Marina was diagnosed with Hashimoto’s Disease over two years ago. Her journey through this condition led her to a public healthcare surgeon in Managua, who removed her diseased thyroid in two operations a year apart. Gloria, her daughter, brought the diseased thyroid home in a plastic cup for all to see before taking it to a private clinic for a biopsy report.
I shook my head in disbelief.
What kind of pubic health system allows patients to bring a diseased body part home, then asks them to pay a private clinic for a biopsy report?
For Ron’s birthday, we decided to make a North American meal for 15 of our Nicaraguan friends and neighbors. Marina said, “My surgeon and his family are vacationing at my house for a week. Can they come, too?”
“Of course,” I replied. Again, I shook my head in disbelief.
Why would a surgeon want to spend his vacation in a humble abode of a patient instead of a fancy hotel? “Aren’t all doctors rich?” I asked Marina.
What I learned about the public healthcare system in Nicaragua will surprise you.
In 2006, doctors in Nicaragua earned an average of $144 a month, 40% less than their counterparts in other Central American countries. “To protest this situation, the 3,000 member strong Médicos Pro Salario doctors’ union initiated a strike in the nation’s 32 public hospitals and 150 health centers on November 14, 2005, demanding a 140% pay increase.” Health Sector Strike in Nicaragua Enters Sixth Month.
Six months later, the doctors were granted a 16.25% increase in salary, bringing their average monthly salary up to $200-$300. Currently, according to a report completed by PATH, medical specialists ( Marina’s surgeon) receive $732-$786 per month. The Nicaraguan Health System Report is a lengthy, yet interesting report.
Per month!!! Again, I shook my head in disbelief. But, it was beginning to make sense to me why Marina’s surgeon asked to vacation in her humble abode.
Watching the interaction this week between the doctor’s family and Marina’s family gives me a new perspective on a doctor/patient relationship. Both families are happy with what they have and share their knowledge, their homes, and their lives with each other.
Early one morning, Ron helped Marina butcher a pig. Ron got an anatomy 101 lesson, as the doctor patiently described the functions of the pig’s organs. “I dissected many pigs in my training,” the doctor told Ron.
The doctor’s mother helped Marina make chicharones ( fried pork skins) over an open fire.
Not once did I hear Marina or her family apologize for the lack of a propane stove. The doctor’s two young sons bathed in the lake and played ball with Marina’s grandchildren. Not once did I hear them complain about the lack of a bathroom or indoor plumbing.
The day the doctor’s family arrived, Marina’s family was frantically trying to complete the new addition, borrow some beds for the doctor’s family, and hand-wash the sheets to place on the beds. It didn’t appear to bother anyone, and in fact, the doctor’s family pitched in to help.
Yesterday, the doctor and his family, along with Marina and her family, squeezed into the doctor’s car, and drove to the other side of the island for some sightseeing. Before they left, the doctor made a makeshift door to the addition by propping an old piece of tin roofing up by a plastic chair.
What a treat for Marina’s family. It was her first time to visit Santo Domingo in ten years.
She couldn’t wait to tell us about her adventure to the other side of the island.
This morning, the doctor’s family is weeding Marina’s flowerbeds and chopping firewood for her. Tomorrow, the doctor and his family must return to Managua. He told us that this was his first vacation in four years and his first time to visit Ometepe Island. Looking into his eyes, I noticed a twinkle that wasn’t there at the beginning of his vacation.
It has been an eye-opener for me to watch the interactions between a patient and her doctor. Indeed…good doctors treat the disease, but great doctors treat the patient who has the disease. Marina’s excellent surgeon can come to dinner anytime!