It's not all Mangos and Zebras

Healthcare in Africa

An essay by Luke

Healthcare in Africa is no joke. Of everything we've seen here it's the hardest to make funny, because really, it just isn't.

I got malaria a couple weeks ago (allegedly, though doctor number two said doctor number one was a crackerjack). It sucked. It really sucked. It felt like I imagine you'd feel if you ran a marathon then drank cheap whiskey till you passed out, then got woken up two hours later. It sucked. Then things went wrong somewhere and I got a lung infection or pneumonia or something. So I couldn't breathe. That sucked more, because then the locals were worried. Tell an African you have Malaria, his response will be along the order of "That's a bummer. The last time I got malaria was a few years ago. It sucked." So when they got worried I got really worried.

I went to the hospital a few days later in a very much second- or even third- tier Ugandan city. It was scary. Not because there were human body parts laying around and AIDS patients bleeding on me, but because it was African healthcare. I have been taught to fear this more than just about anything in the world. I'm not going to say that everything we think is wrong, because the difference between "their" hospitals and "ours" is huge. Probably it's smaller than your imagination, but it is still huge, people die here from things we joke about. That being said, I still haven't been to a public hospital, because I am lucky enough to be able to afford not to. Maybe all the scary pictures in my mind are there in the public hospital, but even then I had some misconceptions. They have x-rays, doctors wear rubber gloves, my blood test was done on a machine, once I got in the doctor's room it was just like any other doctor's visit except he didn't use a computer to tell him what to do. There were no chickens or goats, there was no mention of ghosts or devils or lizard's blood.

I was deathly afraid of getting poked with a needle. Growing up in America I was taught that if you get poked with a needle in Africa, you will die of AIDS. I had to make that judgment call of which do I fear more: whatever is in my body right now, or the possibility of something new getting in there. The former won out, I got a blood test. Even though the needle was triple packaged with safety seals and everything, I am still terrified that I now have AIDS. The hospital was fine, maybe if I hadn't been taught that hiding behind every wall is an open sewer and a guy rinsing off needles, it wouldn't have felt like anything. I don't know, all I do know is that our idea of clean and Africa's idea of clean are two different things. Africans shower twice a day, I can count on one hand the number of time in my life I've done this. On the other hand Americans don't eat any meat that's been unrefrigerated for more than like an hour, and I won't even start on the butcher shop here. All I know is I can't say that I'm going to be completely at ease until I get a HIV test that comes out negative, administered in my own country. Maybe that makes me racist, if so then call me a racist. I fear needles in Africa, I always will. No amount of evidence to the contrary will change my mind.

I talked about this fear with some of my African friends. They're somewhere between insulted and amused by our childish irrationality. The idea that a reputable doctor would be using dirty needles is horrifying to them, just like it is to us. More so, because the fact that people here actually see AIDS and see how terrible AIDS is makes an intelligent person probably more afraid of it. It's like the difference between a child's fear of the boogeyman and a grown man's fear of real-life danger. If you mess around it will destroy your life, period, no questions asked. AIDS is real, another friend was surprised that we didn't know how to spot an AIDS patient on the street. I don't know whether there's any validity to his method, all I know is I've never even thought about it.

People don't believe me when I say that I've never knowingly known anyone with HIV. People don't get it when I say that in my bracket, AIDS isn't really a real concern. That for all my friends who engage in risky sex, HIV is just not on the radar. Death is very real here, and people who can afford to treat it as such. Not everyone has the luxury of thinking they're invincible. The idea that I could die before I'm good and ready isn't really real to me. Not in a you-could-die-tomorrow sense. I'm young, rich and white in America, that shit ain't real to me. My biggest fear is babies.

On the other hand, on several occasions I've gotten into it with people about AIDS in America. I've been told by very educated people that we have a bigger prevalence of AIDS in America than in Uganda. That seems crazy, right? So now imagine you take your Ugandan friend to the doctor at home and they refuse to get an injection and say they fear getting AIDS from the needle. A little insulting and bizarre, right? I guess the moral to the story is that culture is a powerful thing. Whatever "you" do is good, while "they" are a bunch of savages.

I'm ok now, I finished the antimalarials a week or two ago and my bloodwork came back negative. The doctor gave me some antibiotics for my lungs and I can breathe normally again. I'm healthy again and have learned a valuable lesson: USE BUGSPRAY YOU IDIOT.


  1. Excellent writing and quite thought provoking! Kinda scares the crap outta your parents, though...

  2. I just realized that I had been holding my breath throughout your entire essay. When I exhaled, my heartbeat was palpable.

    Maybe I'm a slow reader and I was asphyxiating. Must be sympathy lung troubles.


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