One thing to consider before you travel to less fortunate countries is how reliant you are on medical care. Health insurance won’t do much for you when you are sick in the jungle, an hour away from the clinic. Doctors are in high demand and spread between clinics, so best not to expect you’ll find one there if you do make it.
In 1997, after a forty-five minute drive up a rocky dirt road, Bob and I were greeted by our hosts in what would soon be our new home in Belize. We were there to take over the stables and lodge for the owners so they could move back to the U.S. During that stay, the wife showed us her closet of medical supplies and told us not to be surprised if someone showed up in need of help. Not only were they providing their own medical care, they had extended it to the surrounding community. Her husband took us around the barn, noting that he did the stitching himself when the horses tore themselves up. He suggested we practice suturing an orange to prepare.
Before they left, they handed us their copy of “Where There Is No Doctor,” essential to survival in the bush. After Belize we lived in China, on Guam, and in Nicaragua, eventually replacing the well-worn book with Google.
By the time we moved to Africa in 2012, we thought we were prepared for anything. That was, until one of our housemates had a heat stroke and nearly died. The young intern (let’s call him Dave) was unused to fending for himself, yet seemed aloof and beyond taking advice. It was a bad combination, a ticking time bomb. We crossed our fingers he wouldn’t get into too much trouble before his month was over.
Unfortunately, he unwisely pushed his limits and collapsed in the courtyard one morning. Luckily we were home and saw it happen or he would have laid there in the sun until someone happened by. Dave was incoherent and unable to stand. Several of us dragged him to his bed in the cool basement. Suspecting heatstroke, one ran for ice, another got on the computer, and I called for an ambulance. No dice. They listened to my story and hung up.
Next, I ran to the nearest house where Bob and I had met a doctor. A man came to the gate and told me the doctor was not home, so I ran to a second house where the neighbors said another doctor lived. I banged on the gate to no avail. Although I could see a man walking around in the compound, he was moving away from me. I banged until I realized he’d gone to the side of the house to urinate, and gave up.
Meanwhile, Dave’s muscles had all seized up and he was screaming with pain, eyes rolled up in his head, stiff as a board. My other housemates had packed his armpits with ice and were doing their best to keep him with us.
Desperate, I called another neighbor, a taxi driver, and he showed up with characteristic good cheer to take me to the “hospital” a fancy name for the local clinic. On the way, he stopped at another house he said belonged to the doctor who ran the clinic. After knocking at the gate for a minute, I was pleasantly surprised to see a stately African woman approach. She identified herself as the doctor’s wife and, unsuccessfully hiding her irritation, said he was eating dinner but would meet us at the hospital as soon as he was finished. I got back in the cab and we raced back to the house.
By now our other taxi driver had brought his wife, a nurse and Dave’s muscles had unclenched enough for us to move him. They loaded him into the cab with Bob and the nurse and drove to the clinic. I’d like to say the nurses at the clinic took it from there, but they ignored Dave, offering only a hospital card for twenty cedis. I’d like to say our friend the nurse shamed them into at least taking his temperature. I’d like to say the doctor arrived, chastised his staff and treated our housemate, but he never showed. After an hour, Bob brought Dave home and eased him into bed. We nursed him for the next couple of days, and at the end of the month sent him on his way in one piece.
The moral of this story is, don’t expect medical care to be the same as you are used to back home. Even industrialized nations may not offer the kind of care you are accustomed to. Health Care in the third world can be pretty sketchy so be prepared to take matters into your own hands.