Over the past 2 days I’ve been getting insight and experience of what it’s really like to be a black African in the New South Africa, or more precisely in the ‘New South African Hospital system’.
One of my teachers has been very ill for a while so I took her yesterday to see my Doctor, who referred her to a hospital in PMB. Not knowing what to expect, and with the added complication of her very young baby, we had to first drive back to my house to find out where to go, then into the valley to collect someone to come with us to look after the child if necessary and only then could we set off to the hospital.
It’s never a good idea to go to a hospital any time after about 8am, I’ve found. The queues are horrendous.
Before anything, my car was searched before I was allowed into the hospital grounds. I don’t know what they think I might be smuggling in. We did wonder if it was because there’s been a spate of baby-snatching, but that still doesn’t explain the checking on the way in… Once we’d figured out how to get inside the actual building, an officious clerk shouted at me to sit down when I asked her for help, but then admitted P.
And so it began.
We entered the MOPD (Out Patients) and walked into a long room filled with very sick people, some sitting, some lying on benches, some in wheelchairs, some on metal bed stretchers looking very ill indeed… It seemed that if you wanted attention, you had to make an effort to get it, I spoke to a Dr who got P in quite soon to be seen and then sent her to another room for treatment.
But all the while I was waiting in this room surrounded by people, mostly suffering with TB. It was quite overwhelming and, especially as I’ve been struggling with a little bit of depression this week anyway, I had to fight back the tears. But our time there yesterday was fairly quick, I think we were only in the hospital for maybe 3 hours. Once out of MOPD, there was another queue for prescriptions, but this one was well monitored and only took half an hour (during which time I managed to get help on something I needed translating into Zulu, so the time flew by!)
Today, however, was a different story. We only had to go and get some results, but the Dr said to come early. In the end this is a breakdown of my day:
08:30 Pick up P, baby and our helper from the valley
09:00 Arrive at hospital – usual check for stowaways in my car boot – conversation with security conducted entirely in Zulu (I’ve no idea what she was on about, but anyway…)
09:15 Parked, try to find out where to retrieve yellow admissions file that was given yesterday. On the way pass the main information window, outside of which a man in blue pyjamas with a feather in his hair is lying down waving his arms around like he’s making a snow angel. (No one makes any move to assist him.)
Find correct building, and the queue.
11:15 Finally get file, having waited in the rather hot sun for a while; been befriended by a child who was desperate to feed grapes to the tiny baby; noticed that one gets one’s file quicker if you are, in fact, an inmate of the local prison; set off to find next destination.
11:45 Still waiting in the blood pressure room of the MOPD, whilst an assistant searches for test results, only to be told that they’ve not arrived and to see the Doctor… Walk straight past the queue (the same people are still sitting around later in the day) and aforementioned Dr recognises us (it helped P to have a cute child and a white woman with her, I think) Dr goes off to phone for results.
12:00 Dr (about my age, Afrikaaner, probably attractive behind his face mask!) returns to say results not back yet but will phone again in ’20 minutes or an hour’. Same Dr then goes on lunch break with all other Drs from the department, but as he goes he makes an effort to find us and tell us he’ll be back.
12:20 Female Dr (who must be the boss) turns up and asks us why we’re here as she told us to come back in a week. We explain but she tells us that results won’t be ready yet.
13:00 2 Policemen wheel a guy in in a wheelchair, he’s totally naked apart from the dirty rag of a sheet thrown across him, hands handcuffed behind his back, he’s cut and bleeding all over his upper body, looks like he’s been beaten up, he’s definitely been arrested and the policemen are angry. All Doctors return (perhaps earlier than they want to) to sedate him. Notice that all the Doctors here are very young and white. Where are the older ones? We speculate on what the patient has done, he’s in a bad mood, possibly been caught red-handed, or else perhaps a community taking out punishment on him, or possibly beaten up… we’ll never know.
In such a hospital department, nothing is private. Patients results are discussed openly in the waiting room in front of everyone. The guy mentioned above was wheeled around in front of everyone and finally sedated in a room with the door wide open. In front of us as we waited were a row of beds with some exceedingly ill people in them. One woman was being attended to by her teenage daughters. She looked very weak and frail. I felt for the 2 girls, who were looking after her, they were being so careful but they looked so burnt-out themselves. They shouldn’t be having to bring their mother in at their age. Who knows what other responsibilities they may have to take on in the very near future?
Another bed was wheeled past, with a guy on it who was probably only mid 20’s, he was so emaciated that it almost didn’t look like anybody was on the bed. I prayed that I would never see any of my good friends here in SA in that state, but the truth of the matter is that it is it happens…
There were a few ‘comedy’ moments too, like when the Drs ‘lost’ a patient who was lying on a bed and one Dr was ordered to ‘find her quick, she can’t have gone far’. The patient was wheeled back in shortly after and all was well again. But the same Dr had to take blood from this woman in front of us all as we waited.
13:48 Dr finally comes back with results. She has TB. Needs to go to clinic but also we need to take baby to POPD (paediatric outpatients) for treatment… more queues!!!
13:49 Walk through the door next to us to POPD. Place full of mothers and babies. Sister tells us we need to get an admittance form for the baby. Back to the start…
14:00 Success with form, and it’s free too!
14:02 Join next queue in POPD, this one moves faster, although that’s quite irritating when one is trying to hold a sleeping baby and manoeuvre through rows of plastic chairs with ones bag. P cunningly makes the trip to clinic whilst baby asleep and not in need of feeding, thus saving us a little time in our day…
14:30 Starting to get irritated by woman breastfeeding next to me, not because she’s feeding, but because her child’s feet are getting dangerously close to ‘my’ baby’s sleeping head.
14:35 A very thin woman brings in her baby to be weighed. The child is emaciated, his/her eyes look pained and frightened. It is wasting away and weighs in at 3kg. It’s the first child I’ve seen like that up closes in Africa. Quite distressing.
15:15 The strain of not eating properly all day is starting to show, (and my blood sugar has plummeted). Our helper and I venture outside to seek food. We buy drinks, sandwiches and I get mealies (corn on the cob) and fetkoeks with polony (all traditional food!) from the Zulu market just outside gates.
15:45 All the nurses in POPD sign off and go home. Suddenly there is a rush to see the patients and the queue starts moving faster.
16:15 P and baby have been seen. Not all good news as she has to come back on Monday. Even though her baby seems disgustingly healthy, it’s better to be safe. But she keeps the file so that she eliminates the 2 hour queue on Monday morning (not sure that’s technically allowed, but could you blame her?!?!)
16:20 One more check to see if we’ve stowed anyone away (they didn’t check the x-ray packet for the files though! J )
17:30 I finally arrive back home. What a day! I was only supposed to be gone for an hour or so this morning, but it was an experience I’ll find hard to forget…
Pray for P, she’s got the right treatment so she should be ok. But in a region in the grip of a drug-resistant TB epidemic, you can’t be too careful. Pray too that the baby is ok and doesn’t get ill.
The Drs are saying that in fact it’s not HIV that is killing people here anymore. With the correct drugs people can live with HIV for 10-20 years. What’s killing people is TB.
