I need to
preface this blog post by admitting that I am still very ignorant and have a
great deal to learn about health care here in Nicaragua (you will notice that I
throw out many facts and opinions with no references—I have done my best to
represent reality but please don’t use this to write a paper or anything), but
I would love to share some of my observations and thoughts so far.
Nicaragua has a
government-run healthcare system, so most people have “access” to free health
care at government-run and funded hospitals and clinics. I use the word
“access” very hesitantly, because in order for the people of Nicaragua to
benefit from these services, they have to be able to get there, which means having
the means to pay for transportation and also the ability to take time off work
or away from the responsibilities of their families. It is especially difficult for the many
people living in the rural areas of Nicaragua to get to hospitals and clinics
when they are in need of medical attention.
There is also
much skepticism about the quality of care that is received at these hospitals
and clinics. Marlene, the woman who
works in our home and takes care of Charlotte while I volunteer at clinic 2
days a week, has a niece, Isabella, who is 5 who was diagnosed with leukemia
about a year ago. “She’s just like Mae,”
she often tells me. The family was told
recently that she doesn’t have much longer to live. She has been receiving chemotherapy at a
public hospital here in Managua, and my mom, who is a physician, guesses that
the treatment she is receiving is what someone in the US would have received 20
years ago. A 5-year old diagnosed with
leukemia in the US has a 80 % survival rate, but a child the same age with the
same diagnosis in a developing country, like Nicaragua, only has a 30% chance
of survival. I got to meet Isabella
recently, and spending time with her made my mind and heart race… but mostly my
heart. I have a 5-year old daughter, and
if she was diagnosed with leukemia, I would do everything I possibly could to
give her the best chance of survival—and I would have the means too. How is that fair? What if I were Isabella’s
mom and she were me?
Mae fell off the
trampoline and hurt her elbow over Christmas break, and we were for the first
time faced with the decision of where to take her for medical attention. There is no such thing as 911 here in
Nicaragua (Mae just tried calling it recently).
There is a number that you can call to request an ambulance, but they
cannot guarantee that one will be available to come. And I can
guarantee that there is no way I would be able to tell them how to get to our
house. So, we won’t be relying on that
service. One of our options were the public hospitals and clinics that I have
already talked about. There are also
many little private clinics and diagnostic centers that you can go to and pay
to have whatever test—x-ray, EKG, ultrasound, lab work—done that you want for
fairly cheap (to have an x-ray done costs about $15). The clinic that I volunteer at, Clinica El
Samaritano, is a small private clinic where you can get quality health care for
less than $5/visit (which unfortunately is too expensive for many Nicaraguans).
The place we
ended up taking Mae is called Metropolitano, which is JACHO accredited (held to
the same standards as hospitals in the US), and by far the nicest hospital in
the country. I have heard that the
president had this hospital built so that his family could have a place to go for
quality health care. This hospital is interesting because it also does “Medical
Tourism,” which I had not heard of until recently. Basically the hospital offers packages to
foreigners who want to travel to Nicaragua to have procedures done at a much
cheaper rate than in the developed world.
They make it sound all cushy by offering to plan a Nicaraguan vacation
for you while you are here getting your knee replaced or whatever. I’m not sure yet if I recommend it or not,
but just in case you’re curious, here is the link to their website: http://www.metropolitano.com.ni/internationalpatients/
As you can see,
there are a wide variety of health care options available here is Nicaragua,
which unfortunately translates into a huge disparity in the care people have
access to and receive. As my eyes are
being opened to the different ways that people live, I am experiencing a mix of
emotions. Selfishly, I am so thankful
for the many blessings and options that I and my family have (we even have
evacuation insurance that would pay for us to travel back to the States should
there be a problem that can’t be dealt well with here in Nicaragua), but the
injustice of it all makes my stomach sour.
I don’t understand why in our world the presence or absence of money has
so much power, and especially the power to dictate the quality of health care
that we receive. So, for now I look for
ways to get involved with offering quality care to those who might not otherwise
get it, and I pray. I pray that God will
find a way to redeem this broken and unjust world. And I usually have faith that He will do it…. but it isn't always easy.
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