My tailor says: “Muli bwanji”, How are you? And I answer accordingly “Ndili bwino kaya inu?, I am well, how about you? We do our business and then he says: “You want an Xray, but no medication?” I am floored. He cannot possibly refer to my consultation with the hospital doctor that I barely left? Or can he?
But let’s back up a little. A week ago I started to get sick, but was trying to ignore it since I had too many things to do. However, as these things go one usually does not have a choice in the matter. And so I became sicker and sicker. On Tuesday I was sent home by my principal so I could rest. At that point my voice was gone and I coughed all the time. Laryngitis and bronchitis are actually quite common in teachers and I had my fair share of them over the years. So I greeted the situation as an old, familiar friend. But now I am in Africa. Even familiar things don’t have to work out in familiar ways. Our Peace Corps (PC) medical team had given us an extensive medical kit for our field work knowing that not all of us can reach medical treatment once we are sick. The idea is that we call the Peace Corp doctor in the capital, he tells us what to take out of our box and keeps monitoring the situation in order to possibly change treatment or adjust the situation. And this is how it worked at this time as well. Except I couldn’t find any cough medicine. And the writing on some of the packages was so small that, even with my strongest glasses, I could not read what is in it.
Anyway, my cough (besides the general very sick feeling) became so bad that when I tried to return to work later this week I was sent home again. Without cough medicine there was no sleep. I begged he doctor to tell me what kind of medicine I could possibly hunt for in my village. He did. And I went to the local hospital, a privately run, Anglican hospital which I had visited before to introduce myself in case of an emergency.
I knew exactly where to go, found the pharmacy and was instantly recognized by the two staff working the counter. They sent me to the reception. I handed over my note with the name of the possible drugs and the technician was on his way to find them.
He came back after a long time telling me that the hospital was out of this particular medication, but I could see a doctor so he could prescribe me something suitable. I texted my PC doctor and he says “yes, sounds good, just don’t let them give you antibiotics”. So I waited until I was called to enter the small consultation room with a doctor and an assistant. Of course, the doctor doesn’t know I just want cough medicine. He wants to do his own diagnostics. When I told him about the PC physician he also got a bit offended. I should have known. However, obviously in Africa doctors screen for a series of diseases that we are not normally come in contact with like Tb or HIV/AIDS. “Do you experience night sweats?” “Yes, of course, but this is most likely related to the currently very high temperatures. And have I ever been HIV tested before? Me: “Yes, of course.” The doctor: “And, what was the result?” In hindsight these are all very logical questions, but highly unusual for my ears. But in a country that still has a high percentage of it’s population infected with HIV, this is not unusual at all. I realize, he even gave me the VIP treatment since he just took my word for it. No Tb, no HIV. Simple. Now I only have to purchase a patient book where all consultations and treatments are registered.
The doctor insisted on at least listening to my lungs as any good doctor would and in the end found some noise in the left lobe of my lung. Bingo. Here comes the prescription for antibiotics. I text my PC doctor telling him that now there is a suspicion of pneumonia, which he has to take seriously by law once the suspicion is voiced by an on-the-ground doctor. This changes everything. My PC doctor asks for me to get a chest X-ray to confirm the diagnosis. The hospital doctor is still annoyed and says that here they treat first and do the X-ray later in case the first treatment does not work…PC doctor: “What do you mean?” I am ready to just pay for everything and only take the cough syrup since nobody is supervising me on what I take and what I don’t. However, now it’s a legal issue and I have to take the antibiotics until I get the chest X-ray, and not just any antibiotics, but the ones issued by PC.
The doctor wants me to take a taxi to the capital Lilongwe where I could get an X-ray at the PC office. We are talking about a 12-hour round trip. Then I remember that I have a phone number from a Dutch doctor working at the hospital. I text him and ask if he could work a miracle and arrange for me to get an X-ray. “Yes, of course. No problem”. However, the power had been out for 12 hours already and the generator is broken…
I promise to take my antibiotics and try the X-ray the next day. But if the power is not back on by 9am on Saturday I still will have to go to Lilongwe…
That is when I leave the hospital and stop at my tailor’s booth at the market.
My tailor says: “Muli bwanji”, How are you? And I answer accordingly “Ndili bwino kaya inu?, I am well, how about you? We do our business and then he says: “You want an X-ray, but no medication?” I am floored. He cannot possibly refer to my consultation with the hospital doctor that I barely left? Or can he?
News in the village travels fast.
The story ends with me getting an X-ray at the local hospital the next morning and a passing PC vehicle dropping off the precious cough medicine at my house since Malawi does not have cough suppressants, period. After looking at every possible angle I even understand why the doctor didn’t want to give me an X-ray. It is indeed very difficult to get one in a country where the power is only on for about 30% of the time.