Malaria: First Hand Experience with Cameroonian Healthcare

So, first of all, thanks for all the emails and questions. I’m keeping
a bank of them and will answer them all, either by email or on the
blog. However, for this week, I have a topic already.
So, I didn’t really explain what I’m doing here. As a Cameroonian PC
Volunteer, my job is “Preventative Health and Community Development”.
I will be working with community groups (kids, schools, women’s
groups, political groups, hospitals/health centers, support groups,
ect) for the next two years with my main goal being raising the
standard of living. I will be given a “host institution”. This
institution is either a local NGO or a health center or hospital with
whom I’ll be working for at least the first few months. It’s basically
a starting point. The first few months I’ll be taking stock of the
community and assessing it basic needs. What are the major problems in
my community? How can I help reduce those problems? It will always
start with education. I’ll be focusing on preventing diseases,
particularly cholera, diarrhea, malaria, typhoid, ect by teaching them
hygienic practices and prevention measures. All is subject to change
though as I see what my community needs.
This past week, we were learning about malaria. We learned how to
recognize it if we get it and how to educate people about how to
prevent it. There’s actually a great program going on right now where
health centers and handing out thousands of free mosquito nets to
anyone who goes and picks them up. It’s a huge deal right now and a
large step towards preventing malaria, which is a huge problem here.
Talking to our families, we’ve found that on average, at least one
person gets malaria a month in each household. One house reported that
people were getting it every two weeks. The locals though have built
up a small immunity. They’ve had malaria since they were kids and now,
as adults, when they get it, its basically a mild cold. Malaria is a
small parasitic disease that is transferred through mosquitoes. If
left untreated, one of the four strains could lead to death while each
of them can result in some pretty serious health consequences.
However, people here mostly know what is it and take anti-malaria
medication as soon as they feel a fever come on. The medication is
supposed to be taken every 8 or 12 hours for a few days, and then you
are completely cured. However, you can always get reinfected. For  us,
many of us who have never had malaria before, it is a bigger deal.
It’s like a really bad flu for us. It starts with chills and serious
body aches and progresses to fevers that spike at 102 or 103. It’s
terribly uncomfortable but not dangerous as we are given treatment for
us to self medicate and instructed to go directly to a hospital (if
possible) if we feel it coming on. We also are all on malaria
prophylaxis, a medication designed to reduce the chances of us
contracting malaria.
However, despite sleeping under a mosquito net, taking my prophylaxis
religiously, and wearing long pants at night (despite the ridiculous
heat here), I contracted malaria this week. In addition to malaria, I
also got a bacterial infection.
So Thursday I started coming down with symptoms. That afternoon, we
got our malaria talk about how to deal with it for ourselves and
recognize it. I swear, as Nurse Anne was going through the symptoms, I
was checking each off in head, feeling like she had specifically
created that powerpoint for me. However, Nurse Anne was not nearly as
convinced as I was and told me to wait a day before seeking medical
attention. I headed home and slept for the rest of the day. The next
day, having no apparent fever, I go to school, only to immediately get
revisited by my fever at a much lower 102. I contracted PC and off to
the hospital we go.
On the way, I was thinking how fortunate I was to be going to the
hospital. How lucky I am to be experiencing the Cameroonian health
system from the other end, to get a taste of what patients deal with
every day. And, now that it’s over, I’m glad I did have this
experience, but it was not exactly stellar.
The first hospital they took me to was the Bafia Public Hospital. The
drive me up and walk me into the emergency room. It looks like a train
station. There are round benches with dozens of patients staring
lethargically, waiting for their turn. I felt so guilty. Being the
only white person in the room, belonging to PC, and having an “in”
with the only doctor on duty (our Coordinator was accompanying me), I
literally skipped the line completely. They called me to the corner of
the room and had started my paper work, which literally was a sheet
from the prescription pad. They wrote my name, age and gender on the
paper and ushered me into the first room. In this room, they weighed
me and took my blood pressure. Weighing me was hilarious as they had
me climb into this huge metal chair that was hooked up to a scale. I
figured they had the chair for those too sick to stand while they were
weighed, however, the way the chair was positioned (the open part
facing a wall) it was so awkward to get into, I can’t imagine anyone
preferring this method over a typical scale. Taking my blood pressure
was nothing special, although (EMT’s you’ll appreciate this) they
definitely blew it up to like 250 and kept it there for a good 20
seconds before deflating slowly. Super painful. Don’t ever do that to
a patient.
Anyways, after that I was ushered back out the way we had come and to
a waiting room in front of two consultation rooms. Both of them held
nurses and had a line backed up. However, as soon I walked up with the
Coordinator, a doctor came out of the blue, took over one of the
examination rooms and led me in. Again, overcome with guilt as I
skipped ahead of some pretty sick people including a completely
lethargic baby. By the way, in Cameroon, especially in public
hospitals, doctors don’t really get to practice medicine. They are so
overloaded they end up becoming hospital managers while nurses are the
ones who do everything except major surgeries. Many health clinic
don’t even have doctors. It’s definitely something I’ll explore and
try to work on during my time here at post. Anyways, so it was pretty
extraordinary that I got to see a doctor and not a nurse. He examined
me and talked with me. His bedside manner: completely lacking. He
obviously had places to go and was not exactly happy to be there. He
was polite though. This is apparently a very big problem in a country
where there is one doctor per 10,000 people. Medical professionals
aren’t very nice to their patients. The room we were in was so tiny,
it barely fit a desk and the examination table. The doctor didn’t wear
gloves when examining and the walls were only about 7 feet tall while
the ceilings were 10 feet high (so much for patient confidentiality;
everyone outside the room could hear what was going on).
Regardless, I was sent to go to a laboratory at a local private
hospital. This place was a little nicer and definitely less busy.
Inside was less crazy and the technician wore gloves (although they
were reused) to take my blood. Again, though, the nurse was not
exactly friendly. The doctor, on the other hand, while he wasn’t
actually working with me, came out of his office to have a hilarious
friendly conversation about how close I was to Barack Obama. The
doctor insisted that I was friends with him and therefore, the doctor
would visit me and I would introduce them. It was great. They were
also extremely efficient. They took my samples at noon and had results
and a diagnosis by 2:30. I made it back to help give a presentation at
3:30.
That was my adventure. The next few days consisted of TONS of
medications, a lowering fever and disappearing pain, fatigue, and
ridiculous amounts of nausea due to the strong medications they put me
on. The first night I vomited up everything I been able to get down
the day (which hadn’t been a lot). After 3 days, I was malaria free. A
day later, I was bacteria free. Quick and simple, for the most part.
So yeah, I got malaria. I feel bad ass about it too. I was the first
in our group to contract it, but certainly not the last. Many people
get it more than once, so I have since taking a liking to long pants
and long sleeves as soon as the light starts to fade. I’m all healthy
now, but I certainly had an interesting experience and am making a
list of things that I might want to look at, explore, and maybe work
on at my health clinic when I get there.
Next week we get our post assignments. I’m so excited! I’ll keep you
posted. Keep your fingers crossed for me that I get a good one! I
don’t really care where I am though. I could be in the South, close to
beaches, or the east, maybe working with Pygmies in the rainforest,
although the mosquitoes would be terrible. I could be in the West
areas which are gorgeous and many of them Anglophone regions , or in
the north, which becomes savannah and then desert, often populated by
Muslim populations. There are so many options; I don’t even know what
to hope for.
So hello and goodbye again from Cameroon. Please keep up the emails.
They give me strength when I feel like I just want to give up and go
home. Thanks for the support and love guys!