A free health check at a local church had resulted in one of the orphanage staff being given a referral to the public hospital for a blood sugar test. As it was to be done on an empty stomach, the staff member had abstained from breakfast and was already hungry when we set off in a taxi around 11am.
The health clinic turned out to be a set of rather rundown buildings swarming with people. We shuffled past a long queue of patients seated along a veranda, opened a flyscreen door and showed the referral form to the nurse. “Come back tomorrow,” she said. “We do those tests at 7am.”
The next day I got up in the dark, so that I could be at the orphanage in time, and once again we set off in a taxi. We arrived at the hospital just after 7am, joined the queue on the veranda and waited. The medical staff didn’t arrive until about 8am, by which time the row of patients had all shared a good deal of grumbling about the wait.
The nurse collected everybody’s referral form and began calling out names. When my companion’s name was called we went in eagerly, but it seemed we were only there to pay the 3 Cedis fee. We returned to the queue until her name was called again – this time to collect the change. After another wait of thirty minutes or so, my companion was called in for a finger prick blood test. I saw from the LED display that her blood sugar was 13.4 – higher than normal.
From here my companion was sent to another building to purchase a hospital records book, into which her details would be written. This required another wait in a queue, this time inside a hot building where the ceiling fans hung dormant above us. The queue of hot sweaty bodies, including women with babies strapped to their backs, stretched across four rows of seats. People joined the line at the back and each time a patient was seen, everybody got up and shifted one seat along. I sat next to a man with a wounded foot, who thankfully was not offended when I asked if I could photograph his crutch. Eventually my companion had her blood pressure taken and was sent away to wait again. By this stage she was starving, so we went to a local cafe, where she ate a hearty bowl of fufu.
Fufu looks like a large dumpling, served sitting in a bowl of soup. It’s made of pounded plantain and cassava and has a sticky consistency, a bit like glue. It is eaten with the fingers. To take a bite, you use your first and middle fingers like scissors to cut off a portion, then roll it into a small ball, make an indent in it, dip it into the soup and swallow, without chewing. If you try chewing, you find that nothing much happens – it stays stuck together in your mouth until you give up and swallow anyway. The higher the proportion of plantain, the better the quality, as plantain has iron and other nutrients, whereas cassava is plain starch with no nutritional value.
Then it was back to the queue for an hour and a half wait to see the doctor. The doctor welcomed me and spoke in English, so that I could be part of the conversation. He gave a thorough and easy to understand explanation of what diabetes is, and advice about how to manage it. “No sweets, and no cassava!” he said. “Sorry, no more fufu.” He explained how starch is converted straight into glucose in the body, and that meat, fish and vegetables were preferable to yams, cassava, maize, rice or even plantain. The problem is, the African diet consists mainly of yams, cassava, maize and rice. Meat, fish and vegetables are generally served in tiny quantities as a garnish to flavour the starch. My companion assured us she could change her diet but I had my doubts.
Then there was a queue for the dispensary, which involved handing in the prescription, then waiting in another queue to pay the fee for the drugs, then back to collect the drugs, and then on to the pharmacy for the same performance again. By the time we had all the medication, the whole trip had taken six hours. When we got back to the orphanage, my companion celebrated with a hearty dish of banku (maize dumpling served with a fish sauce).