Being sick in a developing country really blows. You are isolated in an inhospitable
environment, away from family and friends, with no access to reliable medicine
or doctors within reachable distance, you must travel hundreds of kilometers to
the capital to reach your Peace Corps Medical Officers (PCMO). The travel is exhausting and sometimes takes
days. And when you are sick, sitting in
a brousse for hours on end on bad roads takes a lot out of you. I understand fully now why the medical
examinations was such an extensive portion of my application process. Everyone groans and moans about it but really
its completely necessary to make sure that volunteers already with health
troubles are put in accommodation zones such as South Africa or in Eastern
Europe. I rarely saw the doctor before
joining Peace Corps except, most only during annual physical checkup. I’ve underwent many changes in my health here
in Madagascar. Most of illnesses were
mild in nature, however there was one health concern that lasted for an
extensive period of time (four months and ongoing) which eventually caused me
to be medically evacuated abroad.
When I became ill in February of this past year the PCMO had
me come down to Tana so that he could inspect what I was describing to
him. He cleared me after the exam with a
packet of antibiotics. I never knew that
antibiotics were going to be my worst enemy and savior for the next four months
while I suffered physically. My issues
ceased to end. I went between clinics in
two major cities in Madagascar and numerous doctors and examinations. Every doctor would diagnose me with different
maladies and prescribe me with the “appropriate” medication, but no one was
tackling the cause but just the symptoms.
My distaste for taking medication was brought to a standstill by my desperation
to get better. At one point I was using
homeopathic remedies and even considering visiting a traditional healer or to
be exorcised by a small Christian cult whom are currently preparing for the end
of the world this year.
And finally after a taking a long series of ineffective
treatments the PCMO’s and D.C. decided that they’ve dried up all the resources
in-country and it was time to medevac me (medically evacuate me). This meant that I would be sent to South
Africa. All PCVS with major health
concerns in Africa who are unable to be address in their country of service are
sent to South Africa.
What I’ve learned that it’s important to not only treat
one’s physical symptoms but to also to assuage the psychological issues that
concurrently arise. I’ve seen numerous
doctors in Madagascar , in the best clinics, and each would indirectly address
me to one another without actually talking to me. They would hand me a sealed envelope with the
diagnosis with no discussion included unless I pushed for it, otherwise they
would discuss about me to my PCMO vs. to me directly. I felt more like a problem than an actual
living person who needed help. In the
doctors defense I can see how this is a defense mechanism. They can’t become attached or humanize every
patient who walks in their door.
Personally I can see how I would get emotionally drained by that. Really its not that different in the
U.S. Patient/ doctor relations aren’t
always the most cordial but rather have an impersonal vibe. However after this experience I feel that a
doctor can remain professional and be warm and comforting towards a patient at
the same time. Actually I think it’s
crucial in order to facilitate the actual healing process. There must be trust between the patient and
doctor. Also to have people in support
of you is indispensible. Even though I
didn’t have this support in-country, which made things very difficult, my friends
and family from home reached out to me when I most needed it. People always joke about being medevaced to
be able to visit South Africa, however when you truly are sick the idea evokes
less excitement.
I’ve never even once
amused the idea of E.T (early termination) but I was on the verge of ending my
service in order to get the medical attention I needed. Health is the most important asset we
possess. If we don’t have our health
what do we have? Nothing mattered
anymore. I lost interest and motivation in carrying out my service and in
social events. Another thing that I’ve learned that it takes
a long time for things to move in D.C.
There was so much bureaucratic processing that needed to happen in order
for me to be medevaced, which was infuriating and lead to a number of
breakdowns.
I was very impressed with the clinics and doctors in South
Africa. When the doctor told me that I
needed to undergo surgery I actually was relieved because she had confirmed to
me what I already knew: that I was sick.
The doctors’ in-country couldn’t find anything wrong with me. I’m sure in their minds I was being a
hypochondriac- simply making up my issue in my head, but in their defense
they’ve tried their best and they aren’t specialist. I still rely on them a lot. Finally I was receiving answers, being able
to go on a safari wasn’t all that bad either.
As much as our PCMOs attempted to prepare us for our
environments during our PST (pre-service training) its really inevitable that we become sick. Coming from vacuum air-conditioned
environments in the States its no wonder we are more susceptible to becoming
sick. Our bodies are weaker than the
local population. Our skin flakes and
burns easier in the sun than African skin; our stomach’s haven’t been trained
to handle the microbes and germs in the water, air, dirt.
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Overall lessons:
§
Don’t take health for granted
§
One body one mind: need to take care of both as
best as possible. Because you only get
one your whole life.
§
Regular exercise, a good diet, and healthy
coping mechanisms to deal with stress since you are living under sometimes
physically trying conditions
§
Getting sick: it’s the name of the game. Hey, no one forced me to sign up for Peace
Corps.
§
You must become your own doctor for the two years
of your service. I’ve learned more about
medicine and health issues than I’d ever have to in the States. You do a lot of self-diagnosis when you are
in the bush by yourself.
§
Just because a doctor tells you one thing
doesn’t mean that its set in stone and 100% correct.
§
If you know something is wrong with your body
then you probably are correct, you live with it not your doctor,
·
Become aware of your body’s needs and/ or abnormalities,
weaknesses.
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