The Medical Gap

As pretty much the entire universe knows, our youngest daughter gave birth to the most perfect baby girl on Wednesday. But it hasn’t been without its dramas.

Hannah has had gestational diabetes throughout her pregnancy. That means she has had to cut out sugar, reduce her carbs and test her insulin levels 5 times a day. There’s extra scans and monitoring baby growth closer.

Baby had been super active in the womb and it was all looking good that the doctors had decided to let Hannah go right up to the 40 week mark, where originally they were going to induce her at 38 weeks.

And then baby stopped moving.

This was one of those events that stops your heartbeat. I suggested to Hannah to call the midwife whose care she was under, who said we should immediately go to the hospital. Luke (Hannah’s husband) drove pretty determinedly but there was this heavy silence in the car. No waiting, they saw us straight away. The relief experienced when we heard the heartbeat was huge. They decided to keep her in anyway.

Although baby’s heartbeat was good, the doctors had decided to induce baby on the Tuesday night. Not sure why they chose nighttime as the morning seemed a much better idea to me.

babe

I was really impressed with the staff, the quality of care but mostly the concern for baby and mother. The resources and technology are amazing, way better than when I had my kids 25 years ago.

Of course, it all got me thinking about the huge gap between what is available here and that in developing countries. I’ve friends in Kenya who have had babies and it’s a whole different world there.

 

  1. The God Factor

I call it this, because there tends to be a thinking in East Africa from people in certain positions – medical staff, police, teachers – which says ‘Don’t you know who I am, I must be obeyed without questions at all times’.

Kenya: You would never dare question what the doctor says and you simply don’t ask.

NZ: They give you informed options and don’t flinch if you question them ‘why’ or ‘could we try this’.

hospital 2

  1. The Price

Kenya: While there is a policy of free maternity care, practically it’s not so. You need to pay for services like scans. I’ve close friends who didn’t have the $30 for a scan and had a breach baby who died 20 minutes after birth because of complications. The emergency cesarean section would’ve saved his life but that was around $800. They only earn $200 a month. You need to take everything in with you to hospital.

NZ: Every single thing is free. Food, personal bathrooms, sanitary products, scans, hospital stay, sheets, pillows and even free wifi.

tray

We met a young 18 year old who had been raped and become pregnant. We arrived on the day she gave birth to her son. She was not allowed to leave hospital because her family did not have the funds for payment. Every day she stayed the debt was accruing. No doubt the family had to borrow money to get the girl home.

 

  1. Rooms

Kenya: Don’t be surprised if you are sharing a room with 8 other women. Imagine a metre between your bed and the next. Babies are often kept in a nursery, except for feeding.

NZ: While there’s the odd room that will have 4 beds in it, most are single or doubles. Baby is in your sight at all times, in a plastic bassinet beside you.

hospital 1

  1. The Birth

Kenya: I’ve yet to meet a Kenyan man who has been in the birthing room. It’s just not done any other way. In rural areas it’s older women who assist.

NZ: At the hospital our daughter went to, you could have as many support people as possible. In the birthing unit you could have two.

Nairobi has a few really good hospitals, so if you can afford to go to them you do. One is notorious for bad after birth care, but people go there because it’s free.

Our close friends whose baby died not long after a breach birth were forced to go to one such hospital. She should’ve had a c-section but the staff said to her that the lines to the theatre were long and ‘she carried small so she should deliver okay’. Of course, as in Kenyan culture, the dad went home (by public transport) but was called back because something was wrong. When he got there he was told his son had died. He never got to hold him because there was ‘confusion’ to the whereabouts of his sons’ body. He was told it was in the morgue, went there and they said to him he was on the ward. Went to the ward and was told he was in the morgue. What the attendants really wanted was bribe money. A terrible experience to an unnecessary tragedy.

Of course, if you have money, nothing is a worry. I’ve friends who’ve been in birthing centres in Nairobi and loved it. I’ve also known people who travel for half an hour on a motorbike to a rural clinic to give birth, all by themselves.

I applaud the work of Kenya’s First Lady – Mrs. Margaret Kenyatta in creating Beyond Zero which aims to improve maternal health. She is using her position to bring about awareness and change in a much needed area.

Me, one of my goals to is ensure that remote medical clinics have access to water, latrines and hand washing facilities. It’s high on our 3 year goal.

bed

Every life is precious no matter where they are born. For me, I’m getting to enjoy my short time with Isabella Rose and find inspiration every time I look at her to help other children across East Africa have a great start in life.

drugs

 

 

 

 

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When You Break A Bone

This last week has been an interesting one in the Crean household. We had visitors staying overnight who we were taking to the airport the next day. That night Pete (who didn’t put down the bathmat) slipped on the floor as he came out of the shower. He made the biggest bang I’ve ever heard in my life.

Then there was silence.

It doesn't look broken but it is.

It doesn’t look broken but it is.

After yelling 3 times Pete finally answered. He knew right then that he had broken his arm/wrist. I wasn’t convinced and mandatorily put on a packet of frozen peas to see if the pain would subside. It didn’t and so off to the hospital we would go.

Two weeks ago our insurance ran out and we didn’t have the funds to renew it. We put out the word to everyone on our social network sites – nothing. We just hoped that nothing would go wrong until we magically found the money.

Part of the waiting room at A&E.

Part of the waiting room at A&E.

Because he’s a man’s man, Pete insisted on driving the 15 minutes (at 11pm) to Nairobi Hospital. I tried to convince Pete to go to a cheaper one but he was insistent on going there. Nairobi Hospital was the place we went to when he broke his leg on Mount Kilimanjaro. They did a great job, but the insurance was paying for it – $12,000.

I was thinking it wouldn’t be busy getting close to midnight. What a fool I was. The place was packed.

Because Pete had been a patient before they had him on record so I was saved from filling in a registration form. First step – pay to see the doctor ($26). Typically you have to pay for every step along the way before it’s done. Naturally, the staff thought that our insurance would pay for it and wanted to dole out anything they wanted. Till they found out it was a cash job.

Waiting for the first cast.

Waiting for the first cast.

Second step is to go to a nurse to have a look at the wound, take your blood pressure, temperature and weight.

Then you wait once again.

Everything was moving slowly and there was the worst movie on TV. Mind you we had the choice of 3 TV’s in the waiting foyer – a Swahili program, an old cartoon or a movie about a prostitute. At midnight, what you want to do is go to sleep.

There were only a few people left and at 12.30am we were called in to see a doctor.

The next day we returned to get a better cast on.

The next day we returned to get a better cast on.

I’m not sure why doctors ask you “So how are you this morning?” when you wouldn’t choose to be there if you didn’t have to. After I had paid another $57 Pete was given a jab in the butt and we were sent off to the X-ray department. I was thinking it was going to be another hour wait.

Actually there was no one there for a few minutes. I reckon half the staff were sleeping at 1am as no one was around. The x-ray didn’t take long and Pete’s arm just above his wrist had a small crack. Thankfully nothing major (says she who has never broken a bone).

Back to the small curtained area to wait for the attending doctor to give us her final word.

A much happier Pete Crean

A much happier Pete Crean

She had a 5 second look at the x-ray and told us they may want to wire it. No way was that going to happen, there was no money for that. We would have to see the orthpeadiac surgeon in the next couple of days but meantime they would put a cast on it.

Another $93 later, it begins. I had to go out of the room because it was too small for 4 people. Meantime I was instructed to go and get his medicine. I was thinking to myself ‘it better not be just Panadol, as I’ve got stacks of it at home.’

At the beginning of our hospital visit I had asked if all the charges could be put once on a card, thus trying to avoid several international transaction fees. Looked like it wasn’t going to happen.

What infuriated me was the last bill I had to pay was only for $23 for the medicine.

It was 2am before we were able to get out of the hospital. Again, his royal highness insisted on driving home. Pete’s one crazy guy.

Overall the hospital visit wasn’t tragic. Nairobi Hospital is one of the best in town, and it’s the closest to us. You don’t have to pay for parking but like other medical places, you have to wait a long time to get seen. I’m glad it wasn’t something life threatening like a heart attack and you’d die while waiting to be seen.

Nairobi Hospital has a lot of high tech medical devices, it’s just whether you can afford to use these. I was surprised how helpful and polite the staff were in the early hours of the morning.

The medication is working, the heavy cast has been replaced by a much better support cast, after spending another $200.

Dr. Atinga repaired Pete's broken leg 4 years ago. Now he's done the arm.

Dr. Atinga repaired Pete’s broken leg 4 years ago. Now he’s done the arm.

All up the slip coming out of the shower cost $400. Insurance for a year is $1,400. Go do the maths.

The next day we returned to visit Dr. John Atinga who put Pete’s leg back together after he broke it on Mount Kilimanjaro. Unlike the doctors the night before he took a quick look at the x-ray, never mentioned surgery and gave us the simple option – a lighter support cast or 3 weeks and then a review. I wish he was on the night before as it would’ve been a much cheaper and simple option in the first place.

Here’s hoping we can get covered soon as Kenya isn’t exactly the safest place to be in (even without slipping). There’s a high terrorist threat at the moment, the roads are crazy and personal security even walking around isn’t good.

Here’s also hoping we don’t visit a hospital for a long time. Meantime, if you feel you could help us be covered by insurance you can donate online HERE.