Year: 1983
Setting: Branch of the St Francis Hospital, Ikoyi island in Lagos, Nigeria
Position: Only European private general practitioner in Lagos
A few days after my arrival in the Nigerian capital, a policeman comes for treatment for acute gonorrhea. He tells me where he works, we exchange a few jokes, I give him a free injection of antibiotic and sympathize with him. Beyond his well-being, my goal is to start creating a support network for myself in a milieu that can become adverse and very violent in a matter of minutes.
A few days later, as I was driving back from a clinic, another law officer stops me at a checkpoint, a custom remnant of the Biafra war. He gets inside my car and orders me to drive around the block. Then, at a deserted spot, he commands me to stop the vehicle and says: "I need a present," meaning that he wanted a bribe. Half-jokingly and foolishly given the circumstances, I reply that Christmas is just around the corner! Understandably, he gets angry at my response and asks me if I want to go to the police station. My positive answer produces great amazement and disbelief.
On our way to the station, he tries to negotiate what he perceives would be a better outcome for me by repeating his money deal. I do not budge and begin to detect some perplexity seeping into his voice. The minute we pull up in front of the station, my STD friend profusely greets me while my co-driver hurries away in total defeat.
The lesson for the doctor: Building good relationships with patients is even more important in new environments because their support may prove invaluable in unpredictable and dicey situations.
Yann Meunier, MD, is the health promotion manager for the Stanford Prevention Research Center. He formerly practiced medicine in developed and developing countries throughout Europe, Africa and Asia. Each week, he will share some of his experiences with patients in remote corners of the world.
