Malaria & My Trip to a Nigerian Hospital
Since arriving in Nigeria, I’ve mostly been hot. When I’m not hot, I’m comfortable. Cold is a word that I reserve for specifying how I would like my bottled water. When I became chilled and goose bumps started popping on Wednesday night, I knew something was wrong.
Within one hour, my forehead was burning up. I returned home from my friend’s house and went straight for my sweatshirt and thermometer. One hundred and two point four degrees. I popped some drugs, collected an arsenal of bottled water and went to bed, telling my Bengali housemate, Rafiq, that tonight I would not be locking my door and that if I did not emerge in the morning, he should come in. I had a sneaking suspicion that this Mac truck of an illness that had hit me might be malaria – the high fever, the pounding head, the aching bones, the fatigue.
Soon after closing my door, dressing myself in socks and my warmest lounge wear and wrapping myself in my silk sleeping sheet that was usually more than warm enough for these Nigerian nights, I began to shiver. I reached for my cell phone and called Rafiq in the other room. “Do you have an extra blanket?” I asked. He brought his blanket and spent the next hour or so brining blood to my extremities by squeezing my feet, arms and hands as well as calming the headache with pressure points and head massage. I fell asleep.
In the middle of the night (around midnight – I had gone to bed at 8:30pm), my fever piqued. I cast off the blankets, tore off my shirt and lay in a pool of my own sweat. I forced myself to drink the line of bottled water that I had gathered with great foresight. I thought I’d call and tell them I wouldn’t be able to go to work tomorrow. I popped more pills in hopes of calming the fever.
As the sun broke, so had my fever. Ninety-nine point eight, much better. I almost felt whole as I called Cynthia, the woman I ride to work with, to tell her I would be spending the day in bed rather than at my desk. She suggested that she still pick me up and we go to the hospital for a malaria test. I agreed, still tired and achy.
A little delirious and still half-asleep I prepared myself for my trip to the hospital. I took money and a bottle of water…I knew that these were the most important things. I didn’t imagine I would stay long and thought that if I had forgotten anything, I could surely purchase it. Other things seemed trivial – my phone, my computer, movies, a book, my iPod, toilet paper.
We pulled up to the hospital. It was a private hospital – one of the best in Benin City. It was a large cement building surrounded by dirt. It almost looked as if it had been newly finished – structurally sound, but still a bit rough around the edges. The doctor was outside and greeted us with a smile, showing us through the front door where the nurses gathered in their white nurse uniforms, some with small white nurse hats. Their dress reminded me of Halloween more than it instilled confidence. They stared at me. I stared at them. One sat me down right there in reception, stuck a thermometer in my armpit and took my pulse. She flipped through a disorganized notebook to find a blank page to write my name on and recorded my data before taking me to the doctor in his office.
I sat down, staring at a large diagram of the female anatomy behind the doctor’s head. “When was you last menstruation?” he asked. What? I’m here for malaria, not a pregnancy test (Nigerians are obsessed with pregnancy, children, fertility, etc.)
“I don’t know,” I replied, a bit annoyed that he wasn’t getting straight to the heart of the issue. I had DVDs waiting for me at home.
“What do you mean you don’t know?”
“I don’t know. Less than a month ago,” I replied. He pointed to the calendar and continued his questioning. I was not of the state of mind that I wanted to expend my precious energy on figuring out when my last menstruation was. I saw little to no relevance (at least not until he had determined that I needed some form of treatment that could endanger a fetus). I knew I wasn’t pregnant and threw out some numbers to appease him, “I don’t know…the 6th…or the 13th.”
“You know you really should know when your last menstruation was,” he said. “It is important to know so that you know when you get pregnant.”
“No, really?” I felt like saying, but bit my tongue. I just wanted my diagnosis and drugs so that I could go home.
“What is your blood type?” he continued. Another toughie. I knew I should know this one…I didn’t.
“I don’t know.”
“You don’t know?”
“It should be in your passport.”
“It’s in all passports.”
“Not mine.” I pulled out my passport annoyed to be arguing over whether or not blood type is listed in American passports instead of him asking me about my symptoms.
“It is in all other passports. Look next time,” he said still trying to prove his point. “It is important to know your blood type because if you get pregnant and you are…blah blah blah blah…and your fetus…blah blah blah.” I couldn’t believe he was talking about pregnancy again. I could think of many better reasons to know my blood type. As my blood, whatever type it may be, began to boil, he began to ask about my symptoms and I calmed down.
“Fever, chills, sweating, headache, bone ache, diarrhea, nausea, fatigue,” I rattled off the list I had been waiting to share.
He asked a few more questions about other symptoms and jotted notes down in the book. “Sounds like malaria. I’d like to keep you here for 24-hours of observation,” he concluded in less than half of the time he had spent on women’s issues of fertility and menstruation. What? I wasn’t prepared for this! He must have seen the shock and disappointment in my eyes and said that, maybe, if I was doing really well, I could go home in the evening.
I went out to the waiting area and told Cynthia the diagnosis and the request that I stay. A nurse came over and requested that they find someone to stay with me as well as bring some food for me so that I could start my drug regiment. They walked me to my room. I went, first cutting the deal that if I had to stay past 5 o’clock that the driver would go to my house and pick up my phone, computer and some DVDs to keep me sane.
The room was basic. There were two beds with slightly shaky metal frames. The mattresses were covered first in a plastic sheet and then a blue and yellow checkered fitted sheet. There was a pillow and no blanket. A plastic chair sat next to the bed, as did a wooden school desk and attached chair. A small room was to the side blocked by a curtain. Inside was a bag of cement. I lay down.
The hospital was clean – I was grateful for that. I knew it would be basic, but was a little shocked at how basic. I hadn’t expected a TV or an intercom system and could deal with the fact that they brought a second fitted sheet to me instead of a blanket, but had assumed that a hospital (on the higher end) would offer things such as clean drinking water (essential for maintaining hydration), some sort of food (critical to have with some drugs) and toilet paper (do I need to explain?). With a full staff of nurses, it also surprised me that they insisted that I have a babysitter. The company was appreciated, but made me feel like a bit of a burden.
When my food arrived in a small cooler, I ate it up, ready to get on with the drug regiment. Grace, my babysitter for the day, got the nurse to tell her I was ready. She brought in a weathered IV stand. “I don’t want a drip,” I insisted. This sparked a big conversation and the doctor was called in. “Nope,” I shook my head. “I’d like to take the medicine orally.” At first they thought I was afraid of needles. Then I told them that my doctor at home had suggested that whenever traveling that avoid needles. They showed me their sterilized supplies in hermetically sealed wrappers and I politely declined. With a small crowd gathered I looked at the doctor and said that I will start with the oral treatment and that if I got significantly worse, that we could revisit the issue. The American-style medical self-advocacy was a bit foreign to the hospital staff, but went over fine in the end. I got my oral medication and began on the road to recovery.
When 4 o’clock rolled around, I called for the nurse and began my advocacy again. I was determined to go home and spend the night in my bed. The doctor came in and I pinched my cheeks, sat up and looked as perky as possible. “I’d like to go home.”
He smiled and agreed. He also said that my test results were back and that I had malaria (they had taken blood earlier – I had given in and allowed a sterilized and sealed needle for this purpose). We had a brief exchange where he said that even if the test result had come back negative that it would still have been malaria. He used some metaphor about Bin Laden – a malaria test can’t check every blood cell for the parasite, America can’t check every Afghani cave for Bin Laden…even if malaria or Bin Laden aren’t found, we still know they are there. I wondered if he would have used this metaphor had I not been American. I hoped that modern science in Nigeria was more accurate than American intelligence in Afghanistan.
I took my 6 bags of pills and headed home.