In reading through this week’s “sound of medicine” grand rounds – creatively hosted by Cris at Apple Quack – I came across an article by Bongi from Other Things Ananzi, detailing his efforts to find something as simple as sterile gloves in the South African hospital where he was working. Supplies were so hard to come by that nurses in the labor and delivery ward were washing and reusing gloves. Articles like this are a great reminder of how well-off we really are here in the US.
In 1999, I was serving in the Peace Corps as a math teacher at a rural high school in Tanzania. I was the teacher in charge of the girls’ dormitory that semester, and one night two of my students came to my little house in the middle of the night, in a rainstorm, to let me know that another girl was sick. It happened to be a girl who was somewhat known for her malingering, but just in case, I put on my raincoat and followed the girls into the night. We arrived at the dorm and found the sick girl curled up in her bed, moaning. I asked how long she had been like that, and the others told me it had been quite a while. Upon closer inspection, I noticed a large, deep cut on her arm, which looked – to my very untrained eye – quite infected. Her whole arm was swollen and she wasn’t able to bend her elbow at all. My thoughts of returning to bed vanished, and I started trying to figure out how to get the girl to the clinic on the other side of the village. It was about a mile away, down a very steep hill, across the valley, and up another steep hill. There was no way she would be able to walk that far, so I rounded up another teacher who had a bicycle, and together with a couple students, we balanced the sick girl on the bike, and set off into the rainy darkness towards the clinic. The trip seemed to take forever, and then it seemed to take another forever of banging on the door of the clinic to wake someone up and have them let us in.
Once we were inside the clinic, I explained what I knew of the girl’s injury, infection, and fever. The nurse cleaned the wound on the girl’s arm, and gave her some medicine – probably Tylenol – to bring down her fever. I asked about a tetanus shot, which I knew that the clinic had on hand (the WHO supplied various vaccines to small clinics in the area, and every so often there would be a vaccination day in the village). The nurse told me that the girl would have to wait a few days, because once the vial was opened, it had to be refrigerated, and they had no means of refrigeration at the clinic. So the other doses would spoil if they were to open a vial in the middle of the night for one person. I begged and pleaded, and finally got the nurse to go ahead and give the tetanus shot, and they kept our student for the next couple days, nursing her back to health.
The clinic in the village where I lived was always neat and clean, and the doctor and nurses who worked there were truly dedicated to their professions. During the semester that I was in charge of the girls’ dorm, I ended up making many a late-night trip across the valley, and getting to know the staff at the clinic well. They did the best they could with what they had, but what they had wasn’t much.
The village where I lived was hard-hit by HIV, as is most of sub-Saharan Africa. TB, cholera, and malaria were all common ailments. But the majority of the people in the village were healthy most of the time. I very rarely saw anyone who was overweight, and most people existed on a simple diet of rice, beans, corn flour, tomatoes, onions, and dark green leafy vegetables. Few people ate meat, because they just couldn’t afford it. Everyone’s days included exercise in the form of strenuous activity (although they thought my practice of donning sweat pants and sneakers and running laps around the school yard each evening was hilarious). Nobody had a car, nobody had a TV. Here in the US, nearly all of us have cars, TVs, more food than we need, and illnesses that are often related to our lifestyles rather than viruses, contagions, and contaminated water.
Don’t get me wrong – there were plenty of problems. And when my service was up, I was happy to return to Colorado. I (like pretty much every PCV) began my service with very rose-colored glasses and idealistic views. Two years later, I had a much more realistic outlook on development, change, and progress. But my time in Tanzania had a profound impact on my life.
We live in a wealthy nation. Shockingly wealthy by the standards of most of the world’s people. And yet we can’t seem to figure out a way to provide all of our citizens with health insurance and access to health care. While you might not be able to find a clinic in the US that doesn’t have gloves, you will find millions of Americans who are unable to afford health care or health insurance. For those people, does it really matter that American hospitals can afford all the best medical equipment that the world has to offer?