Going Native, Part II

There are borders to how far I wanted to go with the whole “living like a Ugandan” thing. For example, Ugandans have high rates of rather exotic maladies and afflictions. I was hoping to avoid that part of life in the third world, but that’s not how it turned out.

For the sake of the children, I will spare everyone the gory details of what happened, or is happening – except that it involves insects living inside the bed of my hotel and now living, well, somewhere inside me. It’s one of those kind of afflictions that I had heard about but had a very difficult time imagining anyone ever actually got, because it sounds simultaneously both painful and hilariously absurd. Anyway, after a few days of trying to tough it out, I conceded that some medical care was in order.

But what medical care? As the ongoing debate about health care in the U.S. lays bare, there is nothing intuitive about the system I am used to. Medical school. Hospitals. Doctors and nurses. Pharmacies. These are universal labels that we apply to very different things in different places. Given how different I know health care in the U.S. and the U.K. to be, I realized that Ugandan health care might very well be totally foreign to me. When I thought about it, totally absurd questions started bouncing through my brain. Do they have doctors here? How do I know they’re really a doctor? Will they have a framed diploma on the wall, a front office full of forms and records, a nurse to clean me up first? How do I pay? If I go in with an open wound, will I leave with HIV?

Given the circumstances, I got my answers from the same source I always do: a Ugandan. I pulled one of my researchers aside, and asked him to point me in the direction of a clinic. I added that I wanted a good place, a clean place (as if he – by merit of being Ugandan – might recommend someplace that is dirty and bad). Ultimately, I have to admit that these questions were code for what I really wanted to know. Deep down, I knew that for my peace of mind, I wanted to go to the clinic where the white people go, where I knew they spoke English and might offer services familiar to a Westerner. So much for going native. I’m in rural Masaka, though, and so my team leader told me that I had no option but to go to the single local clinic. I’ll admit it: I was scared.

It occurs to me that my mentality about this whole “living like a Ugandan” thing is a bit like Sarah Palin lauding her daughter’s choice to not get an abortion, while missing the distinction between people making the choice to save their babies and have that choice made for them by the government. It’s easy to pat myself on the back for trying local cuisine, staying in local spots, and adopting local customs, but in the end, each decision was mine to make to make. I always knew that – for the cost of just a few thousand shillings – I could have all the comforts I am used to. When I no longer had a choice – when I had to accept the whole package of living like a Ugandan – it was terrifying.

We walked to a nearby clinic, which had a completely inconspicuous front nestled between a tiny grocery and a stationary store. The front room had nothing to indicate that it was a doctor’s office except for a few government issued posters about avoiding malaria and boiling water to kill bacteria (no water here that does not come in a bottle is remotely safe to drink). The woman behind the reception desk – who appeared to be cooking dinner on a stove in the corner while her five-or-so-year-old daughter ran around – greeted me by joking “I’m the doctor.” She probably sensed the panic on my face when it hit me that my “doctor” was about twenty-two, because she quickly retracted her statement and said the doctor would be in soon. When the doctor came in, he took me to the only other room in the clinic, which was only about 10 foot square. Medical equipment was sparse – there was a stethoscope, a box of gloves, and some bandages. I’m sure everything that really mattered was clean, but the room itself did not have the antiseptic atmosphere I’m used to (the dried blood on the walls didn’t help).

And yet, all in all, it was a good experience. The doctor sat with me for thirty minutes, did everything himself, and explained what was going on in detail, despite the language barrier between us. I can’t help but compare it to a few months ago, when I broke my nose and spent four hours in Princeton Medical Center, a top-notch U.S. hospital, in order to get a battery of tests that the doctor – who spent all of three minutes with me – never explained. PMC cost $4,000; the Masaka Clinic cost 10,000 shillings (5 dollars).

The entire experience was a good reminder of a maxim I repeated to myself last summer, when I was living in one of Brooklyn’s worst neighborhoods: even in the worst places people live, there are still people living. What I mean is that you can be in the ghetto – where the crime rate is sky high and drug use is rampant – and the majority of people are just simply existing like anyone else. Things here are bad and there are many, many things that can go wrong, but the reality is that what I got was the whole extent of the health care to which most Ugandan’s have access – and it was okay. That’s not to say I don’t think it’s criminal that I can get a $3000 CAT scan for a broken nose and people here can’t afford a $15 malaria treatment, but the whole experience has been a good reminder that just because something is different doesn’t necessarily mean it’s crappy.

** Addendum: I am back in Kampala, and went to the reassuringly boring (that is, familiarly Western – there was even a fish tank) clinic that all the Mzungu go to. It looks like I am not going to die. Feel free to google “Mango flies” if you really want to know more.

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