Let me paint a little scenario for you:
Your little one is sick. He has a fever, and a cough. You know from your friends, the websites you frequent, your parenting magazines, that a fever that lasts several days should be checked up by a health professional.
So off you go, off to the clinic. Unfortunately, however, you live in a rural area, so it is an hour-long drive to the clinic. You go early, because they don’t take appointments. When you arrive at 7:30, which is when the clinic is supposed to open, there is no one there apart from a rather surly security guard. He writes your name on a list, so that you can go in the order you arrived.
All the other chairs are already taken up by other moms and babies, so you find a seat on the floor. Then you wait. And wait. Around 9:00 AM, the clinic staff start to show up. They dither around for another 30 minutes, chatting amongst themselves, shuffling papers, hardly even noticing the presence of the patients.
Finally, patients begin to be called. Half the time, though, the patient list isn’t followed. Instead, the nurse lets in whoever manages to be closest to the door. So you shuffle, you scoot, you hustle your way ever closer to the nurse’s office every time the door opens.
Even though the little boy next to you looks almost comatose, and is clearly in need of emergency health services, the boy isn’t noticed, and his mother is not called in until it is ‘her turn.’ You hope that the baby doesn’t die while you’re waiting. Will that mean you have to wait even longer?
Almost four hours after you arrived, you are finally called into the nurse’s office. The nurse doesn’t greet you, or smile and say hello. She just motions you to sit down, and begins asking questions. What is wrong with this child? Why didn’t you come earlier? Don’t you know that fever is very serious?, she chastises you. You feel ashamed, but because she is a little scary, you don’t say anything. Then, without ever looking you in the face, the nurse hands you two pills from a jar on her desk, and tells you to give them to the child, and to come back if your daughter gets worse. You are not told what illness the child has, or how to prevent it. You are not told what the pills are. You are excused.
The next time your child gets sick, what will you do? Will you make that hour-long drive to the clinic? Or will you just go to the drugstore, get some children’s Tylenol, and hope that your daughter gets better?
We did a community assessment a few weeks ago where we went out and talked to local mothers in Malawi, and this is basically what they told us. They walk miles, wait for hours, then get treated harshly, sometimes even abusively. All for a couple pills. And yet they still go! This is the miracle of healthcare in Africa – that people even turn up at health facilities at all!
Almost every day I hear government officials and aid workers complain of the peoples’ ignorance, their apathy. ‘We tell them what they should do, why don’t they do it?’ they ask. What we should be doing is asking ourselves why we expect poor African mothers to consent to a standard treatment that we would never accept ourselves. Because they are poor? Because they don’t know any better? Because they should just be happy with the scraps they get? As you in America are debating the need to reform the healthcare system, please don’t forget that inequity is unacceptable, in rich and poor countries alike. All people have the right to quality healthcare.
