I recently completed my rural international placement in a third world country. The aim of this blog is to try to help you understand how fortunate we really are.
Working in the health system in Western Australia you hear many complaints. Extreme waiting periods in emergency departments, waitlists for elective surgery, over crowded hospital wards, short staffing issues…the list goes on. Here’s a short recount of a gentleman on my rural placement to put things into perspective.
A 50 yr old gentleman presents to the rehabilitation clinic with pain in his right leg. He had fractured the mid shaft of his tib/fib at age 21, falling off the roof of a house he was constructing. At the time of the accident he presented to the “emergency department” of a public hospital in his capital city, where health care is “free” (though you have to bribe the nurses, doctors, physios etc if you actually want to receive some form of intervention). The initial “treatment” was to “open it up to reduce infection” (not quite sure of the reasoning behind this). After a few days stay in hospital when his emergency funds had run out a doctor informed him that he would require surgery to have it internally fixated. Obviously he could not afford this. He was sent home to his province, still with a fractured tib/fib, no advice, no walking aids, no splint/ cast, no analgesia, no follow up appointment.
He continued to work as a labourer on a construction site, often carrying heavy bags of concrete – FWB! He saw a “traditional Khmer healer” for a treatment called “coining”. This is basically where they rub, very firmly, a copper coin across the skin until it is red raw and bleeding. It may have helped with the pain (think back to Max’s pain theories) but it certainly did not help to reunite his fracture.
29 years down the track he now has a painful psuedoarthrosis mid way between his ankle and knee, an ankle that will not plantarflex or dorsiflex more than 5° out of pantagrade, globally decreased muscle strength in his lower limb and patellofemoral pain.
If you presented to RPH/ SCGH emergency with a fracture such as this, you could wait anywhere up to 24 hours to be seen/ treated but:
· Pain would be managed medically – during your hospital stay and for a necessary amount of time after
· The fracture would be managed appropriately – surgically or conservatively
· Walking aids would be supplied
· Outpatient follow up appointments would be made with doctors and physiotherapists
· It would be free of charge – no need to bribe the health care professionals.
Complications may arise but will be dealt with accordingly. At least you know in 29 years time it won’t still be broken.
We all take our public health system for granted and of course it could always be improved, but think about this story next time you hear someone whinging about it….it’s not so bad after all.
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3 comments:
I completely agree with that comment. Our public health system is by no means perfect, and we do have the means to improve it further, however compared to so many countries 'its not so bad after all'. It's my belief that this type of health care(in WA that is) should be taken for granted ie. it should be everyones right in the world to recieve adequete medical care for illness/injury however, this unfortunately is not the case. Whilst I haven't been on an international placement, within our own system I have treated patients from such countries whom are being sponsored by a 'wealthy westerner' as they call us, to recieve the treatment they require in Perth. We are extremely lucky that despite the waiting list's for elective surgeries/procedures, if we sustain an injury/illness that requires immediate investigation and treatment regardless of gender/finanacial/race we have access to those services. Which as you say is something we should remember the next time a negative comment is made towards the public health system - it could be a lot worse.
That was a really interesting story that helps to put things into perspective. A lot of people find it easy to complain about whatever might be going wrong but its important to listen to what other people have gone through sometimes to realise its not all bad. The reality is that in Australia we are very fortunate and i think sometimes we should try and promote that message a little more to the people that complain.
I agree as well and think the same concept can be applied to so many areas of Australia- eg. politics. That said, WA has the longest waititng time in ED in our nation and although it may still be a lot better then other countries that dosn't mean we shouldn't still be striving to improve it and at least bring it to the national standard.
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