Monday, April 7, 2014

Medical Care

Okay, I think I promised a post about medical care almost two years ago. Which is a bit ridiculous. But here it is.

Medical care here in camp is…just fine, for normal everyday living. There are a few doctors (I honestly don’t know the number, three or four I think) who are all on staff and share the duties of being on call over the nights and weekends. Right now (and since we got here) there is one expat doctor (first was Dutch, current is British) and the other doctors all speak English and are highly qualified as well. In fact, depending on what your issue is – sometimes it is much better to see a local doctor as they are very well versed in local skin issues and parasites and such.

If, however, you have something a bit more serious, things get tricky quickly.

It is not advised to have someone come here who has serious health issues. They recommend not having older parents visit if they are frail in any way. The biggest issue is just the remoteness. The clinic is capable of getting a patient stable (they can do IVs and have medication and supplies that you would expect for this kind of thing) – but it can take up to two days to arrange and execute a medical evacuation! If it is something more minor – you might get flown to Port Gentil or Libreville, either on a Shell flight or by helicopter (again depending on severity of issue and also the plane schedule!) – but for bigger issues they need to get you to either Europe or South Africa. You can imagine how this is not ideal in the case of say…a heart attack.
I personally have had two experiences with the limitation of care here, neither of which, thankfully, was very serious.

I had a strange growth above my right ear in my hair – had thought it was a psoriasis spot, but then when I changed my eating and the rest of the psoriasis cleared up, that spot didn’t. If anything, it seemed to have gotten a bit bigger. So I went into the clinic, expecting to be told it was nothing.  

Instead I was told…I’d like you to have that looked at within the next two weeks. The doctor didn’t really want to have it tested here, as there were potential issues with sample collection and transport – and then he wasn’t sure the testing facilities were what they should be either. He said it could be nothing, but we won’t know until it is looked at, so you might have to be gone for two to three weeks.

So Kaya and I hopped on a plane to Houston within a week, with the hope that we would be coming back in three weeks time.

It ended up being nothing - seborrheic keratosis – which, awesomely, is something you usually get when you are old!! So, while grateful that it wasn’t anything worse, I felt a little sad that my body is older than I think I am!

The other time was about two years ago. Long enough ago that it was the Dutch doctor who was here.  
I was pregnant, but hadn’t been feeling right for a few weeks. And then I started spotting. All prenatal care is done in Port Gentil, but I was going to wait and have my first appointment done in the states, since I was heading home for a vacation anyway. I was about eleven weeks.

I went into the clinic on a Thursday or Friday, knowing they did no prenatal, but figuring at eleven weeks, they should be able to tell if there was a heartbeat or not. They did an ultrasound, all the while saying, we don’t usually do these, so the results might not be as accurate…I said I understood all of that, I just wanted to know if there was a heartbeat. My gut was saying there wasn’t.

They did the ultrasound and asked how sure I was about my dates, as the fetus did not look eleven weeks. I knew that meant I was going to miscarry. Or rather, that I already had, but my body hadn’t caught up yet to the reality of what was going on. So they made an appointment for me in Port Gentil for the next Monday or Tuesday (the gynecologist only takes Gamba appointments on certain days) – telling me we don’t know, everything could be fine and the baby is just younger than you thought. But I knew. And at that point, I was okay with that. I hadn’t been feeling pregnant for a few weeks.

That weekend I started to miscarry.

Before we had left the states, my sister had miscarried in a scary way – hemorrhaging and ending up in the hospital. And that was definitely on my mind.

So when I went through four pads in an hour, I knew we needed to call someone. Especially since there wasn’t much they could do for me here in camp.

Oddly, no one picked up on the emergency number. This is never supposed to happen, but I am convinced it happened for a reason. We called our neighbor and friend who also happened to be not only trained in first aid, but an instructor of first aid courses. I figured she would be good to have around in case I passed out.
Once she got to our house she was able to immediately get through on the emergency number – as one would expect. The on duty doctor called us back, and that was when we figured out why she was there. The duty doctor on that day happened to only speak French. Did I mention she taught some of those first aid courses in French? 

Anyway, we made our way over to the clinic and Kathleen explained everything to the doctor. They arranged for me to be on the next Shell flight to Port Gentil. It happened to be right before a school holiday, so I got to ride, on a stretched on the plane with everyone heading out on their holidays. Which ended up being convenient, as the Dutch doctor was also booked on that flight, so he could accompany me to Port Gentil. Brant and Xander could not, as the flight was full.

By the time I got to Port Gentil everything was pretty much over. (In a not quite so funny mistranslation experience – the doctor there told me “You have had an abortion.” And while it’s true that spontaneous abortion is another name for a miscarriage, it’s hardly one that is used much in the US!) I didn’t need any blood or anything, though they did put me on an IV.

They kept me there for I think two nights – and Brant and Xander came out to see me and really, as far as medical emergencies go – it wasn’t one. But at the time it felt a bit scary. I have to admit to being paranoid about the thought of needing blood while in Africa. It definitely made me realize just how remote we really are. And just how little can be done in camp if something ever does go wrong. 

Anyway, shortly after I did get pregnant again and we had Kaya and we all came back here – because it really is a great place to live. Just sometimes you have to not think about what ifs. 

My cutie Kaya on her second birthday

1 comment:

  1. Gamba is indeed an interesting and mythic place for most of people outside. I'm quite interested, and impressed with your pregnancy story. How is the medical situation now and going to be for pregnant lady?