Over the past few weeks I have become very familiar with the health system here in Senegal. I work in a health post and I also have gotten sick three separate times so I have been able to observe the health system pretty well.
Nothing describes the health system better than my last visit to the hospital in Kedougou city. I had an infection on my back, I had gotten something similar to it in the states, so I knew exactly what I needed to do. I knew that I needed anti-biotics to kill the infection and I knew I needed someone to clean out the infection. My first thought was to go to my health post in Mako, where I work, because I know the nurse, Magette, well and I knew I could communicate with her. When I got to the health post someone told me that Magette had malaria and had gone to the hospital in Kedougou. Not really sure what to do next I went home, showed my mom the infection and she told me that in the morning the other women that works in the health post from time to time, Mama, could clean it out. The next day I went to the health post and no one was to be found and then someone told me that both Mama and Magette were sick and that nobody was going to be working in the health post today. I called my team leader, Hassana, who told me that I should go to Kedougou to go the hospital. That starts another part of this crazy journey. I get to the hospital, show the doctor my infection, tell him that it hurts a lot, but that I don’t have a fever and that I really need someone to clean it out. He writes me a prescription for anti-biotics along with iodine (which they use for cleaning cuts) and gauze and tells me that he can’t clean it because he doesn’t have the supplies. So I go to the pharmacy to buy the gauze and the iodine, return to the hospital find the doctor I saw before and just kind of point at the iodine because my language skills aren’t quite there yet. He takes me back to this other room where another doctor comes to look at it and this doctor tells me that he can’t clean it out with iodine and that I need to go buy anti-septic because they don’t have anymore left. So, determined to get this thing taken care of, I walked back to the pharmacy bought a giant bottle of anti-septic and then walked back the hospital. I finally got it taken care of and now it’s healing nicely, but it took a lot of determination to get there.
I don’t want this to seem like I am making fun of the health system here or saying that the doctors and nurses are incompetent because that is actually not true at all. I have seen the health system here work very well, especially when it comes to malaria. The tiny little health posts throughout Senegal are probably better equipped to handle malaria then a lot of hospitals in America. With the help of a lot of international organizations and governments the access to cheap, even free malaria medication is very high. The test for malaria is easy, quick, and requires no big technology, which is perfect because many of these health posts and hospitals don’t have any electricity. Even with my infection story, they knew what to do and they could do it, but they just didn’t have to materials they needed. Along with not having the materials that they need they don’t have the staff that they need. In the health post there is usually only one person working and maybe a few helpers, but as I have seen if they get sick the health post closes meaning that people either have to go else where to get the medicine they need or they have to wait. From my experience most people will wait, which is a big problem because when it comes to malaria the longer you wait the worse it gets. If you catch it early you just have to take pills for three days, but if you wait you it can get to your head and possibly have a seizure.
Another pit fall of the health system is the nurses at the health posts are just placed there by the government and often they don’t speak the native language or languages of the area, making it very difficult to communicate. I got the flu here and I had a hard time explaining to my family what was wrong because they didn’t understand how I could have such a high fever without having malaria. I can imagine how hard and frustrating it would be to go to your local health post and not be able to tell them what is wrong with you.
When it comes down to it, you can get the medicine you need for the most common illnesses, you can get pre natal vitamins when you’re pregnant, and you can even get birth control, but for the more complex and difficult diseases you definitely have to go to a big city such as Dakar. I can already see the health system improving. My little village of Mako just built a very nice hospital, which is currently empty, but as it gets up and running it will provide a clean place for women to have their babies and give them so much more room for beds for patients. Hopefully it will also allow them to hire more staff, so that it doesn’t close as much. People understand that health and medicine is important, so it’s changing and improving rapidly.