improvement... and a hospital experience

Many thanks to all of you who were praying for us as we had another antenatal scan and more bloodwork done to check my hemoglobin levels and the growth of the baby! 

We're relieved to report that according to the scan, everything looks fine with the baby's growth.  And she is certainly VERY active.  I feel like I have an acrobat-in-training doing trapeze stunts inside me! I've not gained any weight in the past month, but the baby seems to be happy and healthy.

The bloodwork revealed that my hemoglobin levels have risen from 9.3 to 10.0!  Not as much of an increase as I was (probably naively) hoping for -- but it is a definite improvement, and we're moving in the right direction!  As David was quick to remind me, the fact that I've been able to increase my hemoglobin by .7 within 4 weeks, in an environment which does not provide a high-iron diet, shows that I've been diligent with my supplements and getting what I can by way of diet, and I should be encouraged!  So we will continue doing what we can, and within a few weeks I will be back in the "Western world" where I will be able to rigorously monitor my diet for the entirety of my 3rd trimester!  I do have 3 more months to keep working on my hemoglobin levels!

When we went to the hospital on Monday I was hoping that it would be a quick "in and out" visit like it had been the week before when we took David to be treated for the dog bite on his arm.  Well, the hospital was pure chaos!  I think part of the pandemonium was due to parts of the hospital closing at noon because the following day (Tuesday) was Presidential Elections here and so there was a half-day holiday.  It was very crowded and there were crying babies and harried-looking mothers everywhere.  First I had to wait in line in one room to register.  Then I had to wait in line in the main waiting room to be weighed and have my blood pressure checked.  It's not like a normal "doctor's office" -- it is a big open room with rows of benches on either side crowded with people, and a scale right in the center of the room!  You have to "queue up" and wait for your turn to step on the scale, the staff worker quickly jots the note on your registration card, and then you are waved into a different queue to get to the table at the front of the room to have your blood pressure checked.  All completely in public, for all to see, in front of hundreds of waiting patients! 

There are several examination rooms on each side of the main waiting area where each patient sees a doctor, and I was told to wait in front of Room 16.  I tried to explain that I was not sick and did not need to see a doctor, I just needed to get some bloodwork done and an antenatal scan, but I was told to wait for a doctor anyway!  Apparently the way the hospital works (I'm guessing because no one actually explained this to me) you have to see a doctor first so that you can get a piece of paper with their written permission for whatever bloodwork, radiology, etc. you might need for your condition.  There was no place to sit, so I was standing in line in front of the door for perhaps 20 minutes. The door to Room 16 remains open so you can see that the two doctors inside are dealing with patients.  After waiting for a long time and the line hadn't even budged, one of the doctors inside Room 16 looked up and for some reason called out to me -- I have no idea why!  I was the third person in line.  I don't remember what he said at first but it was something like "What do you need?"  I said, "I just need a full blood count and an antenatal scan, that's all!"  He said, "Go to Room 15!"  I said, "I really don't need to see a doctor at all, I'm not sick."  (Really hoping to save them some time and trouble!)  He insisted: "You are sick.  Go to Room 15!"  *sigh*

So I went back to Room 15 to wait.  But immediately it became apparent that no one waiting in front of Room 15 knew who was in the queue, where the queue started or where it ended!   There were no remaining seats so about 6-8 people were loitering in front of the door.  Every time the door opened, several people who were closest would make a dash for it and try to get inside to see the doctor before the door closed!  It was absolute pandemonium.  I was standing there trying not to get trampled, and really not convinced I was in the right place at all.  A few nurses tried to sort out the queue for Room 15 but gave up because there was so much confusion.  No one knew what was happening!  Finally I spoke to one of the nurses (knowing that she would speak a little English!) and explained my situation -- that I simply needed a full blood count and a scan -- and asked her to tell the English doctor, who knows us at the College, that I was here waiting because she would be expecting me.  (I had spoken to the doctor the previous week to find out about getting a scan, so she knew I was coming that day.)  The nurse didn't know what to do with me so she asked another guy.  The man said "Follow me" and before I knew what was happening he opened the door to Room 14 and took me straight inside, where the doctor was already dealing with a patient, and motioned for me to sit in the corner!  So I waited while the doctor finished with the patient and then it was my turn to explain to the doctor -- again -- WHY I was there and what I needed.  I spent several minutes trying to convince the doctor why I needed the scan and bloodwork in the first place.
"You're not sick!" she said.
"No, but I was anaemic last month when I saw my doctor in Lusaka, so she wants to check my hemoglobin levels to see if they've come up, and she wants a scan to check the baby's growth."
"But you had a scan in Lusaka last month, why do you need a scan here?"
"To check the baby's growth!  I've not gained any weight in the past month and they are concerned to make sure the baby is still growing!"
"Is the baby moving?"
"Yes!"
"Then why do you need a scan?"
and so on.... followed by "Why do you need a blood test?"  Next time I will make sure I have a letter of referral from my doctor!  A referral letter is not necessary, but it certainly would have made my morning easier so that I didn't have to keep convincing people of why I had come to the hospital in the first place!

Finally I got the paper from the doctor, rather grudgingly, which allowed me to go to the lab to have the blood test done -- more waiting. . . and then from there to the radiology department to have the scan done -- even more waiting!  That was an experience in itself.  When I went to the radiology room and told the man at the front desk, "I'm here to have an antenatal scan," he immediately said "Follow me" and quickly ushered me through the waiting room (where about 8-10 ladies and a couple of men were seated) and straight into the ultrasound room where the doctor was seated at his desk.... at the same moment that another man was wheeling another patient who was in a wheelchair into the ultrasound room!  Hospital policy is that urgent cases always go first, and I was just following instructions, so I waited for the doctor to tell me what to do after the receptionist handed the doctor all my paperwork and left me in the room.  The doctor said, "Madam, wait outside the door and I will see you next, after the man in the wheelchair."  So I obeyed and stood outside the ultrasound room door, since there were no remaining seats. 

After a couple of minutes I realized that all the women who were seated were getting upset because it was obvious that I was suddenly at the head of the line when they had been waiting for who knows how long!  There was a lot of muttering and murmuring in Nyanja which of course I couldn't understand but I certainly was getting the gist of the conversation!  Finally one of the women got up and huffed out of the room.  She came back a few minutes later with a nurse who took the woman's paperwork (like the receptionist had done with mine), barged into the doctor's office, gave him what sounded like a major telling-off (in Nyanja), left the woman's paperwork inside, and came out.  The other woman looked pleased with herself.  I, meanwhile, had managed to find a corner of a table to half-sit on while I waited.  I noticed that one of the other women had inched her way to the end of the bench where she was seated and looked like she had every intention of dashing inside the doctor's office as soon as the door opened so as to get inside before I did.  I had absolutely no interest in fighting and elbowing my way into the doctor's office so I completely ignored her.  Sure enough, when the door opened and the wheelchair patient emerged, said woman shot inside the office and immediately plunked herself down on the examination table while I followed her through the doorway and wondered what on earth the doctor was going to do in this situation. The woman sat there with her arms crossed and rattled off something in Nyanja to the doctor and he looked at me and said, "Let her go first. You wait outside and come in next."  So, I returned to my post standing in front of the door.  I felt really bad about being at the "head of the line" and I didn't understand why I was given "preferential treatment" but at the same time I felt very strongly about obeying the doctor's orders, because he was the only one around who was giving clear instructions!  All morning, I had been struggling to figure out where to go and what queue to stand in, and everything was so disorganized that I was determined to follow the instructions which were given to me. I waited, and as soon as the doctor's door opened again another woman repeated the trick and dashed inside, nearly knocking me flat.  The doctor quickly told her to leave, and as I settled myself on the examination table, he muttered something about "always pushing and shoving their way in...!"  This experience made me really sad because I didn't like the feeling of "cutting in line" but I was really trying hard to obey any instructions that were given to me because it was so hard to know what I was supposed to do.  And in a situation like this where there is no orderliness and no one knows where the start/finish of the queue is, the doctor is the only one who can decide who he is going to see next!  It was an unpleasant experience, but I was thankful to be finished quickly and out of the way so that the women could finish fighting over who's turn was next.

In all, it was an exhausting and stressful morning... BUT
* we are so thankful to have a hospital not too far away
* we are so thankful to have access to basic medical care (and if it was an emergency, they would take good care of us!)
* we are so thankful to be able to check the health of the pregnancy without having to travel all the way to Lusaka!

And I learned a few more lessons about life in Zambia in the process!  :)