There’s a hospital (correction, there is a clinic) right around the corner from my house, and although I could probably throw a rock and hit it, I’ve never been closer that about 50 meters. Kinda bad because one of the first things we were supposed to do upon arriving to site was introduce ourselves to the local doctors. It’s wasn’t a matter of laziness that kept me from going, it was more so sheer terror. (Side note – I just won a staring contest with the rooster that was crowing right outside my front door…cock.)
It’s not that I hate hospitals; in fact, every experience I’ve ever had in one has actually been pretty pleasant. I just have a bad feeling about the hospitals here and would prefer to avoid them for as long as possible. In other words, I’m absolutely terrified of healthcare in Mozambique. Scaly, bleeding rashes that cover kids head to toe, broken bones that never healed correctly, battle scars from knives and bullet holes (though not many, most of the people that were nicked by a bullet died due to a lack of treatment), crazy deformities (I know a guy who is missing a shoulder!), and festering open wounds covered in flies are all a pretty common site around these parts. On a regular basis I see people with some pretty horrible looking medical problems, and unfortunately, I’ve let that have an influence on my feeling about the local doctors.
Well, today was apparently that day that I would have to go. I got home from a particularly hectic day (and sleepless week) only wanting to sit and eat. I was helping my neighbors pick some beans off one of my bushes when a friend of mine, a 12 year-old named Elizio, appeared in front of my house and waved at me to come over to him. I was about to shout for him to come to me instead, but I saw this as a opportunity to stop with the beans and make a quick exit. I walked over to him and saw his typical ear to ear smile. This kid is great, and I’ve grown to really love him. He comes over all the time to hang out, draw, drink water and help out around my house. I asked him “tudo bem?” a common greeting to see how everything was going (literally, “All good?”). He said, as he always does while continuing to flash his enormous smile, “Yeah amigo, tudo bem!” But it wasn’t. He was carrying a used motorcycle tire, and told me he was going to buy cell phone credit for one of his neighbors. The lack of actual toys here has forced kids to become pretty resourceful when it comes to finding things to play with. Anything and everything is a toy, and at this point, the site of a kid with anything in their hands (even a blown-up condom) doesn’t really faze me as strange. Still, just to make conversation, I asked him what the tire was for. “For walking, I had a bike accident yesterday. Look at this…” As he finished his sentence, he lifted his leg up to show me a foot that was covered in dirt and swollen to about twice its normal size. I asked him like three more questions before putting him on my back and carting him off the the clinc down the street.
Now if there was ever a place that would challenge my streak of pleasant hospital visits, it’s Mozambique. One of the poorest and underdeveloped countries in the entire world, according to the WHO, Moz only has 889 Medical doctors. That’s a ratio of 1 doctor to every 30,000 people (recommended ratio by WHO is 1:1,000). In the words of my sister: Woof.
Expecting to see something that was more like a dungeon than medical office, I was surprised to find what was actually a modestly clean place. The nurse took us in immediately, and got right to work. She began talking to Elizio in Macua, the local language up here, knowing that he’d be able to explain what had happened a lot easier in his native tongue. There were a few questions, some even shorter responses, and then a few giggles by her and Elizio before the nurse said something I couldn’t understand but was probably something like: “Thanks for the info kid, now prep yourself good cause this is gonna hurt. A lot.”
First came the cleaning. When I was inspecting the kid initially while in front of my house, I had asked him about pain. I very gently probed a few spots on his foot to get a good judgment and when I reached his toes, he was on the verge of tears. Now this woman was not nearly as gentle as I was. In fact, I’m pretty certain the word gentle doesn’t even have a place in her vocabulary. She went to town, driving that sponge like it was an 18-Wheeler with a snow plow on front. I watched as the poor kid squirmed in his chair trying to fight the pain. After the foot was clean, she dried it off with some gauze. Again, she just went at it. It was almost like she was trying to show me what rough actually meant. And then, all of a sudden, she brought out a razor blade and my entire world turned upside down. Holy shit, is that a used razor blade? Why does she have that, I don’t remember seeing a cut. What the hell is she gonna use that for?!
It took all my strength to stop myself from pinning the woman against the wall and yelling for Elizio to make an escape through the window, but then I reminded myself that I’m not in America, and I’m not a doctor. She’s gonna do what she has to do and it’ll all be over soon. Right before she started slicing up the space in between his toes (You read that correctly...), I said those exact words to Elizio to try and make him feel better. In reality, it was more likely I was saying it to make myself feel better.
She spent a good 4 minutes cutting out something invasive she had seen that entered his foot in one of the most vulnerable of spaces. I cringed. He cringed. She cringed. We all cringed for the obvious excruciatingly intense amount of pain the little malnourished kid was probably feeling. As she cut, she also ripped tiny pieces of something out. I never actually saw what it was, but I can take a guess. With all the broken glass, ripped up tin cans, tiny pieces of metal and other horrible things lining the dirt street here, I have no doubt that this kid had managed to puncture himself with something miserable while spending most of his time walking barefoot around town.
After she was done, she wrapped his foot up, and sent us to get counseled – or what is essentially just the Mozambican version of check-out. The guy working the table wrote down the kid’s info, put some pills in a bag, and told him to return in a few days to have the gauze changed. Then, right as we were getting up to leave, the nurse came back and gave Elizio a going away present: a rough injection, coarsely jammed right into his arm. They us we were free to go, and feeling confused because the entire procedure was done for free, I put the kid on my back, and we walked out.
As we walked away, I couldn’t stop thinking to myself. Mission complete and job well done. Well, maybe. This kid is either going to get better, or e now has a horrible case of HIV because I took him to a bush hospital with doctors I know nothing about. I’m gonna try and be optimistic though and believe everything is good. I think that’s better. I gave the kid a piggyback ride home where I left to try and keep himself out of trouble. Sure enough, he showed up at my house not two hours later shoeless and smiling as usual. At least he had a sock on the wounded foot, albeit a dusty one. Oh Mozambique, you’re starting to get a little predictable…
UPDATE: Took the kid to get a checkup today (July 8th) and everything appears to be fine. He managed to actually keep the wound clean (amazing, I’m not sure how), and they changed the bandages and gave him a new one. The process was a whole lot more pain free this time around as the nurse changing his bandages was much gentler. For some reason though, rather than put on some rubber gloves which he had in a box next to him, he decided to perform the entire process using a pair of large tweezers. Literally, every step. Meh. At least the kid’s foot hasn’t fallen of yet.
Poor kid.
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