Just a bit of Malaria

Prior to coming to Ghana, one of my fears was being sick here. I was definitely nervous and scared about getting malaria - okay, clearly no one wants to have malaria, so I suppose that is just stating the obvious. But as of last weekend I can now check having and recovering from malaria off of my Ghanaian "to do" list. While this was an experience that I certainly do not want to repeat while I am here, there were a number of things that have come out of it that I want to share.

When I first became sick I thought that it was food poisoning, or simply my digestive system rebelling against something that I had eaten that day. I had stomach pain that came on quite quickly and then a night full of hourly trips to the latrine. Nighttime latrine trips are unpleasant at the best of times, as at this time the cockroaches and spiders claim the latrine for their own. I do not think that the latrine creatures were that stoked on me being sick either as they were sent into an hourly panic as I fumbled into the latrine, headlamp in full force, hoping that I would finally be done and able to sleep until the morning. No such luck.

When the morning came my stomach was still not well. At this point vomitting was added to my list of symptoms - another really awful activity to undertake in a latrine. I thought that maybe now I was done being sick - I mean, whatever it was that I ate had to be gone right? Wrong again. Then my fever really kicked in and I started to feel really achy - here is the part when I started to think...perhaps I should be getting a malaria test. This is where things got a little interesting.

I realized that I had no idea what sort of health care was available in Buipe. I knew there was a clinic, but at this point all I was thinking is: is it safe? is it clean? do they have well-trained staff? I felt nervous without the comfort of knowing that I can walk into a clinic and receive quality medical care. I am fully aware that this is the reality for many people, not only in Ghana, but in so many other parts of the world, and was a scary reality to be faced with. I called Dan, another EWB-er and my coach, to ask his opinion. He said that malaria tests are so common here that any rural clinic should be good to go for malaria tests...so off I went, the clinic is only a 5 minute walk from my house.

Upon arrival to the clinic I was told that they were out of malaria tests. Great. Still not sure how a clinic can be "out of malaria tests" but alas, that was the situation. They said that there was a private laboratory in Buipe that could maybe do the test so off I went in search of this laboratory. My western mind was thinking "a private laboratory, it must be good". Yeah, about that. I arrived at a building with no doors. Just a curtain. I walked in to the "lab" which was lit with a blue light. There were empty shelves (no medical supplies on them) and a table covered in garbage, what appeared to be used medical "stuff" and a microscope in the corner. To top it off, there was a women sitting there and all she kept saying to me was "go and come, you go and come", meaning "come back later". Or never, I was thinking.

I had the drugs already to take to treat malaria as they are sold at every "chemical store" (pharmacy here) for under 5 GHc. We were told to get them on arrival "just in case". Now my options were to self medicate for malaria or to find a way into Tamale to get tested. I talked to some of my co-workers and found a ride into Tamale. Upon arrival into Tamale I went to a legit lab (they even entered my information into a computer system!) to get tested. The test itself required a drop of blood from my thumb which was put on a slide and looked at under a microscope. I received the results in about 20 minutes. Now aren't you curious as to how the Buipe clinic could be out of tests?

Long story short, I tested positive for malaria, and started taking pills for it immediately. I took advantage the luxury of being able to stay in a guesthouse in Tamale with running water and air conditioning. Three days later I was back on my feet and back at work. Malaria story ended. However, this is the start of another story - healthcare in Ghana. What do Ghanaians do when they are sick? The majority of people in Buipe are not able to get to Tamale when they get sick and certainly cannot afford to get well in a place with running water. I ended up being at the guesthouse with another EWB-er, Jenn, who was also sick and had just had a much more intimate experience with rural health care in her village Tolon,  which she wrote about on her blog (http://jenninghana.wordpress.com/2011/06/10/shit/).

Places like Buipe and Tolon have clinics so on paper they have "health care". At some point in time either the government, or more likely some NGO, came and built a clinic so then suddenly these places are considered to be covered in terms of medical care. Where are the doctors to staff these clinics? There is certainly not a doctor here in Buipe. Where are the medical supplies needed to perform the most basic of tests and procedures? Where is the access to running water - something that seems absolutely essential to provide sanitary medical care. What happens when the power is out? You see where I am going with this.

Unfortunately, many more clinics are being, and will be built, because these things are not being considered. There is an intense focus on infrastructure building in development as for some reason it is important to be able to say "we gave this community a clinic" and then many people feel great about it because they can picture a well functioning "western" clinic and think "that is going to benefit so many people". As I have recently experienced firsthand this is simply not this case, and this way of thinking is benefiting no one, unless you have a strong affinity for empty buildings with "clinic" written on them. There needs to be a shift in thinking, thinking needs to extend past the building of infrastructure and goals need to change. I want to know what is inside of a clinic and who has access to these services, not whether or not the building is there.