01 02 03 Africa Expat Wives Club: A day not to remember - private healthcare traps in Nairobi 04 05 15 16 19 20 21 22 23 24 25 26 27 28 31 32 33

A day not to remember - private healthcare traps in Nairobi

Occasionally we all have a day from hell. Of course this is a global phenomenon and not just particular to living in Nairobi – except, of course, bad days in Nairobi inevitably include traffic.

First of all, I wake up on a Friday morning and decide, on the spur of the moment, to take my daughter to the doctor.  To be honest, this forms the tail end of a longer story.  A few weeks ago I took said daughter (again on the spur of the moment because it was the day before the new school year was due to start), to a hospital satellite clinic which I won’t name right now.  Said 12 year old daughter has been on a low-grade downer for a while now – in fact, if I think about it, it has probably lasted for over a year.  She has lost weight and complains of tummy ache regularly. We’ve done various doctor’s visits and she’s undergone numerous tests over the past 12 months but so far we had drawn a blank. So I dash to the hospital with her in order to try and find answers - the right ones - and, for once and for all, clear up this mess before school starts. However, visiting a clinic is not a speedy process. We (my daughter, her younger sister and I) end up chained to this hospital for close to 5 hours!  

Looking around the waiting room (full), I can see the way this day is going to pan out. In my pushy 'mzungu knows best' way, I ask the nurse who weighs and measures my daughter if there is no way we can get some tests done in advance of our first meeting with the doctor. I tell her that I'm pretty sure it's a urinary tract infection and can we just drop a sample at the 'samples' place now, so that when we see the doc we have results in hand. The nurse demures. She thinks this could work possibly. She gives me some pots for stool and urnine tests.  My daughter disappears into a cubicle to nobly 'try her best'.  When she emerges she says,

'There was no water - but it's okay, the loo did flush and when water wouldn't come from the tap in the sink I just washed my hands with just soap. My hands feel quite odd now, but quite nice and soft.'

My daughter doesn't see steam coming out of my ears.  No water! Bl**dy Hell! And what are we all paying here?

I go to the lab where they do all the testing and drop the samples. The woman on reception (when she eventually returns from goodness knows where - probably went in search of a washroom with water) - says in no uncertain terms that she cannot do testing unless she has a doctors referral. While the woman on reception was absent, we broke into one of the consultation rooms to see if water was coming from that tap. A trickle appeared. My daughter rinsed her hands.

So finally, after an hour, we are called to see the doctor.  It's been a long hour of hearing the nurses call out mispronounced names while a full waiting room look askance at her?  When she called Mary Ngugi and no one got up - I felt like pushing my daughter forward. 

The pediatric doctor seemed very reassuring and in control but he recommends not just stool, urine and blood tests but a full pelvic and bladder ultrasound to boot.  The urine and stool samples 'were in the bag' so to speak, but the snag was the fact that ultrasounds were dependent on my daughter not having eaten anything at all for 6 hours. Fortunately she hadn't eaten anything since breakfast that day but there was still a necessary wait of an additional hour and a half to contend with before she was deemed 'ready'.

It’s great to have instantaneous access to private health care here in Nairobi but, let's be honest, it comes at a cost  – when you walk into any clinic, people see dollar signs.  I’ve lived here for nearly 13 years and even though I could see a pattern emerge clearly, I still found myself allowing my daughter to be submitted for a crazy amount of (very expensive!) tests. But, nor could I say ‘no’ to any of these procedures since my primary aim was to get to the bottom of what was ailing her.  

You become a sort of pawn in these hospitals; passed from department-to-department (with that inevitable visit to the cashier’s desk in between each stage - Ker-ching). My poor daughter. I think that the lowest point came she had to watch her younger sister and I devour a KFC lunch at 3pm while she was still 'fasting', waiting for her ultrasound test. She was still nil by mouth at this stage and took this torture stoically - 'Don't worry mum, you go ahead. I'll be able to eat after my ultrasound' she said as her younger sibling waved a chicken leg in her face.  

To be honest, one of the problems was that my daughter wasn’t that ill. She was definitely happy to muck around with her sister in the waiting room while a disturbing news broadcast on boda-boda serial killers in Bungoma was playing out on the overhead TV. My ten year old stopped to watch. Sh was fascinated to learn that the motorbike drivers had been axed and dismembered. There were some questions that followed. The TV broadcast was absloutely unavoidable. Meanwhile, I had ample time to wonder why the heck my daughter was undergoing all of these tests (and whether there was enough money in the bank to cover them) - but sadly the train had left the station and I felt that we had no option but to go ahead.

The ultrasound process took hours.  My daughter was in the room for ages as her sister and I 'played' outside, doing french plaits, dancing about (there was no one else there) and peering through the air vent in the base of the door).

Again, waiting.  Apparently 'reading' the ultrasound results and gluing fuzzy black and white images onto a large piece of card takes a long time.

The end result cost 40,000 shillings (the exchange rate is not great for us at the moment but this is hundreds of pounds/$100/s!).  For our money, we emerged armed (and I mean ARMED – I could hardly carry it all) – with medication. We left the clinic with no less than x3 types of antibiotics, anti-sickness pills, ant-acid pills and pain killers for what was diagnosed as no less than 3 ailments: urinary tract infection, dormant amoeba, helicobacter pylori and an irregular bladder ultrasound readout and a further hospital visit to a specialist urologist was recommended. Even the in-hospital pharmacist raised her eyebrows and had to call the doctor to her desk to whisper how on earth a 12 year old was supposed to take all of this medication. After some discourse (eagerly watched by me) they together agreed that perhaps my daughter should start with just 2 of the 3 antibiotics and take the last course later.

We got home and after supper, my 12 year old took her first cocktail of pills. She promptly vomited and since it was the night before a new school term/school year was due to start, I decided not to give her anything else until I had consulted not one, but two, pharmacists for a second opinion. The next day I took the sack load of pills around my neighbourhood seeking advice. The pharmacists understandably wanted to see test results from the hospital (which I didn't have at that time as I had been asked to go back and pick them up the following day - since they were taking so long to process - again impatient mzungu). The pharmacists I spoke cautiously recommended my daughter take just one course of antibiotics at a time, so we started with the urinary tract infection one.

Having just finished the first course of strong antibiotics for the urinary tract infection, my daughter woke up in the morning still complaining of abdominal pain. She said, 'I don't want you to be cross Mum, but my tummy still hurts.' 

I couldn’t believe it. I was distracted and disappointed- so here we are the beginning again. Hence, the decision to make a the spur of the moment visit to the doctor. This time opting to visit a more cosy practice of GPs who are not linked to any particular hospital (we didn't go to them the first time around because they are only open for a select few morning hours - which drives me nuts). Inevitably the appointment was during school time. What the heck, I thought. There's no point in just going to see this doc with just pills, I need my daughter to see her. So I headed into town to collect my daughter from school and figured that I had just enough time to make it back to the doctor before the allocated appointment – traffic permitting. Of course, the traffic was awful. I was stressed (quite tired and distracted too to be honest). My daughter was surprised at my very unexpected turning up at school but she was okay about accompanying me. We were in a rush to get back to the doctor’s. I turned to ask which lessons my daughter was missing and wham – I drove into the car in front of me.

I don’t just nudge the car in front but I WHAM-ED into it. And we had been literally sitting in stationary traffic. How did I manage that? I  think that I had assumed the car in front was moving on (perhaps I had subconsciously seen a vehicle move forward up ahead) and bang – I shunted forward while the car in front stayed stock still on an ironic speed bump that was sticking two fingers up at me.  

This 'wham' of mine was significant. I managed to buckle in not just the back door of the car in front, but also their lower bumper, upper bumper, tail lights.  That’s at least 5 components of a car’s back end. Expensive. Oddly enough, my car sustained minimal damage. My daughter blamed herself. She said it was her fault because I had just looked at her before lifting my foot off the brake (my car’s an automatic).  Bless her. All I could think about was the doctor's appointment.

Perhaps it was the Jacaranda in full bloom that distracted me!
Long story short, I had a conversation with a very patient and accepting driver of the damaged car in front and agreed to meet him in an hour, after he had had ample time to consult with a mechanic about damages... He was a fairly cool guy and he had a friend with him. We amicably agreed not to involve the police and my daughter and I actually made it to the doctor’s appointment!

The doctor said that the hospital visit we made previously was nuts (she used the word 'unethical' at one point) and the antibiotics my daughter had taken so far were a waste of time since the urine test reading, as far as she could see, was entirely normal.  The upside was that the doctor, by process of elimination, said that my daughter had to treat the helicobacter pylori stomach bacteria since this was likely to be the root cause of the problem.  I was dreading this treatment as you get a ‘kit’ of 3 horse pill sized antibiotics to take twice a day for a week – and the pills make you feel exhausted and nauseous. I know this because my husband once took the same pills and he complained enough back then. However, dealing with this problem made sense and promised to cure her frequent feeling of heart burn, stomach cramps and acid among other things. So anything was worth a try.

The day was taking a more positive turn until, while I was in the doctor’s waiting room, I received an email telling me that the 6 hours I had spent editing a 100 page document (leading to some quite nasty neck ache) was nul and void since I had edited the wrong draft. What’s more, the killer was that we were still on a deadline, ‘how soon can you send the new draft over? End of today?’

Okay, so that was my bad day. The cost of the car repair was horribly eye watering (suffice to say that we won’t be going on any weekend mini-breaks any time soon – especially when taking into account this and the cost of the doctor’s visits). i think that we may have paid over the odds for the inconvenience factor but the poor driver of the other car was a bit floored by the whole experience too and who can blame him.  

'To be honest' he said, 'I am so distracted right now because of this. I am supposed to be in Nyeri tomorrow morning and I just left my mobile phone in a taxi... I'm all over the place'  - so that's how I impacted his day. I basically ruined it. I was all over the place and now he was.

But on the bright side (since it’s important to always find one), a week on and my daughter has finished her horrible ‘kit’ of antibiotics that did indeed make her feel sick and tired for an entire week, but now I am happy to report that she is feeling better! Her resistance is a bit low though. This morning she woke up with a sore throat. Now it’s time to get her better, feed her up, rest and get that weight back on. 

We watched a Youtube clip about Helicobactor Pylori and figured that it's better that she gets rid of it. Especially as it is the most common cause of stomach ulcers and, if untreated long term, can possibly be cancer inducing.

By some miracle, I managed to get the correct edited document submitted by the end of that day (it was well after dark when I finished) - but goodness knows what state it was in when the client received it.

Don't miss: Jackson Biko writing about his own private health care experience here:
The Walking Dead
As he points out, thanks to Google - everyone is a doctor now!

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