We have had our first close encounter with Zim hospitals. The occasion was Phil's rapid descent from a tree he was trimming, resulting in a shattered ankle and broken tibia and fibula. It happened around 5:30 p.m. and our dear friend (and nurse), Julie, came as soon as we cell-phoned her. She determined The Avenues was the place for Phil's trauma and we followed her in our car.
Upon entering "Casualty" which Americans would know as ER, the pace of time slowed. There was a doctor somewhere. There were people in uniforms, but no one was in a rush. We were offered a form to fill out within 30 minutes. When the doctor was available, it was discovered that we had not yet paid for him to look at Phil. So we filled out another form and paid. The good doc was an ob/gyn, but upon seeing Phil's ankle, declared it broken. He didn't know how badly, we would need an x-ray.
I needed to go to the x-ray dept, fill out another form (all with the same information) and pay another fee for the technician to take the picture. Then Phil was wheeled down the hall, the x-ray taken, and the doctor declared profoundly that it was "worse than bad." This did not bode well. It was clear that Phil would need to stay the night. An injection for pain was finally administered (about two hours after arrival).
Next, blood was taken. Oh, but there is no lab in the hospital, so Julie and I had to hand deliver the blood to an all-night lab some blocks away in a rather seedy neighborhood. We cruised the blocks until we localized the lab, shook the gate for the guard to wake up and let us in, took a complaining elevator to the 2nd floor, and submitted the blood. I filled out more forms and another payment (higher than the previous two) was exacted. Finally the blood was put into the centrifuge. The next client coming in warned us that the elevator was not working (had trapped him for a while), so we thanked him and took the stairs.
Upon regaining the hospital, we learned that now I would have to raise $1800 for Phil to be admitted that night. He could not travel and would not be able to go home, nor would he be allowed into the ward until they saw the green. It was 11 p.m. This is my first genuine encounter with an African Catch-22. Two of our team leaders tried to reason with them. Our mission has used them for years, and they have sent referrals to our mission hospital in the north. The matron finally relented and agreed to accept him for $500 that night. I had to go home and bring it before they would let me fill out the next forms and hope for his admission. After I paid that, they handed me the ER bill, I was stupefied.
Things take longer in Africa, you'd think I'd get used to it after two decades. He came in on June 31st and was finally admitted on July 1. He was exhausted with pain and bureaucracy. When they wheeled him up to his two-man room, the light was unceremoniously turned on, waking the patient in the other bed. Fortunately, he turned out to be a wonderful cell-mate and they are fast friends now.
The next day I attempted a variety of unsympathetic ATM machines, managed to find some money Phil had hidden and paid up for admittance. He was scheduled to be operated on that afternoon, but I had to come and pay deposits for the surgeon and anesthetist. After the surgery, I was called at home to come and pay for x-rays before he would be taken to diagnostic imaging. And so it went through the week. Each time a new expense appeared, I had to pay before it would be rendered.
I am still boggled that when he was coming home we were presented with another bill in the thousands. And he still has the surgeon's fee for the two operations. To be perfectly fair, the care was wonderful. The technicians and nurses were professional. The service was gracious. And the total cost was, of course, less than it would have been in the US. But the obvious priority of being paid was a reminder to me that as I am "serving" it is important for me to do it with a servant heart. Mercenary service is not really service at all, it is delivering a product.