Acute gonorrhea in Congo

Year: 1984

Setting: Ouesso, Congo
Position: Timber consortium medical expert

We landed in Brazzaville and took a private jet to Pointe Noire where we spent the night. The next day, the group is assigned six 4×4 Toyotas to take through the Mayombe Mountains, Brazzaville and the plateau to reach Ouesso near the Cameroon border.

The journey is eventful, particularly when I drove the pickup truck into a river from a bridge to avoid children playing carelessly. It was quite a shock when we hit the riverbed and half the vehicle got stuck in the mud amidst running water. Nevertheless, after repairs and four days of challenging terrain, mostly in the equatorial forest, we arrive at our destination where I have to survey the medical facilities and produce a report.

In the process of touring the hospital and clinics, a local Pygmy nurse asks me to visit her father, who is ill. I follow her car to his village at dusk. There is a short and improvised welcome ceremony, including toasts, before someone leads me to the right hut. At first, it is too dark inside to see, but quickly lamps are lit and I can discern an old man lying on a very rustic bed. Everyone retreats from the dwelling so that I can examine the patient.

The diagnosis is quite apparent: acute gonorrhea. It takes about 10 cotton swabs with alcohol to clean the site where I plan to give him an injection. In the meantime, a group of curious Pygmies has entered the hut. They are watching intently as I prepare the syringe. Unfortunately, as I am about to plant the needle in his buttock, the patient turns his head and sees a metallic glimmer in the flickering light. As a result, he contracts his muscle and this resistance causes the needle to bend at a 90-degree angle upon arrival.

The faces around me look profoundly dubious. I am devastated. From hero to zero in a millisecond! I promptly change the needle and make a successful second attempt after reassuring the patient and the onlookers. I follow up with an explanation about sexually transmitted diseases and the necessity of treating all of the patient’s sexual contacts. Tracing them will be a challenge.

Lesson for the doctor: Regardless of where you practice medicine, human behavior is very similar. Meeting people from different backgrounds who deal with the same medical issues gives us a heightened sense of belonging to the same species.

Yann Meunier is the health promotion manager for the Stanford Prevention Research Center who blogs at Scope at the Stanford University School of Medicine.

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