Disturbing Dilemmas

BY MARK

The man in his mid-thirties hobbled up the ramp at the hospital in Saintard, and asked the security guard if “Dr. Mark” was available.  When summoned, I met the gentleman who was sitting on a bench beside his friend, with a pair of crutches resting across both of their laps.  After he introduced himself, this kind man who lived several hours from our hospital said that he had been referred to us by a mutual friend to determine if we might offer him some advice and/or help. 

His story unfolded that a motorcycle accident six months prior in Port au Prince had left him in another hospital for a couple of weeks.  Afterwards, his fractured leg had not healed correctly.  “Is this something your hospital might be able to help with?”  he asked.  “Maybe”, I sheepishly responded, knowing that I was not an orthopedic surgeon, nor was I an expert in long bone fractures.

After a quick exam and x-ray the problem was obvious.  Both bones in the lower leg (tibia and fibula) were fractured and the fractured segments were about 3 cm (about an inch) apart.  His leg dangled when not supported, but somehow, his pedal pulse was still strong.  I sent a copy  of the x-ray electronically to our orthopedic surgeon on staff who said he could help.  I was thankful. 

BUT THEN came the statement that we hear multiple times every day: “Unfortunately, I have very little ability to pay!”  I understand this statement, especially in Haiti.  Of the thousands of patients who we see each year at the hospital, usually fewer than 10  (not 10% but 10 patients) have any type of healthcare insurance.  (Could you imagine if you needed to pay for your healthcare without any insurance?)  Part of our ministry here in Haiti is to help subsidize healthcare so that those who cannot afford it may be able to access it. Our organization helps with staff salaries, supplies and facilities, thus making healthcare not free, but more affordable.  We are so blessed and thankful for those thousands of patients who have been helped.  A surgery for the man with the broken leg (above) will have many costs.  The metal alone to fix the leg may be about $400 US, the anesthesia, the medicine, supplies, a modest salary for the surgeon and the staff to care for the patient, and the facility will cost somewhere around $2000.  Thankfully we can subsidize that to a large degree, so that the patient may be able to afford the surgery.  But what about the emergency C-section that came in later that day?  What about the lady who came the next day from the mountains with a fractured thumb that needed pins? What about the child with pneumonia who needs to stay at the hospital several days to recover? The demand is always greater than the supply, but whom do we treat and whom do we send away, knowing that we cannot help everyone?

So it is with these types of questions that we struggle daily at our little hospital.  I have been through many years of sitting in classes of various levels, but not one of them has provided an answer to questions such as these.  Mark Twain once said “I have never let schooling interfere with my education.”  I must say that my “education” here in Haiti is huge as we have some of the most stretching and growing experiences I can imagine.  Some things that I am learning:

1) God is in charge. 

There is no way that many issues in our lives can be logically, economically, or educationally reasoned away.  The only solution is to seek guidance Spiritually from the One who created it all.

2) Don’t expect it to make sense.

Things make sense only if we try to rationalize it from our level of understanding, not a higher level.

3) Keep trying.

While our treatment modalities and facilities are far from what we would like them to be eventually, we continue to strive to improve lives.  If we can do so in the name of Christ, then we can not only garner some relief in the moment, but the sense of hope for eternity in Him.

I constantly struggle with slowing down and keeping these “lessons I am learning” in the forefront.  I hope to do better... but right now, I am being summoned to consult with another patient who fractured his leg.  My education continues!