Friday 20 September 2013

The Ugandan Adventures: Part VIII: Mzungu Heroically Beholds the Jaws of Death

When I went to bed, I had a slight itch upon my midriff and in my inner biceps. I thought, ‘Insect bite, probably’, and put some cream on it. During the night, the itching got worse, maddeningly so. Then morning came: my waist, arms and inner thighs were covered with a lumpy, blotchy rash. And the itching was even worse. I showed George my housekeeper, and he said that we would go to the medical centre when it opened.

In the meantime, I was fairly Stoically endowed. Whatever it was, I could cope. Then, out of curiosity, I thought, ‘Why don’t I check that most reliable source of information, the internet, to find out what this rash may be?’ So, after initially attempting to check the NHS symptoms website - only to discover that they only address British diseases… bigoted nationalists… - I typed in the immortal words, ‘Uganda skin rash’. After a few minutes browsing, I discovered that I had Ebola, a HIV rash, German measles, meningitis, and skin parasites (that would leave me dead in about eight hours). As one very helpful website put it: ‘Go the nearest Westernised hospital; there is a good chance that if you don’t hurry, you may be dead or paralysed within the next twenty four hours’. So… Ebola, measles, death, meningitis, death, death, skin parasites, death, Death, DEATH!

Thanks internet.
George, my housekeeper was rather optimistically inclined considering the circumstances (‘The doctor give you tablets… you be fine…’). As we walked to the medical centre, I showed the best of English stoicism: ‘Best keep your head up high, eh George? Whatever will be, will be, eh George? Eh? What oh! Eh, George? Nothing to worry about, eh George? …eh?…George…?’ Inwardly, however, I was beginning to make the arrangements for my dead body’s return to Blighty. Robert Browning’s poem, ‘Oh, to be in England’ came to mind, as did Rupert Brooke’s,

‘If I should die, think only this of me:

That there’s some corner of a foreign field

That is for ever England.’

But as I was preparing for Brooke’s ‘English heaven’ (considering I’m a Welshman, this should cause some pause of reflection…), and fearing my long, painful death in a mud hut in Soroti or a hospital bed in Kampala, I arrived at the medical centre. I was not, I must admit, filled with the greatest of confidence. Although it was clean, it was very dark, with dust everywhere, with cracks in the walls and floors, and an old rickety wooden desk and chairs. As I waited for the pharmacist, I read a big poster all about the symptoms of Ebola:

Rash: check.

Headache: do I have a headache? I think I do, yes, yes, I have a headache! I’m certain of it!

Dizziness: now I come to think of it, I am feeling a little dizzy…

Bloodshot eyes: I have no mirror, but my eyes do sting a little…

The list goes on, and by the end, I was certain of my impending death. Then the pharmacist arrived. He looked at my rash, asked if I wanted an injection (the UK government information on Uganda screamed at me from the deeper recesses of my subconscious: DO NOT HAVE INJECTIONS OUTSIDE OF KAMPALA), to which I politely refused. He then gave me tablets, including pirotin for the itching, and told me it was probably a allergic reaction. I subsequently sent a Facebook message to my Auntie Jenn, who calmly reminded me of the amount of medicine I had been taking in order to survive Uganda. Allergic reactions are somewhat common…
Hero of the day: the optimistically minded George

My medicine, in the packaging given
to me at the pharmacist
And, once the tablets were taken, the itching began to stop, and the lumpy rash began to dissipate. Despite being somewhat drowsy the rest of the day because of taking my pirotin tablet, I was healthy. Nevertheless, this very morning, in the middle of a conversation over breakfast with a Pentecostal Pastor staying at the Guest House, I accidentally took two of the very strong pirotin tablets instead of the recommended one. And just as he was telling me about the institutional structure of Ugandan Pentecostalism in relation to other Ugandan NGOs, I fell fast asleep to the extent that I was afterwards told I was snoring within a few seconds. At which point, George woke me up and helped me into my bed (realising what had happened). For two subsequent hours I slept.

I’m sure the Pentecostal Pastor will now think twice now before deciding to talk about institutional structures over breakfast.

I was one of the lucky ones. The tablets I took cost me 4000 Ugandan shillings (about £1, or $1.30 roundabouts). It would stop me scratching, and thus mean that I was unlikely to be infected by anything worse. I thought it was remarkably cheap. By Ugandan standards, however, it is not. For many, that might have been a week’s pay. For others, it might have been a month’s. Let me give you an example: in one of the village churches I had visited, the gathered weekly tithes and offerings of a congregation of over three hundred would be about 1000 shillings (about 25p, or 40c). This was not the type of giving you expect from a Church of England country parish where elderly ladies may give 25p because when they were told to give as much when they were little girls (currency revaluation and fifty years of inflation not withstanding). Instead, this is all these people can afford to give. The Ugandan teachers are currently on strike in that they are paid so little that they cannot afford to send their children to school (irony not withstanding). In that context, my 4000 shillings is a fortune. Or let’s put it another way: if my pirotin and prednisolone costs so much to the average Ugandan, how should my dear Ugandan friend cope, whose wife has got severe cancer with basic treatment costing £1,500, and whose daughter has got typhoid with treatment costing a further £200?

Sorry to get political, but privatising medicine can only work if the average citizen can pay for it. Otherwise, you get poorly invested hospitals and sick citizens, which, once considered, is a moebius strip of a problem.

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