Monday, July 27, 2009

A Tale of Two Hospitals

This is a reflection about my visit to the private hospital and then the public hospital of El Salvador all in the same day with students on our delegation from Eastern Michigan University.

If you only went to the Hospital Diagnostico, you might not be able to relieve that a hospital like Rosales existed in the country and vice versa.

We went to the Diagnostico first and were given a tour by one of the young residents. Her English was quite good and she was incredibly friendly and helpful. We moved through the cool rooms with the artistic Salvadoran paintings, nice floors, and clean facilities. The hospital used to be a mall and you can see by the set up, do to this unique architecture, specialists are able to have their own offices. We were able to visit the room with one of the only MRI machines in the country and we peaked into the quiet ICU.

The patient rooms were individual rooms with private bathrooms, nice furniture and plasma TV’s. On the fifth floor where the rooms where oldest, the TV’s were not plasma but the view of the city from the balcony was amazing.

In the waiting room we watched as a small boy in overalls was whisked in by his nanny with a cut finger. He was immediately seen by the doctors. As we visited the emergency, the boy cried as they cleaned his finger. His young mother and father had entered and his father comforted him: “Don’t cry, this weekend we will go back Apaneca and you can ride horses again, wouldn’t you like that?”

We finished the tour, thanked our young doctor and headed to Mr. Donut for a quick lunch before arriving at hospital number 2.

It is hard to put the experience of Hospital Rosales into words, but I’ll try.

The chief of residents who took us around the hospital also spoke English. He had studied a semester in the hospital at Yale, so he must have had some concept of the vast ocean that existed between a private hospital and the one he worked at.

Rosales was various buildings. Many of which are the same as when they were build in 1904. The beds in all the wards were full. The first wards were giant high cieling rooms with about fifteen beds in each. We walked into the room for people with kidney failure. A resident was pumping air into the lungs of a patient for lack of a breathing machine. It was hot and there was no AC. Hospital staff moved around from one person to another. Some family rubbed the backs of their family who grimaced in pain.

The AIDS ward was similar.

The Emergency room was a horror. Full of people who looked as if they had come from the most remote corner of the country. Bent over, coughing, with homemade bandages. Some people leave their homes at 3am to arrive here the doctor said. They usually wait on average 4 hours before they are seen. People who need a bed sometimes wait three days. If there are no beds, they roll out towels on the floor while they wait for a doctor.

The OR had about 6 patients many of whom looked gravely, gravely ill. A man in a chair who was not able to have a bed do to the lack of them, explained to a nurse the pain in his chest that was probably a heart attack.

As we reached the nicer wards, the ones with air conditioning, but still very evident of Salvadoran poverty. We saw where the flu patients are kept. One girl in our group asked: why do you give the nicer rooms with AC to the people who aren’t as sick? This may be hard to hear, the doctor said, but we have very few resources, we have to prioritize. Many times we give priority to the people who are younger who have a better chance of living.

We walked on. This is one of the few public, full scale hospitals in the country, he told us. It is free, that is why people come all over. Most of them have to ask for a dollar to get back to their homes. We ourselves don’t have the resources to have enough doctors or enough medicine. We have a whole ward build by the government of Germany in disuse because we don’t have enough Money to pay the staff. When we do open it, we will give it to patients with renal failure, a very common illness here—it’s the farmers who get it, the ones who have been poisoned by the pesticides.

We walked on, sick person after sick person. We reached the end and thanked the doctor. He thanked us. Now you see, he said, the difference between private and public hospitals.

Like I said. Had I just gone to Rosales, I couldn’t have believed that a place like the Diagnostico existed. And vice versa.

3 comments:

Tim said...

I had surgery at the Hospital Diagnostico in January after I fractured my knee. Knowing the difference with the public hospitals, I could only reflect on the fate of a poor Salvadoran who could never expect to find his way into such a hospital and might face a lifelong disability from the same injury as mine.

PaulF said...

Powerful story Laura. I'm without words.
Thank you for sharing.
Love,
Uncle Paul

Listasal said...

The difference between Private and Public hospitals is so large it's difficult to believe its the same country. When I've shown friends from abroad pictures that show those differences they've told me it's like if it were two different countries.