Friday, February 8, 2013

Taking Crazy to the Next Level!

This week, the Embassy offered a refresher course for all health care providers here at post.  The class was for Basic Life support, CPR, and First-aid.  Although I'm not working as a nurse here, the embassy community is eager for those of us in the medical field to maintain our skills....because we are just about the only reliable health care in the country.  Our basic clinic at the embassy and the handful of us with a little knowledge under our belts gives the US community access to better health care than a lot of the population. 
The realization that there is no "911", no ambulances,  paramedics, EMT's or Firefighters that can be summoned to an emergency is very unnerving.  Medical care (other than village medicine-women) is sought only by the very wealthy, mostly those who can afford to fly to Germany for treatment.  CPR is a household word in America, but I was reminded in the class, that very few people here had ever heard it.  If used on any non-American, or in a public place like a market, the result would be devastating!!  My good intentions would be misinterpreted as the cause for the victim's demise.....  causing a mob attack... responsible for my demise!!  Understood!!!  It was clear that our medical skills were for use in our own community ONLY so as not to be misunderstood.....  So much for the "Good Samaritan Act"!! 

Stop this horrible woman from attacking this poor man!!!
How sad  it would be to walk away from someone having a heart attack, or suffering an injury, knowing that I could help.  I realized that even if I could help, the person would have no long term hope anyway. There was no chance of being rushed to a capable hospital, given oxygen and other medications, and definitely no hope of  having a stint placed and follow up care.  Here, a heart attack is a death sentence!  A stroke, a fall, an open fracture or any just about any accident, infection or illness that requires attention is a death sentence.  Simple as that. 
This is the answer to why we never see elderly people here!  There aren't any old people.  I figure most of us have, or will be rushed to the hospital at one time in our lives...If treatment wasn't available, what would be our outcome?! 
Anyway, my point here is we are lucky to have access to such amazing care and facilities in the US.  Even here the US citizens, with our simple clinic, have access to much more than others could even dream of.  Luckily, if one of us finds our self in an emergency situation (and can get to the embassy), we will be flown out to London, Germany, or South Africa for adequate care.
Clearly, the medical situation here weighs heavily on us.  I am more concerned with kids falling, car-accidents, etc. than ever before because of this.  A head injury is likely more than the best-equipped hospital here could handle effectively.   For this reason, it is Seat belts, helmets, and anti-malaria meds for the Woodruff kids....almost to the point of obsession! 

Luckily, we haven't had to go quite this far to make sure the kids are safe here!!
Tyson is exceptionally risk adverse... That's why he was so stunned and a bit horrified when we found out we were having a baby!  Yep, you heard it...The Woodruffs are taking Crazy to the next level and growing a baby here in Nigeria!  (Does that make it an African American baby?)

So Nigeria has the 2nd highest preventable pregnancy deaths in the world (second only to India). Wow!  That's reassuring!  Last year it was estimated by the WHO (world health organization) that there were over 60,000 of these deaths.  Here were some of the sited barriers to receiving care.

  • Pregnant women seeking obstetric care in public hospitals must bring their husbands to donate blood. If the husband refuses or if the woman doesn't have a husband, she is refused care.
  • Women in labor are forced to travel to hospitals on motorbikes.
  • Public health facilities demand in exchange for care that pregnant women purchase basic necessities like antiseptics, syringes and gauze—and that these items be a specific brand name.
  • Doctors keep flashlights handy in the delivery room for use during regular power outages because health centers are not equipped with alternative sources of power.
These are the barriers to receive care in the hospital.  Most others depend on birthing at home, homes that are little more than crude shelters.
Home Birth??  No thanks, I prefer my epidural..and ice chips!

Luckily, I don't have to face the problems of other pregnant women here. Selfishly, my biggest stresses are that I can't get a Cherry Lime-aid from Sonic (with the pellet ice) or a Grilled stuffed burrito from Taco Bell.... the two intense cravings I faced during the last three pregnancies! mmmmm, I will have to get creative because I'm definitely not craving Suya (aka 'Street-Meat')! 

For fetal-dating purposes, I was compelled to go to a local clinic for an ultrasound (The most exclusive, high-tech facility in town).....I don't want to get into the gory details, but I have been in Truck-stop bathrooms that have felt more sanitary.  At least in a gas-station bathroom, you can hover over the toilet seat avoiding most germs. (Tyson claims it wasn't too bad)  This was not the case at the clinic.....I had a malnourished pregnant woman just inches to my right spewing TB bacterium into her handkerchief  during the 45 minutes we spent in the waiting room.  After enduring the crowded room with 15 strangers, the hospital administrator finally came out to tell me that there had been an emergency and I would need to reschedule!  I was happy for the excuse to leave, but she continued to tell me the horrific details of the emergency describing the massive hemmoraighing and "blood all over the room"!  Wow, What a way to instill confidence in potential patients, let them visualize HIV and Hepatitis flying all over the room they were to be examined in! 
Unfortunately, I had to return the next day, but I lucked out... I was relieved there was no Tuberculosis Lady, and no infectious bodily fluids spurting onto the examination table during this visit!!   In fact, I was supprized with how impressed I was with the doctor.  He was knowledgable, capable, and had uncharacteristically good bed side manner!  AMAZING!!  He was also board certified in the US and Europe!  For a moment, I forgot where I was and figured I was in a clinic in Washington DC.  I have a million and one complaints about the sketchy-clinic, but completely satisfied with the doctor....maybe one of the best I'd ever seen!
The most prestigious hospital in the area!  Takes only cash, up-front .......they did have a flat-screen TV on the wall!
At the end of my appointment I went to pay (because all things are settled in cash, no billing, and no credit).  I brought the 30,000 Naira I was quoted when making the appointment.  The ultrasound was indeed 30,000N, but they failed to mention the 'White-man-tax' of an additional 20,000N!!!  Yep, even at a 'reputable' clinic, they were trying to pull a fast one!  Seriously, they were trying to milk me (not even lactating yet) for 20,000N ($150.00) more than the service costs.  I said I didn't bring that much and couldn't pay it, and would make sure the price discrepency was reported to the Embassy.......... The next morning the embassy health clinic recieved a letter reguarding the "financial mix-up", and that I would be receiving a discount for my loyalty and should come back to retrieve 5,000N.  No thanks!!!  Not worth risking TB for $35!!!
Woodruff baby #4.  Alexis has a notebook of names she has picked for the baby...not one of them is for a boy!!
Long story short, I will be having the rest of my prenatal care at the Embassy with two additional trips to Europe for Ultrasounds.  When School is over in June, the kids and I will head back to California and Utah to spend time with Grandmas and Grandpas, have access to proper medical facilities, and most importantly to be close to a Sonic and Taco Bell.  The baby, Due Sept 18th, will require 6 weeks to get a passport and the immunizations required to head back to see daddy!  Then we will head back on our adventure.  I thought flying to Nigeria alone with 3 kids was a handful..... I will just have to carry stacks of tipping money for the airport and lots of Benedryl!!!