Care at what Cost?

Each visit to Justinian Hospital I ponder the cost of care and the time that proceeds treatment.  It's difficult for the doctors who care so much for their patients, but often don't have resources at their fingertips.

Let's say you're in labor and are hemorraging and your kouzinn (cousin), is with you. First things first, she'll have to get you to the main hospital on a dusty road by tap-tap, taxi or pay for an ambulance if she can find money and the driver in time. When she arrives she'll have to buy your chart just outside of the ER.   Your kouzinn has to bring your chart to maternity where when it's your turn the doctor hands her a list.

She is expected to coordinate care for the following: 

Hemoglobin, Hematocrit

IV catheter 

D5W 1 liter

Oxygen 

2 PRBC (2 bags of blood)

pitosyn

She'll have to go to a the hospital's laboratory and pay for your lab tests, the pharmacy down the block, the red cross across town and also must find a vendor for oxygen. 

Once she finds oxygen in a huge tank, she must pay for it to be transported. 

Of course sometimes a few items are in stock and doctors have supplies at their disposal or perhaps God has reserved an oxygen concentrator that's working and the electricity happens to be flowing through the outlets.  

After transporting a newborn with a fever to Justinian, my interpreter helped me bargain for a fair price for each of these items at 2 pharmacies nearby.  I recall quoted original prices for each item was drastically different.

Delays in care can originate in the doctors running out of gloves. The list handed over could include personal protective equipment. Perhaps your kouzinn might even have to call a bunch of relatives pleading for money prior to hunting down each item. The time to procure all items could take hours and the doctors hands are tied to proceed with care. 

There are so many unanswered questions:

Will the Red Cross be open? 

Is it almost shift change at the blood bank? 

Will you need an operation and what costs are involved? 

Will some pharmacies be more expensive than others, and should your kouzinn compare prices so she can maximize $?
What will you and your kouzinn eat? 

The 1st patient and last patient I was able to transport on oxygen from Hospital St. Francois de Sales.
I kept attempting to coordinate with administration for the small oxygen tank to be filled, but without success. 

Our oxygen tank was very low and the family could not find money to buy a large tank, the oxygen concentrator was occupied. I was thankful to see this patient the next week with her family at HSFS. 

The doorway to the pediatric department at Justinian.
Thanks to contributions from home, a tank of oxygen that cost $37.50 was able to be purchased for the department. 

This woman was a patient at Mama Baby who needed an operation for an ectopic pregnancy.
It cost roughly $75 for all her care.
Once again, I was able to give her donated money.
She has no family in the area and her neighbor ran around to care for her.