Here’s a glimpse of today.
An adolescent came into the ward yesterday. She had some swollen lumps. She’d been a bit off colour for a few months. We expected something easily treatable. We did a blood test. The result showed us that it was not something trivial at all. The test strongly suggested an advanced malignancy. I tried to explain to the patient as best as I could that it would help if we did some further tests. The patient said she didn’t have money for tests. She isn’t in the hospital insurance scheme (‘’E-quality’’ – more about this later) . With insurance, the test would cost just a few pence. Without insurance, the test would cost barely a pound. We didn’t do the tests.
I spoke about her with the other doctors and we all felt that her only chance of recovery (this is a treatable cancer) would be to go to the Uganda Cancer Centre in Kampala. There, the treatment would be free, and chemotherapy is reliably available. But she would have to get there. An ambulance would be best, but Kampala is far, and the ambulance is expensive. Perhaps she could go on the bus?
I had another conversation with her relative. They felt they couldn’t make it. The bus fare was unaffordable. At 40 000 shillings (about £9) it is the cost of the difference between hope of survival and certain death.
The hospital has a ‘’Good Samaritan Fund’’ for people in extreme need. It receives contributions from church collections and the profit from hospital’s little cafe. Reverand Caleb, the hospital Chaplain administers the fund and has the challenge of identifying the most extremely vulnerable from amongst the generally very vulnerable population. We asked him to speak to the family. The young lady is the only remaining grandchild. The father and mother had died. Grandmother and granddaughter try and cultivate a small patch of land to scrape a living. Grandmother told Caleb that she didn’t think she could even raise the money by selling the land.
Thankfully, the fund is paying for the bus to Kampala for the girl and her grandmother, with a little left over for expenses in the city. At the inconceivable sum of about £20, there’s a glimmer of hope for her.
Shall I nip to the shop and buy that bar of chocolate after work? Maybe not tonight. My head is still full of how much and how little things cost, and how much and how little has a value.
(PS: Here’s a Christmassy after-thought. Anyone who doesn’t have an idea of what to give to someone for a Christmas present, or knows someone who has everything already, maybe consider a donation to the Good Samaritan fund – it might make a big difference to someone?)