BAGAMOYO HOSPITAL (Fetishes discussed below)
In America and most of the West, biohazard sharps containers are made out of plastic that is almost impossible to break into. Here, they are cardboard and subject to mildew, water, and the easy ability to break down. In other words, they aren’t quite as safe. If you’re looking for a good charity, sending plastic biohazard bins to the hospitals is a great place to start from home. It’s a project I’m working on myself but I have some personal reasons I’ll get into later.
My Mzungu status allowed me into the surgery theater and I was even asked to assist. Although I have some medical training, I certainly lack surgical skills. I was able to help hand out instruments and observe what it meant to ‘scrub in.’ Scrubs are all washed in the same bucket with basic soap rather than an antibiotic and then left in the sun to dry. Oddly enough, the sun probably kills more germs than a high quality soap.
Shoes are left outside and surgical ‘crocs’ are worn during procedures. The most expensive procedure at the hospital was 15,000TSH. To assist with the exchange rate, $1 USD is equivalent to 1,320TSH. This means the most expensive surgery in the hospital cost $11.36 in USD. That says quite a bit about the poverty level of the country, especially given how few people can afford a C-section, a tumor removal, or an appendectomy.
This pile of pills is medication. It was expired upon arrival, but this is the case for much if not most of the meds in Tanzania. Although this may sound barbaric, many meds are effective for much longer than the bottle says. However in this case, this pile has sat in its position for 3 years in the sun and the rain waiting for the government to give permission to use it or dispose of it. And so it sits, as it has, for years. It could have helped people at one point, but for now, it just waits in a bureaucracy that makes the DMV seem like it was designed by God and staffed by the seraphim of heaven.
This is a standard bed on a ward. There are no clean sheets (unless the UN is sending in a photographer) and you will often see blood, urine, or other bodily stains on the beds. They are not changed between patients. Mosquito nets often have holes in them and instead of IV stands, gauze hangs from the ceiling holding medication or saline drips.
This is where babies come from. I did get to see a birth and I could say it’s a miracle, but most births take place at home. A birth here is high risk for disease, multiples, or from an HIV+ mother. There is no love or patience. At one point I saw a doctor slap a woman in labor for not spreading her legs enough.
This is the surgery theater when there is no action. I use it as a close to remind you that in a surgery, your body is literally torn open and the potential for infection can be higher from your surroundings than your disease. Germs, bugs coming in from torn screens, dirt…all of these can be deadly when your organs are devoid of their typical barrier of skin which is far tougher than we imagine. Our skin protects us from deadly diseases every single day and when you are stripped of it you are quite vulnerable.
A pair of volunteers set up a fabulous project about handwashing. They researched the stats on infection in hospitals from doctors, nurses, and other health care professionals passing on illness simply from not washing their hands. My small contribution was to “accidentally leave 20 bottle of hand sanitizer” at the hospital. Donations were not allowed, you see, and my bottles were intended for the other volunteers. It just so happened they all wound up under the signs and by sinks and surgical care stations. I can be soooo forgetful sometimes. Really.
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On Medical Fetishism
I’ve had a growing medical fetish that has appeared out of the blue for me. I work at a climic daily, my colleagues wear scrubs, I have scrubs, I wear gloves every day, and I spend my time in a small clinic room with a bed, stirrups, and the whole nine yards. Again, I face ambivalence with my sexuality. To see the dark side of something is to confront a whole portion of your turn ons that are easier not to think about.
Does this mean I’ll never play doctor/nurse/patient ever again? Hardly. But I will also have the notion that I am blessed to have grown up in country where this can be a fetish. I doubt that there are medical fetishists where I am. Patients don’t eat unless their families bring them food. There is no such thing as palliative care. There is no time for compassion. To be in the hospital means that you are suffering from AIDS complications (50% of all the beds in all the wards are reserved for HIV+ patients), severe Malaria, serious complications from STD’s that are close to eradication in the US, typhoid fever, the need for surgery, severe injury, the need for surgery, or a complicated birth.
I had one day where I broke down in tears looking at a young man of 25 who was suffering from so many opportunistic infections from AIDS that his body had thinned to the point where I could see his heart beat through his chest. No need for a stethoscope, despite the fact I had one. I could look at the clock and count his slow beats. He looked at me and said, “Salaama” which is a Swahili greeting. Patients never spoke to Mzungu volunteers. I took his hand in mine and I replied in the same way as is common. Salaama means peace and as I looked into his eyes I knew that he was dying. I myself am 24. Our ages were so similar, but I had the fortune of being born in a place where this would not happen to me.
ARV’s (anti retro-viral) drug therapies came to Bagmoyo 3 years ago. They have been in the West since the early 1990s. Entire generations have been lost simply because of the place of their birth. How do you put the sexual fun back into something like that? How can I get my charge out of wearing my very sexy scrubs as I “check the vitals” of a “patient” in my care when I have scrubbed gangrene, I have dodged the TB ward, and I have held the hands of the dying?
But I don’t believe that something leaves forever. I think it takes breaks. I know that as I reacclimate to my life here I will find my growing medical fetish once again.
But at the least, you all deserve a photoshoot of me in my scrubs because Sleek Images sent me off with the very finest and I am entirely grateful to them for that. So I’ll put on my stethoscope, I’ll put on my scrubs, and I’ll climb back into the saddle of a fetish that never really told me where it was headed. All I knew was that seeing it turned me on and I wanted to learn more about it. That is a part of me that never changes. I follow roads, intrepid, with a sense of adventure. I want to know where life will take me next.
in regards to the expired medicine:When I worked as a medical receptionist, every time I was charged with "disposing" of the sample medication (given in the HUNDREDS by pharmaceutical companies to doctors for free!)the Nurse Practitioner would rage about the expiration date. She was the one who told me that expiration dates are arbitrary and made by the company which produces the medicine. Maybe you wouldnt want to take your heart medicine years after its expired, but other things… grrr. Thinking about the money that is being spent and the people who are dying for lack of medicine makes me angry.