When your co-facilitator has malaria....

Finding health care in a developing country is always interesting….for expatriates illness, in many cases, leads to self-diagnosis and self-medication. Let’s take my colleague Tim for example. He has lived in various countries in Africa for over 25 years. He speaks French, Creole, Portuguese, English, Woloff and another native language to Senegal. Smart guy. However he hasn’t had a physical in who knows how long, let alone a yellow fever or typhoid vaccination. One evening before we embarked to Pemba, he was feeling a little achey- he thought it would just go away but was worried that it could have been the beginnings of malaria. It was....we think…the next morning Tim had a fever and was sweating profusely. On the way to the training, we stopped at a pharmacy (basically a little shack across from the main hospital). Without a prescription, Tim was able to buy SP (Sulphadoxine-Pyrimethamine) and also pick up some paracetamol (Tylenol basically). Without a malaria test to confirm whether or not this was his issue, Tim self-medicated and after two nights and two days of profuse sweating and restless sleep, Tim was fine. Good as new!

As luck would have it, I contracted some kind of finger infection while in Pemba. Upon our return to Zanzibar, my index finger on my right hand was completely swollen and red and warm. The fingertip was the most painful and where the infection lived. Being very far away from decent health care (i.e. 5% of all HIV infections in Zanzibar are acquired AT the hospital), I held my breath and hoped that (a) I could wait until we got back to the mainland (2) that my finger wouldn’t start to turn a DIFFERENT color like black (3) and that the sore/warm feeling in my arm was just my own psychosomatic thing! I popped painkillers, applied my antibiotic cream, and popped two Cipro- just in case (bad idea). Got back to Dar and tried to get some rubbing alcohol at another small pharmacy. What trouble! First trying to communicate what I needed- rubbing alcohol they do not have- methylated spirits they do (same thing basically). Problem- they only sell the spirits in 5 LITER bottles. I needed like 12 ounces MAX! Oh well- mission aborted, Stuck in out another nice (finger throbbing) and went to a private clinic run by a Tanzanian doctor and a Cuban doctor. Made an appointment in the morning or the afternoon, and saw the Cuban doc and spoke Spanish! Paronchyia- an infection of/around the nail. Some kind of penicillin B antibiotic later and pain reliever and 24 hours- the infection is so much better! Woo hoo! I got good care because I was able to shell out the 35,000 shillings (about 30 bucks) for the consult (10 minutes) and the 7,500 shillings for the drugs (about 7 bucks). Now for something as simple as a finger infection, I probably would have been fine going to a public clinic. However, something like child birth…hmmm. Not something I’d probably do, given that we saw a dead body coming out of the Maternity Block at Muhumbili National Hospital today. Aye…stay healthy people!