I have been in Georgia now for about a month and a half, and I have already had the opportunity to use our TLG medical insurance on two separate occasions. I thought I may as well turn my misfortune into your gain and tell you a bit about being sick in Georgia.
If we could chose where we could be when we got sick, I think we’d all wish to be back in our parents’ house with our moms to take care of us. I remember the first time I got sick in college, lying in my bed in my dorm room contemplating whether I really wanted to grow up if it meant not having someone to bring me chicken noodle soup and hot tea in bed.
If it’s tough to be sick without your mom around to play Florence Nightengale, then it is another level of bad to be sick in a foreign country. I have had the pleasure of falling ill in no fewer than five foreign countries. A cold in France led me to discover that over the counter cough medicine there contains codeine and, if you’re wise, really shouldn’t be combined with wine even if it’s just on glass. Foreign sickness number two was during my year abroad in Moscow, where I had a cold that then turned into sinus congestion that was impervious to all attempts at medicating. I no longer remember why I didn’t try going to a doctor, but on top of the stress of dealing with the medical system there (even though I would have gone to one of the private, Western-style clinics), I also have a tendency of avoiding going to the doctor for something that I think will/should just go away on its own. Anyway, the takeaway from Moscow was the various folk remedies I learned there. Now, my general feeling on such remedies is that they all are based on some amount of truth. For instance, garlic and onion have both been shown to have antiseptic properties. (In fact, in a domestic illness incident, I cured an earache by putting chopped garlic in my ears. More on that below.) My host mom taught me a rudimentary version of what I have come to know as “nasal rinse” back in the states, which back in Moscow just involved warm salt water, a spoon, and the power of my nostrils to suck the water up. (For those of you considering this, although I did just fine in Moscow and subsequently elsewhere using tap water, after reading a story about some folks in Louisiana dying from a brain-eating amoeba, I’m sticking squarely to bottled water now.) I was also encouraged to treat my cough with vodka. Now, the idea that vodka is alcohol and therefore kills germs seems like a dubious reason to take it for a cold, but I can say this much: warm vodka with pepper in it is just the thing for one of those coughs where you have a tickle that just won’t go away. I never have, however, been able to think of what the medical basis might be for thinking that tying a piece of cabbage to one’s throat will draw out the fluid.
I was sick for a good two months when I was studying for my master’s in England, and in retrospect, I really have no idea why I was so against the idea of going to a doctor there. Despite what you hear in America, everything I heard from my friends there (both American and English) is that the NHS is pretty awesome (although undergoing austerity cuts at the moment, so it might be less awesome now). Then, last year, while traveling around the Black Sea from Kiev to Tbilisi (totally separate from my current sojourn in Georgia), I got a cold on my first day in Istanbul and didn’t shake it for a whole week until I was able to relax a bit in my friend’s apartment in Tbilisi. Turns out decongestant in Turkish is dekongestan, or something to that effect, and also, if you’re interested, I learned that Turkish pharmacies carry and advertise large amounts of viagra of dubious origin.
That brings us to my current stay in Georgia. My first brush with the Georgian healthcare system came during our orientation week, while we were all still staying in a hotel in Tbilisi. Basically, I spent a horrible night with what felt like stomach flu but resisted the urge to call the doctor because I figured at that time of the night my only option was a trip to the hospital, and I really didn’t feel up to that. By the time the next morning arrived, my poor roommate brought in Tamuna, the TLG employee who was running our orientation. I was so glad I got sick that week instead of the week after as a few other volunteers did, as Tamuna and her two lovely assistants watched over me all day and continued to ask how I was doing for the remaining two days of orientation. Anyway, Tamuna called the insurance company who sent an ambulance our way replete with not one but two doctors and a nurse/assistant. This my friends, is a country where doctors make house calls, bless them. They crowded into our little room and managed to fit between the overflowing suitcases to figure out what was going on with me (they thought it was something i had eaten or drank, although I’d been sticking to hotel food and bottled water), and then gave me an IV for rehydration, securing the IV bag to the wall above my head with a thumb tack (you have got to love the ingenuity). All three hung out there while the IV slowly dripped in, and then I spent the next couple of days getting back to normal.
Georgia illness number two hit eleven days ago (since this won’t be published immediately, let’s say mid-February). This time was not nearly as dramatic – I got a cold. Friday before last I was coughing. By Monday, the good old sinuses had kicked in, and I spent all week grossing out everyone in my vacinity with my frequent sinus emptying nose blowing, often marveling at how quickly the human body is able to replenish the supply of phlegm. I tried various cold medicines that my host family gave me and that I had brought from home, as well as a nasal rinse (with bottled water now), and I even started to feel like I was getting better a few times only to wake up the next morning feeling as sick as ever. By the following Monday, I decided that enough was enough and I didn’t want to spend my entire time in Georgia feeling sick, so I made the call to the insurance hotline and got myself a doctor’s appointment for the next day.
As it happens, the clinic in the nice Vake neighborhood of Tbilisi was not as scary and “foreign” as I was afraid of. The system is certainly different, of course. The receptionist directed me to the third floor where I found my doctor’s office simply by knocking on her door, and was let into her office that didn’t seem to have any medical paraphernalia other than white cotton medical masks. I sat down, and she asked me about my symptoms. Without inspecting me at all as I would expect from any American doctor (ie, looking at my throat and in my ears, listening to my breathing/coughing, etc.) she prescribed antibiotics, a nasal spray, and a throat gargle and sent me on my way with directions tot he pharmacy. No messing around with insurance forms, either; she just took down my insurance info, put it in the computer, and that was that.
The pharmacy, I realized once I got home, actually gave me a throat spray instead of a gargle, but I guess that’ll work, too. I immediately took my first antibiotic pill with a nice, big glass of water, and then sat down for a nice therapeutic facebook session. It was only an hour or so later that it occurred to me that my doctor had failed to ask if I had any drug allergies, and I had forgotten to mention my allergy to penicillin. For about thirty seconds I panicked as I went to look at the box to see what I had taken and to check google to make sure it wasn’t related to penicillin. As it happens, I was given what in America we call a “z-pack” which is actually a very strong antibiotic that we generally use just for really strong infections. I would imagine that it was my doctor’s go-to choice since, like many post-Soviet countries, Georgia has a big problem with drug-resistant diseases. Russia, for instance, has a big problem with antibiotic resistant tuberculosis, which is seriously bad news. The cause of this problem, of course, is that people don’t take an entire course of antibiotics. (I was actually offered a couple of left-over antibiotics by my host family mid-illness.) Because their doctors don’t explain how important this is, they simply take a few until they feel better and then save the rest for later, which I certainly understand given that even with lower drug prices here, a lot of people can’t afford a 30 cent bus ride let alone some $7 antibiotics.
One last thing I’ve noticed about illness here also runs along the same lines as what I saw in Moscow. I know other TLGers out there are reading this, so I’m sure you can add to these observations, and please do. In my experience, people in this part of the world seem to have a fairly lose grasp on the idea of germs, and certainly have some divergent ideas on what’s healthy. In the midst of my cold last week, my host brother woke up with a sore throat one day. Now, instead of assuming this was a result of spending time around his germ-spewing American housemate, he concluded that it was because he had stupidly had a glass of cold water the night before. The belief that drinking cold liquids will give a person a sore throat also exists in Russia, with some extending it even to room temperature liquids. I remember a fellow American student told us about when his host mom had had some sort of dental surgery and had been told not to have any hot drinks for three or four days. Since she couldn’t have her hot “chai” she simply didn’t drink anything for the entire period. I know this isn’t culturally open minded, but that just seems insane to me. So, when I told my host brother that he probably caught his sore throat from being around me, he just gave me a look that made it clear he thought I was being as silly as I had found my friend’s host mom. I also remember a fellow student in Moscow telling us that his host sister had gone to the doctor for a cold, and her doctor told her that she had gotten sick because she had gone outside without having fully zipped up her coat, only doing so about ten seconds after she had stepped outside. This was from her doctor!
Well, I would never say that America has all the answers to healthy living, and I must say that when it comes to vitamin C delivery systems wild rose hip tea beats orange juice any day of the week. I also took to heart my Russian host mom’s profound belief in the power of raw garlic. In all honesty, a couple of years ago while living in Washington, DC, I found myself coming down with the third ear infection of the summer, and I decided to unleash the power of garlic. I stuck a kleenex full of juicy, minced raw garlic in both ears, and not only did I feel completely normal (albeit a bit stinky) the next day, but I haven’t had an earache since. So if being sick in Georgia scares you, too, then I would just tell you to, first of all remember to tell your doctor about any allergies you might have(!), and secondly keep your mind open since you never know what Georgia might be able to teach you.