Oops

I recommended listening to “It Happens” by Sugarland for this next post:

I broke my leg this week. I wish I could tell you this epic story of how I gripped onto the edge of Kilimanjaro's volcanic peak before plummeting into oblivion. The less exciting truth is that I slipped on some water in the dining room. I've been walking for a good 22 years at this point, but I guess I'm still perfecting that skill.

After completing my dauntless journey last week, I'd say this was the best timing I could've ever had.

That doesn't make this type of injury any easier though. Africa is a tough place to fall apart. When it first happened, I was at home with only my new maid, Veronica, and her 3 year old daughter, Upendo. Neither of these ladies speak a single word of English. As I lay sprawled out and crying on the floor, Upendo walked in and stared blankly. Then she started laughing because she thought I was playing a game, and she wanted to play too! Trying to explain this was a bit of a challenge.

After a short while, I composed myself, texted the other study abroad girls, and called Baba. Within minutes, people were flooding into my house and making horrified looks at my swollen, discolored ankle. I felt like the side show act at the circus. Not to worry, this circus freak was soon to be on her way to the best medical facility in all of Tanzania, Aga Khan. Following in this series of comedic failures, the guarantee of payment from my health insurance was not accepted, so I had to pay each necessary step out of pocket. Actually, my friend Hali had to act as a money runner before each step could be completed. You want to see a doctor? Go to the reception and make a payment. You need an X-Ray? Go to the reception and make another payment. You need a cast? We can't do that until you make another payment! This worked wonderfully until I ran out of cash... but I'll get to that later.

This is no ordinary cast. It's called Plaster of Paris (POP), and I found out that the US stopped using this method years ago. The first notable problem is the lack of color. For my very first cast, I was hoping to rock a nice shade of purple... not this icky beige thing. I suppose that should be the least of my worries. Something went horribly wrong during the process because the POP was eating my flesh alive inside this cast. They soak the fabric in warm water before applying it to the cotton layer surrounding the injury. This incites a chemical reaction, releasing heat, and hardening the cast in a mold of the leg. They quickly wrap it up in gauze to keep everything together. About 30 seconds after encasing my leg in an oven, I was desperately crying in pain. The doctors laughed and said it should get cooler in about 10 minutes. That was about to be the longest 10 minutes of my life—scratch that—the longest 10 hours of my life. The pain never subsided. I didn't even care that I fractured my tibia; my biggest concern was the skin of my heel that was sizzling inside this insulated tomb. Once the doctors recognized that I wasn't appreciating their laughter, they attempted to position me near a ceiling fan in order to cool the cast. Then they said I could pick up crutches at the reception once I make another payment. Too bad I ran out of cash on the last payment. They informed me of an ATM machine near the entrance of the hospital. Hali struggled to push my broken wheelchair around the maze of pebbled walkways as tears continued to stream down my face. Tanzania hasn't figured out drive-up ATMs yet, so I had to hop a good 20 feet over uneven surfaces only to find out that this machine doesn't accept Mastercard. (Mom—why couldn't you work for VISA?!). This was only after I stood outside the doors for 15 minutes while two men had a meeting inside the ATM room, pretending to make a transaction. So Baba pulled the car nearby, and we set out for another machine. After driving a few miles, this time I got to hop up an intimidating curb as security guards giggled and expressed their sympathies.

Back to the hospital. I parked myself at a seat in the waiting room while Hali ran around to the reception. Where did the receptionist go? I guess we didn't get the memo that they were now fumigating the office. They wouldn't be able to attain the crutches or issue a receipt. Please come back in the morning.

The entire ride home was in silence, broken only by my occasional whimpers. Baba made it clear that he was unable to bring me back to the hospital in the morning because he had rushed home from work today to help me. My hero, Amani, came to the rescue by offering a ride on his way to work the next day. SCORE! That option sounded infinitely better than transferring dalla dallas at the crowded bus stop.

That night I couldn't fall asleep. There wasn't a single position of comfort because my heel still felt like it was on fire! I was so tempted to cut off this death trap. Nothing would ease or distract me from the pain. I even called my mommy crying. Am I 8 years old?! In general, I tend to see the bright side, but this whole scenario was such a disaster. I counted down the hours until I could return to the hospital.

My brother dropped me off at the front desk... although no receptionist could be found. So I hopped about 100 exhausting meters around a bend to a different kiosk. This receptionist instantly told me I was in the wrong place and must return to the front desk. Ignoring my pleas for a wheelchair, she pointed back in the direction I came from and said to wait until someone arrived at the desk. By the time I returned, a woman was managing the reception. I explained that I needed to see a doctor about the painful cast, and requested a wheelchair because I still didn't have crutches. She said “Oh this is an emergency! You need to go to the emergency department!” Thank you for being the first person to understand the gravity of my situation, but do you really want me to hop around to the emergency department? Of course you do... She said the only way to obtain a wheelchair was by going to the emergency department.

I single-leggedly hopped another 200 meters to the emergency department, taking at least four quick breaks along the way. Each bounce shook up the bones and scratched up the damaged skin inside my cast, causing excruciating pain. By the time the emergency kiosk was in view, my eyes were overflowing with tears and my face was beat red from pain and exhaustion. It must've been an awfully frightening sight. Suddenly everyone wanted to help me! One man wearing an official-looking outfit pushed a few other nurses and spectators aside and commanded respect. He insisted that someone from the cleaning staff run for a wheelchair. He asked me several questions about the timing of the incident, steps taken to heal the fracture, and what my chief complaint was at this moment. It turns out he was just an intrigued person who saw me from the waiting room—not a real doctor. Thanks for your concern, buddy, but why are you so curious about my medical information? And where is a real doctor?!

I think they all felt bad because I was clearly distraught. I skipped over the reception altogether and they wheeled me into a room. The same nurse was there from last night! He explained that he has seen this extremely painful burning reaction only one time in the past. It is rare, but possible. The doctor arrived to discuss the situation. He explained that they could remove the cast to inspect the damage, but then they would have to put another one right back on. Good idea, doc. Let's light up my previously damaged, super-heated skin to another 120 degrees. That'll make it feel much better. I asked if they have any alternatives to the POP for joint immobilization. His response was “Not in this part of the world.” Oh, Africa. After prescribing some painkillers and retrieving some crutches, he sent me on my way.

Now the tricky part... how do I get home? The only option seemed to be a taxi. This leads to another problem—white girl on crutches—easiest scamming target they've probably ever seen. They knew I would never make it all the way to the bus route, so they all demanded the same exorbitant price to get me back across town. I can't really complain about this though... even though it was more than twice the price anyone else would ever be charged, it only came to about $10.

Although the pain has reduced significantly in the past couple days, getting around the city has continued to be a major challenge. Tanzania is hardly equipped with any handicapped accessible areas. Many stairways don't even have railings! These are such common luxuries back home that I never noticed until I really needed them. For the few times I have attempted to take a dalla dalla, I have only been offered the front seat once. The other times I am forced to quickly and carefully jump up the 2 foot gap into the over-crowded back seating area.

As much as I'd like to consider this an emergency, there are far worse cases that come through the hospital each day. I am so confused about the payment system. Do they really refuse treatment until each successive payment is made? What if I was having heart complications or some other life-threatening condition? I think the hospital does not allow any care until the entire cost is guaranteed to be covered.

I soldiered on through the next few days and returned to the hospital with my friend Pam this morning (Friday) for reevaluation. My biggest fear was that they were going to remove the cast and need to create another mold. I immediately told my doctor that my greater concern was the irritated skin, and if he removed the cast, I wasn't sure I could handle the pain from another one. He said that he needed to see the progress that my leg was making, and would make a decision thereafter.

I held my breath as he unveiled my swollen, blue-tinted ankle. I prayed for a miraculous recovery and no need for further medical attention. Wishful thinking. He said it was badly swollen and I needed 3-5 days of bedrest. He recommended only leaving a horizontal position to use the washroom. I explained that all the Fairfield students, including myself, are leaving tomorrow for safari in Arusha. He was not supportive of this idea because there is at least an 8 hour bus ride involved each way, plus sitting upright in a safari vehicle for most of every day. He said the only way he would allow this trip was for me to promise to keep my foot elevated at all times. This complicates things, but I'll do my best.

Then he glanced at the black splotch on the back of my heel. No wonder I was in so much pain!

I had suffered 2^nd and 3^rd degree burns from the POP. He inspected the cast and noticed that the inner lining had moved during the process of administering the POP and the gypsum was directly touching my skin. At least the mystery had been solved. The doctor agreed that applying another POP would do far more harm than good at this point. He wrapped my frail leg in gauze and sent me on my way. Keep it dry and clean. If anything changes, get to a hospital immediately.

To top off a satisfying morning, Pam and I stopped for some ice cream on the way home.