I’m elated to be with the EMT’s of International SOS.  They are fabulous and I wish they could administer my care.  The five hour ambulance trek was uneventful and smooth.  Thank Goodness.

We arrive at Roman Catholic Hospital in Windhoek, another private facility.  As a foreigner I’ve been taken to private facilities as they are the best Africa has to offer and primarily serve diplomats, tourist, or people with money.  The typical local will never see the insides of these walls.  There are public hospitals however I’m warned by the EMT’s there is no way I want to be delivered to one of them. 

Upon arrival the first task at hand is how will you pay for your estimated stay.  No payment no entry and insurance isn’t accepted.  Credit once more.  I’m hoping that since my cards had been declined this morning for the ambulance ride they’ll sail through from my earlier approval.  Not my luck.  Denied again, so back on the phone once again, just to get admitted.  Once cleared now for, xrays oops we need payment too and wouldn’t you guess denied again and I just got off the phone.

While I appreciate credit card firms being cautious about fraudulent charges it went way beyond ridiculous.  Three more charges later this week from the same facility for other test etc where denied each time and I had to spend time on my cell clearing them with promises future charges would go through.  It made no difference whether it was Amex, Capital One, or Citibank.  This simple struggle just added expense, frustration, and time, when all I wanted is to begin to heal.

Roman Catholic is modern yet dated.  It’s a flashback to entering a facility of the 1970’s.  It’s clean yet things look dated and dirty.  My doctor seems competent but annoyed with spending more than a few minutes with me at a time.  I pepper him with questions at every chance and all he wants to do is leave each time.  I discover I have several broken ribs but not sure how many and there are multiple breaks in my scapula.  He indicates it’ll be about a week before I’ll be safe to travel the long distance home and will reevaluate along the way.

I spend the next week lying in bed.  The nursing staff here is friendlier than before however their hygiene is no better and I encounter the same needle fights.  I’m partially cleaned but my backside remains covered in sand.  By the end of the week not moving combined with the sand grinding into my skin produces huge bedsores.  My door is usually open and there is a steady flow of people back and forth through the hall.  At any moment a stranger or stray could enter at will and some did.  I’m alone and my only connection with the world is my mobile as they don’t have a phone as well.  My wallet and phone are my only ticket out and the worry of theft sets in as well.  Thus I clutch my phone and wallet in my only good hand and don’t let them leave my sight.

Fortunately there are a couple foreign exchange nursing interns here from Europe.  They come from a different environment and it shines through quite quickly.  They’re friendlier and take far better care than any of their peers.  I quickly endear myself to them at every chance.  Two days later one of them agrees to go to a local store and get me a mobile internet adaptor for my laptop.   One more connection to the world and how I got the word out.

By the end of the week I’ve become accustomed to the hospital routine.  I’ve gone through phases of depression and loneliness just wanting a friend and been on constant vigilance of watching out for my life.  The pain has been excruciating only subsiding with drugs.  Simple breathing alone brings stabbing chest pains.  I’m still not confident in what’s wrong and simply want to get out and seek better care.  The thought of this blog and the good stories it would eventually make are at times the only thing keeping me sane and the tears at bay.

Surprisingly the food was superb, three meals a day and more than I could eat.  Oddly, I think the cooks made every effort to give me foods impossible or very messy to eat.  I’m right handed and only had the use of my left.  They’d bring me a steak covered in mushroom gravy.  How do you eat that with only an off hand?  Well, I jabbed a fork in it slide it to the edge of the plate, on the adjustable table skooted up to mouth level, and naw around the edges as the gravy spilled over onto the bed.  Try peeling an orange with only one hand and it goes on.

Some have asked me why I came home and didn’t just go sit on a beach in some tropical local.  It’s hard to explain, but a deep burning desire to be home consumed my mind.  To be in a place where I no longer had to worry, where I had a support system of friends, and where I knew I could rely on the medical opinions burns deep within.

My driving question to the doctor all week was, when will it be safe for me to get on a plane and make the long journey home no matter the pain?  Ie I won’t die.  Five days later the doc gives me clearance and I quickly secure a first class ticket home with prearranged medical assistance departing the next day.

I left the hospital in a wheelchair and the only thing I’ll miss is the three fresh squeezed guava juices a day.  I’m fortunate to be alive and grateful to not be paralyzed.  The accident could have been far worse and I know while I got the best of African healthcare it’s no place I ever want to be again.  I’m fortunate it happened in Namibia, it’s far more modern than the rest of what I had seen.  I’m fortunate to have had the means to afford what most locals will never see.  I could have easily been in a facility far worse with even lower quality care.

In hindsight if something like this ever happened again, I’d have my emergency contact immediately contact an embassy for assitance.  A lending had through the admittance and hours of phone calls would have been a godsend.  By the time the idea had been brought to mind the fires had been put out and I was biding my time to excape.  By the end of the week a simple visitor, a friendly face, would have been grand.

I’m injected full of drugs for the long journey home, with a $2,000 cell phone bill and 42,000 in medical bills I’m hoping my useless to-date travel insurance will reimburse.

Cottage Medical Clinic is an ultra modern facility.  It appears as if the place is brand new, from my bed to the x-ray facilities and everything in-between.  Unfortunately, I can’t say the same for the staff.  Maybe it’s new because this is where Angelina Jolie birthed her children.  Would you rather have a state of the art facility with terribly trained staff or a crappy medical facility with great people?  I vote for the latter.

Throughout the night I go from drug induced sleeping to extreme discomfort.  There is no shortage of nurses here.  At least a dozen of them came in through the night, some to see the new patient and others when I buzzed to get more medication.  Unfortunately they don’t have any oral pain medication stronger than Tylenol.  Thus everything is administered via injection. I had packed syringes and needles in my med kit in case I needed them.  They however are still on the truck and as it quickly turns out the couple I had wouldn’t be enough for what I eventually go through.   A nurse would walk in from the hall with a syringe already filled.  Concerned about the risk of it being a reused needle as is common in Africa, I’d request they bring a fresh syringe open and fill it in front of me.  My request produced dirty looks and quip responses of, “what, don’t you trust me”.  Quite frankly I didn’t, and while I was dopey from meds, I knew I had to sweet talk them into opening one in front of me.  A few times I had to get downright nasty yelling and demanding they open one as they defiantly attempted to stick me with one as I screamed for them not too.  The concern of catching something from a used needle had begun and building fear loomed for the rest of the week.  Their sheer lack of repeated unwillingness to put my mind at ease creating a struggle convinces me they were bringing in used needles.  Not one time in the approximate 40-50 or more injections I received throughout the week did I not have to endure this fight.  In spite of my resistance a couple got through either because I was out or they still stuck me against my demands. (in a few more months six months from when they were used, I’ll be tested)  While the risk of being infected with HIV is low, it’s a potential concern and I’ve pushed it out of my head as there is nothing I can do. 

Other concerns for me while at Cottage included the lack of sterile hygiene and protection of the nursing staff themselves.  The staff never used gloves to protect themselves.  One of the nurses accidently ripped out my IV while giving me a morphine injection.  When she tried to start a new IV she stuck me a dozen or more times unsuccessfully leaving a bloody mess on my arm and simply cleaned it up bared handed.  I assume such practices are a combination of lack of education, cost, and availability of supplies.  For me however cost wasn’t a factor, I’d pay anything at this stage to not have to worry.  If they where this unhygienic with me, I’m sure they were with everyone else and could easily be the spreader of disease. 

Morning comes and I’ve been through my first night of fear, I’m anxious to see Michelle as I know she’s bringing my bags.  I’m still not sure all what’s wrong and am expecting the doctor soon as well.  Michelle shows up alone to my delight while simultaneously I felt let down as I had secretly hoped everyone would show to lend me some cheer.  I’m sad I never got to say goodbye to my new friends whom I’ve spent the past months getting to know.  Michelle’s words still ring true as she entered the room, “Here’s your life” as she set my bag on the floor.  Possessions mean nothing, but it’s all that I had which turns out to be my lifeline to the world.  We chat for a bit and she kisses me goodbye and now I’m on my own to survive.

Cottage doesn’t have a phone available with which to make international or collect calls.  Can you frigin believe it??  I need to contact my travel insurance/medical assistance carrier to make sure this is covered and get them in the loop to assist and my only way to make a call from the hospital is to leave and get a phone card from a local vendor.  Fat chance getting anyone at the clinic to help, they’re useless.   Thank goodness I have my mobile phone.  My AT&T mobile works great at $2.99/min.

My first call to medical notification/assistance seems great.  They take my info and seem like they’re there to help.  Shortly thereafter the doctor shows up reviews everything informing me I need to be transferred to a hospital.  While his bedside manner was great, he’s not knowledgeable enough to treat me and is concerned I might have some lung damage.  (note this entire time, I’m confined in a bed, medicated on morphine every hour, have an IV and catheter in, and I’m on oxygen)  Having read my policy I know medical transport is to be arranged by my insurer.  Using my cell I call them again and this time to a much different response.  First they need to verify with the doctor before they can make any transport.  A few hours later, sure enough they’ve confirmed with the doc I need to be transferred and then ask me why can’t I stay where I’m at? Why can’t I just get a more competent doctor here?  Isn’t there another hospital closer than five hours away which can treat you?  Hello!!!  I’m in Africa, you moron!  How am I to know?  Isn’t that what worldwide medical assistance is for?  Why don’t you tell me? I’m here stuck in a hospital bed and you’re asking me where I should go.  I thought that was your job.  So, how am I to get to where I can receive treatment, will you arrange it for me?  “Ahhh”, came the response, “you’ll have to do that.”  What?  Will you arrange payment or anything?  “Well, you’ll have to make arrangements for that get the receipts and submit them to get reimbursed” “Oh and once you’re at your new facility give us a call so we can track your progress”   %&%*^*(&(&(!!!!!!!   What a waste of my time, fing insurance!!!! 

The doc comes back later concerned about my blood pressure it’s 170/120.  I tell him I’m on High Blood pressure medication.  Would he assist in finding it in my bag?  I’m not sure where it is, as I hadn’t packed my bags.  He’ll have a nurse be in shortly.  We discuss the only option he’s aware of for transport and to my delight it’s International SOS, the guys who brought me out of the desert.  However, I’ll have to spend another night here as they won’t transport me in the dark due to risk in the desert.  Fortunately he arranges for them to get me early the next morning.

Ah maybe a little piece, I’m exhausted from doc visits, phone calls to insurance and my best friends, combined with hourly fights of getting clean needles.  My blood pressures out of site a nurse comes in supposedly to assist.  Ha, these ladies are useless.  I counted a dozen different nurses through the evening and night each of which I requested there assistance to find my blood pressure meds.  One at least opened my bag and one rummaged through the top layer, all leaving me by saying they’d have someone else come by to assist.  Lazy B_t_hes!  I come in and out of sleep scared of falling too deep into sleep knowing I have to stay aware to fight for my life.  I’m anxious as can be and can’t wait for the transport to show as I worry about my blood pressure, nurse hygiene, and the next needle fight.

International SOS to the rescue.  I’ve never been so happy to see an EMT.  They arrive to me lying naked in bed still covered in sand.  What, they haven’t washed you! With a look of disgust.  Where are you cloths?  OMG your BP is out of site.  They instantly riffle through my bag finding my meds in split seconds and then want to know how I’ll be paying for the ride.  Can you believe it, same issue as before my credit cards are denided once again just has they had been the day before.  So back on the phone jumping through hoops to clear the charges before they prep me for a five hour desert journey to what I’m desperately hoping is better care.

While we’re waiting, Rachel and Phil take the initiative to check me out.  Thank goodness there’s no bleeding.  They sit me up to see if that will reduce the pain and makeshift a sling out of my jacket not sure at this stage how I’m going leave the scene.  Word eventually makes it back that an ambulance is on its way while they’ve made me as comfortable as possible by digging the sand out from under me to make a custom fit bed.

A couple hours later, after what seems like an eternity, while my friends have been keeping me occupied with conversation a 4×4 shows up with EMT’s aboard.  They are from International SOS.  They are well trained, equipped, knowledgeable, and friendly. (more to come later on this outstanding company)

They check me out thoroughly, perform an EKG, start an IV, get me on the backboard, and load me in the back of the truck.  A truck was used because the ambulance wasn’t capable of driving across the dunes.  For I’m not sure how long they slowly drive me over the dunes while I grimace in pain with every inch of movement and take me to Cottage Medical Clinic, the nearest facility in Swakopmund.

Upon arrival the place appears closed.  I’m rolled into what they would consider an ER and the lights are out with only a nurse.  A doctor and radiologist have been called in and are on their way.  Michelle, the tour leader, arrives shortly thereafter.  At this stage I discover their priorities are quite different than I’m accustomed.  At this point I’m about crying in pain requesting some relief and the ambulance ride wants payment for service.  Will they take my travel insurance?  No way!  Thank goodness they take credit.  I have them dig through my pocket and charge my Capital One, which is quickly declined.  Ok, try the Amex, same thing.  Next up, the nurse wants to know how I’m going to a pay for x-rays and the clinic bill all while laying on the ambulance gurney in the ER.  No payment, no treatment.  Thank goodness Michelle is there, with her assistance I call the credit card company jump through a dizzying array of verbal hoops to approve the charges. (note I had cleared all my credit cards in advance for use in these countries and they had worked up to this point)

Finally after paying who knows what amount, as I was in agony and wanted treatment, the doctor shows up and sends me for x-rays upon which he gives me some morphine.  Ahhhhhh, it’s never felt so good to feel pain slide away.  I’m informed my shoulder and ribs are broken and will be admitted for the night.  The pain finally subsiding after hours of suffering, Michelle does her job and brings up the topic, what’s next.  The truck is scheduled to leave in the morning and I know there is no way I’ll be able to make it, and she makes arrangements to get my stuff off the truck.  I knew my trip had ended and I’m pushed to my room for the night well sedated for I don’t know what lay ahead.

Day 52 Afternoon

Since I was already covered in sand from a morning of screaming down enormous sand hills on a flimsy piece of particle board, why not have more fun in the sand.  Myself and 10 others from the truck head for an afternoon of quad biking (also known as an ATV or four wheeler) in the rolling sand dunes with Desert Explorers.

My ride of choice is a Honda 250 cc Quad full of power and oomph. We set out single file following a guide into the rolling Namibian desert hills; picture the Sahara only bigger dunes.  It starts out slow for everyone to get comfortable with their bike and quickly progresses to an all out pace. Some of these dunes are huge soaring from base to peak an easy 400 feet or more with flat valleys of sand in-between.  The desert in Nambia is home to the largest/highest dunes in the world some peaking as high as 900 ft.

The weather is brisk with a cloudless blue sky and with my sense of adventure I quickly start fishtailing the bike in the sand as the top inch is loose above a hard packed base.  This bike has some power and with only a minor increase on the throttle can make the rear of my bike swerve back and forth in the sand throwing up a dust cloud of sand as I quickly shift up to accelerate.  As we approach the first dunes I quickly discover if I’m not going top speed in the flat valleys there is not enough power to reach the peak due to the altitude increase combined with the loose sand bogging down the engine to a crawl.   So, quickly I pick up when I’m in the flat’s to floor it to top speed and once I hit the base of the dune start down shifting to keep moment in an arched bank as if riding a bike around a corner on a professional banked race track.  I’m having the time of my life and with a few more runs like this push it faster and faster.  I’ve just come off a dune I quickly accelerated shifting through five gears to reach speeds easily exceeding 70 or 80 mph, my jacket flapping in the wind, grains of sand pebble me as I leave a sand cloud in my wake.  Reaching the base of a large dune I downshift as fast as I can maintaining as much speed as possible and just before reaching the peak swerve the bike while excelerating creating a skid as if skidding a car on ice, throwing up a roster tail of sand.  Similarly as a car on ice I steer the bike into the skid while leaning my weight outward away from the skid to assist in control. Once the bike comes out of the skid I shift up accelerating down the dune reaching ever higher speeds racing toward the next dune to repeat the same thing.

Example of what I was doing

For an hour an fifty minutes I repeat this pattern over and over gradually building my confidence slowing loosing awareness of how dangerous it can be.  I feel invincible and boy is this fun.  I come off a dune following one of my truck mates as fast as I can.  I’m in the valley and straight ahead is a dune half the size of the dunes I’ve been repeating this stunt.  Hitting the base the bike barely decelerates and I only have to downshift twice. As I quickly peek due to the faster speed I skid the rear wheels to the left, steer into the skid, and lean hard to the right hanging off the bike with one hand. In the blink of an eye the bike flips over sideways to the left as I instinctively let go tucking and slam into the ground bouncing at least twice and rolling down the side of the dune a dozen or more times as the bike bounces and flips, three times I’m told, landing a few feet away from where I’ve come to rest.

Injured and waiting for help

Fortunately I’ve come to a stop laying flat on my back.  I’ve had the wind knocked out of me and I can’t get a breath.  My truck mates are quickly at my side asking if I’m ok as I gasp for air unable to initially respond I hear some of them commenting on how epic the wipe out was.  I wish someone had a video to show off the carnage.

Next to come, desert rescue and hospital treatment.

Pictures are now online for Uganda.  Videos will be coming later after I’ve completed the blog and pictures.

Day 51-52 Morning

It’s been just over three months since my accident and I’ve been procrastinating writing about the last of my trip. Procrastination no more! I’m determined to finish what was promised and to finally get loads of wonderful photography posted.

When I last posted I had been in Windhoek, Namibia eating a variety of game meats and had spent a night in Sptizkoppe falling asleep under the stars. From here we headed for Swakopmund with a stop at the Cape Cross Seal Colony.

Cape Cross Seal Colony

Cape Cross is along the Atlantic coast of Africa and his home to hundreds of thousands of seals. While I’d seen a few seals before, the sheer number here is staggering. As I exit the truck the smell of half a million seals feces is overpowering to the point one almost gags. It’s worse than walking through a barn full of chicken shit. I’m not sure what to call the sound a seal makes. Honking? Squeaking? Screeching? One almost needs earplugs as the overlapping sounds cascade up the shoreline from the thousands of seals covering every square inch of the sand and rocks combines with the frothy sea-foamed waves crashing onshore. They’re cute yet ugly. Some lay asleep, others are nursing their young, some poised in conversation with others as if chatting with a friend, some are preaching, others are fighting, and my favorite is watching some frolic in the waves crashing ashore. I’m glad the stop here is short, for my noses sake, and we’re back on the truck in a jiffy after a few picture perfect moments.

Swakopmund is a small touristy town along Namibia’s western coast. It’s squeezed between the Atlantic on one side and the rolling desert on the other. It’s clean, neat, and fairly cosmopolitan, yet it has a village feel. I set out early in the morning with a dozen others for sandboarding.

We arrive on the outskirts of town, it’s bright, sunny, desolate, and all I can see are rolling hills and mountains of sand as far as the eye can see. We’re given some basic instructions and a small piece of paneling like particle board. We don helmets, gloves, and elbow pads and march toward the dunes. As we begin to ascend toward the peak of these enormous dunes everyone falls into a single file line stepping in the footprints of the person ahead. Doing so makes it significantly less strenuous a climb as the sand packs hard and the ascent becomes more like a stair stepping event. If one veers off course from the footprint path the top couple inches of sand is soft and slides around engulfing ones shoes as if stepping into soft flakey snow making it significantly more difficult.

Sandboarding

We arrive at the peak legs sore from the hike and the task is simple, scary for some and exhilarating for me. Lay the board on the ground plop your belly on the board grab the front lip bending it up and go screaming down the sand dune as if tobogganing down a ski slope. Awesomeeeeee!!!!! Arriving at the bottom a lady with a radar gun tells me I clocked 73 MPH down the dune. Not quite enough for me to break the record of 76 mph for the day, set by one of my fellow truck mates. We repeat this cycle all morning hiking up a dune to go screaming down in seconds. I could do this for a few days of fun, however this afternoon I’ve booked a quad bike with the rest of the group.

The beginning of the Africa pics are now online, starting with Namibia.