On Being Sick in a Foreign Country, and How we Inadvertently Bribed a Tanzanian Pharmacist

Within a week of arriving in Tanzania, I had learned the Swahili words for health clinic (matibabu) and thermometer (tamomita), visited said matibabu, and an hour later had pulled an intravenous drip out of Daniel’s arm, spilling IV fluid everywhere and sending the elderly Tanzanian pharmacist into an angry and confused tizzy.

Let me back up.

We had taken the TAZARA train direct from Kapiri Mposhi, Zambia, and arrived late in the evening at Dar es Salaam station. Dar seems like a mixture of Africa and Everywhere Else, with heavy trading port influences, deep and historical, manifesting themselves in the modern city. Muslim men wear flat, intricately embroidered hats, some women wear full coverage robes and scarves despite the heat, women of Indian descent in saris work at their pharmacies. Young men sell flat baskets of cigarettes, SIM cards and small sundries from their left hand, jingling a little silo of shillings in their right, making little kisskisskiss noises to advertise their presence to customers, dodging murky puddles on the street.

There is a whole micro-economy based on cell phones, SIM cards and air time. Even in the smallest, most rural areas we saw on the train, people selling dry beans and bananas from baskets would have cell phones.

We took a ferry to Zanzibar’s Stone Town and explored the fisherman’s market, soggy fishy mud clinging to our feet. We ate grilled meats and rice, french fries and bottled water. We changed guesthouses, having chosen the one we were at in exasperation, touts seeing our backpacks and following us off the ferry, hounding us the whole walk in. I must say, that is perhaps my least favorite thing about traveling.

I still don’t know what caused it, but after a night at our new guesthouse, Daniel came down with a fever and some digestive problems. The fever was coming and going in waves, causing us great unease. And as you know if you’ve been anywhere with endemic malaria threat, one is supposed to treat any fever as malaria; travel health brochures are terrifying when you are slightly ill. We waited a bit, but since the fever was behaving erratically, and Daniel was feeling worse after a few days, we decided to go in for a test. At home, I know how to call 911. Abroad though, you’re suddenly aware that you haven’t any idea how emergency infrastructure works. What do you do if you get sick in the middle of the night, isolated by language barriers (real or imagined) and without a basic understanding of just about how long an ambulance takes, whether there is an ambulance at all, without a mom to call for advice?

We walked out in the direction we thought the health clinic was based on a magazine we had picked up at the ferry dock a few days back. Stone Town is a maze of little alleys and twists, corners and minarets and shops and cafes. Beautiful, sultry, and infuriating if you need to get someplace in a hurry. Lost, we asked a stranger, unasema Kiingereza? Do you speak English? He did, and we asked how far we were from the Mazrui Dispensary. He drew us a map in my planner, at the time agonizingly slow and meticulous (and ultimately very helpful and accurate) and I could feel Daniel starting to get a little sick and panicky beside me.

We walked to the clinic and Daniel was given a finger prick malaria test. As we waited in the lobby for the results, he fended off nausea, stood up as if to step out for a breath of air and, with his hand on the small of his back, very slowly collapsed, face and lips terrifyingly white. A nurse/pharmacist/aide (retrospectively, I’m not sure what sort of training she had), an elderly woman much smaller than Daniel or I, helped me drag him into one of three beds in the back room. The second toe on her bare right foot pointed straight up at my face as we dragged him, and for some reason that very clear image has persisted in my memory of that day. Daniel started to walk a bit and passed out again. When he came to in the little bed, the pharmacist lady put in a saline drip IV the color of Mountain Dew, filled his prescriptions, and sent me in to see the doctor.

The malaria test was negative, most likely Daniel was just severely dehydrated as a result of a stomach bug. On my way back into the back room, the pharmacist intercepted me: “Your bill will be 50,000 shillings,” she said, “but I’ll write 40,000.” Thanks, I said. “You give me the 10,000 shillings.” Oh. The numbers weren’t too bad. I didn’t do the math in my head at the time, but 50,000 TSH is about 30 USD, so the bribe/gift she asked for was about $6. Taken off the original bill. Whatever, just take good care of my boyfriend. Be careful with those needles, lady.

The drip was going pretty slowly, as they tend to do, but the pharmacist was ready for things to move a bit more quickly. She turned a knob on the tube, and things were moving along. Here’s something you might not know about me: I’m pretty paranoid. Here’s something you didn’t know about the IV drip: there was a little air bubble sitting in the tube, not going anywhere, but whose stationary presence I had been monitoring the whole time. All of a sudden, this bubble was quickly bumbling along down the tube, heading right for Daniel’s vein. Now, I might have seen too much CSI, but I imagined Daniel dying of an embolism right there and after frantically trying to alert the pharmacist with the crooked toe to the miniscule bubble’s velocity to no avail, I pulled the needle right out of Daniel’s arm. Crooked-toes yelled at me in shock, saline dribbled everywhere, Daniel stated he was feeling better, and we left.

We looked it up later and small air bubbles entering the body is apparently rather common, and usually doesn’t cause any trouble. Oh.

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2 thoughts on “On Being Sick in a Foreign Country, and How we Inadvertently Bribed a Tanzanian Pharmacist

  1. Small air bubbles in in IV tubing is very common. To hurt a person you would need to inject over 10 ML of air and that person would also need to have a small, but slightly common, hole in their heart called a PFO. About 30% of people have this hole and usually it never causes trouble. If you don’t have a PFO then the air will harmlessly travel from your blood to your lungs and get breathed out. No worries next time.

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