By Mike Jacobsen
Cottage Medical Clinic is an ultra modern facility. It appears as if the place is brand new, from my bed to the x-ray facilities and everything in-between. Unfortunately, I can’t say the same for the staff. Maybe it’s new because this is where Angelina Jolie birthed her children. Would you rather have a state of the art facility with terribly trained staff or a crappy medical facility with great people? I vote for the latter.
Throughout the night I go from drug induced sleeping to extreme discomfort. There is no shortage of nurses here. At least a dozen of them come in through the night, some to see the new patient and others when I buzz to get more medication. Unfortunately they don’t have any oral pain medication stronger than Tylenol. Thus everything is administered via injection. I packed syringes and needles in my med kit in case I needed them. They however are still on the truck and as it quickly turns out the couple I have won’t be enough for what I eventually go through. A nurse would walk in from the hall with a syringe already filled. Concerned about the risk of it being a reused needle as is common in Africa, I request they bring a fresh syringe open and fill it in front of me. My request produces dirty looks and quip responses of, “what, don’t you trust me?” Quite frankly I don’t, and while I’m dopey from meds, I know I have to sweet talk them into opening one in front of me. A few times I have to get downright nasty yelling and demanding they open one as they defiantly attempted to stick me with one as I scream for them not too. The concern of catching something from a used needle has begun and building fear looms for the rest of the week. Their sheer lack of repeated unwillingness to put my mind at ease creating a struggle convinces me they are bringing in used needles. Not one time in the approximate 40-50 or more injections I receive throughout the week do I not have to endure this fight. In spite of my resistance several get through and I’m stuck with a re-used syringe against my demands.
In addition to the re-used syringes, the staff never uses gloves to protect themselves. One of the nurses accidentally rips out my IV while administering a morphine injection, leaving a bloody mess on my arm and simply cleans it up barehanded. I assume such practices are a combination of lack of education, cost, and availability of supplies. For me however cost isn’t a factor, I’d pay anything at this stage to not have to worry. If they are this unhygienic with me, I’m sure they are with everyone else. Boy am I glad I visited Passport Health at the start of this trip. Their pre-trip planning advice and immunizations were invaluable. I could be catching Hepatitis and I don’t know what else from these dirty needle sticks and at least I know I’m protected against a host of things they prepped me for. My primary concern becomes that of being infected with HIV. With a local infection rate of close to 40% and the lack of hygiene I know I’m at risk.
Morning comes and I’ve been through my first night of fear. I’m anxious to see the tour leader and I’m not sure all what’s wrong and am expecting the doctor soon as well. The tour leader’s words ring true as she entered the room, “Here’s your life” setting my bag on the floor. Possessions mean nothing, but it’s all that I have, which turns out to be my lifeline to the world. We chat for a bit and she kisses me goodbye and now I’m on my own to survive.
Cottage doesn’t have a phone available to make international calls. Can you friggin’ believe it?? I need to contact my travel insurance/medical evacuation assistance carrier to make sure this is covered and get them in the loop to assist, and my only way to make a call from the hospital is to leave and get a phone card. Fat chance getting anyone at the clinic to help, they’re useless. Thank goodness I have my mobile phone. AT&T works great at $2.99/min.
My first call to medical notification/assistance seems great. They take my info and seem like they’re there to help. Shortly thereafter the doctor shows up, reviews everything, informing me I need to be transferred to a different hospital. While his bedside manner is great, he’s not knowledgeable enough to treat me and is concerned I might have lung damage. (Note this entire time, I’m confined in a bed, medicated on morphine every hour, have an IV and catheter in, and I’m on oxygen). Having read my policy I know medical transport is to be arranged by my insurer. Using my cell I call them again and this time to a much different response. First they need to verify with the doctor before they can make any transport. A few hours later, sure enough they’ve confirmed with the doc I need to be transferred and then ask me why can’t I stay where I’m at? Why can’t I just get a more competent doctor here? Isn’t there another hospital closer than five hours away that can treat you? Hello!!! I’m in Africa, you moron! How am I to know? Isn’t that what worldwide medical evacuation assistance is for? Why don’t you tell me? I’m here stuck in an African hospital bed and you’re asking me where I should go. I thought that was your job. So, how am I to get to where I can receive treatment, will you arrange it for me? “Ahhh,” came the response, “you’ll have to do that.” What? Will you arrange payment or anything? “Well, you’ll have to make arrangements for that, get the receipts and submit them to get reimbursed,” “Oh and once you’re at your new facility give us a call so we can track your progress.” %&%*^*(&(&(!!!!!!! What a waste of my time, f’ing insurance!!!! (My insurance/evacuation policy was with HCC Medical Insurance. Don’t ever use them).
The doc comes back later, concerned about my blood pressure—it’s 170/120. I tell him I’m on high blood pressure medication. Would he assist in finding it in my bag? I’m not sure where it is, as I hadn’t packed my bag. He’ll have a nurse be in shortly. We discuss the only option he’s aware of for transport and to my delight it’s International SOS, the guys who brought me out of the desert. However, I’ll have to spend another night here as they won’t transport me in the dark due to local risk and he forbids flying of any sort. Fortunately he arranges for them to get me early the next morning.
Ah, maybe a little peace. I’m exhausted from doc visits, phone calls to insurance, and hourly fights of getting clean needles. My blood pressure’s out of sight and a nurse comes in supposedly to assist. I count a dozen different nurses through the night, each of which I request their assistance to find my blood pressure meds. One at least opened my bag and one rummaged through the top layer, all leaving me by saying they’d have someone else come to assist. Lazy bitches! I come in and out of sleep, scared of falling too deep into sleep, knowing I have to stay aware to fight for my life. I’m anxious as can be and can’t wait for the transport to show as I worry about my blood pressure, nurse hygiene, and the next needle fight.
International SOS to the rescue. I’ve never been so happy to see an EMT. They arrive to me lying naked in bed still covered in sand. “What, they haven’t washed you?!” With a look of disgust, “where are your cloths? OMG your BP is out of sight.” They instantly riffle through my bag finding my meds in split seconds and then want to know how I’ll be paying for the ride. Can you believe it, same issue as before? My credit cards are denied once again, just as they had been the day before. So back on the phone, jumping through hoops to clear the charges before they prep me for a five-hour desert journey to what I’m desperately hoping is better care.
Be sure to read Part 1 and 2 of Mike's story, and don't miss Part 4. Keep up with Mike at his website findingflattop.com
