January 18, 2011

January 18, 2011
--Tuesday. We’re still on fluid time – today we were to leave at noon for a 90-minute bus ride to Dibombari for an afternoon doing assessments and health ed classes at the lycee (high school). David woke us up at 9 am saying the phone is back in service (the network has been down for the past week so we’ve not been able to communicate with the outside world from our home base) and we’re leaving at 10:30 at the school’s request. Just then one of our folk said we have several who are down sick – more phone calls, more plan changes. The bus was to leave at 11:30 for Dibombari –at 11:15 Elias (bus driver) discovered a flat tire, so the bus left at noon. Joe and I have stayed at home to tend the infirmary --------
--Thankfully, this morning’s brief power outage is over, and the AC and water are on again. Joe did our laundry. The girls are sleeping. Francois’ rooster has gone away, maybe in search of a lady friend? we hear a rooster in the distance – hmmm. Hundreds of birds are chirping in the nearby guava trees, sometimes there’s a gong that in actuality is probably the breeze blowing the tin on someone’s roof nearby. Its hot on our shady porch, and sublimely peaceful.
--Tonight’s debriefing included report about the little boy we sent to the hospital last Thursday. His mother had brought him to us in her arms saying the past few days he’d had fever and diarrhea, was throwing up, and was getting worse. While we waited for the ride to the hospital to be arranged, we offered some Pedialyte which came right back up. When he arrived at Mbanga hospital he was immediately admitted. Last Thursday it wasn’t possible for us to have one of our group stay with mom and the little guy, they were dropped off and we expected to follow up at the hospital on Monday this week. For various reasons, we didn’t go to the hospital as expected, and Monday evening mom showed up here with the little guy who looked and acted a whole lot better. She told us that because she had no money to pay for his care, his treatment was stopped on Friday, he was discharged and mom’s ID card was taken for security against the hospital bill. They’d been in Mbanga without food for the weekend, until mom was able to borrow about 1500 CFA ($3) for a taxi ride back to Mangamba. She was very grateful for our help getting him to the hospital, and hoped we could help with the bill. So, Tuesday, today, mom and toddler went back to Mbanga Hospital with our folks who were stationed there for clinicals. The bill was paid and prescriptions were filled for 10,000 CFA ($20), and mom has her ID card again. This is how the system works here – pay as you go for inpatient and outpatient medical care, and if/when you have no more money, treatment stops then. We have heard of cases where the treatment was stopped but the patient was not allowed to leave the hospital until the bill was paid – sometimes it’s a few weeks before the family can raise the “ransom.” There is no national insurance, and private health insurance is scarce and inadequate. We won’t make that mistake again – when we can’t accompany someone who we hospitalize, we’ll assure that the payment and return ride are arranged.