A microcosm of our trip: we visited a hospital today and the experience left the group scattered in reactions, thoughts, and feelings. The regional hospital that we visited was equipped with 10 doctors and 20 nurses to cover 50 beds. There were two main wards- one male and one female. The beds lined the room without curtains to divide them, but the curtains were the least of the items noticeably absent from the room. Other than a single IV drip, in the women’s ward there was precious little in the way of medical equipment. A number of women sat or lay on their beds, staring blankly at the sight of their uncommon visitors as they nursed their newborns.
The concrete walls shed paint chips. Relatives of the sick sit next to their beds waving cloths to shoo away the flies and mosquitoes. The smell of feces wanders through the open window. The hospital complex is large but looks as if it was designed and built in another lifetime- perhaps even dating back to the British colonial era, or not long thereafter. The ER is nothing more than an empty room with a wooden examination table and a desk and chair. Comparing it to my years working in hospitals as a consultant wouldn’t just be unfair- it can’t be done. I say a silent prayer that no one on the trip needs to visit the hospital.
This is not to say that the level of care here is horrendous- the rate at which babies are successfully birthed is higher than the states, despite only 60% of births being done at the hospital. They just don’t have the types of procedures and care that we take for granted in the US.
However, the hospital doesn’t have the ability to operate their operating room, not because they don’t have one, or because they lack the equipment of funds to keep it open. Rather, they don’t have a surgeon that has the training necessary to run an operating room that could dramatically increase the level of care accessible for tens (or perhaps hundreds) of thousands of people. The administrator told us he has all the funds to pay the surgeon and ensure the OR is kept running, but there is no one to come and serve the community in this capacity.
Several of our group felt uncomfortable seeing the patients during the tour of the hospital. Some felt as if we were imposing on them and being insensitive in the way we were shown through the women’s ward. A couple felt that it was such a human travesty that these people didn’t have a higher level of care and the ‘tourist’ nature of the tour of the facility and the patient’s ward that they were moved to tears by the injustice of the situation. Still others were much more comfortable with the situation- accepting it as the reality that currently exists. It was interesting how fractured the group became in their reactions to the hospital- it is in times of the greatest cultural differences that we were forced to react to the situation more than logically prepare a polished response to how we view poverty.
Why do we have access to top doctors and a menu of a` la carte medical services whenever we choose when others have so little at their disposal? And is it much different in America for those that are without insurance? I don’t want to color people’s opinions, but I would throw out a challenge to everyone who thinks about the solution to poverty being in providing loans for the poor the simple fact that there are more dimensions to such a complex issue as poverty than income or wealth. And we must rise to the challenge of not only understanding those dimensions, but addressing them in ways that do allow people to rise above poverty on more than just economic scales but also to have access to opportunities that allow the pursuit of education and a healthy life.
Loading ...
I applaud the author and his group for making the trip. I would also caution him (and them) to leave their cultural assumptions and biases at the airport in Nashville.
When you are a guest in someone else’s home, above all be gracious and respectful. I’m quite certain that for every one patient who does get care at this hospital, there are untold thousands more who don’t. Those people would be grateful for the opportunity to be seen and treated in this admittedly primitive hospital setting.
There was a time in this country when people were bled with leeches and limbs were amputated with saws. We didn’t get to where we are overnight, nor will the good people of Bangladesh.
As for whether people in the U.S. without health insurance are getting the best care possible, the author should be thankful for the fact that he will never have to find that out first-hand
The suffering witnessed in the hospital, seems to me, to be a stain on the conscience of modern medicine and science. The way medicine is done for the west is precisely part of the cause of the problems for the 2/3rds world. Medicine is seen as something that usually responds to underserved populations by means of charity, however, I would argue that as medicine is done now, it is also part of what creates the underserved population. There is something terribly wrong with the world which manifests itself in the story of the patient sitting in a sub-par hospital in rural Bangladesh. This is what medical anthropologist Paul Farmer calls the manifestation of “social misery,” and “socially induced forms of suffering.” The suffering patient in the hospital bed is a call for a redistribution of science and technology on behalf of the structures and systems which allow medicine to go on for the “developed” world.
The title of this blog post confuses me. Is the author speaking to a cultural relativism about what “health” is for some and not others? I don’t see how the title ties into the post.
Invariably, different people see different things. I, for one, did not see women “staring blankly.” I saw women in pain and suffering. Their faces reflected this. Moreover, as someone who was “moved to tears” on the hospital tour, I would appreciate not having the supposed reasons I cried assumed, neatly compartmentalized, and reported by someone who is not, well, me. I think that we all know the reality of the hospital’s situation. However, it is a reality that is not right.