“Full of mobile bacteria,” a phrase that I’ve heard way too often in Ethiopia. This morning I finally broke down and went to the clinic after being sick for the last few days. Being sick in Ethiopia really takes a toll on you definitely if you are already in a mood and trust me I’ve had plenty of experience with being sick here. Luckily for me this time I was in better spirits. I’ve had quite some luck the last week at school. My classroom I use for my ELIC (English Language Improvement Center) was painted and I also sandpapered and repainted my blackboard. Might not seem like much but that is a major accomplishment. Once I get the room set up again I will post some pictures. For now I want to go back to this sickness thing. I thought it might be interesting to share with you the difference between going to the doctor in the USA to going to the doctor here.
While I was home in the states in August I went to see my doctor for a check-up and some other issues. First, I had to call the doctor’s office, press in the extension of the nurse for Dr. Ryan and then explain my situation. Just like that I had an appointment after we settled the insurance and payment process for my Peace Corps ‘coverage.’ The next day I go in for my appointment, fill out a form to make sure my contact information is up to date, the receptionist makes copies of my insurance information and then buzzes me in so I can go to the back to Dr. Ryan’s waiting room. After waiting 10-20 minutes since I arrived early my nurse came in and called my name. The nurse took all my vitals after checking my weight and height. Then I waited another ten minutes or so sitting in one of Dr. Ryan’s cozy examination rooms as he cared for another patient. Finally, Dr. Ryan comes in and greets me and this last time introduced me to a medical student from UMKC that was helping him out. Dr. Ryan gets out his fancy little tablet and goes over my history and asks me my symptoms plugging in notes as we go along. We decide lab work is necessary. So after getting all my lab work approved by Peace Corps I go to the lab, they take blood, stool samples from both ends and then they send me on my way. A few days later Dr. Ryan’s office gets my lab results in and everything is fine but they are required to send me a copy of the results to my permanent residence. So basically, that’s what going to the doctor in America is like. I had a follow up appointment while I was home but you get the drill.
Now for the more interesting doctor experience. First off, in most cases I am supposed to call the PCMO (Peace Corps Medical Officer) on the duty phone who is stationed at our Addis Ababa office. It doesn’t matter if the Peace Corps office is closed someone is always on the duty phone. For example today is Columbus day and tomorrow is the Muslim holiday Eid Arafa so the PC office is closed but the duty phone is always a go. The same goes for our safety and security coordinator’s phone and a couple others. However, today the network has been extra horrible so I couldn’t get through to the medical duty phone so I went ahead to the clinic without talking to the PCMO first. There is the Mizan-Aman Hospital at the end of the Aman airstrip but it is always so busy and when I’ve had to go before I was there for about 3 hours minimum each time. Unless I have to have blood work done to test for malaria or something more severe I will go to a clinic across the road from the hospital. It is usually pretty busy but the owners know me so they usually try to rush me in as quickly as possible ahead of any other waiting patients. Sometimes that makes me feel bad in other situations but at the doctor’s office I quickly accept and go right in.
So the process at the Meherat Clinic in Aman usually goes as follows: I go in and point to the door of the doctor’s examination room and say something along the lines of “I need to see her, there is a small problem.” I don’t think I’ve ever waited longer than five or ten minutes to get in to see the doc. Note that there is no need for an appointment. You just walk in and let them you know you are there to see the doctor. This morning I waited about 5 minutes while the doctor (I forget her name) saw another patient. Finally, I went in and did the “salam naw, tafa, dehna nen, exhibir yistiling” greeting for the doc which I hadn’t seen for a while. Translated that means something like, “is there peace, you have been lost, I am fine, thanks to God.” Then the doctor asked me what was wrong and I told her I ate something that didn’t agree with me. She then asked me if I had been eating at home and I told her not for lunch because I am too busy so I usually go out. She then got onto me in the nicest way possible reminding me that she told me not to do that. Well, sorry but I will continue to eat out in risky places because that’s just how life is here. The most common and ritual lab work here is to give a stool sample. Unless you have to check for malaria or something worse a stool sample usually will suffice. Anyways, I told here that I brought my own stool sample from home. I usually don’t do this but I didn’t feel like dealing with the nasty shint bet (urine house) at the clinic so I took care of business in my shint bet at my house, wrapped it up in an empty toilet paper role and brought it to the clinic. A little weird and gross but, that’s life. The doctor asked me how many minutes ago did I get the sample and I told her about 10-15 minutes. She said that was fine. So she filled out an order for the stool test and sent me out. I went to the front desk and paid 10 birr (about .50 cents) for the stool exam, then I followed one of the nurses to the back to the lab area. I waited a couple minutes as a baby was having some lab work done (poor little guy) and then I walked in and the lab technician greeted me and asked me how I had been. Surprise surprise he remembered me because I’ve been there way too often. He looked at the lab order and started to grab a little piece of cardboard and a little plastic stick so I could go to the shint bet and take care of business and bring back a little bit. I told him, “I brought it with me, I could not wait.” He smiled and said, “ishi” which means ok. Then I was sent back to the front to wait for the results. About ten minutes later my lab results were in. I was summoned into the doctor’s office to go over the results. She smiled and said, “we know the results, they are the same as always.” I glared down at the scratch paper they had scribbled the results on and saw “Full of mobile bacteria.” I smiled because I figured that’s what it was, that’s what is usually is. Anyways, the doctor said, “you should take Cipro, your favorite.” I gave her a slight grin and said “well, thank you, I just wanted to make sure before I started taking the medicine.” I said ishi and waved good bye. That was that. I have cipro on reserve here at my house so I will begin treatment tonight. After getting back home, I sent a text to the med duty phone to let them know I had been to the clinic and what the results were. Dr. Ayal one of our three PCMOs text me back and said she tried to call but the network wouldn’t permit it. She asked me my symptoms and everything via text but since I replied haven’t heard back from her. Oh how I just love the cell reception down here.
So there you have a little comparison of the doctor’s office in America and the doctor’s office in Ethiopia. You decide which is more efficient. I do have to argue my lab results were a lot faster here and cost nothing compared to the almost $1k Peace Corps had to shell out for my doctor’s visit and lab work in the US. Have a nice week!