Everywhere Has Its Pros and Cons

 Being in the US, there are constant reminders of the similarities and differences between here and the islands and even mainland East Africa.  One of those areas is healthcare. It can be easy for everyone- Americans, mainland East Africans and islanders— to be down on their own healthcare systems for different valid reasons.  

Learning to Drive in the US

Once when we told an East African that we often came to his country for our healthcare, he was absolutely shocked! His impression was that the healthcare in his country was either poor quality or too expensive (if not both). We let him know that compared to the islands the quality is very good and compared the the US the costs were inexpensive.  Sometimes comparison changes your perspective. 

This week we have been reflecting specifically on getting prescription meds.

No one can deny that the US has a huge number of highly trained doctors and specialists. In the US, there is the best, cutting-edge care of the world.  But access, wait times and cost are concerns.  Also, the system of medical insurance is known for its fine print and run-arounds. We experienced it this week as we spent a great deal of time on the phone and computer— on hold, being forwarded to new people, being asked to call new numbers, sending messages through online portals, receiving denials and trying again. We still don’t have our daughter’s new medication— even though it was prescribed three weeks ago. 

In comparison, East Africa has a growing number of specialists and some good quality care— but it is generally in private hospitals that are too expensive for most local people (though cheaper than the US). Some medications, treatments or specialists are not available. Access is less of an issue.  Our daughter was able to see a specialist right away and started a good treatment plan. Payment for meds is pretty straight forward there.  We front the money and are usually reimbursed by insurance in a relatively quick time. But every time we had to get the meds from the pharmacy it was a pain. The medications being specialized, meant the pharmacy had to do special orders which meant included longer waits and more hassle than promised. Then when it was time to try a new treatment— the options weren’t as good— the depth of treatment options couldn’t compare with the US. But at least there were some options— on the islands neither specialists nor medications would have been available at all. 

The islands don’t have much. The healthcare system is improving, but there are still many types of specialists, even basic types of diagnostics, treatments and medications that are completely unavailable. Funding and maintenance of hospitals is lacking and medical staff often go without pay. On the flip side, access is much quicker and easier, if you have the money and know what you want/need.  There are fewer hoops and approvals required on the islands.  Normally, you can show up at a private clinic and just ask for the test or appointment you want and have it done immediately. You don’t necessarily need a prescription for meds either.  As long as you know the name of the medication and the amount that you want, most pharmacies will give you what you ask for—no questions asked. The problem is not permission but availability.  Several times we have walked around the capital to different pharmacies with the name of a medication written on scrap of paper, asking at each one if they have it.  If the medication is not common, more often than not we won’t be able to find it. But in those cases when we can, normally the price will be a small fraction of the cost of what you would pay for the same meds in the US—without insurance!

Each place has ways in which their medical systems could improve. We are so thankful for those on the islands trying to improve the healthcare there.  We are thankful for all the treatments, procedures and diagnostics we’ve been able to get in East Africa.  And now we are thankful that our daughter has access to the specialists and treatments that she couldn’t find elsewhere… and we’ll be even more thankful once the insurance approves and pays for her new treatment!

Anniversary Hike

PRAYERS ANSWERED
We made a huge dent in our to-do list this week— we are thankful that what is left feels a lot less daunting. We are thankful for reconnecting with family and old friends in the Boston area, including a fellowship on Sunday. Our two older kids successfully passed their permit tests and got their driving permits and have had some beginning driving lessons with Tom. We are thankful for our 23 years of marriage and getting some time to take a little hike for our anniversary. 

PRAYERS REQUESTED
We have had repeated difficulties navigating the speciality pharmacies and insurance to get Grace’s new medication. Please pray that it can be sorted soon with the three parts: doctor, insurance and pharmacy so she can start her new treatment soon. She has now finished the meds we brought from East Africa, so we need to figure something out this week. Megan and the boys leave in just one week and it will be a full one— pray for our continuing stamina and good use of time. Tom and our daughter have two weeks before they head to MN for her college orientation. She would like to get her full license before then— pray that she can have good chances to practice driving and get more comfortable behind the wheel. The islands are preparing for a major meeting at the end of the month of the translation projects from all three islands— pray for the planning and logistics of that gathering and for those traveling from abroad.