Day 4

I am writing this on Thursday as I was too tired to write last night. My duties always slow down at this point as we have nearly finished seeing patients in the clinic. The team is now focused on operating and monitoring the patients who have had surgery. My tasks now include filing, ensuring medications are given, checking on patients midday, and trying to soak up the experience.

Yesterday I saw a number of patients on my own in the clinic. These were all women who had been seen in prior missions and were back for follow up. This was rewarding as I felt much more “in my element”. In the US I work independently for the most part, but here in Rwanda, most of the care is a team effort. These women were success stories–they all had back pain and abdominal pain, but their bladder problem was fixed and they were dry. I think back pain is a universal problem here–nearly every patient has it. These women work very hard, mostly as farmers, and so it’s not surprising that they have back pain. One of the women I saw was 73 and asked if it was ok if she worked in the field digging and pulling.

Insurance in Rwanda does exist but it is not free. The cost depends on your social status, with the poorest paying nothing. I don’t know what percentage of people have insurance, but we saw several women who did not have it. One woman did not have insurance and has a fistula, but she needs a CT scan before we operate. For her, this meant she would need to buy insurance for her family of 6 and then pay a small portion of the CT cost. I knew that it was unlikely this would happen without some help. I offered to pay for all of it if she promised to follow through and come back. As one of the doctors said, I didn’t want her to go and have a party instead of buying insurance. You may be wondering what this cost? Twenty-nine dollars US. Thanks to the Mission committee at my church for the donation to help make this happen. I hope to find other women with similar needs before I leave.