I’m not one for exercise. Never have been. Unfortunately, I had an exercise that I had been delaying for FAR too long that I could no longer I avoid. I needed to go jogging off to a public hospital / clinic in order to fill my script, perhaps do a couple of psychiatric push ups, and leave with pills and mental health in hand. Great. Except that I live in South Africa and the public health systems just doesn’t work that way. No. Our public health system serves one of two purposes: 1) Either you decide you would rather NOT go (like me) and possibly die from your condition and therefore contribute meaningfully to population control or 2) that it serves as a beautiful advertisement for private healthcare, which if you cannot afford it, you’d sell your soul to the devil to attain. Let me explain.
On arrival at the hospital, I met a security guard who asked whether I had an appoinment or a referral letter (looking me up and down). Initially I was startled, thinking to myself that I was not aware that security guard training now included health assessments as well. Because as far as I know, in pretty much any country, you should not be turned away at the door, particularly by someone who does not have the capacity to assess how well you are, particularly when like me, you have a “I can’t see it” condition. Whipping out my referral, I passed the first hurdle and whispered a quiet prayer of thanks whilst dropping the contents out of my bag at the entrance because of the nervousness the security guard had instilled. If I left without my medication from this visit, I would have none left. no money to buy more, and quickly deteriorating mental health that no-one, especially me, would want to see or experience.
The next hurdle was actually finding casualty which one would have to go through in order to access mental health services. I found the triage, and immediately asked the first available nurse what I should do and where I should sit. Most people in South Africa know and plan to spend the whole day in a public health facility, because of the waiting times, no matter how urgent your case may be. One such example was a women who was clearly in severe pain and she could not sit and wait. But she was made to. She was made to walk a too far distance for someone who loudly winced with each step that she took and then she needed to wait again. On talking to the nurse she took a full ten minutes to explain to me, whilst rubbing my arm gently as I explained I required mental health services, that I was at the wrong hospital and needed to go somewhere else. I told her I was not leaving and would go to other hospital on another day, but not today, and that I needed my medication. She frowned, stopped the I didn’t want her to rubbing and barked where I should sit. Great.
After waiting for hours, my blood pressure was taken, and I was asked to take a pregnancy test. I said listen if I WAS pregnant then there’s a few things: the baby is high on an extensive amount of psychiatric drugs, it was conceived via immaculate conception (I am FAST asleep thanks to said drugs way before sex time) and like the only thing I’d like to be erect about is attaining my medication. Then I was asked to wait AGAIN. So you will understand that at this point my humour – and anything else – is beginning to fail me. Finally I was allowed to see a GP (perhaps to check fantom baby’s progess since they aren’t in the habit of dispensing serious psych drugs?) and they read my referral letter out loud (in a room with a patient sitting next to me at the same desk with another GP), with furrowing eyebrows with each disorder my previously private psychiatrist had outlined. I was so “happy” about this group consultation, exploring how um, disordered I am. Even the patient next to me looked at me with those eyes wide you have a serious mental illness look.
Thinking that this was the last leg, I almost collapsed when they said I needed to open a file and then come back. Seeing my about to collapse-ness, the Doctor assured me that I just needed to come back to her, and we’d be off to get the meds, and to make an appointment with the psych ward for further, I dunno, waiting. On way to open the file, she had noted on my triage form that I wasn’t acutely psychotic. Now, if someone can explain that to me, I would be very happy. Does this mean I was um, like ok psychotic? In any event, I got the file, and went back to Doctor, convincing my chest that was caving that it was ok, and that we were at the end. Oh how wrong I was. The Doctor had disappeared and the tears started. I couldn’t help it. I just couldn’t bare waiting, for people to be telling the entire room how disordered I was, for being turned away, for not being sure of whether I would get my medication. So I cried. I cried for all the patients that were treated like this – cattle in the care of casualty – where one would think the most pressing patients would be dealt with – with care, with kindness – as is required regardless of the pain the patient feels.
I believe that healthworkers who do not put the health of their patients first should be barred, that hospitals who turn patients away should be investigated, where the process of putting health first should always be prioritised – and that the patient’s experience of these processes should make them feel better not worse. I am angry because it is ok for people to be treated terribly, for patients to be turned away, and for politicians to spend unbeknowsnst amounts of money on election campaigns that DO NOTHING to change people’s lives. That gets more patients seen, more treatment regimes started, more health facilities functioning. I am tired. I do no want this to be the reality of South African people with any kind of illness anymore. Stand with us. Be part of those who support us as opposed to those who don’t. I am 4 M’s Bipolar Mom.