“Less drama than in 2016”, was Monika’s and my New Year’s resolution for 2017. Ten days into the new year and I was laying on the floor in my house in Freetown with the worst back pains of my life. It took me 20 minutes to move back inch by inch to the mobilephone that laid 2 meters away. The ambulance of the best private hospital in Freetown came within 20 minutes with the relieving morphine injection. Elias came to the rescue and called a welder to break the door – I wasn’t able to move at all, the 10 meters to the door felt like an ocean. The following three weeks were spent laying down and with lots of opium containing painkillers, that kept me happy and hallucinating every now and then. I had to fly back to Switzerland to treat the disc hernia properly and was allowed back after many hours of physiotherapy. Some happy weeks in Salone later, the next set of pains started, this time something was wrong with my kidney. To keep the long story short: I have spent the last three months in Switzerland with several surgeries under full anesthetics and a very slow recovery process. The risk of life threatening complications was big enough to keep me grounded in Europe!
Well, you see that I have been a bit busy the last few months taking care of my health and dealing with my interrupted life in Salone – apologies for all the silence this created! I thought this might be a good moment though to tell some of my hospital stories…
I have a very generous health insurance, thanks to my employer. That means I can access the most expensive and supposedly best private hospital in Freetown – sounds good, but can’t really be compared to hospitals in Europe. The leading doctor (a kidney specialist who couldn’t diagnose my kidney infection properly) is a very nice and kind man, but recommends medical evacuations for basically any illness – he knows his’ and Sierra Leone’s limitations. Thanks to my regular hospital stays (I have slept in all four patient rooms already), I know the staff and they know me. When I was back in March for another visit and spent my waiting time saying hi to the nurses, I was approached by another patient who waited for his term and he said “Sorry, I have some questions around the documents that I need for my treatment – you work here, nottoso?”. I knew then that I have definitely spent too much time in hospitals this year.
It made me calculate: I have spent the same number of evenings in hospitals, as in Restaurants in the first five months of 2017. I have also received in total 42 injections – they are liked a lot in Africa, where the rule is: no matter what sickness, to get better, you need as many injections as possible, in as many different body parts as possible. The nurses are all very friendly, apart from one, who after 20 minutes of bloody failures to get my vein was as frustrated as I was. I told her that this is not very comfortable anymore, to what she replied: “pull yourself together, if you can’t take this pain, you will never be strong enough to give birth to a child”. Something that childless women hear every now and then in Salone!
Alternative medicine does exist in Salone as well – just maybe a tad more alternative than our alternative medicine. During my third visit within few weeks, one of the nurses recommended that “it really is time now to sacrifice a chicken, it just isn’t normal that you keep being sick”. She also told me she can recommend someone, with high success rates. Or she can also ask her pastor to come and pray, he also prays for the sick. Nice to have options!
My hospital, my source of information, my work experience
I am trying to use all my visits in the hospitals to expand my knowledge of health systems, and see them as “field trips” – hopefully helpful in my work at the Ministry of Health. I like asking for costs of equipment, medicines and procedures and it is shocking to realise how expensive the health system in Switzerland is. The machine used for a kidney function test costs one million Swiss franks (about 1.1 million USD) – with that money you could pay 5700 nurses in Salone for a year (therefore hiring 5400 more than what they have now). There have also been lots of interesting discussions with the nurses about my work and Sierra Leone – the nurses in Switzerland are usually fascinated, but also thankful to be working in Switzerland. Even in Salone it isn’t easy to feed a family with an average monthly wage of USD 180, that a nurse earns.
It has been nearly four years now that I have worked in the Ministry of Health in Sierra Leone, working on projects to strengthen the health system. I know the facts, numbers, the theories and reports, but it still hits me at the core how inexistent and incapable the health care is. If I would be a Sierra Leonean with the same kidney problem, I would probably have died before the age of 35 of kidney failure – just because Salone is not able to diagnose and treat it.