Scarlet drops of blood…

…fall on the counter near me, and are hastily mopped up by a blue and white checkered rag.  I look up as the man brings the rag back to the gash above his eye.

“I need stitches,” he says quietly, almost apologetically.

We are filling out admittance paperwork at Hopital Ibn Tofail, the public hospital of Marrakesh.  It is 1 pm.

Be assertive, but not too pushy or they won’t deal with you, I remind myself.  I stand up as tall as I can, try to give off an air of competence, of someone who is educated, of someone who is upper-middle class.  Someone who deserves, not special treatment, but treatment.

I am not here for myself, but for Aisha, a 70 year old berber woman.  Aisha has been having intense abdominal pain, fever and a sever headache.  She has barely eaten anything for the last 20 days.  Now she is moaning quietly in pain.

“All I can say is that she must absolutely be seen by a surgeon.  A surgeon must observe her over a period of 24 hours to see if she needs to operated on.  Go to the Hopital ibn Tofail, don’t let them send you away.  She must stay there!”  These were the directives given to us earlier by the private Dutch doctor.  So we are here, Aisha, her two grown children, and myself, at the Emergency Room.

Now I am looking for a wheel chair, because Aisha is too weak to walk unassisted.  A guy in blue scrubs offers me this: “Just look around and grab the first chair you see”.  So that’s what we do.

We walk past a row of 5 tiny rooms, each one with 2 patients, they are labeled, oddly enough, in English, Box 1 through Box 5.  We are admitted to the Salle de consultation.  The young doctor and I manage to hoist Aisha up on to a worn looking bed.  There are reddish drops on the floor.  The doctor starts to push on Aisha’s stomach, everywhere he touches, she yells with pain.

“Where did the pain start?” He asks.

“Everywhere hurts,” is all she can reply.  The pain seems to be stronger in the lower right quadrant, but it’s hard to tell.

I speak to the doctor quickly, in French medical terminology.  I suppose I’m trying to get him to one-up me, to impress me by showing me that he knows what he’s doing.  Please do your job.

Now another doctor is examining her, again he is pressing on her stomach, “How about here?” he asks.  “Kulshi kai darni” she says, everything hurts.

The doctors whisper to each other, does she have a temperature? …I don’t know, we don’t have a thermometer…send her for an ultrasound, we need a diagnosis. It’s now 2 p.m., I leave for work, with the promise that I will be back at 5.  As I’m leaving, a young man walks in, clutching his ribs as blood trickles down, a dazed smirk on his face.  Through his open shirt, 2 old scars, each over a foot long, slash across his torso .  Thanks drunk guy who got in a fight, for using up what little resources we have.

(a photo of the hospital that I got from their website.  I was not in photography mode for sure)

When I return at 5 Aisha still has not had the ultrasound.  She also has not eaten anything since 6 a.m., since she left her bled in Tamellalt, an hour outside of town.  She has no appetite and will only eat semolina porridge, which we don’t happen to have.  Yet she is so incredibly patient.  She continues to  moan quietly as the spasms of pain come and go.

The man who needed stitches got them, but without anesthetic.  The hospital does not provide it, and he could not afford to buy it.

The doctors wander around aimlessly, they don’t seem to have a very clear procedure, I try to catch their eye again, by looking somewhat important.  The skinny foreign doctor who is now with us calls in a female doctor.  “We can’t keep seeing the same patients twice!” she snaps at him, “Take her to get the ultrasound”. Thank you, you’re competent!

Finally one of the top doctors addresses me.

“What do you need?”

“We need an ultrasound.”

He barks some orders to some of the brancardiers, the guys in pale blue scrubs who seem to disappear for hours on end, and things get moving.

I go back to Box 1, where Aisha is.  There is a little girl on the other bed, her eyes are closed as if asleep, but her hands flutter up every now and then.  She is the same age as my own baby, about 2 and a half.

“What happened?” I ask her mom.  They are from the country too.

“She fell”.  I feel tears welling up and an immense sadness hits me.  I notice the scrapes on her face.  Thoughts fly through my mind, brain damage…please God no.

But I stoically say “She’ll be ok, kids fall, that’s what they do.  Insha Allah la bas.”   No harm.  I wish that by saying it, it could be true.

I never find out what happened to her.

Aisha is in the ultrasound room for an hour.  We are told that the ultrasound shows nothing abnormal.

So they decide to do a blood test.  Which sounds simple enough, but actually involves running across town to the Military Hospital to get the tubes, running back with them, taking the blood samples and returning them to the Military Hospital to be analyzed.  They also give no indication towards a diagnosis.

In the end,  Aisha and her family return home, exhausted from another fruitless day of trying to find relief from the constant pain.  I am once again left with a feeling of utter helplessness.  She is after all, poor, old and uneducated, unimposing, undemanding and patient.  She has neither money, nor is she connected to people in high places.  She is at the mercy of this dinosaur of a medical system.  For all my good intentions and efforts, I’ve done nothing to alleviate her pain.

A few days later, Aisha’s family take her to a doctor who is known to diagnose using only two methods, x-ray, and his intuitive touch.  Apparently, he can feel the sickness by placing his hands on the patient’s body.   He looks at the big stack of prescriptions and procedures that Aisha has had done.  He feels her stomach.  Right away he says “These doctors have gone looking for complicated answers and left the most obvious.  She has Typhoid fever.  I wish you would have not let her get this bad”.

He prescribes some medicine.  Aisha takes them and has a much-needed pain-free night’s sleep for the first time in 3 weeks! Alhamdulillah, all praise is God’s!

Anyone who’s been in pain knows what a miracle the right medicine can be.  I pray that Aisha and all those who are poor and forgotten…whose lives we seem to think are worth less than our own…who bear pain with silent, beautiful patience…I pray that they be granted those spiritual states that can only be attained through suffering… and I pray that they find merciful relief and healing.

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