Wednesday, August 21, 2013

Emergency Situations

                      “Where do people go in the event of emergency medical situations?!” 

This question has plagued my mind recently because I’ve encountered several of them in the past 2 weeks. Now I can’t help but ask everyone I know what they do and where they go in the event that they are sick or have a medical emergency. I’ve been asking out of anthropological curiosity, but also out of hope that if I ever have an emergency health situation I’ll know where to go!

I’m going to share 3 separate health situations that occurred recently to really emphasize how dire the access to decent health care is in Guinea-Bissau.  

Situation Number 1:

            My family and I were eating dinner at the restaurant Papaloca and out of nowhere there was a lot of yelling and screaming happening outside the restaurant. Next thing I knew my step dad moving his car out of its parking spot in front of the restaurant and into the middle of the road.
Artemisia Medical Clinic
            I ran outside and saw that someone had been hit by a car and my step-dad had put his car in the road to stop any oncoming traffic from hitting him (Just days before my neighbors uncle had been hit by a car and ran over repeatedly by other cars. No one stopped driving over him until a passerby pulled out his gun and started shooting it in the air to get the attention of the drivers. The lack of (street) lights at night could have something to do with this). The car that had hit this guy took off and left him lying in the street. He was unconscious and blood was coming out of his ears and mouth, his limbs were bent awkwardly at his side. 
            A crowd began to surround him as folks came to see what happened and tried to decide what to do. The sad reality is that calling the police or an ambulance would be a waste of time. The usual response is that they cannot come because there is no gas in the ambulance to get there.
            Fortunately someone volunteered their car and took him to the hospital. We all wondered if he would make it. The next day on the radio we heard that guy had died. They were looking for someone to come and identify his body.

Situation Number 2:

            A week after getting back from Buba we found out that Abdon, whose restaurant we had stayed at in Buba, had a stroke. He had to drive the 3-4 hours from Buba to get to the military hospital here in Bissau.
            Once in Bissau he spent almost a week in the hospital (just) taking asprin (but apparently that’s what your usually prescribed when you have a stroke).  He had lost sensation in and the ability to control the left side of his body.
            The hospital is a hard place to be because it is everyone’s last resort. When you don’t know what else to do, you go to the hospital.  Lots of beds surrounding Abdon were filled with old sick people who were surrounded by family members either seated on the bed with them or lying on the floor.
Inside the clinic
            At the Hospital they do not provide you with food or water.  Your family or who ever is taking care of you is responsible for brining you food and other things you might need.  So it’s literally like taking care of someone from home, except your at the hospital and not at home.
            When we came to visit Abdon one day we found him trying to cut an onion with his one working arm, the onion being held by his girlfriend. I imagined he wanted to prepare his own food. He is a chief after all.
            There was another day we brought a friend of Abdon’s to come and see him. This guy is a millionaire, so we drove up to the hospital in a very nice SUV. It was early evening and as we drove up we noticed that there were no lights on in the hospital. “There’s no lights at the hospital?! “ I exclaimed. But as we drove through the entrance and found a place to park the entire building became illuminated.
  “Hey! The lights came!” I said in innocent excitement. My sister looked at me and said, “No, we came. ” 
            “What do you mean we came? They only put the lights on because we are here??” I simply could not rap my mind around the fact that all the people in the hospital were lying there in the dark.  
            “Yes,” she said, “They don’t know who we are, but they saw a really expensive car come through the front gates. We could be a minister or someone with influence, so they turned the lights on.”
            When we left all I wondered was if the lights at the hospital left with us. It’s possible the generator is on a timer and we just happened to arrive when the generator was set to turn on. I desperately hope that is the case.
Naveed, my co-worker and his foot
            Anyways, Abdon’s cousin was able to organize enough money to get him to Zigguinchor, Senegal where they have better medical treatment. But the best medical care is in Dakar, so he had to figures out how he would get from Zigguinchor to Dakar. An ambulance ride was 5,000 USD!! An SOS airplane ride was 10,000 USD!!! There is a boat that could take him for 60 bucks, but they wouldn’t let him on the boat in the condition he was in.
            He eventually made it to Dakar and is still there. Its possible he will go to Europe to received further treatment (being part of an international organization, Slow Food, may have saved his life. Not everyone has the luxury of being relocated to a better medical facility).

Situation Number 3:

            When my co-workers from Pakistan got here, one of them had a little cut on his foot. Unfortunately the change in elevation from the plane ride made is foot swell and caused the cut to expand and become irritated. He spent 3 months hopping around from clinic to clinic because his foot would not heal. The humidity in the air was causing some of the problem, but he had also received a prescription for medication that was causing the infection on his food to spread. Finally one day one of my co-workers came to me and said we needed to find another clinic because his foot was getting really bad. What was once a quarter sized infection grew into something the size of a softball. 

            I kept hearing about an Italian Clinic that was supposed to be really expensive, but also really good. The medics are all foreigners, some from Cuba, others from France, some from Italy.  It was a very reassuring site to see.
            They had to call several medics in to look at his foots because they were completely perplexed by what they saw. They called in a dermatologist (who only happens to be in Bissau because her husband is in the Guinean government) to see if she could figure out what was going on. The dermatologist spoke French to another doctor who translated to me in Portuguese what I needed to translate to my co-worker in English so he could translate to my other co-worker with the infected foot in Urdu, one of the many languages in Pakistan.  It was quite a process, but eventually all relevant information was shared.
            Thankfully the treatment the dermatologist gave him completely cleared his foot of the fungus and infection.


            So I started to wonder, in the case of an emergency, what would I do? I have maybe enough money saved to catch a flight to Dakar, but not enough to pay for medical fees in Dakar. This Italian clinic is the closest I’ve seen to anything in the United States.  But there is a catch, the director of this Italian clinic is a registered nurse, not a doctor. Not to knock the qualifications of nurses, but I was recently told she has been prone to making mistakes and incorrect diagnoses.
            It’s kind of scary if you think about it too much. Anything can happen and it’s difficult to know where you will find quality and qualified medics. And there is also no system in place nor equipment available to deal with urgent medical emergencies. You almost have to find a doctor that you have come to trust and consider qualified and create a personal relationship with them so that you can call them whenever you might need. Surprisingly this is what many people ( who can afford it) do.

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