(I’m not using a computer to write this so there may be some formatting issues. Forgive me.)
I’m doing my elective in the supposed hub of South Africa’s economy, alternating between private and public practice in the field of Emergency Medicine. I’m staying with family in the province, but my elective sites are at least an hour’s drive (by private transport) from home and in the opposite direction to where everyone works.
This means I have to make use of public transport to get to and from the hospital every day. The most ‘convenient’ mode of public transport considering my destination is a taxi. Now, taxi in many first world countries refers to a yellow or black little vehicle with metered billing and a guarantee that you’ll get where you’re going.
Taxis in South Africa are cramped and crowded
death traps minibuses which are packed to overflowing, usually not roadworthy and manned by sometimes suspect individuals who ignore it when traffic officers signal them to pull over on the roads.
Also, with South African taxis, there’s no schedule or specific destinations. They leave when they’re full and they go wherever they’re planned to go and you’d better wish that your destination is en route.
Today was my first day taking a taxi outside my home province. The journey involves two legs; one ride to town to the main taxi rank and then another to my final destination. I reverse this journey (albeit via a separate, smaller rank in town) using another two taxis. Each taxi costs roughly R15. So that’s about R60 a day on a journey that can take me anywhere between one to two hours either way. At this point, my external supervisor and I have yet to discuss my time requirements. But let’s assume I will be working at least five days a week. That’s R300 a week. Over a thousand rand a month; the equivalent of what I spend on groceries and necessities during a month at university. Clocking in an average of sixty hours spent on the road.
This is obviously neither cost- nor time efficient.
One could argue that since I’m staying with family for my elective, I cut the cost associated with food and lodging and the exchange factor I might have had to cover had I left the country. So, financially, I’m getting off rather easily.
But this is where the time (and taxi) factor come in.
Coming from living, studying and working in a hospital in the TB hotspot of our country, naturally I’m paranoid about developing the disease. I’ve had more TB patients than I care to remember, so I know I’m already infected–for those who might not yet have covered TB pathogenesis, being infected by Mycobacterium tuberculosis is not equivalent to having TB disease; many are called but few are chosen–but I know that certain things about our occupation (duration and frequency of exposure, the effect of high stress on immunity, etc.) put us at greater risk of developing the disease.
Whenever I usually think of my risk for getting TB, I’m thinking about white coats and facemasks and nebulisers (metaphorically speaking). So it was jarring to find myself in the back of a taxi with twenty other people, sandwiched between an emaciated old man and a voluptuous middle-aged woman, sweating bullets because all I could picture every time either of them coughed were the gleeful little bacilli leaping from their respiratory tracks to mine.
This is a frequent visual for me.
I spent nearly an hour in that stuffy taxi, trying not to breathe too deeply, wishing we could open some windows (the driver refused because he said it would lead to increased petrol usage), wishing I wasn’t waiting for the last stop, praying for some sort of miracle that would speed up the journey.
Eventually, I decided to hop of about half a kilometer from my actual drop-off point and rather walk the rest of the way. (This decision was also prompted by the fact that I wasn’t sure if I would be able to recognize the landmarks in the zigzagging taxi since I’d only visited the hospital once a few days before to map out my transport plan).
It is nearing the end of my orientation day and I’m convinced that taking that taxi was riskier than walking into casualty this morning.
I think I may have a very specific variant of OCD.
Or all those anti-TB talks are getting to me.