“Marriage proposals in the hospital that’s open ‘all the time’”

 Hey everyone,

Well it was bound to happen: I got my first case of malaria or some tropical disease that I am still trying to figure out exactly what it is. Usually when I’m abroad and get sick, I don’t like to tell loved ones at home until I have fully recovered because I don’t want to cause anyone any unnecessary worry, but my latest trip to the hospital was just filled with too many funny mishaps to pass up and I feel I really need to share the experience with everyone. I will preface the post by saying that yes I am sick, but I’m by no means on my deathbed and will eventually recover. So don’t worry; sit back and enjoy the glories of the healthcare system in Ghana through this post.

Last Tuesday I started feeling like I had malaria: aching joints, fatigue, a slight headache. But, in Ghana, these symptoms could also be the sign of a long day and all I could really do was wait it out for a few days to see if they were reoccurring. On Wednesday I woke up feeling fine, but by the afternoon I started feeling as I had on Tuesday; this happened again in the exact same fashion on Thursday. While I was studying here last year, I came down with malaria a few times, so I know how my body reacts to the virus. My past experiences at hospitals here were not the most productive or positive: I spent so much time waiting to see the doctor only to be speculatively diagnosed with a range of different possible alignments and prescribed medicine for each one. It can be very frustrating and a waste of an afternoon, so I decided to just go to the pharmacy and buy medicine. I finished treatment on Sunday and was feeling 100% better by Monday morning. Then, Monday evening my knees began to ache and feel stiff, accompanied by slight nausea and discomfort in the left side of my abdomen. These symptoms weren’t consistent, but would rather come and go, which is more annoying, if you ask me, than feeling awful consistently. So here’s the catch-22 to staying healthy here: it is important to be proactive and go to the doctors when not feeling well; however for most of the serious diseases one can come down with here- malaria, hepatitis (in any form- A, B, or C), typhoid, cholera, etc..- it takes anywhere between 10 days to 6 weeks to develop to the point where the virus can be seen through blood tests. Allow me to give you an anecdote to demonstrate my point: last year I thought I had malaria: my joints felt like they were on fire, I was really tired all the time and just overall didn’t feel well. I talked with many of the Ghanaian staff running the program I was on and all of them said that for sure it was malaria. I then went to the doctor to have a blood test done and the test came back negative. After consulting with the doctor, he told me that the malaria virus can remain in ones liver for up to ten days before it is released in the bloodstream; it is not until it is released into the blood stream that it can be detected through a blood test. The doctor gave me malaria medication because he believed it was still in my liver at that point.

Since I had just finished the malaria medication and was still feeling bad, I decided it was probably time to visit the doctor and try to figure out what’s going on. Today I went to a conference then left after the session broke for lunch to head to Trust Hospital in Osu. First mishap: I enter the hospital and go to register for a patient card. Since I haven’t been to this particular hospital before, I was asked for my basic information, including that regarding my insurance policy. Fulbright has provided me insurance through the US State Department’s plan. However, I didn’t have the policy number or provider info: all of this information is in an email I received over the summer, which I have a print out of… in Kumasi- not helpful to me in Accra. I proceeded to check the email inbox on my phone, but it hasn’t retrieved mail from that long ago since I just bought the phone in October. So, then I called my point of contact in the embassy to see if she had the information I needed; she did not. Okay, no problem: Brent is on Facebook and I ask if he can login to my account and search for the email from there, which he happily agrees to do. Unfortunately the search comes up short and he can’t find the email. Thank God for smartphones because I was able to pull up Gmail on my phone and find the info I needed. Many of you are probably wondering why I didn’t do this in the first place- because my internet on my phone wouldn’t load at first, so I resorted to other measures. Obstacle number one overcome? Check. On to the doctor consultation.  

After receiving my card and paying for the consultation fee to see the doctor, I joined the cue of those waiting to also see the doctor. Surprisingly, and in comparison to my past hospital visits, I didn’t wait long: it was roughly 45 minutes until the doctor called me in to her office. I described my symptoms to her and told her I had just finished the three-day treatment for malaria. She asked me a bunch of lady questions that I won’t go into here because that would just be unnecessary on a variety of levels. Since I am having abdominal pain and recently had my period, she ordered I get an ultrasound. I then told her that I wanted to have blood work done to test for malaria and hepatitis A. Why hepatitis A you ask? Well for one, hepatitis A is easily transmitted when food or water becomes contaminated with fecal matter (AKA people haven’t washed their hands and handle your food.) Unfortunately, it’s fairly common in developing countries. And for two, here’s a fun story: on Sunday I traveled from Kumasi to come back to Accra for the next two weeks. When I arrived, I helped my host sister prepare banku, a local dish, with peppa and fried egg. In Ghana, it is customary to invite others around you to join you when you are eating. Usually when I invite people to join me, they respond with, ‘Medasse’ (thank you), but don’t take any food. While I was eating, the aunt who is also living in the house came out, so I invited her. Well she dug right in and took a big handful of banku, which didn’t bother me. I mean I did invite her after all. However, right after she shoved the food into her mouth and swallowed her bite, she launched a snot rocket across the concrete steps, then, using the same hand, patted my leg. It was incredibly disgusting and made me instantly regret sharing my meal with her. While it would be too early for me to show signs of hepatitis A from this instance, it made me think about the fact that I pretty much buy every meal from street vendors and if their hygiene and sanitation habits are anything like Aunt Adwoa’s, then it wouldn’t be surprising if I have contracted a case of hep A. 

Paperwork in hand with orders from the doctor to get a blood test and ultrasound, I went to the lab section of the hospital. First I was directed to go back to where the ultrasound would be taken. There were no hospital workers present, just a woman who was waiting. She must have noticed the look of confusion across my face as to where I was supposed to go and to whom I was supposed to give the paper because she told me to wait, that someone would come. When a nurse came to attend to her, the woman told the nurse I needed help, so the nurse took my paper and went to bring back the doctor, or so I thought. She returned with a man in regular civilian dress. He told me to come to the office marked with the name of the female doctor who had left for the day. When we went in and sat down, he began speaking to me in Twi, which is fine because I could understand most of what was said to me, but it was a bit annoying because I wasn’t feeling well and he refused to speak English when my understanding of his Twi fell short. He told me, ‘I don’t speak English,’ which, of course isn’t true because (1) English is one of the national languages of Ghana, (2) he is working in a hospital in Accra where they serve foreigners, and (3) schooling is done in English here, so whatever degree he has that got him a job in the hospital, he studied it in English. But whatever. So after we got past all of the basic questions of my name and how to spell it, he began searching the books to see when they could schedule my ultrasound. In the process, he looks at me and asks, “Wo ware?” which in English means, “Are you married?” At this point, I have to admit my patience was wearing a bit thinner than it should have, and I couldn’t help but thinking to myself, “Are you serious right now? I’m here because I’m not feeling well and you’re going to hit on me?” But, I refrained and instead answered, “Yes and my husband is coming here this weekend.” He then spoke to me the rest of the time in English. The conversation turned into a back and forth about what time I should come tomorrow:
Kwame: “Come at 9 AM tomorrow.”

Me: “Okay, but you have me on the schedule for 2:30 PM, so why come at 9?”

Kwame: “No, tomorrow is full, so I am trying to help you out, so come at 8:00 AM.”

Me: “Okay, wait you just said to come at 9 AM, but you still have me on the schedule for 2:30 and now I should come at 8:00? I am not going to wait from 8 in the morning until 2:30 in the afternoon to be seen.”

We went back and forth like this until finally I figured out that the times on the side of the paper were irrelevant. I told him I would be here whenever he wanted me to, I just needed him to tell me a time. He told me 8:00 AM; in other words, I would be here at 8:30 at the earliest the next morning because 8:00 AM really means 9:30 or 10:00 in Ghana time. He also told me that I could not eat before the exam, which I definitely wasn’t looking forward to because I tend to get grumpy and have a lot less patience when I am hungry. Looks like tomorrow will definitely be an experience to be had.

So I had my ultrasound test scheduled; now I needed to go and get my blood work done. Prior to going to see about the ultrasound, I had handed the receptionist at the lab station my papers so that I could get a place in line. When I went back to the window, she handed me my papers with Hepatitis A circled. She told me that I could get my blood tests for Hepatitis B, Typhoid and Malaria today, but would have to come back for Hepatitis A tomorrow because the technician who reads the tests had left for the day. I asked if I could just get all 4 tests done with one blood test tomorrow, which she said I could (this was a process to determine though because cultural miscommunication was incredibly present). After it was established that I should return tomorrow for my tests, I asked what time I should come.

Her response, “Anytime. We are always open.”

Me: “Really? Then why has the technician gone home for the day if you are always open?”

Receptionist: “As for him, he went home. He’s no longer here.”

Me: “Yes, I understand that. I’m asking, when will he be here tomorrow so I can come then for the test?”

Receptionist: “We are always open so you can come anytime.”

Me (new tactic): “Okay, so if I come at 5 in the morning tomorrow, there will be someone here to take my blood for the test?” [being facetious of course. I couldn’t have woken up that early to be there by 5 the following morning even if that had been an option]

Receptionist: “No. As for that one, people usually come around 7 AM.”

Interjection from a lab technician standing nearby: “Ah! No they don’t. They usually won’t come until 8 or 9.” (looking at me) “You come then.”

Receptionist: “Okay, yes. You come around then.”

Me: “And the lab technician who can do the test will be here then? You’re sure.”

Receptionist: “Yes. Someone will be here to do it for you.”

Me: “Okay, thank you.”

So, roughly an hour and a half later, I left the hospital with orders to return the following day.  

Today I left the house and arrived at the hospital around 8:30 AM. I went back to the receptionist from yesterday to try to get my blood tests done. I was instructed that I should first go for my ultrasound. I was directed to a room with at least 10 other people in it, all waiting for an ultrasound as well. Through the course of the hour, the doctor came to the room to call back one woman for her exam. After an hour passed, I figured it would be more beneficial if I went to get my bloodwork done to make sure that I got it before the guy who could read the results of the Hepititis A test left for the day. For those of you who don’t know, I hate needles and getting my blood drawn. I am also terrible with medical issues in general and get squeamish quite easily. Every time I get my blood drawn, without fail, I black out and have to remain seated or lying down to prevent from fainting. Knowing this and knowing that it would probably be even worse because I had to fast in order to have the ultrasound test done, I brought a juicebox and some candy with me to re-elevate my blood sugar levels. I warned the lab technician as well that I would faint, so he should just let me remain seated until I was able to stand again. So he drew blood, I blacked out and when I recovered, I was told that my results for Malaria, Hep. B, and Typhoid would be available in two hours; I would have to return on Friday for the results of the Hepatitis A test because apparently they cannot read the results at the hospital. They have to send the test to another lab that can analyze the results, then have them sent back. I was pretty mad when I heard this because I felt like I was getting a continual flood of contradicting information because the hospital staff weren’t communicating with one another, or at least that is my impression of the total communication error from the day before where the receptionist told me they could read the results of Hep. A tests at the lab, but the man had left for the day and I needed to come back to have it done. In any case, there was nothing I could do about it, so I went back to the ultrasound holding room to continue waiting for my name to be called.

Waiting indefinitely is honestly one of the most difficult things to do if you ask me. I wanted so badly to leave and say to hell with the ultrasound, but I figured I had to be there until 12 to get the results of my blood tests anyhow, so I may as well just wait and see if I can get it done within that time frame. The room was warm; though it had a ceiling fan, it was not turned on, and I have to say that this made the waiting even worse. As I sat there waiting in a room full of pregnant women, I became frustrated at the lack of urgency on the part of the doctors and medical staff to do their jobs and provide the service we were all waiting on. This was mostly because I knew that as I had been instructed to do, these women also had not eaten at all today- and they are pregnant. Fasting and pregnancy don’t mix well and I felt angry that medical professionals could be so seemingly unconcerned that these women had been waiting since before I had gotten there, so for more than two hours at this point, and had probably been up even longer because most women here wake up around 5 AM or earlier to do household chores and prepare for the day, and had not eaten. Even writing this now causes me to get fired up.

After waiting at the hospital for three hours, I was finally called by the doctor for my ultrasound.

It was a quick procedure and roughly an hour later I got my results for both tests. My blood test came back negative for malaria, hep. B, and typhoid (which didn’t surprise me at all. Even if it was any of these things, it is probably too early to be able to see the virus in my blood stream despite having symptoms, as I said earlier in this post). My ultrasound also showed everything- liver, kidney, spleen- to be normal. So I asked for a consultation with the doctor. When I finally got to see the doctor, she said that sometimes it can take some time after you finish taking medicine to treat malaria to feel completely better. Essentially what it boiled down to was the typical: “We’re just going to have to wait and see.”

Five hours later, I was officially done at the hospital and went to eat. After finding a place that served great Mediterranean food and smoothies, I made my way back to Accra to do some errands for Brent’s and my trip. I ended up getting conned out of 300 cedis in the process (approx.. $150). Here’s what happened:

Traffic was terrible and there were no tro-tros heading in the direction I needed to go. As I waited for transportation, there was a woman next to me who called out to a taxi passing by with a man in the backseat. After they exchanged a few words, she climbed in the back seat of the cab. In Ghana, you can hire a private taxi for just yourself or whoever you’re traveling with, called a drop-in taxi, or you can get a shared taxi where everyone in the car is going in the same general direction, but can opt to be dropped at different areas along the route. Unless I am going somewhere where I absolutely don’t know my way, I typically take shared taxis because they are significantly cheaper. Thinking this taxi was a shared taxi, I went to ask the driver where they were going; he responded with a, “where are you going?” So I told him I needed to go to Medina or Station 37 (where I could then catch transport home) and he motioned for me to get in. Shortly after I got in, the woman had the driver drop her off, leaving just myself and the other guy in the back seat with the driver. As we sat in traffic, the man went to pay the driver his fair, handing him a 20 cedi bill. It’s pretty hard to pay for transport with a bill this big if the fair is less than 10 cedi because drivers don’t usually have a lot of change. Sure enough, the driver told the man he didn’t have change, so asked me if I had any smaller bills so I could change it. I changed it for him, handing him smaller bills, but he didn’t end up giving the guy sitting next to me his change. I didn’t think anything of this; five minutes later, the man asked the driver for his change. Rather than reach into his pocket, the driver reached across the passenger seat and pulled the seat lever so that the headrest of the front passenger seat was directly on my chest. I didn’t understand what was going on; I thought the driver was looking for even smaller bills to hand the man his change or something of that nature. I asked him what he was doing and the driver replied that he needed my help finding the lever for the seat. So I pulled the lever and pushed the seat back up. He quickly said, “No! Not that lever. The other one that brings the seat forward,” and pushed the seat back so that I could barely move again. I told him I couldn’t help him find the lever if he didn’t let me push the seat back up because I couldn’t move, as I pushed the seat forward again. He didn’t let me push it far. At this point, my bag was still safely in my lap, but was hindering my ability to help this guy find whatever lever he was talking about. The guy sitting next to me noticed this and said, “Here, let me help you with your bag.” I was so preoccupied and confused as to what the hell this taxi driver wanted me to do that I let him and said, “thank you.” Roughly a minute later, the driver miraculously found the lever he was looking for and brought the seat forward; apparently the foot of the man sitting next to me had been hurt or something (part of the con). The driver then told me they were going to the embassy, the opposite direction of where I needed to go, and he dropped me at a roundabout so I could take a tro-tro to where I needed to go. He didn’t ask me to pay, so I thanked him and left the car. When I finally got on a tro-tro and went to pay my fare, I noticed all my money, except for about 5 cedis, was gone. It was then that I realized exactly what had happened: the driver had created a diversion so that the guy could reach into my wallet and take my cash. I’m assuming that the guy paying with a 20 cedi and the taxi driver claiming he couldn’t change it and asking me for smaller bills was part of it: to see if I had any money in my wallet.

I’m sure some of you are wondering a lot of things when you read this, like, “Why were you carrying around that much money on you?” Well, if you’re wondering that, the answer is because I knew the hospital was going to cost me- it ended up costing me just over 200 cedi when all was said and done- and then I was planning on making some big purchases later in the day, so I brought it with me to avoid being charged an ATM fee again when I had made a large withdrawal the day before and had cash for what I needed to buy. I’m sure some of you are also asking why I let the guy help me with my bag if he was a stranger. Two reasons: (1) When you are being conned, it happens so quickly that you don’t have any time to process what’s happening and think that someone is taking advantage of you and (2) because I’ve never had a bad experience with trusting a Ghanaian when I’ve been lost or needed help of any kind; in my experience, people have always been very trustworthy, welcoming and friendly, so I didn’t think that the guy ‘helping’ me with my bag would be an excuse for him to steal my money.

But, here are a few positives that I found in the situation: First and foremost, at least I didn’t get hurt. Looking back at the situation, I was in a vulnerable place: I was a lone female in a cab with two men. What if I had refused to let him help me with my bag and they tried to get my money in a more forceful way? I mean that’s not a far-fetched hypothetical; it’s happened before and it’s happened here. Money is replaceable and I am willing to have whatever amount taken as long as I am safe and unhurt. Secondly, at least the douschebag that took my money didn’t take any of my credit cards or my whole wallet and was ‘nice’ enough to leave me bus fair to get home. Third, I think I learned a valuable lesson: even though I feel comfortable trusting people here in general, I still have to make sure I don’t let my guard down so much that I am perceived as naïve and leave myself vulnerable to being taken advantage of. I’ll admit, I find it’s a hard line to draw because I don’t want to seem as the unfriendly obruni who is disillusioned with Ghana or the culture, but I also can’t be so friendly that people see me as an easy target. Just as with everything in life, this was a learning experience and as I said before, I’m just thankful that I didn’t suffer anything other than a minor dent in my bank account.

Tomorrow it’s back to the hospital to get the results of my Hepatitis A test, then to do some more errands before Brent gets here on Saturday.

This will probably be my last post until after the New Year. Brent and I will be traveling during the ten days that he is here, so I won’t be spending much time in front of the computer.

I hope everyone has a Merry Christmas and a Happy New Year.

Until 2014,

Chelsea