Friday, June 26, 2015

Is There a Doctor in the House?

The other day, my worker was not feeling well and decided to go to the doctor. I dropped her off after work on my way to run an errand. The next day when she returned for work, she asked if I could help her purchase the medication.  I was comfortable with that option but when she presented me with her list of medications, my jaw hit the floor.

There were 8 separate items listed! No matter how ill someone is, I have (personally) never known a doctor to prescribe 8 medications at one time for one illness. I asked her if she was certain these were all for her and not for different people in the family. Nope. The doctor prescribed them all just for her. I asked her if some were to be taken later and not all together. Nope. The doctor prescribed them all to be taken/used at the same time. Yikes!

Let me interrupt this narrative to provide some cultural information about Congolese doctors.  The average cost to visit a doctor is about 3500 francs, or about $4. Sounds pretty cheap, right? Unfortunately, the average salary for a worker is around $5 daily. So in USD terms, image you make $7.50 an hour for 8 hours (one day of work) for a total of $60. But the cost to visit a doctor must be paid up front at a total of $48. That is a lot of money for someone to pay.

Therefore, if you were to visit a doctor, you wouldn’t just go for something minor like a cold. You would go for something more serious. If you must spend 4/5 of your daily salary to “hire” someone, you expect some sort of return on your investment. And this is what will often happen - the Congolese doctors will prescribe a medication, even if it is useless just because people expect something out of the doctors. This very thing happened to me when I thought I was experiencing a miscarriage with Solomon. I was prescribed a medication for abdominal spasms which if taken, could have been dangerous. The doctor did not know what to prescribe in my circumstance (as far as I am aware, there is no “cure” for a miscarriage) so he wrote a prescription for something he thought would be a placebo. Luckily, I knew there was no cure and was hesitant to take the medication and contacted an American doctor who knew what was going on over the phone.

The other problem is a follow-up visit. Ideally, a doctor will prescribe you something and remind you that if you don’t feel better in “X” number of days, to please call back to schedule a follow-up visit. There is no such thing here. No one can afford to take two days off of work and pay out of pocket almost two full days worth of work in money. Thus, a doctor will often over-prescribe medication in an attempt to cover any and all problems eliminating a need for a follow-up - which in itself is very dangerous.

When my worker presented me with a list of 8 medications, I knew that she was over-prescribed but I could not determine which ones were “placebos” or “useless” and which ones were dangerous if mixed. So I called for back-up! I contacted two doctors, a nurse, and a translator/friend/missionary. A few hours later, we were able to go back to her root complaints and cross-reference the medications prescribed. Only one needed to be purchased and we were able to substitute two others with basic over-the-counter medications we brought with us. In all, had she attempted to take all of those medications at once, she would have felt worse from all the side effects than how bad she originally felt. I am glad my worker trusted me enough to talk to me about what was going on and I am so very blessed to know medical personal here that are willing to help.

1 comment:

  1. Scary stuff. I'm actually surprised she was subscribed 'only' 8 medications. We've had workers and others show up with 10-20 on their list. Makes me wonder how many have overdosed on taking all those. Thankfully, most can never get all of those at once. So glad she came to you, Tasha. Tally