An Apple a Day

I think that the habit which I possess that I would most like to stop would be that of procrastination.  Of course, any reasonable person would have gone to the hospital when the symptoms first appeared mid afternoon.  I, on the other hand, decided to wait until 7:00pm, when the sun had long since set  and most medical clinics were closed,  to go and search out a medical laboratory facility.  So there I am, stumbling through the dark streets , tying to find a laboratory that is still open which can test for the dreaded malaria parasite in my blood.

It is always very disconcerting to be both shivering with bone-chilling coldness and sweating with a fever at the same time.  After finding all of the private hospitals, Jeff and I decided that we’d have to bite the bullet and check into the Kakamega District Public Hospital.

One should experience a feeling of relief to be entering into a District hospital, right?  I mean after all, this is the largest and best equipped health facility in western province.  Offering 449 beds for inpatients and just about every service imaginable, there should be very little left to be desired.  Right??

I admit that I wasn’t particularly excited about this idea.  From what I had been told, I could expect to be greeted by long waits, limited facilities operating, and an overall undesirable environment.  Considering how the Kenyan government seems to run the rest of it’s social services, I had every reason to believe these stories.  However, when faced with a body full of malaria, one has to take what they can get.

We arrived at the hospital by 7:30pm, stepping into an environment of perpetual confusion and uncertainty.  Limited lighting in the hospital compound made it quite difficult to see the giant water filled potholes littered along the path.  After manoeuvring around them and after becoming somewhat lost in the maze of pathways between buildings, we finally found our way to the emergency room.  As we approached the open-air entrance a young man was being wheeled past us on a stretcher, seemingly unconscious and exposed for all to see.  “Caribou hospital”, I thought.

There was a sharp contrast between the darkens that was outside and the yellow-fluorescent lighting flooding the emergency room.   As a rookie to this facility it was all a bit overwhelming for me at first.  People seemed to be moving about in a haphazard way with no one appearing to be running the show.  It was hard to discern who was a nurse vs. who was a doctor vs. who even worked there at all.  And then as you stand there you see that there is definitely some order to the chaos.  People seem to be waiting in line along one side of the room for their turn with the doctor who had yet to be seen.  In the middle of the expansive open room was a line of three all purpose tables serving as the diagnosing zones, as well as to treat minor issues.  The tables were littered with assorted medical supplies and marked with hand written signs of ‘Clerking table’ posted up high with generous pieces of black electric tape.  In between each table were special bins for medical refuse, most nearing their point of overflowing.

On the far side were the four emergency rooms.  To use the word room is a bit of a stretch, as each space was separated by only a thin curtain of light-dust colored fabric with the word ‘casualty’ repeated along it’s length.  Whenever a moderate gust of wind blew through the room the curtains would raise just enough to allow everyone to peek in and see the misery wallowing within.

And wallow they were, for each room seemed to have it’s own moaning patient within.  There was a myriad of injuries, from bandaged heads to burned arms in each of the rooms, with most of these patients surrounded by family and well wishers.

As I stood in line at the reception counter, waiting patiently for my turn to check in, another hand-written sign was to my right.  The sign read:

Top 10 Emergency Room Conditions

  1. Severe malaria
  2. Abscesses
  3. Fractures
  4. Cut wounds
  5. Rape cases and GBV
  6. Anaemia
  7. PTB and ISS
  8. Psychosis
  9. Soft Tissue Injuries
  10. Respitory Conditions

In one sense it was reassuring to know that I was suffering from the most common ailment, thus ensuring my successful treatment.   On the other hand, the physical state of this facility was working to counteract this confidence.

I am sure not by choice, but the level of hygiene and sterility in the emergency room was not exactly of the same standards as I am used to back home.  For one, the large open entrances on either side of the emergency room ensured that any bug or puff of vehicle exhaust can roam in freely.  A fine layer of dirt and grime seemed to coat most surfaces, and a few small patches of unknown fluids were scattered around the floor.  While only a few of the ceiling tiles appeared to be ready for collapse, most displayed markings of water damage.

Between the myriad of hand written signs and the messages written directly on the wall, like the instructions “Pay in Cash” sprayed on the wall behind the emergency beds in big black letters, many of the refinements that I had come to associate with a hospital seemed to be more of a luxury here.  However, I do not mean this to be a criticism of sorts against this facility.  Rather, I commend the efforts of those working here for making due with what I can only assume to be the absolutely inadequate resources the medical staff recieves.  In what is the Kenyan way, one must simply be resourceful and creative.  The attitude is such that a simple lack of resources will not stop someone from doing their work.

After paying a measly 58 cents CAD, Jeff and I planted ourselves at the back of the line of people waiting to be seen by the doctor.  I never thought that I would say it, but I seriously missed the waiting room chairs found in Joseph Brant Hospital back in my home town.  The hard wooden benches found here  left something to be desired and in no time numbness crept across my butt.

To this I certainly did not notice, however, as I had only malaria on my mind.  Here I was, sitting inside on a warm Kenyan night, and yet I could not stop the shivering.  In a futile effort, I held myself tightly together in an attempt to retain what warmth I did have.  However, as malaria inherently invades and bursts one’s red blood cells in a cyclical pattern, no amount of insulation could help me out.  On top of that, the headache remains constant and perpetual, like a white noise of uncomfortableness.  My muscles and joints ached in a way I can only compare to when one hasn’t worked out for a long time and the body is screaming for activity.  In this case, multiply that by 10.  Finally, the fatigue that sweeps over your body limits your desire/ability to do anything about the symptoms you are experiencing.  Possibly this was the reason for my procrastination.  Naw, check that, I just couldn’t be bothered.

If you had asked me prior to this if I thought motorcycles might be allowed in the emergency room I would have told you to stop asking such stupid questions.  Then, in a roar of activity, a motorcycle comes cruising directly into the emergency room and parks next to one of the beds.  A moaning girl, apparently suffering from somewhat severe burns on her arms and face, was then removed from the back of the idling motorcycle and was placed on the bed.  A small team of medical officials rushed into the enclosed space and began their work as the driver switched off his bike and sat down on the bench beside it.

Jeff and I sat there, making conversation with each other as we observed all of the action around us.  Babies were crying as they received an injection to cure what ails them as prisoners from the nearby prison were escorted to a bed by gun-toting prison guards.  The caged TV in the far corner was blasting some new rhumba hit as the young man sitting beside be suffering from some sizable exposed gash on his head was drifting in and out of sleep.  A father threw down his registration papers of his young child in protest of the incredibly long wait he was experiencing as a grand-mama to my right coddled the young child resting in her lap.  And on and on the list goes.

Finally, after four hours of waiting, it was my time to see the doctor.  I sat down at one of the tables in the middle of the room as she wrote down my symptoms.  It was a no brainer for her, but proper procedure demanded that we go through these steps.  It was at this point that I learned why the hospital seemed to run so slow.  In front of me was the one and only doctor on duty tonight in this emergency room.  This, being one of the main hospitals in all of western province, obvious experienced a large number of inpatients, and this doctor was undoubtedly overwhelmed with it all.  To help her were three student nurses, who despite their good efforts seemed to be flustered amongst the chaos themselves.   The doctor explained that it was not always like this, but tonight in particular was a rough one.

Finally, after seeing the doctor, after waiting for the lab results to come back, after paying for my medication and receiving it, we were finished and ready to head home.  By this point we were the last people left in the emergency room and an air of calmness was in the room.  Undoubtedly, the next big influx of patients would arrive and the chaos again, but for now everyone seemed to relish in the inactivity.

As jeff and I jetted home on a motorcycle taxi, I kept my fingers crossed as I hoped to not have to return to the District Public Hospital any time soon.  Those damn mosquitoes…

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