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…