12 June 2015. It was 9:00am and I sat there exhausted in the lobby of Beit Cure International (BCI) Hospital – supposedly one of the best hospitals in Malawi. I arrived late the previous night after traveling five hours on a pot-holed and accident-ridden highway from Lilongwe, the capital city to Blantyre. This trip was an urgent request by my physician to get a second opinion for my leg injury. Unfortunately, this visit was one of many over the last five months that allowed me a raw, but privileged access to the Malawian healthcare system.

First, let’s go back to my minibus accident on 9 February 2015

It was 5pm and I was quick to clock out from work. I flagged down the minibus beside the road. The minibus is a hybrid between a family and utility van, and minibus drivers are notoriously reckless. Just a few weeks ago, a minibus carrying 14 passengers flipped three times and killed two passengers in southern Malawi. 

This recklessness – no doubt – contributes to the fact that motor vehicle crashes are ranked one of the leading causes of death in Sub-Saharan Africa.

The minibus was jammed pack with four sitting per row, which legally and safely sits three. As we proceeded, I noticed a green sedan encroaching into our lane. Both drivers interlocked glances, but my minibus driver sped up. The next thing I heard was the screeching tires and all 19 of us thrown forward. The bench that I sat on was dislodged from the baseboard and I was shoved up against the metal engine. Suddenly, a sharp pain permeated up my leg. I looked down and my pants were ripped behind a freshly new wound.

My introduction to the Malawian healthcare system

Helen, who is the Malawian Country Manager at Global Health Corps, arrived and took me to a local private clinic. The injury was benign. The doctor gave me a tetanus shot, prescribed a week’s dose of antibiotics and painkillers and bandaged me up. The doctor insisted no stitches.

I’ve heard of horrific minibus accident stories, so I was grateful that I hadn’t become just that, a tragic story.

9 March 2015. Over the next two weeks, my leg became swollen. Green pus inundated the wound and the skin around turned bluish-purple. I was worried, so I consulted my “American doctor friend.”  He demanded that I go to the hospital and so I went to the African Bible College (ABC) clinic. A doctor from New Zealand confirmed that it was an infection. She prescribed a week dose of cleaning and dressing, but no antibiotics. She said to apply honey twice a day to the open wound. I looked up at her, puzzled, and she said, “It is proven to work…and it has worked wonders for the locals.”

I didn’t question her because I believe that indigenous and traditional medicines can offer an alternative to Western medicine. So I agreed and applied the local, natural Mzuzu honey for two weeks.

However, four months later I was back in the clinic again.

11 June 2015. The signs should have been obvious a few weeks prior, but I ignored them. I had a fever and the lymph node in my right groin area had hardened. When the wound oozed and turned red, I knew I was in trouble. I visited ABC clinic again and the same New Zealand doctor suspected a more serious infection. She prescribed an x-ray to make sure it hadn’t infiltrated the bone. She saw nothing, but she wasn’t satisfied. So she sent me to a specialist in Blantyre immediately. She told me, “There is something going on under there and if this were my leg, I would get a second look.”

12 June 2015. The following morning I saw the orthopedic doctor, an American, at BCI Hospital. I told him about the accident. He prodded and palpated, and decided on an MRI. I agreed without thinking about the cost, how the procedure would occur, or worse, what they would find. I assumed that it would be cheap. Also, I figured I would just strip down and get into my surgical gown and be out the door just like that – well, I was wrong. My 9am day ended at 5pm.

The MRI Centre at Queen Elizabeth Central Hospital, which is the government hospital and the only facility in the country with an MRI machine, was 30-minutes away. When I got there I bypassed the dozen pregnant women and went to the front of the line because I was a “paying customer.” This was my first reality-check to what privilege can buy in the developing world. However, moving to the front of the line did not equate to me finishing early. BCI had failed to tell me that it would cost $500, cash. Additionally, I had to bring a CD for the MRI images; and I had to travel another 45 minutes to get them read by the only Radiologist in the city. To say that I was flustered would be an understatement – I was agitated. I was that “spoiled American” who expected the convenience of Western medicine. 

Once I got to the Radiologist’s clinic I was surprised that it was nothing more than cellulitis. I was relieved, but deep down inside I had hoped for something worse because that would’ve at least validated my shameful charade in the city.

 What I learned from this experience

Never compromise when it comes to your safety and health.

It is important to not delay seeking medical attention – as it could be a matter of life or death. Trying to resolve an infection months later could save you time, frustration and money. Secondly, don’t self-medicate. Rather, seek the advice of trained professionals no matter how minor the injury or illness may be. Lastly, make sure to have traveler’s health insurance – otherwise you could end up paying exorbitant fees out-of-pocket.

As an American living in a developing country, I was thrust into a healthcare system that was foreign, unfamiliar and difficult to navigate – a system that I took for granted back home.

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