We recently discovered yet another scam with the health care system as known here . . . . We call it double dipping.
The local version of health care has a lot to do with going to the muzungu (us whites foreigners) for needed money for medications. Though there is a local health clinic (run by our team leaders, Drs. Myhre) there are the usual unsatisfactory outcomes of universal medical care. Long lines, poor service, and lack of “free” medicine. Thus people bring their books to us. Having been warned about the propensity for stealing in this process we have a pretty simple but we felt effective system in place. We are revising it once again.
When people arrive at the clinic, they present any old little blank exam book, bought for 200 shillings, which subsitutes for a medical record. Into this book (often a new one each time, rather than more entries into the original) goes the pertinent data for the patient and their illness as well as the diagnosis and needed medications. If the patient goes to the health center, and if the health center has the medicines in stock, and if the person who distributes medicines is behind their counter, all goes well. Otherwise, they come to see us.
Our policy is not to fill prescriptions written by local “clinics” or “drug shops”. Unlike the health center, these clinics are usually run by completely untrained personnel who are merely making a buck selling medicine. Unlike in the States, here you can buy most any available medicine without a prescription. So, just like the used clothing business, or any other one, people travel to a city and buy in bulk then return here to sell. These drug shops are also notorious for swinging deals with locals to swindle us out of money. “you write the scrip, we’ll bring you some of the money the buzungu give us for meds”
Our simple policy when seeing someone who’s sick and needs financial assistance? 1) go to the health center 2) bring your book to us 3) we read the diagnosis to ensure that it was written at the health center, that it seems accurate and thorough and to note any medications and costs 4) we may pay the bill in full, or in part, or send the patient back to the clinic if we feel their care was inadequate. Keep in mind that these patients often have life-threatening illnesses such as malaria and travel to the clinic on foot, children sometimes alone, or caring for a younger sibling who is sick.
Now we have found the latest snag in our system . . Double dipping. We have forgotten to sign the books and write PAID over the drug listing. Apparently people have been hitting up more than one missionary for a single bill. The people who do this kind of thing are a small minority but it’s still discouraging when you are pouring your heart and life into them and find out that you’re little more than a malfunctioning ATM distributing more money than you should. Funny, must be the way God feels about His relationship with me sometimes . . . . Hmmm . . . .
Chocolate, stolen from under the Christmas tree by girls we had considered sponsoring at Christ School. Apples, stolen from the basin as they are washed. Legos and Playmobile, stolen by children as they play. Our phone number, used by someone unknown to try to collect money for a medical treatment we did not authorize. Our time, spent explaining and re-explaining why we are not willing to provide money for this or that to many someones’ whose character we feel, does not merit that level of trust and connection. Of all, it’s our heart, invested into lives here, that feels most raped by breaches in trust. And yet, we can only wonder how the locals view us and our decisions. Can they possibly understand them? And certainly they are not all wise or right decisions. Can they accept our humanity and give us the grace we so sorely need?
We learn a lot about ourselves as we find these glaring gapes in relationships. Our response teaches us about how we view God, ourselves and others, and offers us a new opportunity to accept His grace for ourselves and pass it on to others. After all, He didn’t come for the healthy but for for the sick. And that’s both them and us.