James, the Zipline wire, and My Second Visit to the Local Health Clinic

Last week I went to a local private clinic to get tested for malaria. I had some, not all, symptoms, but I passed with flying colors; malaria free. If you know me well, I would be among that “exceptional” 1% who gets malaria despite taking malarone nightly. I have historically referred to this phenomenon as “Laidlaw Luck” or really odd misfortune at inopportune times, but I avoided it unscathed. Although I didn’t feel better, it’s always good to know you don’t have malaria.

That said, it’s also good that I knew how to get to the clinic, as I was there again this morning. On the weekends, the house where I am staying has 24 hour guard service. James, one of the guards, was apparently playing in the yard with Cleo, the rambunctious pup.

As it was relayed to me, James was running around with Cleo and forgot about the little boy’s toy zipline between two trees. By the looks of James’ wounds, he nailed it. By the time James came knocking on the back door in a panic, blood was running down his neck in several places and he was visibly dizzy.

Aside from the Grey’s Anatomy-esque drama of it all, who do you call in this situation? In Tanzania, no less! I asked him to lay down and try to talk to me, while dabbing his neck for an initial clean-up on his wounds w/ antibacterial wet wipes. I wanted to get a sense for how deep the cuts were as I was figuring out what to do. If you are an ER doctor reading this (highly, highly unlikely), I hope that was not the wrong thing to do. No one who I know who lives here year-round and/or is Tanzanian was answering their phone to give me more information. With no other options, I decided to take James to this private, non-emergency clinic.

Thankfully, there is a car at this house – however, it is stick-shift. I learned / taught myself how to drive stick-shift after a 30-minute lesson last weekend from a British friend. Due to Britain being the last colonial “visitor” to Tanzania, the road rules remain and one must drive on the “other” side. It is truly scary how wrong it feels to drive on the left – the stick shift is commanded by your left hand, not your right, but the foot pedals are normal. It's quite a brain teaser. James and I got in the car and I drove carefully to the clinic. For the brief 10 minute drive, James might have become more worried for his personal safety as my passenger, than by his neck wounds. If I provided him that pause from physical discomfort, instead, channeling his pain as fear for his life, I am glad to have done what I could. :)

After some commotion explaining what was going on, who James was, and how this happened, we registered and waited. Despite waiting a long while (still bleeding), James told me how much nicer and faster this seemed than the government hospitals he is used to for primary care. That is, indeed, a statement – albeit perhaps sadly expected -- of developing countries like Tanzania.

This local clinic is fine – it has everything at the minimum with no expectation to offer more. Tanzania is, by numerous mentions even captured in the NYT this summer, a country with one of the highest female death rates during pregnancy due to poor pre-natal education and care during birth. I can’t imagine treatment gets much better after one gets past that.

James will have to go to a local hospital if he wants neck x-rays; the cost of an x-ray from a private hospital would be astronomical. There's aren't very many machines in the entire country. While James was being seen by the doctors, I waited in the lobby area (read as: outside) with the fake Maasi who is paid tips to “watch” your car so that no one attempts a break-in. He told me it was rare to see someone like James come to this clinic. I said James got hurt and deserved the best possible care immediately – the fake Maasi smiled and nodded with a gap-toothy grin.

This could have been a lot worse. This episode was a strong reminder that when things are good in Tanzania, they are actually great; however, there is little infrastructure or available support when something goes wrong.