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Student health is a daily burden on my psyche.  The issues are varied; everything from students faking illness to get out of class, students suffering from serious ailments while we are at least an hour from a real health care facility and don’t have a school vehicle, to the general lack of medical and first aid common sense among staff, students and community health providers. It’s difficult to describe all the events that have horrified and bewildered me since arriving here but let me try to explain.

A student fell into the well during my first three weeks at the school. She had fallen awkwardly, hurting her leg in the process and couldn’t walk. Staff decided to take her to the dispensary (the local health care facility which has a few beds, medication sometimes, and a poorly trained ‘doctor’ who I believe has a certificate in health from somewhere….) But we had no vehicle to transport her there. We also have no first aid kit at the school. Not even any Ibuprofen or Tylenol on hand. So the students had to take turns carrying her down the road in the heat of the day. Thankfully the dispensary is only about 1km away. But I kept asking myself, what if she had hit her head? We would have had no way to rush her to hospital!

Since arriving, I’ve noticed a large number of students have strange skin infections. I believe, for some of them, it’s ring worm. Others I’m not sure about. They go to the dispensary and receive injections or powders but the problems don’t seem to clear up. This weekend, a student who I know has had a terrible infection on her foot for a couple weeks was writhing in agony. I could see the infection had spread to both of her feet now.  I took a look at her ‘medication’. It was penicillin powder.  I asked her what the doctor had told her was wrong with her foot. She said it was a fungal infection. So how, I wondered, was this powder supposed to clear up a fungus? I ended up calling the School Manager, who was away on business in Dar es Salaam and asked him to bring some anti-fungal meds back with him the following day. What kind of doctor gives an antibiotic for a fungal infection?

A student badly burned herself on hot porridge about three weeks ago. The cook, a man in his forties, told her to put sugar on the second degree burn! When we found out we took her to the dispensary for proper treatment. But I’m not surprised. Everyone seems to have homemade remedies for things and very little actual common sense when it comes to cuts, burns, infections, diseases, etc.

Today, I noticed that 20 students were lined up to go with the Matron to the dispensary. I asked, “What’s wrong with all of you?” They said UTI (urinary tract infection). Well honestly, there’s no way that all of them suddenly developed UTI’s on the same day. And it’s convenient that they get to miss physics to go to the dispensary. I couldn’t help but frown. If the doctor had some simple diagnostic tools, he would quickly dismiss them all as liars or find out what was really potentially wrong. For example, we had a girl who everyone said was suffering from a bad UTI for over a month. She was treated with antibiotics continuously with no improvement. She was so uncomfortable for so long that she thought she was never going to recover. She had actually given up hope that she could be treated. They finally drove her to the hospital and discovered it was a raging yeast infection. The poor girl had been in agony with the wrong diagnosis for weeks.

Some of the girls here are extremely tough. They don’t let on that they’re feeling sick. Some however, are better than Hollywood actresses, feigning unconsciousness and possessions from demons, etc. I never know what to believe. One girl had a headache and said she was feeling a bit sick. I touched her forehead and realized she had a fever. She said it was nothing. She ended up going to the dispensary just as a precaution and was diagnosed with malaria. Another girl had some stomach pain and diarrhoea and pretended to be unconscious for 4 hours, refusing to talk or walk, so we had to carry her to the dispensary in the middle on the night and wake the doctor up at his house to come and check her. It was ridiculous. A couple hours later she walked back to the school herself, talking and laughing.  They don’t even realize that their pretending doesn’t add up medically. But the staff can’t discern it.

If students go to the dispensary, they receive an injection for everything. Skin infection? Injection. Stomach ache? Injection.  UTI?  Injection.  Bruised hip? Injection.  And no one asks what’s in those needles. What exactly are they being treated with?

Overall, it’s a daily frustration for me. I have to remind myself, this is Tanzania. I can’t have the same expectations that I would at home. But all the ‘what if’s’ plague me. I don’t see any immediate solutions either. The dispensary is our only source of medical care and we are ill equipped with sense and equipment. Silently, I’m just praying I don’t get sick myself. So far I’ve been very lucky. Fingers crossed.

Cheers,

Marike

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