Medical Care

I've been to the doctor twice since I've been here. Medical care here is very different from Western medical care. When I saw a doctor for pain in my back, the doctor saw me in a conference room, not an examining room. You don't remove your clothes, and in addition to the doctor, there was a nurse, my translator, and a random old guy who saw a foreigner being examined and came in to see what was going on. No one seemed to think having a strange guy in the room watching me was at all weird. (As a Westerner, my thoughts were a bit different. But, it's one of those cultural things you just let go.)

They don't take your temperature, BP, etc. The doctor just looks at you to determine if your color is correct, if you appear to be healthy. You pay up front before any care, there is no billing or anything like that. If we need care, our schools pay and the Peace Corps reimburses them. Locals will be denied care if they don't have the cash to pay. This includes ambulance care.

I also had to have surgery to remove a lymph node in my inner cheek. I saw a dentist in one large room with about 30 dental chairs in it. There were no instruments to assist him, so another dentist held my mouth open with his fingers while the first dentist did the surgery. (I had local anesthetic.)  Our Peace Corps doctor was there watching to make sure everything was okay. (I had to travel to our Peace Corps headquarters city for this surgery, it wasn't done locally.)

It's a very efficient system in some ways, because there are no concerns for privacy, no billing, etc. As a foreigner, we don't have to wait for care, but if a local needs to see a doctor or dentist, they go to the hospital, take a number and wait for someone to see them. But I didn't have to go through that process either time. I felt guilty walking past long lines of people. Everyone knows why you don't have to wait.

Before I saw the doctor for my back, I casually mentioned to my students that a doctor from the hospital was calling me to setup an appointment. (Our Peace Corps doctor was helping to arrange this visit.) They were silent. I thought I had committed some faux pas, that you weren't supposed to discuss this or something. Turns out they were probably just in shock that a doctor was calling ME. It doesn't work that way for them. When I found that out, I felt terrible about telling them. Last thing I want to do is advertise the special treatment we receive.

When I went to get my diabetes test, I paid about $1.50 for the hospital visit, and about $.80 for the test itself. I didn't have to see a doctor, I just went to the lab and got the test and results.

If we need emergency care, we are sent to either Thailand or Singapore, or back the U.S. We aren't expected to have serious problems taken care of here. In fact, being transported for medical care is of such high importance that we will be removed from the country if for some reason the medical evacuation company can't guarantee our transport. (This happened in 2005 because of SARS.)

Well, I know this was long, I hope it was at least a little bit interesting.