Alfred Dawes | Broken promises, broken families – the true cost of healthcare

In my 20 years as a practising physician and surgeon working at various levels in the public health system and privately, I believed I had a good understanding of healthcare in Jamaica.

However, it was not until I immersed myself into the lives of my constituents that I really got a true picture of the challenges we face as a nation with regard to the health of its people. To be up close and personal in the homes of those affected by a broken health sector is an entirely different experience from interacting with a patient lost in a crowded health facility. The humanity behind the suffering is magnified in their homes.

To hear families lament about long waiting times for surgery is commonplace. But to meet the daughter who has to repeatedly take time off from work to take her father to clinic and the operating theatre for months of postponements and cancellations hits differently. After too many absences from work, she lost her job. They are struggling to make ends meet, and because of the painful hernia, he can hardly work.

One lady brought me inside her bedridden mother’s room. She had recently suffered a stroke. There was no money to transport her to the hospital to obtain the physiotherapy she needed to regain some functionality. The taxi fare was just too much, and taking a bus was out of the question. But all that was secondary as she was thankful that mom was alive. Her most pressing issue? She needed some help to fix her fridge because she has to be keeping her mother’s insulin in a cooler box with ice, which she replenished daily. The only way to prevent the valuable medicine from going bad.

LEFT RED-FACED

I once scolded a diabetic patient for walking around with sky high blood glucose levels. When I looked into her nutrition history, I was left red-faced. Rice was all she could afford sometimes. On better days, there would be butter. Some days she missed clinic because she has nobody to take her and she has no fare. How in this situation can we preach that her health is her responsibility?

And then there are the countless messages from desperate parents trying to do the best for their ailing children. They must find the money to pay for CAT scans and MRIs privately because the machines in the hospital go down often, leading to long and dangerous waiting times when they are functional. The public-private partnerships have crumbled, with many entities refusing to continue to treat patients referred by a Ministry of Health and Wellness that owes them millions in unpaid bills. Desperate families resort to cake sales and cook-outs to raise the lifesaving funds.

Many of us live in a bubble. Unfazed by the stories we hear about the broken health system. Never able to identify with the victims much less feel empathy. We have never truly imagined ourselves in that chair for three days waiting on a bed. Sleeping while sitting. Feet swollen from hanging down. The aches and stiffness in our bodies. Even us doctors who lament when we lose a patient because of a lack of resources don’t see the other side of the loss. Setups and nine-nights are a part of my weekly schedule. It is where you truly appreciate that the one who the system failed was a beloved relative and friend. When the community shows up to bid them farewell, you understand that every life lost leaves a grieving extended family. It demands that health professionals do their utmost to treat every patient as a stalwart even when society doesn’t recognise them as such.

DO BETTER

We must do better. From time immemorial we have heard promises of improving healthcare and better social safety nets to protect the most vulnerable among us. Yet for far too long we have looked at human suffering as an opportunity to exploit rather than build value into the system. As a civilised society we ought to do more for those who never had boots with which to pull themselves up by the bootstraps. There is a large section of society who are not poor enough to be considered for the PATH programme but are struggling to take care of their most basic needs. They need the support of those who can meet their needs and more. We have the basis for this in healthcare with no user fees at the point of service. But that system is broken and patients are getting what they pay for nothing.

We should not be asking the poor to go buy the stitches needed for their surgeries. Or write a request for a privately done scan and tell them come back with the results when we know that they will never return for months, if they are so lucky.

We must find a way to fix the system on a whole and not just health. Many Jamaicans are suffering and simply cannot afford to take responsibility for their health. They can’t eat better. They can’t afford screenings that are not available publicly, and they can’t fill their prescriptions. The care we provide them is the true measure of how compassionate we are as a society. Our humanity requires this from us.

Dr Alfred Dawes is People’s National Party member of parliament candidate for SE St Catherine and shadow spokesman on health and wellness. Follow him on Twitter @dr_aldawes. Send feedback to columns@gleanerjm.com and alfred.dawes@gmail.com.