As mentioned before this area sees about as much in the way of healthcare as
Brown and Blair see eye to eye. Not a lot then. The best way to describe the
clinics that operate here is that they are islands of treatment in an ocean
of no treatment. There are no GPs, dentists, and no pharmacies and the only
drugs available are sold in markets. I walked past a shop on Sunday selling
pillowcases, pocket mirrors and IV Gentamycin! The population here can’t get
enough of medicines, injections in particular; if they haven’t had an
injection then they haven’t been treated. We have outreach sites that give
medicine to more than eighty three percent of all the patients they see.
This has massive repercussions in terms of resistance to antibiotics and
costs. It is a problem we are urgently trying to address. However it is also
an issue that cannot be totally solved by us, as outsiders. It is a question
of education, and in a place where only a privileged few go to primary
school and any form of mass media is non-existent it will take years to
solve properly. Besides, it’s not a predicament we have yet solved in
Europe. I lost count of the number of patients I saw as a nurse in London
demanding antibiotics for self-limiting viral infections.
It’s not much of a surprise also that a boom industry here is the
traditional healer. These people range from the mildly hopeless to the
lethal. A particularly barbaric practice is that of cutting. Here, (and in
many parts of the world) it is believed that burns and cuts will alleviate
symptoms. The human body has a fabulous way of healing itself over time, but
often it is the traditional healer who can take credit for the hard work of
the patients own immune system Most commonly we see the patients after the
traditional healer has got his hands on them. In many cases the deep,
infected lacerations present more of a problem than the original illness
does. This is particularly the case with nodal TB. There is a practice here
of attempting to gouge out the offending lymph node with something
resembling a sharp spoon. It is therefore impossible to assess a lymph node
that should be swollen but not painful (if indeed it is nodal TB) because
someone has kindly taken a rusty implement to it and made it very painful
indeed. However in most areas there is nothing else on offer and until a
very large amount investment occurs the traditional healers profits are
safe, even if their practice is anything but.
