J's Hospital-errific Weekend!

I said I wanted to experience the culture. I said I wanted to be uncomfortable. I said I wanted to stop being a "bourgeoisie" NYU student and integrate myself into the Ghanaian lifestyle.

Be careful what you ask for.

Perhaps this was just karma for having such a great stomach during all of my travels throughout my life. Or perhaps this was just a big slap in the face to JS' I'm too good for modern medicine and I want to try to keep natural attitude. Either way it sucked.

What am I talking about you may ask--well, J took a little trip to the hospital this weekend.

Yes, yes, some of you may already know and have been reading (or receiving my mother's incessant mass text messages) my incessant mass facebook/myspace updates, (CRAP. This is one of those "I'm just like my mom" moments. Oh well. Embrace it eh?) but for the rest of you, story time! (This may be a longer email than I had anticipated. For those of you who don't want to read it know that I'm healthy, on lots of medication, and almost at 100% and skip to the last few paragraphs!) (I use a lot of parentheses.)

Friday night--dinner with our meal plan at Sunshine Salads followed by a little (alcohol free) soiree courtesy of NYU at one of the dorms. They basically invited a bunch of Ghanaian men, bussed them in, and took us all back to seventh grade where the boys stand on one side and the girls stand on the other. Of course, being the nut that I am, I was running around from group to group practicing my Ghanaian hand shake (it has a joint finger snap at the end--so cool!) and telling people to be social. I was also tired of the standard "what's your major, what level are you, what country are you from" blah blah blah getting to know you crap and was ready to get jiggy with it. I was finally feeling better after 2 weeks of flu/salmonella poisoning/ridiculousness and was ready to jump, jive, and wail (if you will). Add about a bucket of sweat and that's what our little soiree turned into! Actually, somehow everyone took my shouts of "DANCE! I'M BORED!" to mean "GET IN A CIRCLE AND CLAP AND PUT PEOPLE IN THE MIDDLE TO SHOW OF THEIR SKILLZ!" (sic.) At about 11:15 I was tired and ready to get some rest but the mother in me told me that I needed to help clean up. Thank goodness there are about 7 other girls on the program who were raised with the same values. We rallied together and picked up soda bottles and packed them for recycling (they are anal about returning the glass bottles here--the restaurants and vendors will chase you down the street to get them back!), picked up the garbage, and shoved the Ghanaian boys off the tables and brought them inside. The Ghanaian women were surprised by how strong we ubruni women are ;). After picking up the place and making sure the CRAs didn't have much left to clear up, those of us well-mannered ladies got in the van and headed to our beds for some much needed rest.

Rest.

At about 3am I woke up freezing. I turned off the air conditioner, put on a sweater, and wrapped myself in a blanket. Then the shivering started--uncontrollable shivering that lasted for about 3 hours. Lucky for me the shivering came with bouts of bathroom trips (no explanation necessary). Up and down the bunk bed I went wondering what the heck was going on and terrified that I was going to wake up my poor bunkmate Julia. At about 6am the earthquake ended and fire erupted. I ripped off my sweater, threw off my blanket, and stared at my ceiling wondering if I was imagining things or not. At about 6:30 I was so hot and felt as though someone had socked me in the head, I got off my bunk, grabbed my blanket, and layed on the floor in the hallway. I was really weak and didn't want to go down the stairs. By about 7 I decided to go lay on the nice cool tile of my living room downstairs. Between bouts of hot and cold I slowly realized that I wasn't just imagining things. My body was so hot I was pretty sure I could crack an egg and eat that for my breakfast. I went and woke up my poor CRA Debbie (she had mentioned sleeping until noon and I felt really bad) at about 7:30. She felt my forehead and called the nurse. We went back out to the living room to wait for the nurse and I told her all of my issues:
-shaking and cold
-hot and sweaty
-bouts of hot and cold
-body aches (particularly in my joints)
-MASSIVE headache
-GI issues

Debbie shook her head and said, "I think it's malaaaaria... Don't worry, the pills will make it all go away!" I then took two ibprofen and drank someone's apple juice while laying on the floor in the living room. Talk about classy.

As the rest of the house started to wake up for their various weekend activities, they saw my decrepit self laying in a hot mess (literally) on the floor. We told everyone we thought it was malaria but that I'd be fine.

At the time I felt fine besides a massive headache, a little weak, but good enough to hold a conversation.

The nurse was stuck in traffic but arrived at about 10:30. She took my temperature and blood pressure--my temp was about 105F, pulse at 106 (my resting is about 65-70) and my BP was around 100/60...a little low, but nothing serious. She suggested we go to the hospital. I resisted, of course--I absolutely hate hospitals and have never been admitted to one in my conscious life! They are full of sick and sad people and make you wait so long that you end up catching various infections in the waiting room! No thanks.

But they made me so I got my ID, Chris (another CRA) got a cab, and off we went.

On the way to the hospital I started to feel really nauseous, but figured it was just the broken fumy cab and bumpy roads. We stopped at an ATM for the nurse--while nurse Mary was out of the cab, the cab driver asked me to marry him. I looked at him with my makeupless face and disheveled hair and said, "No!"

By the time we got to the hospital I felt like absolute s-h-i-t. I was suppressing the nausea and was having a really hard time staying awake. Nurse Mary was wonderful and took care of all of my paperwork for me.

The Nyaho Medical Centre is an open air facility (as most facilities in Ghana) with a "take a number" system. You drop your ID card in the box and wait your turn. It doesn't matter how sick you are, you wait your turn. By the time it was my turn to go to the Temperature Room, I felt as though I could hardly stand up. This is not normal--I am a strong girl and refuse to believe that I am ever sick. When I am sick, I take various combinations of symptom-suppressants and continue with my life. The fact that I couldn't stand up was a little troubling to me. The nurse took my temp and blood pressure--she didn't tell them to me (which I will touch on later) but I looked at my chart. My temp was 38.6 and my BP was 90/35. Time for me to panic. I told Mary my readings and she said, "3-5??? You're joking!" And ran out to find someone to see me. But in Ghana you wait your turn. They walked me over to the waiting room where I proceeded to go in and out of "consciousness." We'll just say that I was taking a little nap, ok? At one point a nurse was calling a name that was not mine and I woke up to Mary yelling, "That isn't her! This is JS." The person the nurse was calling was the overweight white woman staring at me who proceeded to look up and say, "Oh, that's me." Psh. I went back to sleep.

Finally it was my turn and I walked into the doctor's office--it was FREEZING! My only reaction was to gasp and grab my arms, sit in the chair, and huddle over his desk.
The doctor looked at me and said, "How are you doing today?"
I replied, "I've been better. How are you?"
He just chuckled and continued reading my chart, asking if I was taking my prophylactics (my anti-malaria pills, not condoms), and if I had been wearing bug repellent.
I said "yes yes yes yes can you please just give me something to get rid of my headache?"
He said "Hmmm....add meat?"
Mary replied "I would LOVE that."
I thought to myself, "But I'm not hungry! Besides, I eat enough already, why would you want me to add meat?" and said out loud, "Pardon me?"
Then he said, "We would like to admit you."
Oh.

OH.

"NO! I hate hospitals! I just want to take my pills and go home! I don't want to be admitted into a flipping hospital in flipping Africa!"

Yes, imagine me hysterically crying. I'm pretty sure he only heard about two words of the above sentence.

Mary came over and told me that it would be alright and that they would take good care of me but that it would be in my best interest to stay there for observation. She called Christa (the eccentric program assistant director) and Christa told me that for any Westerners who appear as sick as I do, they automatically want to admit them for malaria. I told her that my stupid Larium was overpriced and overrated and the food they served us with our meal plan was poisoned and that I would indulge in the hospital's overprotective scheme to take the "rich ubruni's" money only because my blood pressure was so low I couldn't walk.
Ok, you can chose for yourself what part of that sentence was said aloud and what part was kept in my head. ;)

Anywho.

They stuck me in a wheel chair and wheeled me off to the lab room where they drew some blood (needle #1) and gave me vials for various sampling. No need to elaborate. As I was being wheeled from the testing part of the hospital to the admitting part of the hospital, I saw another girl from my program sitting in the waiting room.

At some point in time I arrived in my room, but I don't really remember getting there. I know that just as I crawled into my bed I was told to get up and give those little samples. Woooo. Point to note--they do not provide/allow hand soap in the hospital room bathrooms. I'm still quite skeeved.

I crawled back into bed, took my glasses off, and fell asleep. Then I heard "Hello. How are you. Ok sorry, a little poke, ok?" I said, "What?" Segway into Needle #2. and #3. Now I give blood every 8 weeks and know what it feels like to have a needle inserted into a vein. It hurts at first but then you have the nice dull pain of the needle sliding INTO the vein. I have also had the unfortunate experience of an incompetent nurse going THROUGH the vein AND rolling the vein. No dull pain, just pain. This was just pain. After yelling, "Ow ow ow for the love of GOD stop." She replied, "I have to put it in the vein!" I moaned, "You're not doing it right. Get away from me!" Instead, she proceeded to try to poke a different vein, equally as painful, equally as wrong. I proceeded to knock her in the head with my leg and implored Mary to get her out of the room. Mary got her out of the room and I rummaged around for my glasses. Now, to the nurses credit, my blood pressure was so low it was difficult to find a vein--but not THAT difficult. I looked at Mary and said, "I know that this is going to hurt. But I know that she is doing it wrong. Please get someone else to do this or don't do it at all." Mary went and came back with a new nurse who put the needle in quite nicely (Needle #4). They hooked me up to this little bag of saline solution and I went back to sleep.

--I'm going to pause to say that the entire night was a jumbled blur of activity and I don't really know what was going on the entire time. But it's funny to try to remember it...--

Mary came in and out and I was absolutely drenched in sweat. The good lady got a cold towel to cool me off like my momma would do if I had a high fever.

At this point another student, James, had been taken to the hospital.

"Sorry, I have to give you injections now, ok?"
I wake up and wonder what is going on. A nurse is standing over me (ok, I'm going to be honest. Without my glasses I can't see any thing. But because the people here are black and their uniforms are white, I can "see" them! It's great.) and said I have to give you two little injections. I asked what they were for and she replied vaguely that they were for fever and headache. I just nodded and gave her my arm (I was too weak and tired to even argue--obviously I was sick). She laughed and said, "No, no, not there. In your bum!" I said, "You're joking. You seriously can't put it in my arm?" "No, we don't do that here! Which side?" "No, really, you can't.." "No, which side. I just turned around and said "This is ridiculous."

Two shots (#5, #6) in my bum. They still hurt and it has been 4 flipping days. I do NOT recommend that. But they made the headache go away and my fever break so I guess it's alright. :/

I went back to sleep and opened my eyes to a figure. Now, in my state of delirium, I thought she was asking what I had eaten the night before.
"Sunshine Salads. We ate the same thing. Spring rolls, vegetables, rice, salad. Oh, salad with pesto!"
Then I heard, "Spring rolls? No we have chicken, fish, rice..."
"Huh?"
I put my glasses on and realized that she was asking me what I wanted to eat for supper. In some jumbled sentences I managed to get out chicken and plain rice and went back to sleep.

At some point in time a nurse came in to take my temperature. I saw that it was about 7pm and I knew that I hadn't eaten any thing that day--I wasn't hungry but I'm smarter than my stomach and asked for some food. At some other point in time a lady came in and woke me up with food. I ate the chicken and rice and went back to sleep.

I am omitting my frequent trips to the bathroom. Let's just say that after every meal and then some and nothing actually stayed in my system for two days. The IV's wheels didn't work so it was quite an awkward experience that I hope never to have to endure again. As I'm sure you feel with this horrendously long email.

At some point in time a bag of antibiotics was put into my IV and I was told to let them know when it was finished. I woke up and saw that it was empty and told them that it was finished...about 45 minutes later I called ANOTHER nurse that it was finished and they put the saline bag on again.

Just as that occurred I heard a voice outside--I knew it was Christa. Her voice is loud, American, and unforgettable. I possibly have nightmares that involve Christa's voice. So I put my glasses on and waited for her arrival. She opens the door and immediately says, "We need to get you a private room!" and rushes out to speak to the nurses. When she comes back in I say, "Oh, it's not really that necessary." "Are you sure? When we have other students come to the hospital, we try to get them into a private room. It's ok to be a little snotty, you know." "Um, I just don't want to move very much." "Ok, well if you want a private room..." "Ok, I'll let you know if I feel like moving." She asks how I'm doing, assures me it's not malaria, and assures me that it was not the food that NYU provided.

Bullshit. (sorry)

She hands me InStyle magazine (because all females are vapid and superficial, duh) continues to assure me that I'm in good hands. I was so lonely I was happy to see her. Ha. Anyway, after assuring me that I was in good hands and telling me that I should be in a private room (bourgeois NYU conspiracy!!!) she leaves to go to some party (I'm pretty sure she didn't come in earlier because she was getting her hair re-done. Not even joking.). Oh yea, apparently being the Assistant Director of NYU-Ghana means that she's a little socialite in the rich people's world of Accra. Go her.

After she leaves, Mary comes in to check on me. Ellie had just been brought to the hospital and was being taken home. Mary left for the night and I ask the nurse to make sure the IV was working.

The story of the IV: WARNING--this is a little graphic. Not for those of you squeemish about needles or blood.
So the little bag was about half the size of those in the US. From having sat with two anorexic roommates in a hospital in the US hooked up to IVs, I was sure that I was supposed to have 4 of the Ghanaian bags over the course of about 10 hours. I had only used about half of one of my bags. The nurse said that it was working and that I just needed to rest.

At about 2am I wake up drenched in sweat to the all too familiar smell of blood. I don't think my nose is bleeding, so I'm a little confused--then I glance down at my hand. I push the emergency button and fumble around for my glasses. The nurses come in, turn on the lights, and look at me in absolute horror. I look down at my hand to see that it was covered in blood and that the IV had disconnected. I turn around and see that my entire bed was covered in blood. My blood. My blood from my HAND. Pillow, sheets, clothes, everything covered in a lovely shade of red. I look up and mumble that I was sorry. They say, "You have to be careful!" I said, "I was sleeping!" I thought "YOU IDIOTS. ISN'T IT YOU FLIPPING JOB TO CHECK ON ME SO THIS SHIT DOESN'T FLIPPING HAPPEN?" I sat in a chair as one of the nurses tried to clean up my hand, the other my bed. The nurse then went to put BACK in the IV. The bag was empty. I said, "um, excuse me, no. No. Sorry. The IV is clogged up with blood. You can take it out now." The nurse said, "No, we have to put it back in." I said, "NO. You will take it OUT now." She sort of scoffed and took it out. I went to the sink to wash my hand off and of COURSE my vein started to burst out with blood. I said, "Excuse me, I'm bleeding." The nurse just looked and said, "Oh, she didn't put plaster on it? Just wait." I applied pressure like a smart human being and proceeded to wash off the crusty blood from my hand. The nurse came and put some tape on my vein and I went back to sleep.

The next day I was woken up at 5:30. I sat around and eventually they brought me some oatmeal and toast. I was convinced that I was going to go home.

Ha.

A nurse came in and told me that I needed to wash. I said, um, ok. Mary had brought me some clothes and body wash from home, so I went to the little communal bathroom to take a shower. Well, the shower head didn't work to it ended up being a very cold rinse off with the buckets that were in the bathroom. Sanitary, I know.

A doctor came by around 9am. First doctor I had seen since being admitted. The doctor-patient ratio in Accra is something absurd like 1:100,000, so I had expected very little interaction with a medical professional. I asked him if I could go home and he full on laughed at me! I mean, I thought I was asking a serious question here and he said, not you'll stay at least one more day. I asked him what was wrong and he just said, "Did you miss a dose of your prophylactic?" I said, "No." Then he left.

So in Ghana, they don't really tell you anything. I learned this in Medical Geography but didn't actually believe it. They would not tell me what they were sticking into me, what I had, what the test results said, nothing! In the US, they give you ridiculous amounts of information with details that you don't even understand. Here, I actually had to have Mary call them while she was at home and have HER tell me my test results. All she told me was that there were no malaria parasites in my blood but that parasites don't necessarily show up for 2 weeks, so they were going to treat me for food poisoning and malaria just in case.

Fine fine fine, why can't they just give me the pills and send me home?

Nope. Here comes needle #7. I ask what this is for and the nurses just said "Infection and fever." They are sticking two vials of unknown substance into my veins and all they can say is "infection and fever?" When they are finished, I ask if they can take the needle out and they said no. Great. So I sat around all day with a lovely needle in my hand.

Mary arrived with my homework and computer and I luckily had a little wireless connection where I proceeded to scare everyone with news of my hospitalization. Of course, I could type a facebook status so I was doing pretty OK. I told my dad all of the pills that I was taking and he and I googled them to figure out what the hell I was having shot into my system. It turns out one of the pills was banned in the US because of the crazy after-effects. When I told the nurse that I didn't want to take it, she told me that I had to and handed it to me. I of course told my dad that she made me take a pill I didn't want to take, he called Christa, Christa called Mary, and Mary had a few heated words with the nurses about the right to refuse treatment.

Anyway, I'm pretty much over writing this email and I'm sure you're tired of reading it so I'll wind up.

I was in the room with four other people. Two on one side, two on the other. I was placed next to a window which happened to be next to a church. I heard worship songs (the same as in the US!) all night Saturday and all day Sunday. They have VERY long services here. The patient next to me was a little baby with malaria and food poisoning. He laughed for the first time on Sunday afternoon and I was so happy. On the other side of the room (which I couldn't see from my position) were two very loud women. One was on the phone all day Sunday and all day Monday telling people that she was still in the hospital--it was slightly amusing. Hey, I was bored. The other one was doing this awful wheezing moaning thing. Mary had "investigated" them to make sure they didn't have any contagious diseases. The rooms are unairconditioned so I was constantly sweating and the night nurses really like to turn the lights on at various times in the night and say, "Sorry! Wake up!" to give people medicine. They give you medicine here at the EXACT time they're supposed to.

The hospital is very very lonely. All I wanted to do was talk to someone or read something substantial or do SOMETHING! They do not give you water, so when I felt like I could walk I ended up getting up (needle in hand) and walking out to the waiting room where there was a water cooler to fill up my water bottle. I definitely question the sanitary state of the hospital as I'm pretty sure they don't scrub the walls after icky patients.

Aunty Akosua (the Director of the program) came by on Sunday night from her village--Christa had told her that I was ill but hadn't kept her updated so she decided to come into town and see for her self. She's such a nice lady....She really cares for each and every student in her program.

On Sunday, four more students were brought into the hospital. When I finally told the doctor that I was leaving on Monday, there were three students in the waiting room.

Last night at our "Meet the Faculty" meeting, Christa had the nerve to blame our sickness epidemic on our rampant drinking. Eh hem. Oh Christa. I've been sick with one form of the flu or another the entire time and have been told to "stop being lame". I did have one half shot of gin with a bottle of club soda on Thursday night, but that was it. I did not drink at the soiree nor did 8/9 people who came into the hospital over the weekend. The fact that she tried to blame our hospital trips on alcohol was absolutely appalling.

At the end of the endeavor, I was stuck with 7 needles and given four different pills--one for arthritis, one for headaches, one course of anti-malarials, and one course of antibiotics. I'm only taking the latter two.

All in all, the hospital trip was a true cultural awakening, but I am sure I was treated far better than most people in this country. I was at a private hospital--sure, they don't have any electronic machines and take your temperature from your arm-pit, but I still received treatment. Had I been taken to 37 Military Hospital, one of the main public hospitals in Accra, I'm sure I wouldn't have had to wait in the long lines that begin each day--but the rest of the population does: you wait in a line all day knowing that if the business day ends before you are treated, you will have to start again tomorrow. No matter how sick you are, in Ghana, you wait. As a Westerner, I was treated with more drugs in one weekend than an average Ghanaian would see in his/her lifetime (minus the malaria medication). Ghana, although one of the more developed countries in Africa, lacks a lot in the medical realm. Hand soap in the bathroom, proper medical equipment, and more vigilant attention to patients are only the beginning of a list of issues with a PRIVATE hospital in a major city. Imagine what it is like for a Ghanaian living in a remote village! This weekend really made me take a step back and be thankful for the life that I have been given. The health care that I have had access to my entire life is a privilege that many people in the world could never dream of. Hell, if any thing seriously happened to me, I would be med-evac'd out of the country immediately. The numbers of people who could use malaria medication, antiseptic, or even a good night's rest in a well sheltered home is astounding. Think about all of the children who still die from malaria, a disease that is easily treatable with cheap medication. Hopefully one day health care on this continent will reach an acceptable amount of people with an acceptable level of quality. Thinking about my situation in comparison to those in remote villages makes me a little sick inside (don't worry, not the bacteria/virus kind).

I am very fortunate and thank each and every one of you for your caring thoughts, prayers, and well wishes. No need to worry in the future--I am in much better care than the rest of the country (and NYU program!). I have RS's forceful words and SS's prayer groups behind my back.

Love to you all!

J

PS: Sammy's landlord woke up up on Thursday night to tell him that they had turned the water on! No bucket brigade needed (but definitely on stand by).