I had two rather interesting interactions this weekend. Seemingly unrelated, but intertwined in my mind all the same.
I had a conversation with a doctor, and my question to him was a simple one: in the first 35 or so years of my life, my blood had been drawn less than ten times. In most of those, it was when we were growing up in Maseno, and malaria bouts necessitated testing for the plasmodium falciparum parasite. The other three were in 1998, when I donated blood after the bomb blast, and when I needed to get full medicals on starting a new job. Now, blood is drawn at every hospital or clinical visit. Even for a minor headache (true story) the first course of action is lab work, involving blood tests. Worst is when my children are ill. The poor babies are in full sufferation mode, and it's made far, far worse by the insistence on finding a vein, poking in a massive needle, and drawing blood for analysis in the lab. In those days in Maseno, with far less advanced technology, all the blood needed was drawn using a prick on my fingertip. Now, however, only a vein will do. Once, when one of the children was ill, I simply refused for the medical officers to draw blood from a vein (the girl was simply too ill and in too much pain). The second time, because of a bout of diarrhoea, the nurse couldn't find a viable vein, and inserted the needle into my son and started hunting for a vein that way. I almost punched her, and told them blood wouldn't be drawn that way, or that day.
I thought I was being paranoid, or simply a kichwa ngumu parent/ patient, until the conversation this weekend. The doctor, to whom I'm eternally grateful, told me I was actually on the right track. He agreed that there were too many lab tests being ordered nowadays, which are uncomfortable, expensive and time-consuming. In his opinion, the sudden explosion in the number of medical labs has led doctors to reach for this short cut. It does lead to more accurate diagnoses, but at the cost of, well, far more money and far more time spent at medical centres. He called it the Americanisation of Kenyan medicine, and, unfortunately, we will soon be paying American rates for even simple medical care. Soon, you won't be able to afford a hospital or clinic visit without medical 'insurance', which in itself leads to its own vicious cost spiral.
What surprised me, though, was one of his conclusions. The doctors-from-the-country-that-shall-remain-unnamed may actually help with the salvation of Kenyan medicine. Because the-country-that-shall-remain-unnamed has had to develop its medicine under sanctions, and thus far less money and equipment, the doctors from there are far better at clinical diagnosis, i.e. diagnoses from observing and listening to the patient. Language barriers and political issues notwithstanding, these Cub-sorry - these doctors-from-the-country-that-shall-remain-unnamed may in the long run, save us from ourselves.
The other encounter was a far simpler one, involving a much shorter conversation. I walked into a shop, wanting to purchase a mobile phone. I saw one that piqued my interest, and asked the shop attendant to take it out of the display case. I then asked her to switch it on, at which point she refused: 'we only switch on phones at the point of purchase'. Now, mobile phones nowadays all look the same. Smartphones are all oblong boxes with an all-glass front. The only difference between a 150,000 bob all-singing, all-dancing iPhone 20 and a cheap Chinese no-brand unit with a Geiger counter that costs 5,000 bob is how the phone actually performs. And the most perfunctory way of witnessing that is to actually switch it on and observe it. But no. This shop attendant was under strict instructions - do NOT switch on mobile phones unless the customer has actually handed over cash. Most people, after all (I assume that conversation went) are here to waste our time. So, off I went. Money still intact in my pocket, phone unpurchased.
I'm not sure in my mind why those two incidents are connected. Is it because they happened on the same weekend and are thus stuck together? Or is it because both are saying the same thing - listen to your patient/ customer?
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