Hospital Beds and Blue Cards

There is an effect in movies in which the camera moves from a small shot to give a glimpse of the larger picture, like in Gone with the Wind, when the camera moves from one hospital cot to several to many until all you see is white specks across the landscape. I experienced this effect last week, but instead of white cots, I was overwhelmed by blue cards. I will explain…

I returned to visit John, and was surprised to find a large crowd around his bed, one of the twelve beds in the C6 ward, on the sixth floor of the hospital tower. Visiting hours brings crowds of people to hospital rooms here, but John’s family lives a far distance away, so I was surprised by the number around his bed.

I was more surprised when I realized that it was not John that they were visiting, but a patient with a large head wound, in John’s bed—with him! Numerous other beds in the room were double booked as well.

After speaking with John and the charge nurse (in charge of the one other nurse on the hall of 70 or so patients), it became clear that the best course of action was to take John from the hospital, and bring him to the AIDS clinic on the third floor, which had already closed for the day (the problem with his leg was an effect of HIV). We hoped to take him home that evening, but after a couple hours of trying to locate his file (and being a general nuisance to everyone who worked in the hospital), it became obvious that I could not take him from the hospital until morning. I was as mad as could be, but didn’t know who to be mad at. I was confronted by a sin that is impersonal, a sin of inequality in this world that we live in, where pets can get health insurance in California, but Tanzanians can’t get their own hospital bed.

Anger is an easier emotion to hide than sadness. Returning to tell John that he would be stuck in the hospital another night, I felt the need to pretend like everything was alright, hiding the outrage that was largely borne out of my experience of something different, something much better, experiences unknown to people here. While I felt powerless, I hated saying goodbye to one feeling helpless.

I decided to rely upon the one resource I had left; the power of nuisance. I told the charge nurse that I was not able to leave until John had his own bed. It may not have worked for a Tanzanian, but I considered it a small victory that after a few hours in the hospital, John again had a bed of his own.

When I returned in the morning to settle his account, John gave me his blue card. This card is issued by the government to HIV patients, and helps to track their disease, their CD4 count, and their medications. The card also covers the cost of medical expenses; I saw that John was charged for the last night in the hospital, and I prepared to mount a grand resistance against this expense, only to find out that all the expenses were covered by his blue card.

On to the AIDS clinic (which has no sign), me and my friend, with three functioning legs between us. Here, there were a hundred or more people, each holding blue cards, present for their monthly blood check and medicine supply. These are the segment of the population that has overcome stigma and have been tested and have accepted the help available to them.

I was captivated and overwhelmed by the rooms full of people, by the doctors lined up behind tables consulting patients in rapid succession, by the assembly line blood testing center. And I couldn’t help but notice all of the blue cards, cards that would disappear again once the patients left the hospital, only to surface again the next month, the one obvious indicator of a disease that attacks in so many ways. Each person has their own story, their own complicated situation that contributed to contracting the disease.

Nursing mothers. Old men. Children. Prisoners. Older women. Professional looking people, people who are desperately poor. A demographic that shatters presuppositions, the only common factor being their common fate, and the blue card that no one wants to have.

More later on John and his family…

Be imitators of God

I leaned over to hear my friend’s words, words that took great energy to speak, as my friend lay ill in the hospital bed, words that took great effort for me to hear, as the other 11 patients in the small room all had numerous visitors. I got even closer, squatted down in the small gap between the bed and the wall, as he repeated the words of the missionary Paul: “Be imitators of God”.

We are in the middle of many adjustments here in Tanzania; it is as though we are having to relearn how to live. Water is different (not drinkable out of the tap, and sometimes not available from the tap). Shopping is harder. Cooking a simple meal can take several hours. Driving here (town and bush) requires complete attention and focus. And I have already disclosed the power situation.

Perhaps the biggest challenge is the loss of control we are experiencing. In America, many things aren’t as they should be, but if something is wrong, there is somebody to call, a change to be made, a complaint to be filed. And when things do not go as planned in America, our schedules and plans may be delayed, but here, our schedules and plans are often soundly defeated by the chaotic nature of Tanzanian life.

As was the case this weekend. John, a church leader here, sent word through a family member to our friend, Urbano, that his leg was in such pain he could not even walk, and he had been confined to bed for a week. Urbano borrowed a cell phone (in his village without electricity or phone lines) and called me, begging for help.

This weekend I was planning on going to a leadership training meeting, a meeting to work through issues of conflict resolution, grace vs. legalism, what it means to be a church, etc.. I wanted to be there, wanted to contribute my opinions, wanted to spend this time with the other missionaries and the leaders emerging in the church movement here. But my plans had to change.

Helping people here rarely requires great financial sacrifice, but usually requires a great amount of time. Getting John to the hospital consumed two days of time, lots of driving, getting lost in people’s cassava fields, lots of waiting. This began on Friday. It is now Wednesday, and the hospital still hasn’t examined John (the hospital is running on generators, so diagnostic tests like X-rays are greatly hindered). So I return daily, checking on him, bringing food and drink, despising the hospital, but enjoying John’s company.

John is in an advanced stage of AIDS, so it is hard to know what is going on. This could be a simple leg injury, or it could be one of the myriad ways in which HIV cripples and kills people here. So his words are even more significant, even more reflective, almost prophetic.

I squatted down at his side out of convenience, lowering myself to hear his words. “Be imitators of God,” he repeated. I yearned to hear his words, his stories, and his heart, and I found great personal clarity. I am called to imitate a God who chooses love over control, who defines greatness by service, and who humbles himself, not out of convenience or necessity, but as an outflow of his endless compassion.

Be imitators of God. A scripture now impossible to forget.

Odds and Ends:

--We have had a few people write about our friend Ruth. She is doing well, recovering from her surgery. We have been able to provide for her medicine, and will do our best to make sure that she is able to continue to receive this medicine. Thank you for all who have offered to help; you have encouraged us greatly!!!

--We are completely confused about the power situation here. Apparently, the hydroelectric dams have ceased operating, and for a short while we were cut off from the national power grid, but an airplane landed in the capital city with phony electrical generators, and our power is back to how it has been; the lights come on at 7:00 pm, and turn off around 6 am.

--Unfortunately, the water situation here is degrading too. The lake level has dropped below the main intake for the city water supply. So our part of town has water during the night time hours only… thankfully, our water tank gets us through, and we don’t do baths or laundry during the day anyways, because of earlier mentioned power situation.

--The mangoes are back in season, and the pineapple. This makes us happy.

--Our housing project has us missing Home Depot.

--We are still learning language, trying to catch up to Josiah, who is getting proficient at telling people what to do in Swahili. I think he aspires to do this in every language.

--While eating out at the nicest restaurant in town ($5 a plate), we overheard a wedding reception next door. The DJ was playing such wedding favorites as Phil Collins “Another Day in Paradise” and Wham’s “Guilty Feet”. Almost as funny as my barber singing along to the Indian version of “Karma Chameleon”.

--I was delayed going to language class the other day when the sliding door fell off the minibus I was waiting to board. This is an acceptable excuse here.

--Killed two snakes last week. And a thousand-watt transformer.

--Myth-buster: while some things are cheaper here, most things are actually more expensive, especially when you have to replace everything because it is low quality and breaks easily. A cold coke for a quarter, however, does make a stifling hot day a little nicer.

--Good news: We have moved into a short-term house down the street from our housing project, so we now have room for the boxes and items we shipped from America. I am enjoying getting my books back (coffee and a good book helps with culture stress!) and Charity is unpacking her kitchen stuff. Josiah has his tools. And Elijah has cardboard to chew on, unless he is…

--walking! Taking four or five steps. Then he dances away. Especially if he sees a banana, which are always in season here!