Wednesday, October 13, 2010
Welcome to my looney bin...
This is were I go to receive psychiatric care. Tygerberg Hospital in Belville (just outside of Cape Town), South Africa. I also see neurology for my BIH, have all my lumbar punctures (or spinal taps) done in this hospital and all my government funded meds come from there. What do you think?...does it have a nice aesthetic feel to it??.
Before I start, I want to say very clearly that I am GRATEFUL for the medical care I receive. I am not on medical aid and therefore rely on the state. It isn't fancy or comfortable and sometimes it's very basic. But I would not be breathing right now if it wasn't for this place. And considering how medical care (or lack of) is on the rest of the African continent and even in different provinces of South Africa, I have been lucky.
Believe it or not some of South Africa's state hospitals are famous. Just down the road from Tygerberg is Groote Schuur hospital where Dr Christiaan Barnard performed the first human heart transplant operation in 1967. Chris Hani Baragwanath Hospital in Johannesburg is the world's largest hospital. Tygerberg was commissioned in 1972 as a teaching hospital for Stellenbosch University. When it was first built it was a world- renowned "state of the art" facility. Unfortunately what was "state of the art" back then is considered to be ancient now and Tygerbery- because of lack of funding- has failed to keep up with the times.
I hope the pictures do justice on how incredibly MASSIVE this place is. Connected behind the building shown in the photo above is another building, it's twin and just as massive. This place has it's own post office, bank and water supply. I will never forget how overwhelmed and terrified I was the first time I came here.
Three of the most well known characteristics of Tygerberg is 1) You WILL get lost, no matter how many times you go there 2) The number of DOORS you will find- there are hundreds of them in each passage and I have no idea what's behind them as they are always locked. And 3) The loooooooong passages.
This is passage I have to walk down get to the outpatient's. I'm estimating it is about 1.5km (almost a mile) long. By the time I get to the end of it I feel slightly more depressed than when I started it. I always wonder about the inconsiderate fool that designed a hospital with passages this long. We have seen people people on BICYCLES riding down here.
On my way to outpatients I pass the lovely, homely looking psychiatric ward. They were in the process of moving when I took this photo, normally the doors are enclosed in big black buzzer gates where you have to identify yourself through an intercom. The police man both the inpatient and outpatient ward. I have gotten to know most of them, they are wonderful gentlemen and very respectful but if you get even slightly fidgety they will start gravitating in your direction.
The both the outpatient and inpatient ward are located on the lower ground. Yep they shoved us underground out of the way and where no one can see us. And you go down that passage and there is a distinct "hush". I feel like I am entering a secret society.
SA State care works on a first come, first serve basis. Basically I make an appointment for a specific date, but your appointment can take place anytime during the morning depending on when the psychiatrist finishes his/her ward rounds. I have to roll my ass out of bed at the crack of dawn to be at the hospital by 8am ( I live over an hour away from the hospital) for when they open at 9am to give them my folder and get in the que. Then between 9am- 11am all the patients eyeball each other ( "it's not what you think! I'm here with my 'friend' ") until the psychiatrists get back from their ward rounds and see the outpatients.
The majority of state health care in South Africa in provided by med students doing their specialty or residency. The same is true for Psychiatry. I have often found myself sitting in the hallway looking warily at some of these students and hoping to hell that they did their homework instead of going out drinking the night before.
You cannot choose who you see, a psychiatrist is assigned to you. If you don't like them I guess you could complain but the general consensus is 'beggars can't be choosers'. I can honestly say that I have been lucky in the two psychiatrists I've had. The first, Dr Dunnit was a young girl just a couple of years older than me. She was soft spoken and very caring and I honestly felt she had a true passion for what she did. Her knowledge was boundless and she was more focused on self- help than doping me up with meds, although she did increase my meds. Because these student are on a rotation basis you'll have them for about a year before you'll get a knew one. My second psychiatrist was a slightly older women who was is very positive. I was pissed off the first time I saw her though because she refused to give me sedatives!. But I guess it was for the best.
There are four state psychiatric hospitals around the Cape Town area. The most famous of which is Valkenberg. We used to make jokes about this place at school -"Dude you're so dumb you should go to Valkenberg! haha!. Whatever. I'm not laughing now. There is still a chance that I may have to be admitted to hospital and since I don't actually live in the catchment area for Tygerberg I will land up at one of these four hospitals. I have heard some hair raising stories about Valkenberg. A girl from college used to live right next to the infamous "Ward 20" - the maximum security ward- and she told us stories about how they would take patients from building to building in steel cages.
Anyone who has visited that hospital will need one of these when they are done.
South Africa's private health care is top notch- rivalling some clinics in Europe and the States but you will need the magic medical aid card to gain access. Because I am unemployed at the moment all my health care and medicine is free. In most cases and depending what province you live in the doctors and specialists take good care of you. But our hospitals and resources are falling apart due to lack of funding. No doubt the sudden explosion of AIDS in the last 30 years has put a lot of pressure on the government. But I do get angry when I read newspaper articles about our defence force writing off R1-billion (about $147 million) in "unexplained expenditure". THAT could have fed every hungry person in South Africa for a year ( I kid you not) or built several new hospitals OR provide the best care to the estimated 4.5 million South Africans living with HIV.