Reflections on Healthcare and the Lack of It

I’ve had the (mis) fortune of getting a couple of samples of the Jamaican healthcare system.

Strangely enough, they both involve bicycle rides.

Last Christmas on a bike ride to Hollywell, I rode a mountain bike that had the seat raised too high. The result was a sore “seat,” in a delicate part of the anatomy where “the sun don’t shine.”

I worried about it for a few days, got a “rear-end inspection” from the dutiful girlfriend (now wife) and decided that it was hurting too much and needed to see a doctor of some kind. Incidentally, this was Christmas Eve – a Friday.

My mother recommended that I call her family doctor, but he was away on leave, so we decided to chance a visit to Oxford Medical Center. I called ahead, and they were open, so I quickly went down, mentally preparing for another inspection. I was hoping that my worst fears would not come true (anything starting with “in” or “im” counts as a worst fear … incontinence, infertility, impotence were included.)

I walked into an empty waiting room, having been told ahead of time that they were closing early due to the Christmas holidays. I signed a waiting book, and then was quickly called to see the doctor on duty, which all happened in the space of 20 minutes or so.

Well… surprise… the doctor turned out to be a woman. A younger woman in her 30’s.

After a detailed “inspection,” including my first prostate exam, I was judged to be fine and just had sore muscles. She wrote a scrip for a few drugs and asked me to return in a few days. The cost was about US$25. The visit took about a half an hour.

In the meantime, I returned to the US and called the doctor assigned to me by my HMO. Unfortunately, he would not be able to see me for 30 days. However, if it was an emergency, I would need to go to an emergency room. But, there might be some openings on some of the afternoons, and if I kept calling I might be “lucky” and get an open slot. I tried that a few times, and gave up. Fortunately, I was returning to Jamaica the following week, and decided to forget about trying to see the doctor in Florida, and to use the health insurance I was actually paying a whopping US$262 a month to never use.

I returned to Jamaica about 2 weeks after the initial inspection, and my doctor did a further exam (sparing me another prostate exam, thank you very much) and she decided that I needed an ultrasound. She moved quickly, and later on that day while I was at the barber’s getting a haircut, she called and told me that there was an opening the following day if I wanted it.

I quickly said yes, and by the following day after another inspection, accompanied by grainy movies of invisible muscles, I was judged to have suffered no serious damage by a doctor who happened to be a fellow Old Boy of Wolmers Boys’ School, and was a few years behind my father, and didn’t think that my father would remember him from those days as he was ahead, etc. etc. It’s interesting the things that are discussed in these inspections.

The cost was about US$50.

Just this past week, I had another opportunity to test out Jamaica’s healthcare system by dislocating my shoulder on a bicycle ride down Stony Hill, in a collision with a minivan. I’m fine otherwise, and may need surgery, incidentally.

On the way down to Andrews Memorial I was dreading the worst. I quickly called ahead and asked my wife to bring EVERYTHING to the hospital – insurance card, wallet, food, clothes, books, magazines, my laptop – everything that we would need for a LONG wait. To my surprise, the entire process was so quickly done that I didn’t even get to open the laptop. When the specialist gave his final judgment on my condition it was about 2.5 hours after we first got there, and that included nurses’ intake, seeing a doctor, getting x-rays, and seeing a specialist.

The process happened so quickly that I could not even finish my magazine article, as there was not a single waiting period that lasted more than 30 minutes.

My poor wife was left dragging my laptop and all of my other crap home… unused and untouched.

The interesting thing is that I have just gotten health insurance in Jamaica. For more coverage than I had in the US, I paid about 10% of the total bill. That’s right – the prices were that much different.

The prices that I paid for the first incident at Christmas were less than my deductible in the US.

I had no idea the differences were that broad, and while I’m aware that a US hospital has much more equipment and the latest of everything, the system was so bad that I would have to wait at least 30 days to see any of it.

In a nutshell, in the US I paid 10 times more to have the best machines, and to be treated as a widget. In Jamaica, I’ve gotten very warmly treated and run the risk of not having the latest solutions readily available.

Remarkable.

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Keeping this Blog Going

OK…. I’m back. I think that I can now declare that my wife and I have moved back, at least physically.

Our stuff is mostly out of their boxes. We have even visited the US, and while we were there we didn’t run for our lives to the nearest real estate agent to try to get a rental. In fact, for me, the US has begun to feel like a foreign place again. For my wife, however, it reminded her of home.

This difference in feeling and thinking is what I’m going to focus this blog on in the upcoming months. I had initially thought that this blog would be a short one, and that it would end when the physical move back to Jamaica ended. I’ve decided that the physical move is the perhaps the easiest.

The deeper move is one that is spiritual, emotional and mental. This is all exacerbated by the cultural differences and similarities between Jamaica, the US and even Trinidad (my wife is Trinidadian in background.)

So, on to a whole newest of observations, that you: The Patient Reader, hopefully will find worth reading and re-reading.

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Welcome to My Blog to ALL

Hello and welcome!

If you are relocating to Jamaica, then this blog is the only resource of its kind, and a great place to check out what its like to move to live in Jamaica.

I returned in 2005 after over 20 years of living in the U.S., with my wife in tow -- her third trip to Jamaica.

While the whole blog is useful to expats, some are specifically written for expats and can be accessed here.

Since moving here, we have established a business assisting foreigners in making a successful transition to living in Jamaica.

Enjoy!

fwade

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Welcome to My Blog

A Note from fwade, the author of this online diary: Moving Back to Jamaica

To be taken straight to the latest entries in the blog, click here.

If this is your first time here, welcome! There are many ways to read this blog, but here are some basics:

1. The articles are written in reverse date order, with the most recent posts presented first. To go back to the very beginning, you can look in the Archives from the Main Page, or click here.

2. You can make a comment on any post -- I read all of them and reply to many!

3. At the top right, you can subscribe to the blog which simply means that you are sent email whenever I post a new entry. That way, you can keep current without having to come and check. If you understand what a RSS feed is, that is also available.

Once again, welcome to Moving Back to Jamaica, and I hope you enjoy what I have written about my move back.

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Bureaucracy, Jamaican Style

I think you know what I’m talking about – long lines, long waits, surly staff, heat and humidity, dust, deadly boredom, no parking, etc., etc.

Well, the truth is, with the exception of a single experience, I have not had very bad experiences in my Move Back to Jamaica…. and I was expecting the worst.

In fact, I think that doing business in Jamaica has become much more easy, and interestingly, that doing business in the USA has become much more difficult. (for reasons related to 9/11.)

Cases in point:

I was able to get JPS (the power company) to turn on our power in 1-2 days.
The cable company turned on cable service in less than 24 hours.
My wife was able to get Digicel cell-phone service in about 30 minutes.
My dealings with Customs and Immigration, including an episode in which my wife had her passport taken in Customs but not returned, were by and large straightforward (other than the fact that it was taken.)

The one glaring and obvious exception has been Cable and Wireless (C&W), the monopoly fixed-line provider.

After going into the office to get service turned on, I was assured that it would be taken care of in 5-10 business days. I gasped, as it meant that I would have to move in without a fixed phone line. They also informed me that I could not apply for DSL service until I had gotten a phone line… which made no sense to me whatsoever, but seemed like that would be a battle for another day. I was given a card with a reference number, with no date mentioned in writing of a day for connection. I told them that the apartment I was moving into has had phone service available there for years.

Nearly 30 days later, nothing has happened. I have gotten no information, or even a call from C&W. I have a friend who works for the company that I have asked to intervene on my behalf, but nothing has happened there either. I called twice and was given the distinct impression by the three people I spoke with, including one supervisor, that they could not care less whether or not I became a customer of the company. They advised me that my order had not yet reached “Installation” and that basically, was that.

In the meantime, I am contemplating forgoing a fixed line altogether, as I had someone in my apartment complex connect me to the WAN in the complex, which is available for free at the moment.

The only reason that I am even contemplating getting fixed line service, and DSL is that I plan to use VOIP, and the quality is much better over a DSL line (although that remains to be tested.)
C&W remains the one blot thus far in my attempt to get the essential services installed and in place in short order. So far, my experience has been one that makes me shrink from doing further business with them, and although I may have to, I am actively searching for alternatives. The buzz on the street is that there are alternate providers of DSL and wireless services coming on stream, and that I can use VOIP through other means. I look forward to it, which I know is not something that the executives of C&W are planning for in their strategic planning retreats for 2006.

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