Summer 2010 in Ghana

Monday, August 2, 2010

Kelly woke up this morning with severe chills and a 103 degree fever, so we decided to head to the hospital.  For my part, I had a 100-degree fever and didn’t feel great, but was in decidedly better condition than she, at the very least.  Will was to accompany us to the hospital, and asked Mr. K to call us a cab immediately at 7am when we awoke, because we were pretty concerned about Kelly.  After a leisurely “small small bite for the tummy,” Mr. Kabutey determined that he was ready to go, and his cab finally arrived at 9:30am.  Will’s mother had talked to Dr. Nartey, the Chief of Ada, who recommended the Nahr-Bita Private Hospital in Tema as the best in the country.  We instructed Mr. K and the cab driver to take us there, and a bona fide trail of tears ensued.  After waiting to see Dr. Nahr himself (one of the most famous Docs in the country), he told Kelly and me that, if we had fevers, we both had malaria.  While Kelly’s malaria could theoretically have relapsed from her first case two weeks ago, I had no reason to think I had malaria, and, considerably dubious about the accuracy of his diagnosis, we went to get our blood tested for the parasites. 

We entered an outdoor room with a roof and a few rows of crowded wooden benches, and Mr. Kabutey told us to cut the entire “queue” (which made us very uncomfortable).  We were afraid of any needle-puncturing-skin operation, but the nurse took the needles out of double plastic wrapped individual containers right in front of us, so our fears were assuaged.  After pricking us sharply, the nurse told us to sit and wait, and sent us away.  The nature of the prick was not one that would easily stop bleeding.  I began to ask for a Bandaid, but she looked at me like I was speaking Swahili so I stopped, and resigned myself to a little unavoidable bleeding onto the margins of Gone with the Wind as I read and waited. 

Twenty minutes later, the nurse handed Kelly and me small slips of paper with the words “No MP detected” on them, and sent us back to the main building to Dr. Nahr’s office.  Dr. Nahr glanced at our slips, declared that in his opinion, we still both had malaria (despite the absence of the parasites in our blood), and began to write prescriptions for us.  Kelly was a bit out of it because of her high fever, but I protested, calmly responding, “I do not think, Doctor, that I have malaria.”  (I had no interest in paying 12 Ghana cedis for a prescription that could save someone else’s life when I had a cold and simply wanted someone professional to tell me to drink tea, get some rest and have a few Tylenol.)  He looked at me with a hint of surprise, as though he had not previously considered the possibility that I might not, in fact, have malaria, and replied, “Oh, ok,” and threw away the prescription he’d been writing me.  I could not help thinking that this was probably the most highly regarded doctor in the country, and I, the patient, had just matter-of-factly told him that I did not have malaria.  Oh dear. 

Anyway, we proceeded out of the office to another nearby half-outdoor building that was also full of packed benches, where we waited for Kelly’s prescription for about a half an hour.  By this point, Will and I were very concerned that we had no reason whatsoever to think that Kelly actually had malaria, and yet we knew we needed to treat her because she was obviously extremely ill.  I find it frustrating that because malaria is the Ghanaian equivalent of the common cold (although obviously much deadlier), even the most highly qualified doctors do very little else than tell people with fevers that they have malaria.  With native Ghanaians, they are usually right.  And if they’re not, malaria medicine is cheap so they might as well prescribe it just in case at first, and figure the rest out later.  We were pretty sure, however, that Kelly’s 103 fever was not malarial, and we wanted a doctor to actually look at her medically and examine her symptoms and diagnose her without the obligatory malarial assumption. 

Anyways, we traipsed back up the stairs to see Dr. Nahr a third time.  He spoke on the phone briefly with Will’s mother, a doctor who formerly specialized in Infectious Diseases, and she was exceedingly underwhelmed after the conversation (and, as a result, she became even more concerned about the situation).  To appease us, Dr. Nahr began writing Kelly a prescription for nearly every drug/antibiotic in his arsenal, and handed Will a paper with eight different medicines written on it.  I suggested to Dr. Nahr that perhaps Kelly ought to just take Ciproflaxin (which we already had a considerable amount of from home), and he nodded and said “That might be good too.” 

We went back to the pharmacy to pick up all the drugs, but they were out of seven of the eight Nahr had prescribed, and Will and I were pretty sure they weren’t really necessary anyway, so we just left and went back to the big testing room where Nahr had sent us to get more tests done on Kelly.  Her stool test came up negative for Typhoid, which was not surprising because she’d been inoculated for it before we left (we had tried, and failed, to explain this to the Doc).  The nurse then decided perhaps the finger prick had been an insufficient blood test for malaria, and that the inner elbow (where there are bigger veins) might yield “better” results.  On her third try at inserting the large needle into Kelly’s arm (she missed the vein each time) the nurse wiggled it around and finally punctured the vein.  The blood, however, still tested negative for malarial parasites.  We went back up the stairs and reported the negative tests to Dr. Nahr.  As we turned to leave, he said that Kelly, of course, would be staying as an inpatient for three days so that he might monitor her condition, and thus she could not leave.  Kelly’s fever had gone down a lot, and we were all acutely aware that she would probably receive much better medical treatment at home with Nurse Emma than at the hospital, so we protested and were finally released.  We returned to Manye a little after 2 pm, exhausted frustrated, and dehydrated.  Kelly immediately took some Cipro, and was feeling dramatically better by the evening, although a large, dark bruise had already spread over her left inner-elbow.