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Health has always been of great concern all over the world. A nation’s development depends largely on it. It has been said, that Health is wealth. This is true because medical care is expensive and the human body is the most priceless commodity on the market.

Amongst the growth, development and attention every person tries to acquire, medical care has been the least and hardest sought. Seemingly desired but seldom concerned.

It is not so comfortable expressing ignorance and neither is it exposing one’s body and privacy to another person, is it? When people sit in front of the Doctor, so many thoughts run amok through their minds. They perceive the outcome of their visits immediately they have their hands on the door knob or even in the waiting area. “Who is this Doctor and how can he or she help me? Is he or she nice to talk to? Why is he or she not smiling? Will he or she really listen and manage me well? Will I leave satisfied or regret this visit? What will he or she think of me when he or she sees my penis or sagging breast?”


Most people do have good reasons for not seeking medical attention. Although some are just ignorant, others suffer a true sense of anxiety, dilemma and fear. They either present a false state of their problem or serve the prescriber with a puzzle to solve. This is a defence mechanism to sometimes assess the nature of the Doctor they have fallen unto. They wonder if she would be nice and interested to know more or just take what they have presented without further probe. Unfortunately, many walk miles away more traumatized and mentally abused because of the Doctor or nurse’s lack of tenderness and care. But I thank God and I believe that if Eleanor was an Angel, she surely would have had a good report to tell The Heavens about me!




@ 11:42 am.



Painful watery mouth (recurrent for 5/12)

Before I could continue to do my Direct Questioning (ODQ), I was thrown into frenzy! I paused for while to be sure I was in my right senses, and hearing well what is being said (because the consulting room can be extremely tiring and exhausting sometimes). I kept getting the same feedback on every clarification. I paused my questioning and went straight to examination.

She opened her mouth at my command, but I could not see water or any kind of unusual fluid. I checked the throat, the mucosal membranes, beneath the tongue, almost everywhere but there was nothing I could see. Her speech and buccal movement was also not suggestive of pain in the mouth. So which mouth was exactly “watering” with the pain?

I don’t think my reaction was well cultured enough because I was growing out of patience. She looked totally indifferent of the situation and that almost spurred the anger already starting up within me. I tried everything nice and funny, but she was still not willing to open up. I nearly wrote her off to the next Doctor on duty, at least to punish her for her own game. But suddenly, I had that magic intuition that is always with the doctor.


Doctors can most of the times predict the actual complaint of a patient. Not only the complaint, we are also capable of reading ahead the patient’s emotions to know their state of mind!

What sat before me this day was total fear of being laughed at, because she had a hygiene related infection which is very common with women.

Her actual complain:

Vaginal discharge

Painful urination (recurrent 5/12)


Offensive discharge+, waist pain+, lower abdominal pain+, frequent micturition+, urgency+, fever•, vomiting•

Drug hx – nill


A young lady, looks well, no pallor, no jaundice, afebrile and well dehydrated.


Fast forward……

Abdomen – abdomen is full, soft, moves with respiration, there is supra pubic tenderness. No renal angle tenderness

Laboratory results:

Urine R/E

Appearance – Amber

Protein – negative

Nitrite – negative

Leukocyte – ++++

Uribilinogen – negative

Bilirubin – Negative

Pus cells – 20/1

Epithelial cells – 15/1

Blood – ++ (not in menses)



Urinary Tract Infection (UTI)


She looked sad as I broke the news to her. In her eyes, she wished to be talk to, to be counselled on how she contracted UTI. She instantly stole my heart as Theodore in Alvin and the Chipmunks always does with his voice and innocent looking face. I held her hand, reassured and educated her on what UTI really is and the causes.

So what is UTI?

Urinary tract infection is an infection of the urinary tract usually caused by bacteria. The urinary system consists of the bladder, urethra, ureters and the kidneys. UTI is commonly diagnosed in women because of the anatomy of the vagina (closeness of the anus to the vagina and closeness of the urethra to the vagina)


  1. Wiping the anus from down to up. (Faecal matter from the anus contains millions of bacteria from the gastrointestinal tract. Any small amount bacteria that enters the vagina can cause the infection)
  2. Sexual intercourse; “fingering” with dirty fingernails and sometimes sleeping with a partner with sexually transmitted infections like Gonorrhoea.
  3. Wearing soaked sanitary pads for a long time
  4. Wearing dirty panties.
  5. Pregnancy; UTI is usually common in pregnancy. Almost every pregnant woman gets this infection before term. It can be mistaken for “offshore” complains such as fever, severe lower abdominal pain, headache, general body pain and severe waist pains with or without vaginal discharge. You cannot wait to hear painful and frequency of urination which are usually present in a non pregnant woman. The urine r/e and blood film for malaria parasites (which also sometimes come with similar complains) gives the differential diagnosis.


“And also do not forget to be drinking water frequently because it flushes out bacteria from the urinary system.” I ended with a fulfilled smile.

She admitted of being guilty on this and that, and promised to do well because of possible complications, which is another tale for another day.


(c) Eunice Godbless for CLITH NGO 2017

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