Where you can see a doctor for only 60 cents

I was quite excited when I was asked to pay Tsh12 000 (about $6.67) to see a doctor in Dar es Salaam. I had been in Tanzania for nearly four months and had dared not see any doctor, though I had a skin rash three days after my arrival which I could not explain. I thought it was too expensive and just went to pharmacies and bought products that I had read on the internet could treat rash. These ranged from aloe vera, baby powder, deodorants without alcohol, miconazole cream to garlic. I was thinking like a typical Zimbabwean. The consultation fee in Zimbabwe ranged from US$20 to US$30, so if I could buy something without a prescription so much the better.

Three months went by. I suddenly had a chronic headache which would not go away even after taking paracetamol.  I really had to see a doctor. I was not sure whether it was just a headache or I had malaria because I had been out in the country. When I went to the private hospital that I had used before, I found too long a queue and some patients had even given up.

I was supposed to go to Zanzibar after a week. And I remembered that last time I had obtained the best medicine for my skin itching in Zanzibar. It had only cost me Tsh2 500 (about $1.39).  I later bought more supplies in Dar es Salaam for Tsh2 000 ($1.11). Besides, Zanzibar was a much smaller town and my friend, Juma Khamis Juma, could help me get the best private doctor in town where I would not have to queue.

I could not locate Juma on the morning of the first day and did not realise that he had returned my call late in the afternoon because my phone was on silent. I was supposed to be in Zanzibar for three days and the first day had already been wasted. I phoned him in the evening and told him I badly needed to see a doctor. We arranged to see one in the afternoon of the second day and he took me to a dispensary on his scooter.

I got the shock of my life when the doctor’s clerk told me that the consultation fee was Tsh1 000 (about 56 cents). I asked Juma whether he meant Tsh10 000 and not Tsh1 000. He confirmed that it was Tsh 1 000. I asked him whether I was seeing a doctor or a nurse. He said I was seeing a doctor.

When I asked why a doctor was charging so little, Juma said, doctors who ran dispensaries were qualified doctors who worked at government hospitals. They operated at their “dispensaries” in their spare time.

This didn’t quite click with me because in Zimbabwe, doctors who worked for the government but had private surgeries charged the same fee as private doctors who ran their surgeries full time.

But the doctor I saw was a real doctor who after examining me said I should have a urine test. When I went back to the clerk, he told me this would cost Tsh 2 000. After my results I was given a prescription and everything cost me Tsh 12 000.

That sounded odd to me. The medicine was more expensive than the doctor!

I had learnt quite early in my career not to say something was cheap before putting the prices into context by looking at the general coast of living in the country and people’s incomes, becauseasa foreigner I was thinking in United States dollar terms. But, I could safely say that seeing a doctor in Zanzibar was quite cheap because fresh chips or French fries cost the same amount on the street and most ordinary people could afford them.

In Zimbabwe, fresh chips cost $1 while doctors charged $30 for consultation only. So while in Zanzibar the cost of a seeing a doctor and buying a packet of chips were the same, in Zimbabwe one could buy a packet of chips every day for a whole month for the consultation fee of a doctor.

But something seemed odd. Medicine in Zanzibar and Tanzania was generally more expensive. I remember paying Tsh13 000 ($7.22) for six malaria tablets which I had to take as a course. I could get the four-two-two-two tablets for malaria in Zimbabwe for a dollar.

I am therefore still asking myself, should things be the other way round- that the doctor should charge Tsh13 000 while the tablets cost Tsh1 000, especially  if one does not need a prescription?

But then, one can also argue that it is better that the doctor charges a lower fee because some of us get well after seeing a doctor and being assured that we are not yet about to meet our creator and sometimes do not even bother to buy the prescribed medicine especially if it is expensive.

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