Reality Check

Once upon a time there was a girl who kicked around the idea of graduating, becoming a paramedic, and joining her honorary brother and his wife as they whizzed around Ptown in ambulances and then went off to save lives with crazy killer skills in the boonies of a developing country. She even designed herself a major centered around health in developing countries to help out. Too bad there was a catch, and too bad she didn’t give it credit. Those who know her really, really well are familiar with the story where it took three people to hold her down to put an IV in when she was seven. Well, she thought she’d gotten herself over that slight aversion to needles (going into herself or others) that had, several times, involved nearly passing out. And then she went to a hospital in the boonies of Kenya and realized with dismay that a certain traitorous sympathetic response still took up residence within her body. What? Oh yeah. That would be me. So, career option # 1, Paramedic: crossed off. It sucks, but that’s life. On the bright side, ladies and gentlemen, I give you the process of elimination at its finest.

We take for granted so many little tidbits of knowledge that come with being part of an educated population. A woman came into the OPD this week with malaria, complaining that the drugs given to her in January hadn’t been effective since she obviously still had the disease. Explaining that the drugs had in fact worked, and she had gotten malaria a second time, was futile.

For the frequency with which people come into the OPD with malaria, prophylactics would really be a cheaper option– especially at the price for which they’re readily available in Kenya. Unfortunately, people fail to recognize that the whole point is to take the meds before you start to feel like you’re going to die. Instead, the drugs are sought from the chemist and consumed without consultation after the individual has self-diagnosed. Too bad doxycycline and mefloquine don’t work after the fact.

People also have this really weird notion that injections will fix anything, even if nothing is wrong in the first place. They come in complaining of random pain. The doctors order an injection of saline, or a multivitamin, and the pain goes away. Gotta love placebos.

Honestly, the level of ignorance is astounding. A woman brought in her 2-year-old daughter with chicken pox, a temperature above 102ºF, and febrile seizures. It took ten minutes to convince her to admit her daughter to the hospital. I mean, really. Go up another 1ºC and your daughter’s brain is going to begin fizzling and frying to death. I know it’s expensive, but it’s still your kid. Or, does her sex factor into your reluctance? I know girls aren’t as valued as boys, but still.

Speaking of which. When women come in to give birth, their husbands drop them off, turn tail and run. Women go through labor and give birth alone. Because 1: Men are chickens. And 2: If the baby’s a girl, there’s a good chance the husband will end up mad. Never mind it’s his fault– he’s probably never heard the word “genetics.” When the baby comes out, the first thing the mother sees isn’t the face. They turn the baby around, pull its legs up and present it butt-first so she can see the sex.

Technology in the OPD is sadly lacking… or unbelievably oldschool. There’s one ECG. It attaches to the patient with clamps on the wrists and a bunch of little bell-shaped silver pieces that stick on around the heart. The nurses follow a chart to set it up, and half the time they get it wrong. There are no backboards, no heart monitors, one blood sugar meter (finger sticks are done with syringe needles), one nebulizer, and doctors share stethoscopes.

Handwritten patient records– those that haven’t fallen apart– are stored alphabetically by first name in cardboard boxes. Sort of. The organization doesn’t extend beyond the first letter, so finding a record more often than not involves flipping through dozens of pinned-together paper cards adorned with illegible handwriting. If, that is, the top half of the card hasn’t been decimated by wear and tear.

Intake forms do not ask for birth date or an emergency contact. They do include NHIF number (Kenya’s version of subsidized health insurance), names of subdistrict and village, names of headman and chief, phone number of the person who admitted you (if it exists), level of education, nearest primary school, and age (if known).

In other news: My host mom walked into the living room the other day clutching a chicken by the wings. “You eat chicken?” You know I do. “We eat this tonight.” Sure enough, the pot on the table that evening contained an entire chicken, feet, legs, and head included. The next day, she served leftovers: head and feet.

I’m in Nairobi for the weekend. Went to one of my Swahili professors’ weddings today. In the suburbs of Nairobi, I think. Kind of hard to tell where we were, but upon disembarking from the matatu we were led to the church by a guy on drugs and wearing a tarp as a skirt, who declared he was going to kill our boyfriends when we told him we were married. The ceremony itself was a really noisy affair, with kids underfoot everywhere and lots of yodeling.

And finally: Appallingly dubbed Spanish telenovelas will, without doubt, bring about my slow, painful, tragic death.