A Trip to a Zambian Hospital

I am not sure how or why, but my body continues to be punished physically. Two weeks ago I concussed myself while playing football. On Thanksgiving I was electrocuted twice by my shower. Yesterday I cracked my head open. Lots of fun!

In all my years of playing sports I have never been injured as much as I have been in the past two weeks. A wise friend told me that this might be God’s way of telling me to slow down.

Yesterday began in the happy light of recollection as I remembered our Thanksgiving feast. After morning prayer, I had no class, so I returned to bed. I was awoken by a knock at my door at about 10:00. I had completely forgotten that our German friends from Kazembe were coming for a visit, so I got up and started to host them. We had a nice day around Lufubu. Nate graciously offered to give them a long tour so that I catch up on sleep.

At around 15:30 we went to the oratory to play with the kids. There weren’t many there because we had Adoration scheduled for 16:30. Most of the regular oratorians weren’t so much bought-in to the “Church” aspect of Oratory (Home, School, Church, Playground). I went and joined the circle that was kicking around a football.

We played for a while until the church bells started ringing for Adoration. We packed up and headed to put the ball away. Before we could do this, one of the kids kicked it really far away as a kind of joke. He ran to go get it, then kicked it back towards us in a tall arc. I ran to intercept it.

I was flat on my butt in a complete daze. I realized I was in the process of making a kind of mental checklist: teeth ok, eyes ok, head…

I put my hand up to my forehead and it came away soaked with blood. I realized all at once that I had just smacked at full speed into the metal netball pole that jutted out of the grass. I couldn’t help myself and cursed loudly.

I did the same thing the day before when I was electrocuted. Then, my stream of expletives had drawn Schubert, the electrician, to my door.

“Schubert, my shower is shocking me!”

“You are being electrocuted,” he asked, almost as more of a statement than a question. I couldn’t manage the absurdity of the inquiry and laughed out loud.

Schubert had been in the electrical room trying to fix our power. Since the house had been struck by lightning Tuesday we had been having blackouts every night. He must have been flipping breakers or something because I quickly realized that the ground wire of my water heater (which for the electrically un-inclined carries excess current under fault conditions) was connected DIRECTLY TO THE PIPES THAT CARRIED MY SHOWER WATER. So every time the device faulted (twice, apparently) I received a big shock—and not just a little zap, but enough to make my arm and then my legs violently convulse.

The first time this happened, I had soap in my eyes and was reaching to turn down the hot water. Before I could reach the knob, my arm seized and convulsed for almost a full second. I let fly some choice words and was immediately thrown into shock. I checked my face, my arms, my heart. I was alive! If anything got hammered into us as electrical engineers, it was that water and electricity do not mix. I figured that somehow a hot wire had come into contact with the piping somewhere (I had not yet noticed the ground wire…) and, still in a complete daze, decided to try and quickly rinse and get the soap out of my eyes.

ZAP!

I was doing the Elvis rubber legs and screaming. Another stream of expletives flew out of my mouth. What is going on?

I later learned from Fr. Cao that this is quite common in Zambia. The German girls as well had experienced something similar in Kazembe. It completely broke my brain that this is something that people just deal with rather than fixing. There is a strange attitude towards problems of this nature here. There is a sort of rampant fatalism and defeatism that prevents the truly impoverished from bettering their material conditions. It is the reason why people in the village refuse to go to the hospital just up the road in Kazembe—which is free, by the way. The poor have been propagandized to believe that their lives aren’t worth much. They believe no one cares about their suffering, and they make no effort to avoid it. It also means that don’t show much interest in the suffering of others—no one ever showed them sympathy, so they simply don’t know it. It’s heartbreaking.

Yesterday, as I laid on the ground next to the netball pole above a quickly-growing pool of blood, I let fly a choice expletive. Those who know me well know that I am not in the habit of cursing anymore, but the old man is hard to kill. None of the children speak English, so hopefully they had no idea what I said. They stood there in shock, looking at my bleeding head in horror and completely unsure what to do.

I knew that head wounds look much worse than they are, so I got up and assured the kids that I was ok before heading inside to bandage myself. We had made lots of jokes during SLM orientation to the effect that I was going to be the most over-prepared missionary in Zambia: I had brought lots of gauze, meds, wound closure kits, blood stoppers—along with anything else I thought might be useful in a bush-survival situation. It turned out I wasn’t so much “over-prepared” as “adequately prepared”.

It was a wicked gash—over an inch long and deep to the bone. More worrisome was the fact that I had just been concussed last week, and I figured there was a non-zero chance that I would turn myself into a vegetable if I kept hitting my head.

I put the emergency plasters on and wound my head with gauze. Nate and the girls came in to the house very worried and asked if I was ok. I told them I probably needed to go to the hospital. This was communicated to Fr. Cao, and we were all soon piled in the truck to head to Kazembe.

On a low hill north of Kazembe, rising from the savannah and thatch-roofed houses, is a modern metal-and-glass hospital that sticks out of the landscape like a giraffe in a phone booth. I had heard there was a good hospital nearby, but I had always assumed that people were referring to the two-room rural health clinic near the market in Kazembe. Seeing the metal-and-glass monstrosity on the hill for the first time was an utterly surreal experience after weeks and weeks of nothing but crumbling concrete and thatch houses. I was the nicest building I had seen in Zambia. I began to suspect that I really did turn myself into a vegetable.

I was brought in and seen by an off-duty doctor—“you’ll have to excuse the shorts”—who did most of the suturing with sunglasses still on. Even from the moment I arrived inside the building, it was a very strange mix of first and third-world. It was indisputably a several-million dollar facility, yet at 17:00 was completely without power and had no backup-generators to run the lights. They struggled for a moment to find gauze for my head, and, for a moment, took seriously my offer to use the gauze and blood-stopper I had brought in my own backpack. The phrase I heard probably the most during my (brief) visit there was “we don’t have”:

“Nurse, I need a surgical blade.”

“We don’t have.”

“Nurse, I need epinephrine.”

“We don’t have.”

“Nurse, I’ll need a flashlight.”

“We don’t have.”

They ended up having to do the suturing in the (empty) emergency room—simply because this was the only room that had west-facing windows to catch the light of the setting sun. When it went down, they finished suturing by the light of an iPhone camera.

After the stitching was done, the doctor asked me: “Do you have a picture of your wound?”

“What?”

“From before.”

“Yes,” I said. “Would you like me to show it to you?”

Still on the operating bed, I pulled out my phone and showed it to him. He took the phone and studied the picture.

“Ah, ok. I will take another for you.”

Using my own iPhone he then proceeded to take a close-up picture of my stitched up wound. “Thanks?” I said.

All in all, the doctor did very good work. After the adrenaline shots, I hardly felt a thing. He recommended that I come back in the morning for a CT scan. He warned me that insurance would probably not cover the CT scan, as they only took a very specific kind—something called “NEEMA”—but he indicated that it was likely I wouldn’t have to pay. The Salesians were well known around there and I was working for them. I walked out of the hospital that evening without having given them insurance information or paying a dime.

This morning, we returned to the hospital at 8:00—“come as early as you can to make sure we have power for the CT machine”—and the same doctor met me at the front, wearing a Man City jersey and sunglasses. He told us that he has spoken with his supervisor and, unfortunately, we would have to pay for the CT scan.

“How much is it?”

“Fifteen-hundred”, he said, and I breathed a sigh of relief. I was expecting several thousands of dollars.

“Kwacha,” he continued, and I nearly laughed out loud. That was less than 75 USD. For a CT scan!

I was inside the CT machine within minutes. After a quick scan, during which I was able to see my entire skull and brain—I have a very funny looking head—I returned to the reception desk, where the doctor was waiting. He told me he was prescribing some other antibiotics for me, as he thought the Azithromyacin I had brought from America was not the best option. He directed me to pick them up from the pharmacy window after I paid for the CT scan.

As the receptionist wrote the receipt, I asked her how much it would be for the drugs.

“For the what?”

“For the antibiotics I was prescribed.”

“Oh! This is a government hospital. They’re free. And your visit—it was free as well. Only the CT scan you have to pay for.”

Whattttttt???? I said mentally. I was completely astounded. $75 total for emergency stitches, antibiotics, and a CT SCAN!!!! If Zambia is doing many things wrong, that at least they’re doing right. I have no idea how that kind of system scales, but in this district hospital in the most rural district in the country—it seems to work very well.

To be fair, the quality of care was good, but if I was having serious medical trauma I highly doubt that they would have been able to save my life. They didn’t have emergency room staff working when I went—and the “off-duty” doctor I saw yesterday was the only one there, and the same one I saw today!

I also didn’t see a single other patient the entire time I was at the hospital. It seems that the local people have a great fear of hospitals—to go to there means you are sick, and no one wants to be sick.

Even Br. Philip, as we were washing dishes today, told me a story:

“You see this scar under my eye? Several months ago, I was cutting bananas. Some of the barbed wire from the fence was caught by a tree branch. It swing across and wham! Gave me this cut here. I just cleaned it and put some powder on it. No one noticed it. This is the African way. I am afraid to get those, what do you call them—stitches.”

So there you have a very clear picture of Zambia. A country with first-world amenities and third-world problems. Where free medical care is available to all citizens and few take advantage of it.

For this visiting missionary, it worked out alright. I’ll have a wicked scar for the rest of my life. But, as I was telling Nate, in every video game I’ve ever played, I’ve always given my character a gnarly scar over their left eye. My uncle said it best: “every guy wants a scar somewhere that makes them look like a bad***.” Though this one was gained by smacking into a pole like an idiot and not in some seedy underworld knife-fight, it will still be a good story to tell. “Oh, the scar! I got it as a missionary in Zambia…”