Sunday, February 23, 2014

Gratis - the cost of healthy mothers and babies

The cost of healthy mothers and babies

Prenatal classes for all the pregnant women who visit the clinic.  The posters are made on from materials I buy at Scrap in Portland, Oregon.  After I did it once, the midwives took over
Ever since I have suggested that the prenatal care cannot cost anything, I have head the word “ gratis” passed around in animated voices of disbelief.   The social doctor is vehemently against it.  He says free health care will ruin Haiti and no one will pay him.

I look around the clinic.  Five paying patients a day is not going to support even one of them, yet alone the whole staff.  They are not earning their keep, even with their payment system.   It is not financially viable.   There is a chart person, a lab tech, a pharmacist, two nurses, two doctors, and now two midwives.  There are all sorts of housekeeping and grounds people.   Outside the clinic there are hundreds of women with no prenatal care.   He shrugs.

“How much is a visit,” I ask. 
“About $1 US. “
“How much are they earning?”
“Maybe $4 a week.”
“So ¼ of their total weekly income must go to this visit and this does not count lab work and pharmacy and the four hours to walk to and from the clinic.
“How much to have your baby, in town, at a hospital?’
“It starts at $50 US dollars but you pay more for medicine.”
“Two months of their yearly income. “
“Is family planning free?” 
“Nothing should be free in Haiti.”
“Healthcare is free all over the world.”
“Not in Haiti.  I need to be paid.”
“You are being paid and you got a free education.”
“I need more.”

The debate, over health care, rages in my country as well.  However, even the most conservative politician, understands that prenatal care for all women is a sound social and economic investment in the long -term well being of a community.

 The countries with the best maternal and newborn outcomes provide medical, social and economic support to the newest members of their society.  The yet to be born are nourished, given medical care, and once born given time to be breast fed and provided with a free education.   Mothers are offered an opportunity to choose when and if they will have more children.   Many give mothers paid time off in the last weeks of pregnancy and ample time to care for their newborn before returning to work.  

One of the new midwives providing care
doctors in Haiti and many part of Europe, complete a social year as a gift to their community for a free education.  The social year doctor is pretty much against free care, prenatal care and midwives.

“There are very few pregnant women in this area.”

“But there are so many children.” I reply.

“Well, even if there are pregnant women, they don’t like prenatal care.”  He explains.   “Haitien women do not like prenatal care.”

I had seen women walk miles for prenatal care in other parts of Haiti.  I am confused and the midwives were hired, I thought, to meet an identified need.

“Have they ever had it?”


I always consider the possibility that I am wrong and wrong in another person’s country is even worst.  I walk around on the roof and consider.   If no one comes because it costs, then why have the new midwives?   Is health care a human right or something only a few can purchase?  For my own country, I want health care for all. It is what I want for all women, everywhere.   I toss my cards with every pregnant women needs free health care. 

The young doctor, who is also the clinic director, was born and raised in these mountains.  I am at the clinic for over a week before I see him.  When I do, he smiles and quickly agrees to free prenatal care.  Within two weeks, there are pregnant women sitting on benches, waiting for care.   The new midwives are smiling and doing the work they were trained to do.  I breathe deeply and smile.

1 comment:

  1. hope that social year doc does not need anything that I am able to provide............bad apple