A Little Perspective

Recently I had the opportunity to go with some friends to visit a few hospitals here in Cotonou. Was I in for an eye-opener. Six of us went with Jean, one of the translators on the Africa Mercy ward.  He had some connections with the local medical folks that allowed us to tour both a government and a private hospital here in town.

People had mentioned that the African health care system was pretty different but I didn't know to what extent. Upon my arrival to the Africa Mercy this summer, I remember thinking that some of the equipment on board was pretty old in comparison to back home at PCH. Granted we are in the middle of Africa using donated supplies so this is to be expected. But after visiting the local hospitals here, I realized how lucky the Africans are that get the opportunity to come to our ship. It doesn't even compare.

The first hospital we visited was the local government hospital. Upon arrival we met the charge nurse and had a walking tour of multiple areas. Think of a creepy hospital horror movie with dingy lighting, dirty floors and rusty medical equipment. Then fill the halls with people sitting on gurneys, lying with open wounds, and their family members all just waiting around patiently. This was our tour of the ED. We learned that everyone has to pay for their own equipment, supplies, meds, and so on, and they don't get treated unless they have the cash up front. Even outside, there were tons of people milling around along all the walls of every building, with their blankets set up for sleeping and their cooking utensils in tow. Jean explained that the hospital doesn't provide food for the patients, so care givers must come to provide the necessary nutrition and sometimes even patient care, pretty much living outside the hospital doors in the sweltering heat.

We saw the OR's (one of three were being utilized as the surgeons were on strike) and we had the opportunity to see every exam room on our personal tour complete with patients being examined as we walked into their room! (HIPPA violation anyone?) About 70% of the people in the ED were there due to zimi accidents (the ever-present motorcycles that skid about town before crashing periodically). We learned that it cost about $8 US a day for a standard bed in the communal ward, and roughly $60 US day for a private room - VIP style.
As we walked to one of the OR's we encountered an overwhelming stench. I looked at my friend Christina and said "I think I'm going to throw up. What is that?" Now hospitals don't smell all that great to begin with, but this was unbearable. I had never smelled anything that literally made me gag instantly and I couldn't place it. As we walked closer to the OR I realized it was the smell of rotting flesh, coming from a man lying almost naked on a gurney set apart from everyone else. There was just a small sheet covering from his belly button to the bottom of his right leg. Other than the smell I noted the flies. They were everywhere. Upon further prodding, the nurse explained that this poor man had been lying there in the hallway all by himself for a week. The flies were due to the fact that his leg was rotting underneath this cloth and needed to be amputated, but he had no one to provide the money for the operation ($160 US) and the scan needed prior to amputation ($12 US). He only had enough for some antibiotics, so there he lay, drifting in and out of consciousness. It was awful to think that this was ok. Back home this man would have been treated emergently regardless of his financial status. We spoke to one of the doctors about paying for the operation and she didn't seem too optimistic that the surgeons would be off strike in time. Then she wished us well and sent us on our way. We left feeling rather defeated.

We moved on to visit the peds clinic (also where the dietitian works!) which looked very peds-friendly, as well as the dialysis center. On a more uplifting note, the doctor explained that people with renal disease get government funding for their dialysis trips. In the dialysis center things seemed pretty up to date. Some of the nurses even said these were the same dialysis machines they used at home. Such a stark contrast compared to the ED.

Our next stop was a private hospital where Jean's brother was an OR nurse. We had a patient show us his skull fracture via x-ray (he was rather excited) and then we happen to walk in on the preparation for a C-section. We were able to watch the whole entire thing from about 4 feet away! (Roughly HIPPA violation #18 at this point). We saw the much more sterile procedure this time around. We got to watch the epidural go in, and we saw the surgeon perform the cesarean and grab around in that mama's belly to pull the baby out. The crazy part was when the OR nurse actually handed the baby through the window one foot away from us on a platter (yes you read that correctly) for clean up. Then she proceeded to hand the umbilical cord through the window as well. We had the opportunity to stay and wait to see the baby, interestingly, before mom even got to hold her. We all took turns oohing and ahhing over this little bundle of love. It was so great to see this after our very dreary experience at the government hospital. While we were still noticeably in an African hospital by African standards, it was refreshing to see the joy of bringing a new life into the world.  While we were waiting for the baby to be cleaned up we came across this ad on the wall below.  Mercy Ships teaching in the local community!

  

Our African hospital tour provoked unexpected emotions in each of us. From the birth of a baby to a very unkind dying process we were each changed that day. The lack of access to good healthcare just doesn't sit well. So much of third world living won't ever sit well. Conclusion: When in Africa, never get sick.

P.S. After much more wrestling that night about what to do, we decided regardless that we wanted to try again to get this man his surgery. My friend Christina spoke with Jean and he returned to the hospital the next day. This man's brother arrived that day as well and the man did get his surgery. Unfortunately he died afterward - at least with dignity and surrounded by his family.