Shanksteps #147
by Greg Shank
February 16, 2010
So the 18 yo boy that I talked about in the last Shanksteps feels much better. He has fled the hospital leaving a $200 bill after receiving about one week of IV antibiotics and IV solution, surgery, and dressings to the stab area. It seems to be the young, with traumatic injuries that flee the hospital, leaving us short of supplies and cash. Granted this is a huge bill for him, but then again a surgery for $80 is not expensive by local standards. Add in all the other products he consumed, it was a fair price. Just to the north of us an appendectomy at a private clinic/hospital costs $200, which is about 6 times what it costs here.
It is true, most of the people here are subsistence farmers. So many do not have money. Others, even those who have stores, cattle… also say that they don’t have any money, even very important people of the community have said the same. When do I help financially and when do I not? Everyone claims to be poor. Many times they are able to pool resources from other family members or friends. And they do the same when something happens to their friends, vise versa. The community really does help each other through rough times. But when they flee the hospital that leaves the hospital in a way that we cannot recuperate. We have asked for help from the Chief and form the local military. But they are essentially unable to help, as the volume is so much.
So do we do as all the other hospitals and require money before treatment? While I was gone home at Christmas there was a woman who came in with vaginal bleeding who was in labor. The nurses determined that she needed a C-section. She was referred to the Mokolo Hospital. There she arrived without money. I am told by the staff and neighbors that she arrived, and they refused to do anything because she didn’t pay. Apparently she died outside their hospital. This should not happen as there are suppose to be special funds set aside to treat emergent patients, based on funds from the government. We do not receive any of these funds currently. So where do we draw the line? I know a line my conscience draws! But that has not helped the 50+ patient charts we have from 2009 with varying bills, all unpaid. The same quantity for 2007 and more in 2008. Whatever is decided it will likely be the children and women that will suffer the most, because they are the ones least cared for and thus the ones who will not be paid for and thus not receive adequate care or rapid care. I do hate some aspects of insurance in the US but at times wish it could be done at a local level here. Then we would enter all the reimbursement issues that are there. So obviously, there is no great solution. I assume it is trading one frustration for another, with the hospital usually losing.
Greg