask you what you are
afraid of because you seem to be fearless.
Me: I am afraid
of not having access to Western medicine and a drugstore around the corner.
Present Day: June
2012
Yes, the same
fear still lives inside me and I have yet to adjust to the Rwandan medical system
or seemingly complex pharmacy protocol for purchasing over-the-counter pain or cold
relief. Recently I had my second more serious bout
with “sickness” since I arrived in Rwanda, and the frustration with being so
far away from Western medicine and my grandmother’s homemade chicken noodle
soup recipe has not ceased. I have
always been one of those people who gets SICK when I get sick, and more often
than not, I am the one who somehow picks up the random affliction that only
affects 1000 people per year (ie. Rocky Mountain Spotted Fever at the beginning
of 2011). One of the downsides of
feeling under the weather here is that whatever it is that has a hold of your
system, doesn’t seem to let go for a long time.
Simple colds last weeks, coughs drag on for nearly a month, and
allergies never seem to go away. This
does not just affect me, as each of the volunteers in the Village has battled
one too many long-lasting colds, coughs, and other medical problems. I can deal with all of that, despite the long
duration, but when more serious symptoms arise, medical advice is needed, yet in short supply. Despite Rwanda being the
most densely populated African country, very few of those people are medical
doctors. On top of that, most every doctor is a general practitioner, without a specialty in any area. Case in point, Rwanda is a country with 12.5 million people, however there are only 10 Pediatricians - 10! This is a place where the sun is intense and it feels as though you are baking each time you are outside, yet there is only 1 Dermatologist.
There are common
go-to diagnoses for sickness in Rwanda.
If you are sneezing, or have a runny nose, people diagnose you with the “flu.” If you are having difficulty breathing, you
have “the asthma” (yes, they call it THE asthma). If you have a headache, you have malaria, and
if you are coughing, you have TB. Things
here are very black and white, except when they aren’t.
Case #1
In March, I
developed a headache which lasted many days without relief. It was dizzying and just downright
awful. Of course everyone immediately
said that I had malaria, so I went to the hospital that “white people” go to in
Kigali to seek medical advice and to get tested for malaria. What would seem to be a simple process was
anything but straightforward, and the conversation with the ER doctor went like
this:
Dr.: What seems to be the
problem?
Me: I have had a headache
for over 2 weeks.
Dr.: Where are you from?
Me: America
Dr.: NO, WHERE?
Me: You mean the state? Originally I am from Ohio.
Dr.: What about your
grandparents?
Me: Is it going to help you
diagnose my problem if I tell you they are from Germany?
Dr.: Ah, you come from an
intelligent family.
Me: Is that a question?
Dr.: Are you married?
Me: No
Dr.: Why not?
Me: I have a headache
Dr.: What about a
boyfriend?
Me: I live in Rwanda. I have been here since December, and my head
has hurt since March 18th.
Dr.: Do you have children?
Me: No
Dr.: How do you feel about
pregnancy without marriage?
Me: Do you want to know if
I think it is right or wrong?
Dr.: mmm (Rwandan way of
saying ‘yes’ without really saying anything – sometimes it’s accompanied with a
raised eyebrow)
Me: It doesn’t jive with my
life, but it works for some people, and for them it is fine and I won’t judge
them.
Dr.: So you say your head
hurts?
Me: (sigh) Yes.
Following that riveting examination, the doctor felt my pulse, and sent me for blood work and a urinalysis. (I am still waiting for the urinalysis results…3 months later…)
I returned to his office
several hours after the lab work, and the following transpired:
Dr.: You are sick.
Me: Oh? What did the
lab results show?
Dr.: Results? I don’t have
any results. But you are sweating and look tired. I will give you medicine.
Me: It is a hot day and I
have had to walk a long distance from the lab to the pharmacy to here. That is why I am sweating and look tired.
Dr.: No, I believe you have
a fever and are sick.
Me: ok
He then wrote me an order
for 3 prescriptions and several weeks later my headache subsided.
Case #2
I developed
chest pain several days ago, and with each passing day, the pressure and intensity became more and more
severe. Chest pain doesn’t fall into any
of the “usual” categories (flu, the asthma, etc.), so I caused a bit of a
conundrum among those who wanted to diagnose me within the Village. I know that the chest and lungs are quite
connected to the nervous system and emotions, so I hoped that I could attribute
it just to that, but feared it might be something more serious. I was bound and determined not to return to the
hospital for the same circus-act of an examination, so this time I went to a
private doctor at his practice. When I
entered the clinic (spelled CLINIQUE here), the nurses/lab techs were sitting
with their bare feet propped up on the sofa, watching a Rwandan soap opera, of
sorts. I almost turned and walked out,
but was encouraged to give it a chance by a colleague who said that what I was
witnessing was, “normal” in Rwanda. Normal? Right.
I could hear my mom in my head, saying, “Why the hell are you doing this
to me – living in Rwanda????” (Indeed
she said that exact phrase to me that night when I called to tell her what had
transpired. Do I know her well or what?)
This time the
doctor actually listened to me, took copious notes, truly EXAMINED me (even with
a stethoscope), and 5 minutes after his tech took lab samples, the results were
being reviewed by the doctor himself. Efficiency
and effectiveness…amazing! The bad part
was that some of the results were inconclusive, but I did find out that I don’t
have worms, and I don’t have parasites.
The doctor said that it is likely that I am trying to recover from bacterial pneumonia and that my chest pain is from musculoskeletal bruising from all the coughing.
He put me on 2000mg of antibiotics a day, cough syrup with codeine, and
a prescription pain killer. If nothing
else, I’m more comfortable than I have been in days, and I can finally get some
sleep without squirming in pain every few hours and turning like a rotisserie, trying to get comfortable. I asked the doctor if the medicines will help
me feel better, and his response was, “I hope so. Good luck!”
I honestly don’t know what I expected him to say, so why did I even
bother?
There are so
many medical issues here that don’t exist in America. Aside from a mosquito bite being annoying,
itchy, and red, you don’t give a bite much thought in America. Here, that simple, annoying mosquito bite
could very likely be the cause of malaria - a painful, scary, and sometimes
deadly disease. A simple cough in the
states is aggravating, but you don’t automatically think that it might be tuberculosis
if it lasts a few days longer than you hope.
I live in a whole new world over here in Rwanda, with new realities and
those realities can be a bit terrifying.
Hopefully I have
had my fill of medical mysteries and curiosities in Rwanda. If nothing else, each medical experience seems
to make for a good story for everyone back home. Think of me next time you run into CVS or
Walgreen’s for some cough and cold relief, and be thankful that you have a
doctor nearby who is well trained, trustworthy, thorough, and knowledgeable. Maybe he or she wants to volunteer in
Rwanda????
Favorite Picture of the Week is to the Right (story coming in another blog...):
Favorite Quote
of the Week: “I do not understand why you are not feeling better – I prayed for
you last night.”
Highlight of the
Week: A traditional dance performance by the students at Agahozo-Shalom Youth Village to wrap up the “Restoring the Rhythm of
Life” celebration week in the Village. See a portion
of the performance in the video below:
