22 March 2014

The Cost of a Check Up

Lately my mind has been occupied by the reality of the great cost of seemingly small decisions pertaining to life in these parts.  A patient who runs into a burning house in order to salvage her life savings.  Or the son who decided to hold his father upright while walking because he can't spare the extra money on a walker.  Or the grandmother who hasn't eaten for two days because her kiddo has a therapy appointment.

My Favorite F. came to see me on Wednesday.  She was supposed to come last week, but they didn't have enough money for the bushtaxi fare to get to the NGO clinic that would drive them the rest of the way to the hospital. 

When they arrived, Granny greeted me and immediately helped herself to a floor mat that was rolled up in the corner.  She spread the mat in the middle of the gym, laid down and fell asleep.  When she awoke about half an hour later, I asked if she was unwell and needed to see the doctor.

'I'm fine,' she said.  'Just hungry.'
How many times have the words 'I'm STARVING!!!' crossed my lips?  Countless, I'm sure.  How often has it been true?  Not a single one . . . except maybe for that time in preschool when I wouldn't eat my eggs . . . for a weekend . . . on second thought, nope, not then either.

I know what it's like to feel my stomach growl . . . but I don't know what 'hungry' really means . . . at least not in the way Granny does.

Turns out, in order for her to get to the NGO clinic to catch a ride to our hospital, they had to go without eating . . . for at least two days.  They didn't have enough money for both the taxi fare and food, so, she made the impossible decision, and came in for the check up.

As F. came running up to say hi, the first thing I noticed was that her belly had shrunk . . . and then that she was lighter to pick up.  I guess that's what happens when you're no longer provided with PlumpyNut on a regular basis.

I heated and resized the mask while F. made her way to the bottom of the peanut bottle I had stashed in my office for those days when I work late.  Granny improvised FunDip-style with a baggie of milk powder and sugar from our coffee break supply.  It was clear . . . they were not simply 'hungry'.

The mask was tightened and F. is making great progress . . . most of her scars are softening and flattening.  Her pigment is returning, and she's as sweet and cheeky as ever.  We sent them on their way with a bag of hard boiled eggs, peanut butter, baguette pieces and half a dozen mangoes to share with the other women and children in the vehicle.

As I said goodbye, I wondered if I would go to the doctor if my co-pay was two days of fasting . . . and what about Granny?  How many more times will she be able to scrounge up the fare to get to us?  At what point will she give up on the value of the mask and just stay home?

I cannot begin to comprehend the weight that comes with the decision to provide an ongoing consolidation of resources for one child when there are at least a dozen in the whole household . . . and a little girl at that.  I'm unable to imagine how the pain of hunger could influence reason . . . but I know that it is a dictating factor.

In the mean time, I do what I think is right, follow my convictions and hope that what is offered out of care is not misunderstood as a buyoff or bribe.

Suppose a brother or sister is in need of clothes or daily food, and one of you says 'Go in peace, be warmed and warmed and well fed!' but does nothing about his physical needs, what good is that?  Faith, by itself, if it is not accompanied by action, is dead.
                                                                           James 2:15-17


Hannatu said...

Deb, a lady brought her daughter to me. She had a huge gash in her foot that really should have been stitched, but several days later it was too late for stitches. I asked her why she hadn't taken her to the clinic. She said, "You know we don't even have money to eat let alone go to the clinic." Wow. I almost felt like I'd been slapped...and that I deserved it. I did remind her that I was always happy to help pay for the clinic when it's a true emergency. But it's just incredibly sad that people have to choose between food and necessary medical care.

COTA2014 said...

I would love to talk to you more about your experiences! Please email me when you can, ajones10386@gmail.com

Jessica Mack said...

I am fascinated with your blog and how you weave rural African culture with therapeutic goals and patient values. I recently came across a newsletter at work (privately owned PT clinic in northern Wisconsin, USA) pointing me toward Galmi Hospital and/or SIM. I have visited many countries (most recently Uganda) and am driven to dive deeper. Are they still seeking physiotherapists at Galmi Hospital? I wish to serve but have student debt to repay. Do you know who I can discuss employment options with? Thank you Deborah.

Stephanie said...

Stories like these break my heart! You have to be here and see it first hand to really grasp what deep poverty really is. May our hearts be filled with compassion for those born into impossible circumstances.