Hard Choices

I have often written about how good the medical system out here is and that I would have no problem using these medical services if I happened to get seriously sick. What I have of course neglected to mention is that expert medical care is way beyond the means of the vast majority of people living out here. Thats why its so good for those that can afford it - the private hospitals are nearly empty...

The following story really brought it home to me the really hard choices people have to make when they are faced with a serious medical emergency that they cannot afford.

It turns out that if you need to have a heart operation in Kenya, it is cheaper to fly to India, have the operation there, recuperate in India and then fly back, than to have the operation in one of the 'private' hospitals here.

A Camara colleague's father (based here in Mombasa) had a minor heart attack about 2 months ago. He was recommended to go for an angiogram (a standard test these days in the developed world where a catheter camera is inserted into the coronary arteries via the leg and they are examined for occlusions and disease using the camera together with a CT scan).

He was unable to pay for the operation so he spent the last two months asking friends, family and foundations for the necessary funds to fly to Madras in India and have the operation done there.

In the end with considerable help from the International Lions organisation he raised sufficient funds for himself and his son (my colleague) to travel to India for the operation. Even with the two people flying, it was still less costly than having the operation done here.

They flew out to Madras about two weeks ago.

And then things began to go wrong.

The first problem is that my colleague has serious responsibility here in the digital hub. He was the first employee and effectively founded Camara Kenya, he signs all the cheques and essentially is responsible for all technical operations on the ground here. In a very short space of time he had to delegate a lot of responsibility to people still very new and inexperienced. Inevitably some key responsibilities were going to be missed. In this case,he forgot to make another person a signatory on the Camara account here. Effectively that meant that no-one could sign cheques.

The second problem arose after the angiogram was done. The doctors in India recommended that the father undergo heart surgery rather than the more straight forward angioplasty operation(an operation which essentially involves widening blocked arteries using a balloon and stents supports inserted via the catheter). The gamble had been that only angioplasty would be required as the recovery time is much quicker. My colleague was hoping to be back in Mombasa within 10 days.

As an aside, in an amazing example of the power of technology, my friend emailed me the angiogram scans from India which I forwarded to St Vincents hospital and within a few hours the diagnosis was confirmed. Heart surgery was required. In an ominous sub note, the advice from Vincents was that it would be up to 2 months before a person could fly after undergoing heart surgery.

A week ago my colleagues father underwent quadruple bypass heart surgery - a ten hour operation which without going into the sordid details is an extremely traumatic experience for even the fittest of bodies.

The father has been in ICU all this week and has underwent another emergency operation to drain his lungs after he developed complications breathing after coming off the ventilator. All the while, my poor colleague has been watching the drama unfold around his dad, whilst sleeping in the hospital, in an alien country, utterly helpless to do anything.

We have been ringing one another daily for updates.

And then the final complication. A container of 400 computers is sitting in Mombasa port and needs to be cleared through customs. The only person who can sign a cheque for the container is my colleague in India.

If we do not clear the container quickly, we incur charges that mount by the day.

As I write this the problem remains unresolved. Here is what we have had to do. We have asked my colleague (with all that is going on over in India) to DHL a letter to the bank in Mombasa authorising the transfer of funds to another account so that the container charges can be paid.

The problem is that there is not enough money in the camara account as a couple of cheques are being cleared before money can be transferred. It takes a long time for cheques to be cleared in banks here for understandable reasons.

In the meantime, funds are tight in Ireland. When you send almost 100 people to Africa, which essentially involves paying for 100 flights at about 1000 euros a go you can have cash flow problems. We are in overdraft in Dublin presently.

Despite that, Camara Ireland has transferred some money to my personal account just in case the complicated payment procedure fails (I hope the CEO and board forgive this indiscretion - I feel a little like Father Ted having to justify this large sum of money just 'resting' in my account - but to be honest there was no other way of doing things).

Its all going to be very tight because I leave Mombasa on Wednesday morning.

And so this is what can happen to people here when these hard choices are made. I blame nobody for the mess. Its utterly understandable given the choices people had to make but look at the consequences....

On a positive note the volunteers from Ireland have arrived and training has begun in earnest.