Friday, May 27, 2011

random medical notes (how much does your diaper cream cost?!)

Today I went out to buy Nystatin cream.  One of the kiddos has a diaper rash.  So, went to a few pharmacies.  You don't need a prescription to buy what you want, you just ask.  One of the bigger pharmacies I went to asked $5 for the cream.  Now, if I had just gotten here, I might have paid it.  But now I know better.  $5 is a lot of money for a small thing of cream!  (Keep in mind, big aid organization pay their temp day laborer about $5.83/day!).  Would you pay your entire salary of one day to treat your daughter's diaper rash?  No way.

Personally, I know this pharmacy has a bit of a racket going.  There isn't health insurance here, so many NGOS (big aid organizations) contract with clinics/hospitals to see their employees and their family members.  Everything is covered by the NGO.  Well, this causes the clinics/hospitals to take gross advantage of the NGO and the patients suffer (and in my opinion are put into harms way).  They are frequently misdiagnosed, way over prescribed medications (most of the time that they don't need), and subjected to exams they don't need so that the facility can charge the NGO more money.  For example, if you go in for a simple cold with a cough (no fever), you might get antibiotics, two kinds of cold medicines, reflux medicine, and an xray.  Back to today, I went to another pharmacy and they sold the medicine for half the price.

Overall however, having no access to health insurance, good quality health care, or affordable medications means that many people die from preventable illnesses or they treat themselves with traditional medicines (which may or may not be safe and effective) or they don't get treated at all.  An example, an albuterol inhaler to treat asthma can cost $8-12/per inhaler.  If you make $40-50/month affording an inhaler is an impossible cost.

What if your baby has hydrocephalus?  Or your child has diabetes?  Or a heart condition?  Or asthma?  Or malaria?  Or meningitis?  Or an abscess?

How do you possibly run a hospital without outside support if most of your patients can't even afford medication let alone the cost of their stay?  You can't.  That is why, hospitals like Panzi or Kaziba can't run their hospitals without support from the outside.

Interesting note--here in Bukavu, you are not discharged from a hospital until you pay your bill.  (You actually CANNOT leave, even if you wanted to).  And the longer you stay the bigger your bill.  On the one hand, sounds pretty horrible.  On the other, how is a hospital supposed to even run if it cannot collect their fees?

Okay, now I have a question.  I hear a lot about a surgery done to babies in their throats.  They get sick and have difficulty breathing and then they get something removed from the back of their throats (and not in hospitals).  And it sounds common.  Epiglottis?  Diphtheria?  Any guesses?

Kaziba Hospital (photo is taken standing at the orphanage, so this is the backside)

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