Is Our High-Tech Health Care System Better Than War-Ravaged Sudan's?
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Four men were carrying someone down the road in a bed.
I had encountered some strange things in southern Sudan -- seen malnourished children; nearly stepped on a large snake the color of pinkly opalescent milk -- but nothing more compelling than this.
What impressed me as I struggled to catch up, was the speed at which they were moving, each man carrying a leg of the bed, which was constructed of rough-cut wood and a lattice of rope. I could see its occupant was a woman. The little procession walked with fierce determination, despite the sweltering heat and the mud.
Akon is a market town and a county seat in South Sudan, and this was the main road, but the rains had turned the red clay into a sea of braided puddles.
Finally they stopped and I was able to meet with them. I learned that the woman lived in an outlying village. Her husband and brother-in-law and other members of her extended family had carried her like that for two hours to get to a clinic here in Akon that consisted of a big shade tree and a meager stash of medicines -- on the chance that someone could save her.
She was gaunt and feverish, suffering from abdominal pains. She told her story in Dinka and someone translated. She'd gone into labor, and after two days of contractions, the traditional midwife had determined that the birth canal was too narrow, and had cut the baby up and withdrawn the pieces.
I wondered if something was left in her uterus or maybe she'd been cut. They looked to me hopefully. Lacking any medical training, I felt helpless. But I sent for my Dinka colleague, Chris Koor Garang, a "Lost Boy" who had become a U.S. citizen and a certified nurse. He'd brought medicines with him. Chris gave the woman an oral antibiotic and instructions for taking the remaining doses.
This was her sixth pregnancy; all had ended badly. The pills, condoms, and other birth control options that we take for granted in the industrial world were not available to her. Nor were the anti-diarrheal medications and routine vaccinations that save infant lives. South Sudan, torn by decades of colonialism and decades of war, has an estimated sixty percent infant mortality rate, about the highest in the world. Maternal mortality is also high: one in ten women dies giving birth.
Miraculously, this woman lived.
Now fast-forward two years, to last March. I was visiting my son in Vermont -- which was fortunate, because when I experienced stomach pain and nausea, I could get to a local ER, and then be taken by ambulance to one of New England's top-notch hospitals. There I underwent emergency removal of eighteen inches of small intestine that had become twisted and gangrenous.
I was lucky. Had I been traveling in South Sudan, we might have assumed I had some parasite. I never would have made it to an airport for transport to Nairobi in time for surgery. I wouldn't be alive to write these words.
As I lay in the Intensive Care Unit, emerging from a five-day medically induced coma, attached to various life-support systems -- attended by a bevy of surgeons, anesthesiologists, pulmonologists, radiologists, and nurses -- I experienced a string of hallucinations. When my mind was finally clear, one image kept surfacing.
It was that woman being carried down the road in the bed.
We were fortunate, each in our own way. She had become for me an emblem of survival.
Our beds could not have been more different. Mine contained computer-driven air-pouches that pulsed in a manner designed to preserve muscle tone and prevent bedsores. It weighed probably 800 pounds.
Was I grateful for the technology that saved my own life?
But my point in recounting theses two stories is not to contrast a failed or non-existent healthcare delivery system with a successful one. On the contrary, that woman and I both represent failed systems. They've simply failed in different ways -- the one from poverty, the other from profits.
My own treatment was commodified, under the dictates of U.S. hyper-capitalism, to an extent that comparable treatment under socialized medicine is not. The total price for my surgery and related expenses came to $144,000, or eight thousand dollars per inch of intestine removed.
Fortunately my expenses were covered -- under Medicare, supplemented by the excellent private healthcare insurance my wife gets as a retired University of Connecticut professor. Our private plan is almost as good as that enjoyed by members of Congress. I was out hardly a dime.