I had my first experience a few weeks back of being sick enough that it required a visit to a local clinic. It was just an ear infection, but I felt lousy for a couple of days and stayed in the cottage mostly sleeping and putting antibiotic ear drops in my ears every 8 hours. I was surprised at how many people came by to check on me when the word got out that I was ill. It’s a fact of my life now that I’m living on the Bahá’í grounds that I can’t “hide.” Everyone always knows where I am and if they need something, day or night, they come by the cottage. But this had been my first experience of well wishers stopping by to check on me. I commented about this to Carolyn who suggested that because they didn’t know how sick I might be, people wanted to come see me in case I didn’t survive! I’m not sure that’s entirely true, but apparently illness is taken very seriously here. I have observed that people get sick often here, primarily with malaria and typhoid or flu, and that the quality of medical services, if you can even afford them, which so many people can’t, leaves a lot to be desired.
There are a number of medical clinics around, and I went to one recommended to me by several of the Bahá’ís who have lived here many years. The doctor seemed competent, the nurses were in uniform and kind, and they had a pharmacy on site where you could immediately get your prescription filled. Beyond that, it’s all questionable. The doctor was able to see me quickly, and just as quickly deduced I had an ear infection, but I had already determined that. I was a bit disconcerted however, to watch him clean the otoscope to examine my ears. He simply took a piece of gauze with alcohol on it and pulled it through the hole of the scope! No nice sterile, one use only disposable instruments here! He prescribed the antibiotic ear drops and sent me on my way – it cost me all of 7000 shillings, about $3 – that includes the antibiotic! When I returned in a week to have a follow up exam, he had the nurses do an ear wash. This is where I felt like I had gone back about 30 or more years in time. In the treatment room, I sat on an old fashioned examination table. The ear wash kit was wrapped in cloth and I can only assume (and hope!) that the instruments had gone through the old autoclave sterilization procedure. When the nurse opened the kit – I was floored to see her pull out a huge metal ear syringe through which she drew hot water to then plunge into my ear. Seriously, I had not seen instruments like these since I was a child. In fact, I’m wondering if that’s where old American medical instruments were sent – to third world countries in Africa and other places. All in all it wasn’t a terrible experience, and the nurses were very sweet. I was just shocked at how basic the medical facilities really are.
So if that is my experience and I can afford clinic visits like that – what happens to people away from the city where medical facilities are harder to find, or those people who can’t afford treatment?
A child born in Uganda today has a life expectancy of 53 years. The longer a child lives and manages to get past the dangers of baby hood and childhood, the longer the life expectancy, so that if you reach the age of 30 your life expectancy in Uganda may be as high as 70 years. Now I have met plenty of elderly Ugandans, so it may not be as dire as it sounds, but just within the Bahá’í community I’ve met so many families in which either a child or a parent has died. And it appears that life in Uganda is harder on women than on men – which is logical given that women in most societies do so much of the heavy work of the household. So far I’ve met several families where widowed fathers are raising the children and few of the young people I’ve met have both parents living. In fact it seems that by the age of 20, most young people have lost their mother. It’s pretty distressing to think about, but it’s a hard fact of life. In fact, one of our staff members is taking care of her mother who is HIV positive - a gift brought to her by her philandering husband – another common problem.
In fact, according to the WHO, HIV/AIDS is the number one killer of Ugandans, followed by diarrhea-related illnesses (this is what gets the babies), and malaria. Oddly, for the number of people I have met who have had typhoid, I was surprised that was not on the list. But here’s the problem – symptoms of typhoid and malaria are very similar, but the treatment required for each of them is different. Often times a person will have typhoid, but because it looks like malaria, they treat it as malaria. And by the time it’s realized that it’s not malaria but typhoid, it might be too late and the person dies. So my guess is that a lot of the deaths that are attributed to malaria may actually have been due to typhoid.
It’s a hard life in Uganda, and any country in Africa. It’s easy for us in countries like the United States to take what we have available to us for granted and to assume that the same services we have access to exist elsewhere. It’s hard to believe that in the 21st century that these issues of health and medical treatment still exist in these countries. It’s all part of the great disparity between wealth and poverty, the haves and the have nots and the unwillingness of many who have to share with the have nots. It’s easy to sit in our comfortable air conditioned or heated homes in the U.S., watching our HDTV and snacking on whatever fatty foods are handy, to not relate at all to the pictures we see on the TVs about drought conditions, famine, AIDS epidemic, etc. And while Uganda is definitely not suffering from a drought and food is plentiful, I’m still in the middle of a situation that is untenable to me – that there should be anyone suffering from and dying from diseases that have been eradicated in the U.S. and Europe, but are still so prevalent here. It’s just something to think about.
And just for anyone who might be worried about my exposure to any of these diseases – I was well immunized against typhoid, tetanus, diphtheria and pertussis before coming here and I’m taking daily anti-malarial medication. And I know how to boil my water before using it as drinking or cooking water – so I’m pretty safe.
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