Med-tech Zimbabwe style

5 04 2023
Zimbabwean medical technology can be surprisingly advanced – if you can afford it. This is a Holter ECG recorder.

“Enjoy getting the sensor off your chest” the nurse said and smirked. I didn’t share the humour and suspected this was why she said that shaving my chest before attaching the Holter ECG was unnecessary. At least she had a sense of humour.

I was strongly beginning to suspect the whole exercise was a waste of time and a not inconsiderable amount of money. The specialist physician who’d done the ECG and echo cardiogram had already said that all was normal as far as he could see and that only the MRI angiogram scheduled for the following week might show something. I left $810 poorer.

Last Friday morning at 4 a.m. I had to get up to go to the bathroom. When I got back to bed I asked Marianne what the bandage on my left ankle was for. It has been there four months for an ulcer. Not surprisingly she was concerned. The next three hours were a blank for me but apparently I repeatedly asked about the bandage and looked at my computer programming work and apparently recognized it. I have a vague recollection of asking who my doctor was and where the practice is located (which I have been visiting for years). When we visited the GP later that morning I asked Marianne to come with me just in case I missed something (not that I’d have had a choice!). We emerged 20 minutes later, blood sample taken and with a long list of tests to be done. It looked expensive.

Access to the Zimbabwe medical system requires a subscription to medical insurance and frequently quite large sums of cash as US dollars. The latter is often referred to as a “co-payment” which is another way of saying that “you pay us up front and then claim back from your medical aid/insurance company as we don’t have the patience to deal with their habitually late payments”.

First appointment was with a technician who was working out of his home with an EEG in his spare room/office. He told me that I most certainly had not experienced a Transient Ischemic Attack (TIA) otherwise known as a mini stroke and relieved me of $200. I noticed that he was fond of his dog so forgave him – mostly.

I haven’t seen the test results for the 72 hour Holter ECG yet but I guess they will arrive in due course. The record sheet that I had to fill in detailing any “out of the ordinary” experiences I left blank. There weren’t any.

Yesterday was the turn of a MRI-A (A is for angiogram) in my brain. I had to get there at 7.30 in the morning and forgoing my morning coffee – MRIs have a way of going on for a long time and I suspect the operators would have been unimpressed if I said I needed to use the toilet – I headed out early taking a big mental breath to deal with the morning traffic. It was all a non-event. I arrived early and one of the staff agreed that the traffic was unusually light. The MRI machine was new and made by Canon, the camera manufacturer. It only took 30 minutes then I was off to the Doppler ultra-sound of my neck vessels at another clinic occupied by the same company in another part of town.

They relieved me of $105 (yes, all fees were mentioned in advance and nobody mentioned the local currency – US dollars only) and then after a short wait it was into the examination room. I could just see the screen placed on the opposite wall for my convenience. The technician was not very communicative but did say he could see no problems. The machine made all the right heart noises too.

Now I have to go and see a specialist physician after the long Easter weekend. He will take $100 (he’s seen me before else he would take $200). He has a bit of a dour reputation but was also my physician for the back surgery a year ago and was very kind not charging for hospital visits once he knew I’d been injured in the Rhodesian bush war. “Because of people like you Mr Roberts, people like me got to go to medical school”.

I do have another off-shore medical aid scheme based in South Africa which will reimburse at least some of the costs. However they will only pay what the procedure or tests cost in South Africa which is often considerably less than in Zimbabwe. I’ll have to wait and see.

So what was it that I experienced? My sister-in-law Jane, who lives in the UK and is a better Googler than me, sent me this link which accurately describes it. It’s called TGA or transient global amnesia. It happens, it’s not serious and there’s nothing one can do about it.

On the way back from the gym this afternoon I drove past the local municipal clinic. Once a part of the primary medical care system designed as a first port of call for the average Zimbabwean citizen without access to medical insurance it is now nearly derelict. The gates don’t shut, there was one vehicle parked inside and not a soul to be seen. The last time it was used was for Covid vaccinations and that was sponsored by the WHO and other agencies.

About the units

9 05 2015

Zimbabwe (Rhodesia as it was then) went metric in 1970. We were using the old imperial system up to then; acres, pounds, ounces, miles, feet and inches etc. The property my mother owned in Penhalonga was measured in morgen. The metric system is far easier to use. Like I mentioned to my sister in the USA it’s all in base 10 and length and mass are related. Want to convert metres to kilometres? Move the decimal point! Despite all this, 45 years later, relics of the old system remain.

Yesterday in the industrial sites of Harare I was shopping for hardware essential in our annual maintenance programme. I blithely asked for 25kg of 6 inch nails! I could have asked for 150mm nails and everyone would have known what I was asking for but try saying “150mm” and then “6 inch”. Much easier to say 6 inch! Relics exist elsewhere too, nowhere more bizarrely than in plumbing. Old style copper and steel piping is measured in inches and refers to the internal diameter. PVC piping is measured in mm and refers to the outside diameter. It is a blatant conversion of the old system; 50mm is 2 inches, 32mm is 1¼ inches etc. Speed and distance are all firmly metric as is temperature and mass. ºF is utterly meaningless to me though I can grasp pounds weight and speed if I think about it. That the weight of the recent UK royal baby was measured in pounds didn’t mean much except that I think it was in the normal range.

One day the world will actually share the same system of units and we will look back at the old system with puzzlement and wonder why we put up with it for so long. That it costs the USA (and presumably Liberia and Burma) vast amounts of money to not metricate is beyond doubt. The only disputed fact is how much.

For a fascinating and entertaining read on the invention of the metric system (amongst other things) read Chet Raymo’s “Walking Zero”

Appropriate technology

24 08 2013

Freightliner truckThis is a Freightliner truck. An American brand they are popular in Zim ever since a number were imported from the Middle East quite a few years ago. This one arrived at work yesterday to take a modified container to Hwange in the South West (the landlord’s son converts them into liveable cabins). I got chatting to the driver. He admitted there were rather a lot of electrics that had once stopped him on a weigh-bridge because of a faulty oil pressure sensor. They’d also disconnected the automatic greasing facility – trust Zimbabweans to “make a plan” to get around inappropriate technology.

Growing up on a forestry estate in the Eastern Highlands of Zimbabwe my father had a Peugeot 404 pickup truck. It was definitely more comfortable than the Land Rover it repaced and it lasted well on the less than perfect roads – not least because my father maintained the roads AND the pickup! I haven’t seen a Peugeot 404 for some time now but they were made to last – appropriate technology at its best. They were followed by the Peugeot 504 which was definitely more luxurious by the day’s standard and didn’t last as well.

Other appropriate tech cars included the Renault 5 with the gear stick on the dashboard and yes, you do still see a few around. A physiotherapist friend and her twin sister had one when I was at the St Giles rehabilitation centre in 1979 which they had to hire from their father who happened to be the managing director of Anglo-American in this country (Anglo-American is a VERY big company in Africa!). Somewhat thrifty was Mr Carey-Smith!

I own a seedling nursery business that is definitely appropriate technology orientated. Nearly everything is manual with a few exceptions, one of them being the clipping of the tobacco seedlings for which we use a Husqvana hedge clipper. It works really well for the purpose and requires little maintenance. Unfortunately it does require 2-stroke oil to be put into the petrol so when the operator came to me yesterday and said the machine had just stopped I had a pretty good idea what had gone wrong. Now I’d really like someone to come up with foolproof technology but maybe that’s a contradiction in terms.

Not quite Earl’s Court

18 05 2013

Zimbabwe probably has the highest density of pickup trucks anywhere in the world. It was certainly reflected in the stands at the Harare Motor Show today. Along with a few boats, earth-moving equipment and heavy vehicles. There was a smattering of leggy female models thrown in but none that I really felt like photographing; especially when they couldn’t answer basic questions about the pickup truck I was interested in and then couldn’t find the keys! I guess I might be getting old. After half and hour I’d seen everything I was interested in and it was time to move on – definitely not the show of the Earl’s Court venue.

The show is on late tonight so I guess most people will be going for the party. We are a match for anywhere in the world when it comes to drinking, and sadly driving, too. I hope they are warmly dressed as the weather has gone vile.

Hope on Heroes’ Day

13 08 2012

It’s a public holiday today; Heroes’ Day when we are expected to remember the heroes who fought for Zimbabwe (against me) and are buried in Heroes’ Acre. From what I could see going into town precious few of Harare’s residents were giving the afore-mentioned heroes much thought as they participated in football clinics or just generally relaxed. It’s not that surprising – most Zimbabweans are too young to remember the war. I was on my way to a French lesson with Shelton. Half the way through there was a roar and we looked up to see a formation of 4 training jets go over on their way to the National Stadium where Bob was addressing the crowds. Shelton cynically commented (in French) that the crowds where mostly there to see the high profile football match after the ceremony.

It is true that we have little left to celebrate in Zimbabwe. The economy is in tatters and shows little sign of rejuvenation. We have extremely bad press worldwide and tourism is moribund despite the mostly friendly population and great weather. Then on the way back home I noticed a bundle of fibre optic cable casings lying on a manhole cover and thought; no, there IS still some hope! Somebody is still investing in Zimbabwe regardless of the apparently dismal future. Actually fibre optic cables have been going in all around town for at least the last 18 months but at least they are continuingto be put in.

Tech spaghetti too – I got some funny looks from passers by whilst photographing a pile of piping!

Tech Spaghetti – fibre optic cable casings

Appropriate technology

7 08 2012

I was in the local irrigation supplies outlet, and looking around whilst the connectors I’d wanted were sourced, when I noticed a rather natty water tank float gauge made in Australia. I didn’t ask how much it cost. I know the Zimbabwe version (on the right below) is much cheaper and spares are dead easy to find too.

Water tank float gauges on the local market