Where Can We Go For Care if the Hospital Turns Us Away?

By Maria Victoire (Ivory Coast)

Photo by flickr user Umayyr

Photo by flickr user Funky64

Life expectancy in Africa is 52 years for men, 54 for women. People die every day for a lack of care.

I overheard this conversation: “When you’re sick, will you go to the hospital to get a shot?”

“No!”replied the other one.

They know what they’re talking about – everyone knows that the hospital is where you find death, because finding quality care can be so hard.

Someone else said: “I pray I will never be sick, and if one day I have to go to the hospital I will ask God to take me, because the hospital isn’t a place where we are cared for anymore.”

People do what they can to care for themselves with herbs and teas that they have around them. But once a patient needs a more complicated procedure (an operation for instance), then the problem becomes serious. Death is on the look out whenever malaria or Typhoid, or even a simple fever is passing through. To go to a small pharmacy costs at least 200 FCFA – and even this is difficult to pay.

I have seen things I wouldn’t have believed had I not seen them with my own eyes. We were in the emergency room of one of the university hospitals last month. It was during Easter – the uncle of a friend had been hospitalized in an emergency. He had been declared dead by the doctor, but then was still breathing when he arrived at the morgue!

When they realized that he was still breathing, they immediately sent him back to his room. To save him, the family had paid for an expensive taxi to take him to the hospital. Since he was admitted in the emergency room, none of the different doctors who had seen him bothered to say what his sickness was. The family wasn’t even informed of the results of the tests that were done. They were told, “We have to do a test, and it costs 12,000 FCFA.” “There is another blood test, it costs thousands of FCFA.” It adds up – the expenses accumulate, all of it beyond what the family had in their budget.

After having insisted on the swelling in the man’s abdomen, the doctors announced that in fact there were three symptoms! Then they asked the family to bring them two empty bottles so that they could take the fluid out of his abdomen. The family rushed around the hospital looking for two empty bottles. It is very difficult in Africa to find empty bottles because everything is used, everything is sold – jars of jam, ketchup bottles, coca cola… The family searched everywhere but in the end had to spend 500 FCFA to buy a bottle of water – just so they could have an empty one!

When the two bottles were brought back, a nurse took the uncle aside in the hallway and told him, “You have to pay us something so we can take care of you!” But the family had no money – they had driven for hours from south to north to get quality care, they had paid for all the analyses and tests, the hospitalization, and now on top of it all they were asking for money so that they would take care of the sick man!

These professionals have taken an oath to care for sick people. “Not taking care of a sick person is a crime,” said one mother. “Everything turns around money – to take care of you, they check if you have money, and if you don’t they send you home.”

Another shocking story: a woman had just been admitted, but her husband didn’t have the money to pay for two tests which cost 9,000 and 12,000 FCFA. Suddenly the nurse said to the husband: If you don’t have money, you have to leave the hospital: we’ll take care of you when you have money,” and she took the IV out of the arm of the woman and her husband got together her belongings and they left the hospital.

Once more, we see that the right to health doesn’t exist in many places where poverty reigns. We cannot separate the right to be cared for from all the other fundamental rights – people pay a high price indeed for living in extreme poverty.

[This post originally appeared in French on the blog Un Monde Autrement Vu]

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One thought on “Where Can We Go For Care if the Hospital Turns Us Away?

  1. It sounds extremely cruel on the part of the doctors who actually have to tell people that they cannot treat them unless they come up with the money. It’s like pronouncing a death sentence when there could be ways to save a human being. Are there people who have chosen to become doctors or nurses in order to have the power to decide over life and death? I wonder if this is not a curse rather than a power.
    I have been to public hospitals in several different countries in the south to visit people as well as to get treatment myself and I realized the expenses that go into medical treatment. Even for a simple injection they first sent me out to buy the material (syringe, medicine, cotton pads, iodine, you name it), because they just don’t have enough funds to buy enough in advance. In Vietnam where I lived longest, the first question was: Do you have an insurance? Because if you do, then they put you in the express line as a VIP (you have no choice in that) for the pleasure of not having to wait for hours on end. The price is accordingly higher, but it was still much cheaper for my health insurance than if I had got the same treatment at home. I learned that this method of having different treatment classes helps to pay for others who cannot pay. Obviously it’s not enough. There were never big crowds of foreigners or “VIP” (except some weather-worn backpackers) who would accept to get treatment in such basic conditions.
    The equipment is simple and used to the limit and hygiene certainly is not always very good. But the doctors and nurses are extremely dedicated given their modest salaries and the long hours of facing sheer interminable lines of patients many of whom arrive from the countryside with the night bus at 4 o’clock in the morning and often wait until one or two in the afternoon to get to see a doctor. The sick are lying in the hallways on mats, attended to by relatives, and there is little privacy if at all in the emergency ward or the orthopedics where I had to go frequently. And when you go to the wards where those are who need to be hospitalized, you find them lying in rooms with twenty, thirty or more beds, and patients are mixed because the staff don’t have enough space to separate gender when there is hardly enough space to separate contagious patients adequately from the others.
    It is of course upsetting when you see the conditions in which people are treated, or that some are even refused a treatment they cannot pay for. But I am upset also when I see in which conditions doctors and nurses do their jobs and the terrible decisions they have to make when they run out of material and medicine. For example, operating without adequate anesthesia is horrible for the patient, and so it is for the surgeon. It’s very difficult not to become hardened when you don’t have the means to do your job properly… Our compassion with those who don’t have access to health care must not stop short of rethinking the whole unjust global health system before condemning the attitude of individual staff who have been alienated if not desperate by unbearable working conditions.

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