March 26, 2014

The One in Which I Go to the Clinic

After four days of kidney pain, I decide it's time for my first trip to the clinic.
A friend comes to get me from school and we arrive at the clinic around 11:15.
I go to the reception and ask to create a file, she flips through a stack of ripped cardboard 'cards' about the size of a post-it note.  Hands me one with the number 28 and asks me to sit.  
We spot a bench in the back, with just enough space for the two of us to sit and wait.  In front of us are four rows of seats, various sizes and types, with about 5-6 chairs in each row.  Each one filled.  Adjacent to us it's the same picture, creating two groups of chairs with an aisle between.  Behind us, through the wall we lean on are the offices of two doctors.  In front of us is a third doctor's office, the reception, which is right next to the dawa (pharmacy) which is a glassed-in room about 6sq. feet.  
To my left there are windows and a porch where there are more seats, also all filled with people waiting to see the doctor.  We are the only two wazungus in sight.

I listen as the receptionist starts calling out numbers in Kiswahili.  Thank goodness I know what 28 sounds like.  I get up and go to the window, she hands me a little yellow card and asks me to write my name.  I ask if she wants both names and she nods.  After writing my first and last name she looks and says, "Only two?" slightly shocked.  "Ndiyo," I reply, "yes.".  She asks my year of birth, and I tell her 1984.  She writes it in the log book, then uses a calculator and quickly types in 2014 - 84.  Her answer reveals 1930 and on my file where it says age, she writes '30'.  
She hands me the small yellow card and tells me to keep it.  It has my file number on it and if I loose it there is no way for her to find my file.  Good to know.
I slide one foot over to the next window to pay for opening the file.  After convincing the elderly woman behind the window that I am, in fact, a resident, I pay the 15,000 /= fee for my 'new patient visit'.  As I wait for the receipt I look at the chart, and wonder if it would be worth the 30,000 /= to pay the 'express visit' pay as the sea of people behind me doesn't seem to be moving or dwindling.
About 10 minutes later I hear my name called and wander toward the direction.  Another woman is sitting in a chair, confirms my name and asks me to stand on the scale.  I do so and she says something to me that sounds like "blah blah blah ipo"  I think 'ipo' is a Swahili word but I can't for the life of me remember what it is.  So I smile and say, "Pole, kidogo Kiswahili."  So she laughs and repeats herself, "Amanda, the girl with the apple."  Oh!  Right.  I was holding an apple earlier.  She's been speaking English to me this whole time.  I look like a genius right about now.  She writes my weight, takes my blood pressure and my height, "You're tall!" she exclaims.  Um.  Ok.  "Go sit and they will call you."  
I take my seat again and my friend informs me that next the girl will walk my folder into one of the doctors' offices and then they will call me.  Sure enough, after about 20 minutes the doctor steps out and calls my name.  Interesting though, all the other doctors just sent the last patient out to call the name of the next one going in.  
I go in, tell him my symptoms and he's curious - "How you know it's a kidney?"  Because I've had a kidney infection before I assure him.
So he tells me he will get a urine test and a full blood workup and to go across the 'parking lot' to the lab.  And also asks me to call "Margaret,"  apparently the next patient.
We walk over, give the lady the ticket he's given me with his write up, and wait for my name to be called.  When she calls my name I walk in and sit down in the blood-giving chair, hoping, praying and scanning nervously for where she's getting the needle from that she's about to prick me with.  With a huge sigh of relief on the inside I see her open a drawer and pull out a sealed syringe, open the fresh package and prepare my arm for it.  Afterward she lays a cotton ball on my vein and hands me a cup.  "Urine," she says.  I leave the room and walk the ten feet to the 'choo', surprised to see two individual stalls with doors.  I open one and see a squatty.  Attempt to open the second (sometimes places offer both types of toilets, a squatty and a western style toilet - hey I had high hopes what can I say).  The second door opens slightly but I'm met with a grunt and the door closes again.  I walk into the available stall and close and lock the door.  And I stand there.  Staring at the squatty.  The cotton ball precariously perched on my bleeding vein.  The empty cup with a little red lid.  The spray hose dripping on the floor.  The muddy (choosing to believe it was mud) footprints on the floor.  How on earth am I supposed to pee in a cup, over a squatty without this cotton ball falling off my arm and bleeding all over the place?
I climb the two steps and try to find a place to set the cup that looks at least a tiny bit sanitary.  I prepare myself and unscrew the lid to the cup and the cotton ball falls off - bloody side up, onto the floor by my feet.  Super.  Oh well, I can't be bleeding that bad anymore, I think to myself.
Until I feel a warm trickle running down my arm, dark red blood in a huge line pouring from my vein.  T.I.A I say to myself, and I pick that cotton ball up and put it back on my bloody arm.  Don't worry, I put the 'clean' bloody side on it - not the side that was touching the floor.
After an… erm… interesting filling-of-the-cup experience I glance around for TP to wipe the blood off my arm, among other things.  And of course.  None.
I walk out of the stall hoping for a sink with soap and Thank-The-Great-Lord-Jesus there was! And the angels rejoiced.
I handed her my cup and went to the reception area.  "Return at 5pm for your results."  5pm?  Are you sure?  The doctor's office closes at 5.  "Yes, 5pm.  They will be there.  Come at 5pm."  Okay.
So I get dropped off back at school around 1pm.  History class.  My colleague graciously agrees to lead class while I eat my lunch, since I missed it.  I munch my crackers with peanut butter, thankful our administrator keeps Bactine and band-aids on hand, even though the sticky part is pulling at my arm hair as I reach for my crackers.
It's nearing 5 o'clock so we head out the door.  Luckily it was our night to have the teacher car so we're able to drive ourselves to the clinic.  We arrive and they appear closed, even the security gate is pulled most of the way shut.  I walk in, wearily, and head to reception.  "I'm here for my test results." I tell her.  "They are with your doctor," she says.  "I look around the empty clinic…. "and where is he…?" I ask.
"In there," she says, pointing to his office door.  Right.
I eventually enter his office and he searches for my file folder among the dozen or so files laying on his desk.  "Where have you been?" he asks.  Hm?  "Where have you been?"  I went back to work, I'm a teacher.  "I have been calling your name 'Amanda, Amanda' since 2pm."  What?  The lab told me not to come back until 5.  "I've been calling your name since 2," he says with a smile.  Pole sana, they told me to come back at 5, even after I asked them about it being so late, they said 5.  He shakes his head, finally finds my file and asks me to come closer.  He shows me the print-outs of the urinalysis and blood work.  "Urine - normal.  Blood work, normal.  Look here.  Hemoglobin, not normal."  He shows me the numbers, the range and the normal percentage, and then what my results are.  Astoundingly low.  "You have an infection in your body," he declares.  Ahhh, so it's a kidney infection then?  "No.  You have an infection in your body."  Um.  Right.  But it's a kidney infection because I don't have any other symptoms except pain in my kidney, right?  "No.  You have an infection in your body and it is hurting your kidney." Okay then.  So what do I do? "Don't worry, I will tell you.  I will give you something."  Oh, an antibiotic?  "No.  I will give you lomefloxacin, an antibiotic to get rid of the infection."  Uh-huh.  Okay.
He scrawls the prescription and we say our kwaheri's and leave the clinic.  But not before I realized I wanted a copy of that bloodwork and went back to snap a pic of it with my phone.  TIA after all.

The next day our friend graciously runs to get the rx for me while I'm in school.  When I get home I google the name of it.  "No longer available in the US."
I try to research why and come up empty.

This. Is. Africa

{and I wouldn't trade it for the world!}