Why are we afraid of snakes?

Snakes are nothing; they tend to be more afraid of us than we are of them and slither off into the grass. Now ticks and mosquitoes, they seek you out to suck your blood. I have a new respect for these vectors. The advantages of doing battle with a tick have been an ability to have a different insight into healthcare delivery in Swaziland, lots of time to read, and being pampered at Gloria’s B&B. The disadvantages have been a never-ending headache, extreme fatigue and a longing for the efficiency and effectiveness of American Healthcare.

To those prone to worry--never fear; if I had been acutely ill, I would have been whisked to Pretoria, South Africa and received 21st Century healthcare immediately. I was not acutely ill but neither did I have the classic tick fever characteristics (except for the bite), so I ended up in 1990 Healthcare. Previous blogs have described the 1940’s healthcare provided at the local regional hospital, that is, inadequate staff, dark, poorly ventilated wards, peeling paint and few supplies. Imagine my surprise when I was taken to Mbabane private clinic and stepped into the 1990’s. Clean white walls, private exam rooms, call bells, side rails that worked and even a digital BP machine. The physician was so/so. He did lab work that showed I was in perfect health but had no idea why I was sick. Swaziland tends to attract 3 types of physicians; the marginal, the altruistic, and a combination of the two.

Okay, so let’s leap to the 21st Century. History and lab work are sent to a tropical disease specialist in Washington, D.C. and a neurologist in South Africa. A trip to Pretoria is scheduled for specialty consults, head CAT scan and a lumbar puncture (no way!). Sound like 21st Century? Saved, just as we were to hit the road, by a rickettsia test that finally came back (took many days as it had to go to SA). I managed to get bit by a particularly nasty tick. Washington and SA consult again and decide that I have been undertreated. I get better on longer treatment and come home to a husband that has had enough of being a bachelor in Africa.

So what three things did I learn from this experience? Dummy, wear long pants and insect repellant when walking in rural Swaziland! Number two, the gulf between healthcare provided to the majority of Swazis and those that have money is as big as an ocean, or at least 50 years of medical improvements. And perhaps most important, I have come to believe that decent, available healthcare for the majority of the population must be a top priority for any country that wants to develop and prosper. Tick fever is endemic to Swaziland but most don’t get treated and so deal with the sequelae of chronic fatigue and joint pain. Of course, Tick fever is nothing compared to AIDS, TB, Malaria, water-borne diseases etc, etc. How can a country prosper if people are too sick to be productive or educate themselves?