I am back in bed after 4 longs days on the road. Strange to travel 15 hours, crossing international borders, just to see a doctor who can give a thorough examination. We are so thankful to know what is happening in my body - it is so much better than all of the questions of uncertainty. My pelvis has several cracks in it - one of which could be operated on - but it is not recommended in pregnancy. So for now I rest. For now I try to manage the pain and heal. There are so many types of pain... the pain of my broken body being re-knitted together, the pain of not being able to do the work that I love - spending time with our 30 boys at Kwetu Faraja, the pain of not being able to hold my precious 14 month old Joseph Kitebha, the pain of not being able to cook for my family and care for them as a wife and mother....
Pain is manageable in the USA and many other countries, but in Africa it seems that people must learn to live with pain. There are very few medicines available. When Tylenol was just not cutting it, my husband Paul went to a chemist to ask about Hydrocodone.. "That drug is illegal! you wont find it in Tanzania" he was told. I am often amazed to think of how frightened Tanzanians are of pain medicine.
Imagine laying on your death bed - you have AIDS, untreatable cancer, or kidney failure (and there are no dialysis machines or kidney transplants). You are dying and you know that you are dying... and the pain is fierce. A little morphine would give you peace in your last days - except that morphine is illegal... so you are given Tylenol to ease the pain. The good painkillers are "addictive and dangerous" I am told. I have a Doctor friend from UK who comes each year to volunteer at one of the local hospitals to teach the doctors about palliative care. He tries to reason with the local doctors "if you are dying it doesn't matter that the pain medicine is addictive, the medicine is only dangerous if you don't know how to use it". So the first big battle of pain medicine is trying to find a way to teach Tanzanians how it can be beneficial - only then will it become available.
There are some good anti-inflammatory medicines - all of which are dangerous for developing fetuses. We finally found a good pain medicine, and it worked great until it ran out... we went back to the pharmacy for a refill and the adventures started once again.
The next complication of African medicine - Most available drugs on this continent are counterfeit, meaning they are made in some back ally someplace in China or India and they would NEVER pass the international standards. Most of these medicines are missing the active ingredients, some have poisons in them, but the bottom line is that they don't work. Fake medicine is a thriving international business - just Google "Counterfeit medicine and Africa" and you will get hundreds of pages coming from the World Health Organization, the UN, every news network imaginable... It is a HUGE problem, yet one that many people are unaware of. It is so nice to go to a pharmacy in Indiana and pick up a prescription knowing that it is going to heal you. Here, filling a prescription is like playing Russian Roulette.. it could heal you, it could kill you, or it could do nothing.
So here I am on my bed with 6 different brands of Tramadol (pain medicine) hoping that at least one of these will actually have the active ingredients so that I can have some relief. Once we find a brand that works we will stick with it! I have been without a "working pain medicine" for 4 days now - I guess we will either find one that works or I will just manage through the pain like the all of the other Africans.
I am reminded of what one of my boys said to me 6 years ago when faced with a devastating situation... the children's center where I worked had a huge fire that destroyed the dormitory. Standing in the ashes, water, and charred ruins I was so sad and shocked. One of the boys came to me and said "Mama it is okay to be sad for a little while, but then you have to choose to be happy. This is Africa, we are used to pain, we know all about pain... the pain will control you unless you decide to be happy."
Pain is manageable in the USA and many other countries, but in Africa it seems that people must learn to live with pain. There are very few medicines available. When Tylenol was just not cutting it, my husband Paul went to a chemist to ask about Hydrocodone.. "That drug is illegal! you wont find it in Tanzania" he was told. I am often amazed to think of how frightened Tanzanians are of pain medicine.
Imagine laying on your death bed - you have AIDS, untreatable cancer, or kidney failure (and there are no dialysis machines or kidney transplants). You are dying and you know that you are dying... and the pain is fierce. A little morphine would give you peace in your last days - except that morphine is illegal... so you are given Tylenol to ease the pain. The good painkillers are "addictive and dangerous" I am told. I have a Doctor friend from UK who comes each year to volunteer at one of the local hospitals to teach the doctors about palliative care. He tries to reason with the local doctors "if you are dying it doesn't matter that the pain medicine is addictive, the medicine is only dangerous if you don't know how to use it". So the first big battle of pain medicine is trying to find a way to teach Tanzanians how it can be beneficial - only then will it become available.
There are some good anti-inflammatory medicines - all of which are dangerous for developing fetuses. We finally found a good pain medicine, and it worked great until it ran out... we went back to the pharmacy for a refill and the adventures started once again.
The next complication of African medicine - Most available drugs on this continent are counterfeit, meaning they are made in some back ally someplace in China or India and they would NEVER pass the international standards. Most of these medicines are missing the active ingredients, some have poisons in them, but the bottom line is that they don't work. Fake medicine is a thriving international business - just Google "Counterfeit medicine and Africa" and you will get hundreds of pages coming from the World Health Organization, the UN, every news network imaginable... It is a HUGE problem, yet one that many people are unaware of. It is so nice to go to a pharmacy in Indiana and pick up a prescription knowing that it is going to heal you. Here, filling a prescription is like playing Russian Roulette.. it could heal you, it could kill you, or it could do nothing.
So here I am on my bed with 6 different brands of Tramadol (pain medicine) hoping that at least one of these will actually have the active ingredients so that I can have some relief. Once we find a brand that works we will stick with it! I have been without a "working pain medicine" for 4 days now - I guess we will either find one that works or I will just manage through the pain like the all of the other Africans.
I am reminded of what one of my boys said to me 6 years ago when faced with a devastating situation... the children's center where I worked had a huge fire that destroyed the dormitory. Standing in the ashes, water, and charred ruins I was so sad and shocked. One of the boys came to me and said "Mama it is okay to be sad for a little while, but then you have to choose to be happy. This is Africa, we are used to pain, we know all about pain... the pain will control you unless you decide to be happy."
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