Sunday, February 26, 2006


It seems a lot of time has been spent in hospitals recently. The Dixon blog (my last entry) talks a little of the hospital experience (“ . . . on this day when we found ourselves waiting 14 hours to see the doctor”). I don’t always need to go to the hospitals, but sometimes – if I need to be sure to have information, specific information, specific questions answered, details about a prognosis, etc. – then I need to go. Other times I need to go if we are taking a Liberian to the hospital for surgery. Hospitals are a different process here than what we are accustomed to in the U.S., and in my last blog entry I had promised to describe them a little more.

I’m not sure if this method is really any better or not – I suspect it’s not – but I’ve been told that “You need to get to the hospital as early as possible – around 6 or 7 at the latest!!” (As far as I know, appointments with doctors are not an option here – maybe in private clinics, but that privilege is definitely paid for.) The idea with going so early is that the patient can register, or if registered in the past, can collect the file from hospital records, and be among the first to submit his/her file in the department or with the doctor to be seen. This is what we did with Dixon – he arrived at 6 and took his file to the nurses for the doctor he was to see – and he was the first one to do this for that day.

Remember, we were still there 14 hours! And partly this is because Liberian refugees aren’t always treated very respectfully (mostly due to differences in cultures, I think – different approaches and attitudes toward things – this could be another topic for another blog entry), and in this case the nurse who received his file was asking Dixon to pay more money than usual and delayed accepting his file for about an hour, by which time a number of other people had already arrived. But there are so many other aspects, too. One is that when you come so very early you are there hours before the doctor comes. And no one tells you, “OK, you will be seen 9 hours from now, so go about any other business you might have.”

Registration and file collection - in action
Anyway, registration or collecting a file can be a struggle – and can take up to 3 hours (it would have taken longer the day it took 3 hours, but I found my way to administration and complained about the unreasonableness of this).

So, finally, after hours, you get to see the doctor. Often, the attitude is reminiscent of attitudes we in ‘the west’ also shared 30 – 40 years ago, and some people still have – that the doctor is the authority, the one and only authority and no questions should ever be asked, we need to trust and obey and keep our mouths shut except when taking the unknown medications with unknown side-effects which we have been prescribed for an illness for which we have not been told the name, the cause or any future prevention strategies.

Sometimes, a different type of doctor is seen – one who shows empathy and compassion, answers questions, and treats the patient with respect. Sometimes. And then it’s nice to be treated with empathy (you’re probably suffering from some ailment, which is why you’re there, after all), get some questions answered, be talked to as though you are a human being with some level of intellect beyond that of mushroom.

After seeing the doctor, the patient may get sent for lab work or x-rays – which will involve another waiting period – and then a need to return to the doctor (maybe the same day, maybe another) to have the information reviewed.

In general, hospitals have crowds of people. Seats are usually at a minimum. Endless, endless waiting takes place. People – patients and staff alike – get tired and annoyed. Not much empathy is shown. Drugs are prescribed – drugs and more drugs. (And often the patient will also already be doing some “country” or traditional healing method, or will add that to whatever drugs the doctor has prescribed.)

Anyway – this has been my life lately, it seems. One hospital I’ve needed to take some orthopedic patients to is a 6-hour drive. We leave around 4:30 in the morning, end up spending at least 6 hours at the hospital, and then drive 6 more hours back. (There was a closer hospital we were referred to in the past – only a 3-hour drive – but they no longer want Liberians to be referred to them – again, the cultural/attitude problems mentioned earlier.) Fortunately, once we’re actually with the doctor at this hospital, he’s been one of the ‘good ones’ – someone who’s taken time, looked patients in the eye, explained procedures and treatments, etc. This lady's posture says it all

For most hospitals, if a patient is admitted there is a need for a caregiver to stay with the patient. This person sleeps somewhere with other caregivers. This person’s role is to cook for the patient, wash the patient's sheets and other things needing washing, and help to meet other needs the patient may have.

There are private clinics/hospitals and in these you get treated more compassionately, frequently have less of a wait, usually have things explained better, and usually feel more comfortable in trusting the doctor's opinions. However, you pay for that treatment - therefore, I usually end up at the other hospitals, waiting 14 hours to be treated like a mushroom.

I had promised to give updates on Dixon. He’s scheduled for surgery later this month – I still don’t know where the money is to come from, though, and am hoping to work something out with the hospital. Right now, I’m extremely grateful to the people who have responded to his need – and we’ve managed to raise $225. There’s not much time to raise the balance of a little over $1000, so we’ll see what to do when the time comes. I trust it’ll work out – we do the right thing with what we’ve been given and God always seems to work the rest out – even though the working out can at times be a nerve-racking, sweat-inducing, uncertain time which may lead to temporary (hopefully only temporary) indebtedness. I’ll keep you posted.


At 2:33 AM, Blogger finishthatpaper said...

Hey Steve -- nice blog and amazing photos, really capturing the feel of the places and the long waits there. But two comments/questions: 1) what kind of hospitals are you going to --- public? church-funded? who funds them and how much to people pay for doctor visits? 2) what's the difference between cultural/attitude problems and plain old discrimination? It looks like you are just speaking carefully but maybe you really mean something different?

At 2:07 PM, Blogger steve said...

Hi finishthatpaper, we have gone to some private hospitals - as with Abbie - but they're more expensive and not often an option. We've also been to some mission/church associated hospitals - and frequently their prices are more reasonable and even the care is better and more empathetic - but there are none very close to us. So, we often end up at the government/public hospitals - and these tend to be crowded, unpleasant places to hang out at for hours/days/weeks on end. Don't know details of funding. A simple doctor visit resulting in no further treatment or medications could cost around $3 - which sounds like nothing, I guess, but could feed that same person for a couple of days, at least. Question #2 might need a blog entry in itself to answer - maybe I'll consider that for the near future.


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