Friday, February 12, 2010

Health Care Reform?

"The system is broken" in many ways in Kenya -- from the top down.

That is reflected in the quiet pleas of the impoverished, the angry voices of the disenfranchised, the wasted bodies of the HIV-infected, the sunken eyes and swollen bellies of hungry children. Still, people cope, and Americans might consider some options (and/or adjust some expectations) vis a vis our frail-but-still-functional medical mission hospital here...

Where there are no outpatient appointments, but where people come when they are truly ill and wait patiently for attentive care. Where the hospitalized bring their own water, plates, utensils, wash basins and toilet tissue. Where family members (who are charged room and board at $4.50 pp, half the daily hospital rate) provide personal patient care and save paraprofessional salary expenses. Where IV antibiotics are limited in scope but remarkably effective when/if we have them. Where oxygen tubing and bedpans are cleaned with Jik/chlorine bleach and re-used, of necessity. (Note: needles are NOT.)

Where water and electricity are erratic, but where methylated spirits and kerosene lamps can suffice. Where chickens may wander the wards, but where sunshine, fresh air and simple foods are plentiful. Where major surgery is unavailable because we have no surgeon, but where simple fractures are set, C-sections are performed and healthy babies are delivered daily. Where no one can afford the one insurance policy available in Kenya -- which just covers hospitalization (but not surgery), anyhow. Where the ambulance fee ($2.50 to/from the nearest town) is often averted by transporting patients on piggyback, wheelbarrow, and piki-piki, but where the majority of them still arrive and leave on foot. Where a family's cow may be sold to pay a hospital bill, but where invoices are issued if necessary.Where people live who would otherwise have died.

The system is not ideal, but it is far worse in Kenya's government hospitals, where outpatients are frequently prescribed expensive, often inappropriate, lab tests and medications but are rarely given physical exams. Where inpatients must bring the same personal care essentials to the hospital but are admitted two to a bed -- and are seen twice a week by poorly trained medical officers, vs. twice a day by Dr. Hardison. Where surgery is not performed unless "kito kidogo" -- "a little (more often a lot!) extra" -- crosses palms. And where discharged patients are literally locked in a crowded back ward until their bills are paid.

Perspective is all?

Thanks be to God and to all of you who support and pray for us and those we serve.


Al said...

Your words open a world of insight. Thank-you.
Al , father of Anna.

Dianne, Dee, Mom, Granny said...

Asante sana. It is a joy to be sharing this experience with your lovely daughter!