When I was at home many people asked me what I thought of the health care system here in South Africa. My general response was that it wasn't nearly as bad as it could be, but certainly no comparison to "western" systems.
This week I spent another 2 days in hospitals with one of my new babies. I found that my experience last year, though eye opening, was by no means the be all and end all of South African health care. Coronation, the hospital we were admitted to in December when little Thabo was sick is specifically designed for Mothers and Babies - and as such has a more limited number of patients and more specialized staff.
This week's adventure began at Yusuf Dadoo hospital, where one of our HR Manager's friends is a doctor. I was so grateful for the connection, because he streamlined the process for us and skipped us past some of the queues. Despite this, we were at that hospital for 4 hours and actually made it up to the ward (after a very long and painful x-ray process because the technicians were inexperienced and nervous with small babies) before being told that "no, this is not a 'high level' hospital so we don't deal with skull fractures". As such, we were then transferred, by ambulance to Leratong hospital. The ambulance ride was an adventure in itself with me perched on the stretcher holding the baby, one leg wrapped around a wheel so we wouldn't go flying every time the driver accellerated or screeched to a halt.
Leratong has a bit of a reputation as a not-so-nice place to be sick. I have certainly seen that this is fair! When we arrived we were again jumped in the queue for a file because we arrived by ambulance but still had to sit with those still waiting to sign in. They make you sit on long wooden benches, according to the order you arrive in, and every time someone goes up to the desk you must continue to scoot along the benches until you reach spot number one. The people who are forced to queue like this (for over an hour just to open a file) included an ankle injury (who nonetheless helped me with all of my things when we had to move and the baby was asleep), people with children who just want to lie down because of the pain, and one man who had a heavily bleeding head wound that "wasn't serious" enough for them to take him as an "emergency" case. Eventually when he started getting blood on the floor they brought him a wheelchair and took him back - and then cleared the area so they could mop (for more on my mopping pet peeve, check back in a few weeks!).
After you open a file (no mean feat when you have to convey all of the african names (address, employment, child's info) in an american accent), then you are sent to the admission corridor where the doctors check you and determine how urgently you will need attention. Thankfully we had already been seen by the doctor at Yusuf Dadoo, so we did not have to see the first 7 doctors and went directly to the surgical doctor at room 8. There were 3 people in the queue for that room, one of whom had been waiting to be seen since 9:00 that morning. It was now 9 at night! (I learned later that most of Leratong's surgical staff has recently resigned..). When the doctor finally arrived I was given another lesson in how important it is to be an advocate for your child and to understand what everyone is saying. This doctor, in addition to nearly everyone else that we saw, took a cursory glance at one of the skull x-rays and was going to send us home before I pointed him to the x-ray which actually showed the fracture.
Finally we were sent up to the ward, 9 hours after the whole process started. In this country, and especially at that hospital, they do not generally allow you to stay with your child overnight, so I arrived back the next morning at 8. When I looked at his file, the Dr had already been and had, again, seen the wrong x-ray and decided he was fine. He obviously didn't read the history either, because he requested a consult from the hospital social worker, thinking I was the one abusing the child! Happily, the first doctor we'd seen called to check up on us and straightened things out. We spent that morning going from place to place - Ortho to remove an arm cast from a previous fracture, Opthalmology to check for concussion or bleeding, and then to get a CT scan. This was the bright spot in the experience because we had Nurse Miriam, who was an absolutely lovely Christian woman that accompanied us everywhere we went (they don't trust you not to run off with the child). She was an angel, again jumping us ahead of some queues, running back to the ward for nappies and milk, and generally navigating the system.
Eventually when all the tests were done we were sent back to Yusuf Dadoo so the original doctor could compile a report for when the child's case goes to court. Happily the little one is doing well now and doesn't seem to be in too much pain. In the future though, we will be going back to Coronation!
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