Adventures in the Ethiopian healthcare system

The beginning of the rainy season is upon us, and that means mud, power outages, and water shortages. Right now every day starts out sunny and brisk (~55 F) with temperatures rising to a glorious ~75 F by midday, followed by a sudden drop in temperature to ~55 F as the rain moves in around 3pm. Much to our displeasure, it behooves us to get up early and do the majority of our work before lunchtime (12:30pm – 2pm) so we can make it back to the house warm and dry.

Internet is harder to come by in Ambo these days as network failures and power outages become more commonplace. We were told that water shortages will also occur regularly as the mud caused by the rain infiltrates and clogs the water lines, resulting in a shutdown as workers address the clogged pipes. Two weeks ago we experienced our first water shortage, an all-around humbling experience and a great reminder that water quantity, not just quality, is of paramount importance for sanitation, hygiene, and overall health. We supplemented bottled water from neighborhood suuks (kiosks/bodegas) with harvested rainwater from out gutters (to flush the toilets) and jerry cans of tap water from our neighbors (to clean our dishes and prepare food), but in the end it wasn’t enough to prevent Emily from contracting [what she knows from personal experience to be] giardia, Ani from getting a stomach bug, and me from coming down with a mystery illness. With 3 out of 6 people sick in a house without running water, our bathroom quickly turned into a public health nightmare with hand sanitizer as our only defense between the toilet seat and our food.

During my second episode of the recurring fever with a temperature of 103 F, I decided to go back to Addis with Emily and Lisa so I could recover in a place with running water. As I booked my flight to Kenya for the following week (due to my expiring visa) and with no time to see if the recurring fever would stop on its own, Lisa, who grew up in Addis, offered to take me to the local hospital to get checked out. The Korean Hospital is certainly one of the nicer hospitals in Addis, though everything is relative as their bathrooms were worse than our bathroom in Ambo. To have a consultation with a doctor, I paid 200 ETB (10 USD) and was admitted to the emergency room. The doctor (whom Lisa said was likely a med student or recent graduate), determined I needed a blood test, urinalysis, chest x-ray, and EKG. 2100 ETB (~100 USD, which we paid my pooling our money together because I never carry that much on my person at one time) and 5 hours later, it was concluded that I was fine. All my tests checked out and by that time my fever subsided and I felt much better, so we called it a day and went home to rest after a long day of travel and hospital visits.

48 hours later (Saturday) my fever returned, right on time. With my flight to Kenya on Monday and little faith in the public hospitals in Addis, I decided it was time to visit a private clinic. I found a newly opened, 24-hour clinic affiliated with the Norwegian Hospital that accepted walk-in patients, so 5 of us packed into Biruh’s car (another Emory student whose family lives in Addis) and went on our second medical adventure. The Viking Clinic is located in an upscale neighborhood in a spacious house that was converted into a medical facility. This time I paid 2700 ETB (135 USD) for a consultation with a Norwegian doctor, whom I trusted fully, and rested in a private room under a down comforter as the same tests performed previously were rerun. Although we were convinced I had malaria (recurring fevers 48 hours apart are a telltale sign), all of my blood work, urinalysis, and EKG results were normal and only slightly hinted at a bacterial infection. 7350 ETB (~370 USD) and 4 hours later, I was diagnosed with an upper respiratory tract infection [or the flu] and prescribed some antibiotics and fever reducer, which we picked up at a pharmacy on the way home for 300 ETB (15 USD).

With less than 48 hours to go before my flight, I started taking my antibiotics and drank plenty of water. Besides a miserable vacation in Kenya, I was mostly concerned that I would not be allowed to enter the country as my fever was scheduled to return on the day of my flight and African airports continue to strictly monitor travelers’ temperatures as the ebola outbreak continues in West Africa (yes, that’s still happening). Spoiler alert: my fever has not returned since I started taking antibiotics and I successfully made it into Kenya. In the end, it seems I had an infection after all and the antibiotics did the trick. Thanks, Norwegian doctor!

Looking back, I find myself thankful for the healthcare (and insurance) I am afforded in the US and reminded that plentiful, clean water is not something to take for granted. While the quality of healthcare in the US is comparable to the Norwegian clinic I visited, a doctor’s visit and prescription antibiotics would have cost significantly more in the US without health insurance. Even as Ethiopia’s economy struggles to keep up with the rest of the world, the benefit of government-subsidized medicine is not lost upon them. Just as important, access to plentiful, clean water is essential for proper sanitation, hygiene, and good health. The importance of water quality is obvious to most, though the importance of water quantity is often overlooked, especially in America where waste is the name of the game. I am reminded of the drought in California and cannot help but think that many people are in for a rude awakening if water usage habits are not addressed in the near future.