“I feel reborn.”

9/17/12   Mr Dlamini- “I feel reborn.”

 

   This morning we were taking some of the folks from the migrant camp to a clinic two hours away.  As is often the case in Swaziland, our travel party grew by two more women and a 9 month old baby.  The clinic shuffle is a game frequently played in Swaziland.  Folks who are sick, will travel from clinic to clinic and sometimes even mixing in some traditional healers until they are very sick.  They are trying to avoid being tested for HIV or TB.  One of our ladies has a rash; another had an injured arm.  We need to get an early start but I’m frustrated that I don’t have time to suss out whether either of these ladies really need to take a 2 hour ride and 5 hour wait at the clinic.

    Our patient, Mr. Dlamini has not showed up yet.  For those of you who are worried about violating confidentiality.  Mr. Dlamini, is the royal family name, and the Swazi equivalent of John Doe.  He is afraid to go to the clinic, and wants someone to accompany him.  He has been sick for a long time and is getting progressively worse.  He had a negative HIV test a month ago.   Today, he has a personal patient advocate, me.  This kind of work falls under the not very sexy but important category.  Driving to the clinic and sitting with someone for hours doesn’t look good in a mission newsletter but it goes a long way towards making someone feel valued by God and people.  And I can speak from personal experience on that one.

    We arrive at the clinic and stand in line one for reception.  I wander after Mr. Dlamini to line two- vital signs and nurse Wratchet in red.  We go into a triage room and the nurse was actually kind and not openly hostile which is more than I can say for the nurse who is actually taking the vital signs.  Line 3- we are waiting for the doctor.  We made it to this stage after only 1.5 hours, which is actually fairly efficient. 

     We have a number that we randomly selected off of the table in the vital signs room.  People are lined up regardless of the number; going in to one or the other exam room Helter Skelter.  Finally after 30 min an orderly type takes control and reorganizes the anarchy.   We go into the doctor, and he is actually pretty kind.  He does a physical exam and finds an enlarged liver.  We are sent for labs- wait in that line, then x-rays- wait in that line and talk American politics with the x-ray tech from the Democratic Republic of Congo.  Wait again for lab results and for the doctor and all staff to take a lunch break.  Then… finally take labs and x-rays back to the doctor.  Wait again for an hour.  The lab and x-rays showed hepatitis and pneumonia. The doctor actually does a fair job of explaining this even though all his furniture has been taken out of his office, and we are moved to another exam room while the new furniture is installed.  We head to pharmacy where only two of the four medications are available, also pretty standard fair for the Swazi health system.  We collect all our patients and head more than an hour back to the migrant camp. 

    When we arrive, one of the health motivators comes over to translate, and Mr. Dlamini calls his brother over to hear the details.  Between the health motivator, Corine, and I we break down what Hepatitis is and how it is transmitted.  We talk about the lifestyle, dietary, and medication changes that will be required.  We talk about how it is an incurable disease that he can give to a partner.  After 15 min of what I think is a very bleak talk, Mr Dlamini tells us “I feel newborn.  I was worried I was going to die from some unknown illness”.  This was definitely not the response I was expecting.  There are not abundant resources and treatments even in the United States for Hepatitis, and the treatments that are available are out of range based on cost and access for a poor migrant worker.  Mr. Dlamini shares that his greatest fear is that he will be too sick to support his 5 children, and he wants us to pray for him. 

      Very rarely in this healthcare system do people sit with patients.  Healthcare workers are not just present with folks or explain to their patients what is happening to them and their bodies.  Granted, Swazis are not obsessed with their “need to know” quite like Americans.  However, health education, even on an extremely basic level, ie “this is you medication and this is what it is for”, does not happen most of the time.  I hope that sharing a commodity as precious as time communicated to Mr. Dlamini that he is valuable to people and to God.