Health Care

No, this is not a post about the continuing debate over health care reform in the United States (that's still going on, isn't it?). The past few weeks for Cori and me have been an adventure to say the least.

We spent Christmas weekend at beautiful Ada Foah. However, the day after we returned, I awoke with a spiking fever, terrible nausea and diarrhea. An hour later I was in Accra at a private hospital receiving an IV drip and having my blood tested. Turned out I had an acute intestinal infection - probably something I ate in the previous week. I was admitted and spent two nights at the place, first taking antibiotics via the IV, and once I was able to keep things inside my stomach, I was given tablets, and eventually discharged.
Some interesting notes and observations:

• All private health care is cash-before-care. At one point Cori had to hail a taxi to take her around the city looking for an ATM that would work so she could get the money to pay for my blood work. In the meantime I was laying on a treatment table connected to an IV moaning in discomfort.

• Doctors tend not to tell the patients what's going on with their treatment. And patients tend not to ask questions. It took a monumental effort to find out what type of medication I was being treated with, for what exactly, and how long the treatment was expected to take. Vast generalization here: perhaps Americans have a stronger preference to be "in control" in life compared to their Ghanaian counterparts.

• A few times a day a nurse would enter and give me a clear plastic bag with pills inside. I was instructed to take them, but wasn't told what they were. Once I found out that one of the pills was for stomach muscle pain I decided not to take it: I didn't have any pain any longer. When the nurse came back a few hours later she ask why I hadn't taken all my pills. I told her I wasn't having that symptom any longer (it was just a pain pill). On her face she wore the kind of look I would imagine would come from me saying something like "tomato puppy slippers are down yellow." Her reply, "but you must take your pills. Why wouldn't you take them?" Um, side effects, unnecessary consumption of chemicals, cost savings...? I don't have pain! "But those are your pills. You must take them." Eventually she left the room, confused and frustrated. I never took that pill.

• I was in a shared ward - my room had a total of four beds, three of them occupied. We had one bathroom/toilet...across the hall. There was no soap in the bathroom. In fact, I never saw any soap or hand cleanser the entire time I was in the hospital. Just prior to discharge I was "interviewed" by the head nurse who was looking for quality feedback on the hospital. I told her there was no soap in the bathroom. Her explanation: They have a soap dispenser but haven't installed it yet. See, the hospital is planning to remodel the bathroom and they want to wait for that remodel to be completed before installing the dispenser so this one isn't damaged in the construction forcing them to get another. Huh? How about a hand soap pump from the grocery store?

The hospital had strict visiting hours: 6:30-7:30 am, and 5:00-6:30 pm. And while I observed a handful of visitors to other patients asked to leave, Cori was never once hassled even though she would arrived around 7am, and stayed for 12 hours. Some have said I received obruni privileges.
It took me about a week to fully recover, and just as I did, Cori fell ill. I was at the embassy in Accra when I called Cori at home to discover she had a severe headache and chills. Uh oh! Classic malaria symptoms - according to all the books. I called a colleague and asked him to check on her. A half-hour later, Cori was at a local hospital. When I arrived she had a desperate look on her face. Minutes earlier the nurses had hooked her up to an IV, and just as the fluid started to flow Cori's throat closed up - she couldn't breathe. Scrambling to get someone's attention and gasping for air, she finally had the IV removed, her airway opened up, and she vomited. Within minutes she was receiving Malaria treatment even though the lab results wouldn't confirm that fact for another hour. We never did figure out why the IV solution caused the reaction.

By morning Cori's fever had dropped and her headache was mostly gone. But for five more days she stayed in the hospital with severe diarrhea. At some point the doctors started treating her for a GI infection (We weren't sure when because, remember, the doctors tell you very little). On the third day Cori was visited by the hospital owner (most private clinics/hospitals in Ghana are owned by a veteran doctor - I haven't seen any evidence of corporate health care here). He is an OBGYN and quickly diagnosed Cori's abdominal pain as the result of premature contractions (she's only 20 weeks). Talk about fear and concern! Thankfully the right doctor came along at the right time - he prescribed medication that ended the contractions, and spent the time necessary to answer all of our questions, really putting our minds at ease.
Thankfully two subsequent ultrasounds have shown a healthy baby with a strong heartbeat kicking and dancing around in there.

Blood tests indicate that the malaria is gone from Cori's system. Her stomach is about as good as it has been during this pregnancy - which isn't too good, but a lot better than it was during her time in the hospital. Still, we decided that that was enough adventure for our unborn so Cori left Ghana this morning, headed for Wisconsin.

It will be difficult spending the next few months apart. We went through this 4 years ago when I taught in Hungary, and it was rough. But this time it will be different. This time she's been where I am, she's seen Ghana. When I tell stories about people, places and society, she can relate. That will help us feel closer. At least I hope it will.
I plan to return to Wisconsin some time this spring to be with her when she goes into labor. She's due at the end of May. After that I may return to Ghana to finish the school year.

Until then I'll just try to blend in among the Ghanaians.

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