This summer I have been focused on preventative health care. Not on purpose. It just worked out that way. One thing my momma always taught me was to keep up to date with your medical and dental check-ups. And my dad taught me to keep up to date with your car maintenance, which is essentially preventative health care for your car (I’m talking to you K.C.!). I am very obedient with all of these things. Plus, I am a health care provider, so I have to represent, you know? So, in addition to being filled with the usual summer leisure activities, my calendar has been peppered with a variety of health maintenance appointments. Super fun, right? Don’t be jealous. It has seriously been taking up a lot of my free time. Then multiply those appointments by 4, because of all the other people in my family that also require check-ups and dental cleanings, etc. OK, multiply it by 3, since my husband doesn’t ever go to the doctor if he can help it. The last, and only, time in his adult life that he had a physical I had to intercept him in the kitchen on his way to get breakfast and draw his fasting blood work at the table, because no way was he going to the lab voluntarily.
We are a healthy family, and I am grateful for that. I know many people for whom this is not the case. Still, sometimes you get news that you don’t really like to hear when you go for your regularly scheduled health maintenance visits. Like that you have a cavity between your teeth because you didn’t floss well enough. Have I mentioned how judgy my dental hygienist is? Or that your mammogram looks very normal except for the fact that you have “lost significant volume since last year”. Um, what? Or that your oldest child is “starting puberty”. Sweet mother of Mary. In the scheme of things, nothing terrible. Except for the puberty thing.
But really, how lucky am I that I have access to all of these services to keep me healthy? That is what I thought about when my heels were up in the stirrups, wearing that joke of a paper gown that just barely covers my altogethers. There are places in the world where people do not get this kind of care. I pay my insurance premiums, and I am going to take advantage of all the screenings and judgemental advice made available to me.
The other reason that I have been thinking a lot about preventative health care is that I have started working on a primary health care project in Haiti. Many of you followed my journey to Haiti earlier this year, which was a life-changing experience for me. I have been given the privilege of participating in some ongoing work with a nonprofit organization, and our plan is to organize some medical missions trips to Haiti again next year. At this point, most of my work has been researching, making connections, talking to lots of people who have done this type of thing before, and praying for direction. We have some good ideas of what we want to do, but have to work out the logistics of implementing the plan in a way that is helpful and sustainable in the long-term. It sounded like a simple plan at first, but the more I think about it, the more complicated it seems.
I keep reminding myself that it is OK to start something, even if you don’t know how to finish it yet. So, I am just starting, and trying to release my expectations of how it will turn out. Our advisory board will have our first conference call in September and I will have others to join me in this endeavor. We will figure it out together.
The health care system in Haiti is currently in severe crisis. The resident physicians at the public hospitals have been on strike since March. This has essentially shut down most of the major public hospitals, creating even more strain on an already weak system. The doctors are protesting low pay and poor working conditions. The average resident physician in Haiti gets paid the equivalent of $140 per month. They are subjected to terrible conditions in their workplaces, sometimes performing medical procedures or surgeries by the light of their cell phones, with unsanitary facilities and not enough medical supplies. If this is the case for the physicians and staff, imagine what the patients are subjected to. In addition, the country is facing a widespread cholera epidemic, the Zika virus, and all of the ongoing health problems associated with malnutrition and poverty. If you are poor in Haiti, the odds are that you will not get medical care if you need it.
The challenge is, how do we help without inadvertently making the situation worse? Haiti is filled with NGO’s, and yet even with all of the good intentions, foreign aid, and support from well-meaning people, the problems continue. The fact is that we could start this project and end up doing nothing other than creating dependency on foreign aid, harming the local economy, taking the pressure off the Haitian government to take responsibility for its public health system, or even take jobs away from local health care providers who need them. I am sure that there are a whole host of other negative consequences that I haven’t even thought of. When I start to think about it too much, I feel paralyzed.
I think we are never going to be able to do it perfectly. We are imperfect, and the system is so fractured. So there is no perfect way to implement such a plan. But there are some methods that are better than others. I have been able to make contact with some people in the past few months who are currently doing similar work in Haiti, and their insight has been so helpful.
So listen. Assuming you have health insurance, go get your colonoscopy if you’re of the age to do so. Get your mammogram, your PAP smear, your routine blood work, your dental cleaning, your vaccines, and your physical. Get your car serviced while you’re at it (ahem, Keri!). None of us particularly enjoy all of these things, but imagine if you didn’t have access to them? Be thankful you have these tools to detect disease (or a faulty transmission) early, so you can get the care you need. Think of the people who don’t have easy access to those tools, not just in faraway lands, but here in our own country–though we can talk about that issue another day.