A trip to ED

I remember thinking when we first got here – I must write all this stuff down! There are so many things that were just completely mind blowing in the beginning that now seem so routine. Maybe that’s why it came to mind again today at the hospital – because graças a Deus, visits to the hospital are far from routine for us. But today, after putting it off as long as I could, I had to make a trip with Tilly. She has had diarrhea since Sunday and combined with abdominal pain, fever and headaches with no real improvement – I figured it was time to rule out malaria. So here’s a blow by blow description of our visit to the main hospital here in Lichinga – the state capital.

We left it til quite late in the day, Tilly woke up feeling a bit better this morning but then after an afternoon sleep, had a temp of 38.5 and looked like death warmed up. We drove to the hospital (about 5 mins away) – I can’t imagine walking there with Tilly on my back… but that’s what 99% of people here would have to do. When we arrived, everyone was sitting on the ground outside of the “banco de soccoro” – the emergency department (I use that term very loosely). I walked up to see what was going on and realized that the cleaners were sloshing water all over the floor so no one was allowed through.

A year ago I would have just waited there until they opened it back up (hmmm… you can’t technically open up an open walled undercover area I guess – they moved the chairs away from the entrance) but I have learnt that this is just not the done thing. So I took an alternative route through the other ED part and strutted through their like I owned the place til I got to the window where you have to register. It seems to be that the best way to proceed in these situations is by literally pushing through to the front. It’s not rude, people won’t get angry (most of the time) – it’s just an entirely different method of “lining up” than I am used to.

It seems though I still need to work on my blocking skills because as I was waiting behind two men (herein referred to as Mr Moz and his Vietnamese friend – what can I say, I’ve taken to reading other peoples confidential information over their shoulders as I wait in lines – I’m going to need some serious retraiing on reentry to Australia), standing as close as I thought humanly possible, another lady came and “pushed in” in front of me! That was my take on it but who knows, she may have been there first and then been coming back to her rightful position in the line (that is a thing here) – I doubt it, but I’m not quite so skilled as to be yelling at people in a strange language when I’m not 100% sure that what they did was wrong.

So after waiting for her to give her details and move on (which was actually kind of good cos I got to hear all the questions the receptionist was asking before my turn) I was up. People aren’t very tall here in Moz – so when you’re 5’10’’, speaking a strange language to a lady sitting behind plastic screen with a little hole that is no where near your ears – it can be difficult. I answered all her questions plus a barrage of what’s wrong with her from some other random woman standing in the cubicle and I managed to get through it just fine (if you call registering as Matilda Pek fine – stupid Portuguese alphabet with its weird letter names) and was given my piece of paper to take to the next station. If you imagine it as a bit of a race – it’s way more fun.

So by this stage I was behind Mr Moz and his Vietnamese friend with the mysterious illness and pushy-inny lady with her teenage daughter and her baby. We all stood in the cramped hallway outside the examination room (hmmm, that’s a bit generous) waiting to thrust our piece of paper into the “doctor’s” hand (I use inverted commas because a) I genuinely don’t know if these people are real doctors and b) after what one of them did to assess my broken foot, I hold very little respect for their methods).

There was some tension when the dirty water that the cleaners were pushing out of the acute trauma room (ewww… I just try not to think about it) started approaching us all in the hallway and we had to move to the other side. Another man saw this as an opportunity to jump into the doorway to thrust his paper in first (a trick here is to avoid all eye contact with those surrounding you – something he was doing quite well). The “doctor” told him to wait and shut the door. In the process of doing so, he squashed Matilda’s fingers! At this point we made eye contact, I made an “eeeeeee” noise at him and he backed off – too scared to try his pushing in on me again.

We were in – another bit of body blocking of the doorway as the previous people exited (thank God for all those years of basketball!) and I managed to get us into the room safely. Not being separated by a piece of plastic – I managed to get Matilda’s name across correctly. After describing her symptoms, we were given another piece of paper (the back of a scrap of recycled Dr roster sheet) to take off to the laboratory for a blood test. The race was on… Mr Moz and his Vietnamese friend with the mysterious illness had also headed off to the laboratory.

After a short walk outside of the ED, through the carpark and across a well-trodden bit of dirt, I arrived at the transportable where Pathology used to be. After nervously greeting some random lurking outside (nervous because I didn’t know where I was going not cos the dude was scary) and soon realizing that Pathology had moved, back into a real building – I arrived, barged my way straight in (with a com liçensa to be polite but no intention of waiting) and dropped my form on the counter. I then headed back outside to sit and wait to be called for my test.

I wasn’t really called so much as directed to go in by Mr Moz whose Vietnamese friend had apparently already had his test done. Who knows how long I would have sat had I not been actively encouraged to once again barge my way in. Tilly was so not impressed about having a blood test. It made me think back to when we did it in Perth… with that special numbing cream and lollies and a nurse way more nervous than we were for fear of inflicting psychological trauma on a 3 year old. Compared to that – this was awful. They didn’t even have stickers! After not one, but two attempts to find a vein, some crying from Tils and wrangling from me… we had our sample. Some would consider that a bad experience but I actually thought those two guys did a pretty good job. The needle was new – that’s always a good thing!

After that, it was back outside to wait for the results. It was at this point in the race that we started to gain some ground on Mr Moz and his Vietnamese friend. I think sometimes the people in the lab wait until there at least a couple of samples to turn the machine on (sorry Tim – showing my complete ignorance here!). So when the results arrived, we were in the lead. Mr Moz and his Vietnamese friend pulled a sneaky move though by going in through the back door. In my defense, Mr Moz wasn’t carrying his Vietnamese friend, whereas I had Tilly on my back. I arrived in the hallway seconds after them only to discover we had both been thwarted by the cleaning lady!

To be honest, I’m not sure why I even bothered returning to the doctor. It doesn’t take a linguistics genius to figure out what “Negativo” means. And I didn’t really have any intention of following through strictly with the doctors orders (I have trust issues) but the super responsible, always follow the rules part of me figured I should follow through with the process and make 100% sure that “Negativo” wasn’t some secret code word for really bad malaria.

So the cleaning lady had now moved onto washing the major hallway outside the examination room and we were given strict instructions to go and sit and wait in the undercover area until they had finished. So we backtracked outside and around and joined the group, who were originally seated on the floor outside, on the chairs undercover. Followed by another gut churning display of pushing mucky, muddy water out of a hallway and down a ramp, we literally sat there watching the floor dry.

As soon it looked good to go and I saw someone else up the other end walking on it (and the cleaner had her back turned) I charged back into the small hallway outside the examination room. Hot on my heels were Mr Moz and his Vietnamese friend and just about every other person in the waiting room. No one could deny it though – I was in the lead. To my dismay, the doctors were still on their “the floor’s being cleaned” break so we were forced to wait again. When the doctor did return, I looked up to see Mr Moz making a move toward the door but then he very graciously ushered Tilly and I in first.

She sat on the chair quietly while I went again through the torture of spelling in Portuguese and tried my hardest to convince the doctors (there were two by this stage) that yes, honestly, she is only 5. “She’s big hey!” I don’t think they actually believed me, probably thought – poor silly woman who doesn’t know her alphabet in Portuguese, doesn’t know her numbers either!

After going over her symptoms again and checking through the lab results one more time, they sent me off with a script for ORS, paracetamol and Metronidazole… not bad. Off we went down the ramp to the Pharmacy where after waiting just a few minutes, the lady gave me three sachets of ORS and the antibiotics and informed my they didn’t have any panadol. You know what that all cost? 5 Mets! That’s like 17 cents! Amazing!!! After getting a run down on how to prepare the ORS – we were off.

All in all – it was probably quicker than a trip to ED in Perth, fast lab results, cheap drugs. It’s lacking a little in the ambience and customer service departments, but we really can’t complain.