The Ins and Outs of African Hospitals: Make sure you have Insurance!

In late August 2014, whilst travelling in Zanzibar with my friend Juan*, we decided to hire a scooter to explore the island. After spending a lovely day seeing the sights, it was just past 10pm when we finally decided to take the 30mins ride back to our lodge. The roads were quiet, few people were around – all we saw were small groups gathered outside houses to watch football on the one and only TV in the village.

With less than 7km to go, Juan, who was driving the scooter yelled “Oh crap!”. We skidded off the road, fell off the scooter and landed on the dirt path with the scooter on top of us.

I was in shock and couldn’t feel any pain. Until I looked down. My mind finally registered the strange angle of my arm and the pain suddenly shot across my body. I screamed. Juan, whilst badly grazed all over, managed to keep calm and was able to use his mobile phone as a torch to flag down a passing car. I couldn’t even hear a car coming.

We were lucky. The car that stopped turned out to be Zanzibar tour operators. They took us to the police station to lodge a report (this took at least 30 mins) and then to a private medical clinic, Dr Metha who did a very sloppy job trying to clean the blood out of our wounds (think he was angry at being woken up at 1am in the morning). His one piece of invaluable advice was, “no matter what the hospital says, do not get an operation in Zanzibar”. We were then sent to the best hospital in Zanzibar for x-rays and treatment.

Zanzibar Hospital
When we arrived, the hospital was dark and dingy and eerily quiet for a Saturday night. It was rundown, no air-conditioning, mosquitos everywhere and did not look very sanitary. We were placed in wheelchairs, seated far from each other and whilst there were no patients, were told to wait.

At this time, Juan was feeling rather faint and wanted to sleep. Feeling afraid he might fall into a coma, I kept nudging him to stay awake. I went for an xray and the nurses attempted to clean Juan’s wounds. He had large grazes on his arms, legs and feet. They started by rubbing his wounds abrasively, sprayed stinging iodine and were told to air-dry for quickest recovery. Not believing this theory, he insisted on bandages. (Wouldn’t there be massive risk of infection if wounds were not covered?). The nurses relented and put cotton wool which stuck to his open bloody wounds and were impossible to remove.

The scariest experience for me was when they wanted to admit me to the ward. The nurse wheeled me to the back of the hospital where it was completely pitched black and the only thing I could see were iron bars, behind which stood an unused gurney and a ramp up to the next floor. I panicked. There was no way I was entering that space, it looked like a scene straight out of a horror movie, a point of no return. I shook my head furiously repeatedly saying ‘no no no’. The nurses replied with ‘Oh your friend will join you later’. I don’t think so.

Another hour later, it was about 2am at this point, with periodic yelps coming from the surgical room, the nurses finally finished cleaning Juan’s wounds. He was dead tired and just wanted to sleep. I relented and was admitted to the ward. They allowed Juan and I to share a room. Needless to say we didn’t sleep much.

A few hours later, the orthopaedic surgeon came to see my arm. I had severely dislocated both the Ulna and Radial bone in my arm and urgently required surgery. He tried to convince me to have an operation in Zanzibar but Dr Metha’s advice was ringing in my ears: no way was I getting an operation here. I was wheeled into the emergency room where he gave me a backslab cast. With no painkillers, he twisted and prodded my arm back into some sort of alignment. This was one of the most painful experiences in my life (the most painful experience was when I decided to get a tongue ring). Juan experienced a similar story and got a cast on his ankle. I later learnt that it’s normal to get morphine in developed countries.

Then came the tidal wave of visitors, none of these were friends: from the Zanzibar tour operators who scraped us off the side of the road, to the owners of the scooter company, to our lodge owners. I just wanted to go home, why were they here? We had to tip each of our ‘visitors’ so they would leave us alone. We decided to fly to Johannesburg for treatment. Enroute to the airport in the hotel chauffeured taxi, my iPhone was stolen from my handbag.

Johannesburg hospital

We checked ourselves into the emergency room at the Sandton Mediclinic (Private hospital). I was asked to take xrays again (post backslab) and wait for further treatment. This is a great hospital, run with efficiency and very comfortable even if they kept asking for medical insurance and payment information. The emergency doctor Dr Mwunze was amazing and was keen to help. She called the orthopaedic surgeon on call who quoted at least R100,000 (USD 10k) to insert metal plates into my arm. They needed at least R50k deposit to secure the operation.

I had bought 1 year travel insurance when I left Hong Kong to work in Lesotho, so I called and asked them if they would cover. It took 2 days of ringing around to get a clear answer. Since I had left the country for more than 90 days, my insurance would not cover this. So what do I do now?

I contemplated going back to Australia to get the operation done. At least healthcare is free. Feeling rather stressed, anxious and in pain, I finally broke down. I didn’t want to go home, it would feel like a step back in my African journey.

God sent me an angel. We met some local South Africans at lunch who recommended the Johannesburg public hospitals. I went to Helen Joseph Hospital immediately, was admitted and operated on straight away. All for a cost of R150.

Helen Joseph Hospital is one of the best Johannesburg public hospital though it is very run down – if ever a place could do with the ‘broken windows theory’ this is it. It has high electric fences, bars on all the windows, flies everywhere. The food is awful and the nurses are downright rude. I was put in a ward of four patients and every morning at 4am, the nurses would wake everyone with a tub of hot water so we could ‘clean ourselves’. Then we were told to sit around and wait for doctors’ rounds at 8am. I was one of the lucky ones, at least I was able to get up and walk about. The patient across from me had been in hospital for 2 months after getting hit by a bus, was pretty much paralysed from the waist down and had at least another 4 months of treatment to go. She is my age.

One day, I heard two patients talking: a nurse in another ward was raped the same night I was getting my operation. I couldn’t wait to get out of there. My operation had gone well but the healing process did not. The cast was on too tight and I had blisters from the swelling. My cast was removed and I was told to elevate my arm as much as possible. I also had a funny rash on my arm which I later realised were bedbugs. I begged to be released, I couldn’t stand the place a minute longer. Luckily one of the resident doctors took pity on me and released me after 4 days in hospital.

It was a gruelling experience in a public hospital but for R150 (USD 15), this is good value. I was lucky I didn’t have to wait 2 weeks for the operation and a post-surgical check by a private orthopaedic surgeon gave me the all clear.