Africa Is Not For Sissies – Part II
If I’ve learned one thing in nine years of marriage, it is that I am a thinker inseparably bound to a doer. To say this has been a source of friction would not be incorrect. But it would be more correct to say that it has been a source of strength.
Not long ago I had my own wrangle with African healthcare. I had a spot on the skin behind my knee that was growing in a funny way. It didn’t seem serious to me, just one of those things you pick up with each successive trip around the sun. Jes, however, was determined to have me do something about it and insisted that I see a dermatologist. He recommended a biopsy, and so I got my first ticket into an African hospital.
The day we arrived I must admit I was a little apprehensive. You hear strange stories about what happens inside the hospitals here, that overall, it’s not a very pleasant place to be. Honestly, I think that would be true about any hospital, how much more so in Bangui. Visitors describe the Hôpital Général somewhat like the Bastille, a sprawling gray building with shutters but no glass windows, and lots of howling pouring out of those shutters. I was glad to see that, despite being a little rundown, its reputation as a “place of no return” seemed dubious and exaggerated.
Medical service, like mobile phones, is always prepaid in Africa. That means that when you go for your consult, the doctor gives you an appointment time for your procedure and a list of things to bring if you want everything done. My list had Betadyne, Lidocaine, gloves, gauze, bandages, suture, a scalpel, lots of amoxycillin and some other odds and ends. You take this list to the pharmacy and they put it all in a bag for you. The pharmacies here are pretty well stocked, and you don’t always need a prescription to buy medicine. You just walk in and ask for it. They also stock hydrogen peroxide strong enough to make rocket fuel and pure alcohol that makes a delicious limoncello. You can also buy blood. Twice now, I’ve seen children who couldn’t be any older than seven or eight, walking in the burning sun along the main road outside Bethel with pints of red cells and plasma in their hands, still several miles away from the hospital.
We entered the hospital and asked for directions to the dermatologist – down the hall to the left. On the way we passed an oral surgeon. There we heard some genuine howling, really, guttural moans punctuated with shrieks, coughing and what sounded like pleading. People here try to save a few pennies any way they can, which usually means cutting out the painkillers and anesthesia. One more reason to floss regularly.
He wasn’t in his office yet, and the wait gave me a chance to survey the hospital. The corridors are open to the air, and our seating area overlooked a courtyard with the hillside beyond. All along the hill were little clusters of one room houses with no windows and a door that locks from the outside. I asked a passing orderly what they were – the psych ward, he responded, of course. Down in the courtyard is a waterless toilet and an open shelter, that is, an African kitchen. Bring your pot and firewood and you can cook for your sick relatives. The hospital doesn’t serve food, to discourage vermin. Washed clothing and linens hung over the fence, not a bad idea considering nothing disinfects like UV radiation. Despite being very dusty, everyone else waiting was dressed up, with nice shoes and handsome fabrics.
Finally he called us in. After a few perfunctory questions, he was ready to get down to business. We removed our shoes and entered the operatory. Jes came with me, so did Olivier. It was dim and gray, with flaky paint on the floor and walls. It looked a lot like a garage, with medical supplies and beeping boxes where tool chests might have been. Really, a car on blocks and a big puddle of oil would not have looked out of place. I removed my trousers, jumped on the operating table and gazed about. My eyes followed a matrix of extension cords and plug multipliers around the room that terminated in a single, semi-charred outlet. Under the table was a big basket of everything else that had been cut out of people prior to my visit, plus whatever was used to sop up the mess. I opted to look at the wall.
For all the time it had taken us to get to this point, he couldn’t wait the extra two minutes for the Lidocaine to start working. Lying prone on the table, he laid one arm across my leg, put his weight on it, and started cutting. He worked quickly, with an in-and-out circular path, much like one might core an apple. I must have had a terrible look on my face. I know this because my wife, the one who is always beside me to comfort and support me, put her hand on my shoulder and asked, in all seriousness, and I quote, “Do you need something to bite on?” No thanks honey, just tell him to drill a hole in my head to let the bad man out. By the time he put in the last stitch, the anesthesia had finally kicked in. “Joël” he said, “mo yeke ta koli.” Translation: you’re a real man. Glad I passed, when do I get my feather?
It was a long week waiting for the results, but finally Thursday came around and we headed back to the hospital. We waited for the dermatologist again a full hour, and when he showed up he didn’t have the report. He just said “Hi” and left for the National Laboratory next door. We waited another hour. I had almost forgotten why we were waiting when I saw him coming down the foot path through the courtyard with a smile on his face. “Good news!” he yelled, effusive with the encouraging report as he stumbled down the path. Great, I thought, why even bother meeting to discuss the results? This is so much more efficient, bellowing the important parts of our patient-doctor conference along the hillside for the entertainment of everyone who has already been gawking at the white man with the cane for the last two hours. I can go home now.
If you do come to Africa and get sick, be prepared for people to show an inordinate amount of interest in you as a sick person. Tom often mentions that there are many things in the Bible he never understood until he came here. Take for instance the case of Job – why would anyone sit around simply to commiserate with an ailing person for weeks on end? But that’s what they do here. The traditional prescription for every illness is companionship, not necessarily conversation, just the reassuring presence of another human, even if that means packing a dozen sweaty bodies around your divan of distress. Once I went to the meeting without Jesenia; she stayed home with a cold. Urijah, a friendly eleven year old that comes to the meetings with just his nine year old brother, saw the empty space next to me and sat by my side. He asked about Jesenia, and I told him she was home sick. His face stricken with concern, he asked, “But if you’re here, who’s sitting with her?” While Jesenia was convalescing from typhoid, she heard a brief knock at the door and a half second later the entire housekeeping staff walked through and took their place on the bed with her. Their presence was their gift. It is the African way. And when you step back and look at the interest with the proper attitude, you realize, it truly is a joy to be so loved.
At first though, this is not easy to accept. Like a wounded animal, I like to retreat under the covers when I get sick. I look terrible and prefer not to share my hideous condition with others. Plus, it gives me an excuse not to shave for a day or two. But, as in so many other areas, we’ve had to adjust. Like the time I stubbed my pinky toe so hard I know I broke it. It swelled up like a chubby purple sausage. The only thing dumber than injuring your toe like that is having to explain to all the interested people, and there will be many, how you did it. I wish I could have said, “defending my wife’s honor” or, “lifting a vehicle off of a crippled child” or, “snatching a puppy from the throes of an oncoming train”, but no – I wasn’t watching where I was going and I kicked the bed. In a land of bamboo sleeping mats this sounds hysterically idiotic.
This interest in your infirmity seems to grow exponentially with the lightness of your skin. As one local brother told me, it is both happifying and comforting for Africans to see a white person at a local hospital. They know that westerners are accustomed to a certain standard and typically refuse to accept anything less. They also know most whites are so ridiculously wealthy that they can afford absurdities like refrigerating their water and the rooms they work and sleep in. Wealth brings choice, and when a white person chooses African healthcare, it means it has met some kind of imaginary standard, as if to say, “you’ll be O.K.”
Perhaps with this weight finally off my shoulders, I was free to concentrate on lesser banalities, like the hasty way I had dressed myself that morning. Being thoroughly absorbed in knowing the results of the test, I hadn’t paid much attention and threw on white ankle socks, black shoes and pants that the last wash had made into high-waters. Not shocking, but goofy nonetheless. Jes noticed too. Hobbling back to the car, I asked, “Would you have married me if I dressed like this back when we were dating?” Without missing a beat, she threw a reassuring arm around me and said, “That’s why I married you . . . I needed a project.”
love to all,
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