Sunday, February 24, 2013

Anecdotes about TZ Hospitals

I've not been writing much lately because for the past few weeks I have continued to be sick and I'm trying to stay away from being whiny and all "woe is me."  But I thought I might make a few observations about my experience because going to the doctor's here is totally different than in that states and it's probably nothing like you might think.
  •  Most of the hospitals in Mwanza have a lot of up-to-date technology. Now, they don't have everything that we have in the states (i.e. dialysis machines) and what they do have is not kept up properly. But some people may be surprised to know that I got x-rays and an ultrasound on equipment that's just as nice as in the states. Unfortunately, the power is not always consistent, so when I was laying on a table getting an x-ray, the power went out. So I had to lay in the dark for about 30 seconds until the generator kicked on. It was no big deal to me but I just wonder what happens to people who are on life-support. What can 30 seconds of not breathing do to a person? And it's horrible to think that a nurse probably has to choose which of the people in her care she will manually push oxygen. Horrible. This just shows how important infrastructure is. I have a TZ coworker who always says, "No power, no life." That's literally true in this case.
  • You can't really go to just one hospital and have everything done that you need. I think I went to 6 different places to have various tests. This can make it extremely confusing because there is no one consolidated medical record for me. I had to start charting my own record in a notebook I have at home so as be ensure that I'm not missing anything and so I could tell each new doctor the whole story. I can't imagine how difficult this process would be if a person did not know how to advocate for themselves. How can doctors see trends and know the whole story if there is no record on file? I only realized that some things that were done had been done incorrectly once I had everything written in one place. No one would've ever caught that had I not done it. Again, Tanzanians have such a high mortality rate. Gee, I wonder if this has anything to do with it?
  •  The people at each hospital I went to throughout this whole time were all super sweet to me, calling me their sister and welcoming me a million times to come back again (I hated to say to them that I hoped never to return). For example, when I had to put a medical gown on, the nurse locked the door and had someone outside standing guard while she stood guard inside. I don't know that it was necessary to do all that, but I do appreciate the gesture and the privacy. I wish they'd done the same for Tanzanians. Two times I was brought through a room where a Tanzanian person was partially undressed and getting an examination and one other time they left a door open while another really sick woman was getting dressed in a chair. Guess there's no such thing as HIPPA here.
  • This is no war-zone, so when you go into a big hospital it's not like there is blood and guts everywhere. However, because there is a lot of disorganization and people are pretty much left to their own devices to go from one section of the hospital to another, you'll see really sick people just sitting/walking around. I saw a little kid with a whole cast on his arm (fingers to shoulder) just whimpering in pain; another skinny skinny skinny kid with a huge growth on her neck that obviously impaired her ability to eat or turn her head; a guy laying by himself on a gurney in the hallway, eyes rolled back in his head with a catheter bag in (I know this because the bag was sitting on the bed 1/2 full); one woman was sitting in the waiting area behind me and I guess she just got too tired because she just slumped off her chair and onto the floor and laid there, head down and all. I guess I'll stop there, but you get the picture. Sad stuff.
  • It cost me less than $300 USD (paid in TZ shillings, of course) to have all of my medical tests done, including consultations and medication. That includes an ultrasound and about 10 x-rays. Crazy!
  • I love the fact that in Tanzania you can just show up at a hospital and get something done. You don't have to schedule an appointment or anything. By word of mouth I heard that there was a pretty good urologist in town. My colleague and her TZ husband took me out to find the place. We just walked right in and he sat me down to talk about what was going on and give me advice. Not only that, I saw him 3-4 times and texted and called him a bunch and he didn't charge me a thing. Awesome! 
  • You don't need a prescription for medicine in TZ. There are tons of pharmacies on every street and you can just walk right in and ask for whatever you want. Most pharmacies just carry the basics to treat the most common ailments (malaria, amoeba, cough, etc) and it's all ridiculously inexpensive. Unfortunately, the medicine that I am on for the next few weeks isn't easy to find and it's not at all cheap. I went to a big pharmacy in town that usually has everything. I told them what I needed, they gave me a bag of medicine and sent me on my way. Before I left the store, I clarified which medicine was which because they had put some of it in an unmarked envelope. But once I got home I realized that they'd sold me the wrong stuff. I had to drive the 1/2 hour back into town to return it. Once I got there they insisted that it was the right one. They have these 2-3 guys that sit at a desk in the corner and their job is to look up in a medical book what prescription you want and then give you the equivalent that they have. Unfortunately, the "equivalent" that they had was completely not the right one. They gave me medicine for heart failure instead of for bladder problems. I insisted it was wrong and returned it. Again, here in TZ you have to be your own advocate. Thank God for Google and my forethought to actually look at the literature inside the box.
By the way, when you read about all the tests I've had done you might think I'm dying or something. Nothing could be further from the truth. Basically my bladder wasn't fully emptying so urine was left and was developing constant bacteria. I'm on medicine for the next few weeks to get it all fixed up. I'll be glad when it's all over!

Tuesday, February 19, 2013

Grocery Shopping

On the way home from work today I made a quick trip to a new grocery store that I wanted to check out. Mwanza is growing every day and there are a ton of little grocery stores that tend to carry much the same things. Cereal, powdered milk, pasta, canned beans, olives, capers, olive oil, etc. I am always on the lookout for a place that has some variety, so I decided to check this place out.

My coworker was with me as we perused the isles and she stopped at the cereals, picking up a bag of muselix. She was asking the cashier how to cook it and what to do with it so I explained to her that it was like a cereal and that it did not need to be cooked. I said you could eat it raw or you could put milk on it and that it was healthy because it had nuts and oats. A few minutes later I found a bottle of tahini (a rare but not uncommon thing) and my coworker wanted to know what it was used for. In English I tried to explain what I use it for (hummus and felafel usually). Then I went to checkout and the cashier wanted to know what I use the tahini for. Explaining it in English was hard enough, but in Swahili. Yeah, that was a lost cause. Then she started asking me about other things in the store and what they were used for. How do I explain in Swahili what rosewater is used for when I'm not even sure in English.

It just struck me as funny that all the grocery stores in Mwanza have these same items and no one knows what they're used for. Surely there aren't enough westerners to support a dozen stores that all sell the same things that no local person uses. Well, I guess if all else fails with my job with women I could maybe find a use in a grocery store in town.

Thursday, February 14, 2013

Tumaini Jipya (New Hope)

It's Ash Wednesday* and the season of Lent has snuck up on me fast this year. I have been sick for the past three weeks with malaria, a persistent urinary track infection and a bacterial infection. The malaria started 3 weeks ago; I took medicine but it came back again 2 weekends ago along with the UTI. So I took different malaria medicine and an antibiotic. But by the following weekend the UTI was still there and, in fact, had doubled in count and had brought with it the bacterial infection. So now this week I have been getting daily antibiotic injections and have been going to a urologist and getting tests to make sure there's nothing seriously wrong with me, since I never had this issue before moving to TZ and have had it pretty persistently for the last 6 months. Anyway, I write all this to say that the last 3 weeks have been pretty crappy. Chris has also been sick and doped up on medicine for the past week and together we've made quite a pair.

When I'm sick I tend to get cranky. I don't make a good patient. I like to always be doing something, so to sit and do nothing, resting and recuperating is not easy for me. And when I'm away from home and feeling yucky and stuck in the house doing nothing, I find myself falling into self-pity and doubt. I start to focus on all the things that I don't like about my life instead of the things that I do like.

So I have decided that I am going to try to take a moment each evening in Lent to talk to Chris about what I liked for the day, what went well or what was positive. There are so many things that go right each day, but it's so easy to focus on what went wrong, especially here where things seem to almost always play out differently than I expect. I am going to try to think of this Lenten season as a time of renewed hope, "tumaini jipya." A time to remember that I am here in this exact place for a specific reason. That reason may never be revealed to me but I must have hope and faith that I am where I am supposed to be and that my life is playing out the way it should.

For now I want to say how thankful I am to be here with Chris. There is no one I'd rather be home sick with than my best friend and hubby. That has to be the best thing about this whole Tanzania experience so far. Time is not as jam-packed here as it is in the states and Chris and I get to spend a lot of time together. I feel like our relationship has grown and changed and gotten so much stronger over the past year. And I am so happy to be doing this with him.

*Well, it was Ash Wednesday when I started writing this post.

Thursday, February 07, 2013

A Week of Challenges

This week started out with a bang with me being asked by my boss at work to attend a week-long training on Quickbooks. Why would I be asked to attend a Quickbooks training when I'm not an accountant? Well, that one I'm still trying to completely figure out. Basically, I think he wanted someone to attend who could institutionalize the knowledge and really absorb what was being taught. I could attend and then later help our administrator (who is not very good at computers) to set up our accounts and get them running. So, I willing jumped in and then realized, duh, it's going to be taught in Swahili!

Luckily, I caught most everything that was being said because the program is in English so the class was pretty much more Swanglish than straight Swahili and that's a lot easier for me to understand.

QuickBooks training (in Swahili)
The training class listening intently.

Unfortunately (or maybe fortunately because it got me out of 3 more days of training?), on Tuesday night I got sick with malaria and an infection and have been pretty much in the bed ever since. I had malaria (first time ever) last week, took 2 days of medicine and thought I'd kicked it. But then over the weekend I started feeling signs of a bacterial infection. I tried to rest, drink water, take care of myself so it would go away, but alas "nimeshiwa" (I didn't succeed). 

Breakfast of champions
This is my breakfast for the next few days. Since arriving in TZ I've pretty much constantly been on some sort of preventative or curative medicine. I don't even remember the days when I didn't take medication.

What sucks even more is that Chris is sick too. He's got amoeba and an infection. They say misery loves company (though I wouldn't really go so far as to say we're "miserable," more just uncomfortable), but I would argue against that notion in this case. Although it is nice to have company while being confined to the house, it also is a pain because neither one of us feels much like doing the necessary things around the house, cooking, cleaning, making food, etc.

Poor Smokey wants so bad to come in and play because she's been neglected by us all week. Too bad she can't help around the house; but just don't think she'd get the dishes as clean as we prefer them to be.

Smokey wants to help in the house
Looking in from the kitchen door. "Isn't there anything I can do in there?"