A Neglected Side-Effect

by Eric Weber, Tufts University Medical Student

Two young men are critically injured after their motorcycle is hit head-on by a bus.  Shocked but determined, their families struggle to get them access to appropriate care.  One requires a surgical amputation of his leg necessary to save his life, after which he is connected to a home “wound vacuum” device for several weeks to help prevent infection.  The other gets multiple bone realignments and is sent home with a prescription for IV antibiotics, which he must go to receive daily back at the hospital.

Willy & Eric in the halls of Centro Medico BournigalThese two patients have much in common: their friendship; their tragic accident; their families’ love and determination to help. And lastly–that neither of them could follow their doctors’ treatment plan.

Sadly, the doctors caring for each of these young men failed to take into account one side effect of their treatments: financial impossibility.  The amputee’s “wound vac” required device-specific canisters that were insurmountably expensive to keep replacing, to the point that the family had started to sell many of their belongings.  Meanwhile, the patient prescribed IV antibiotics had to pay for specialized transport to and from the hospital due to his leg’s immobilization.  The family could not afford to continue this, even after receiving financial help from their neighbors.

As the lone “gringo” in blue scrubs performing home visits it is both humbling and disconcerting how happy these two young men were every time I appeared on their doorstep.  They thought I was someone who could “fix” them, but in truth, it was HHI’s Clinical Referral Specialist Willy and the HHI case management team that saved these patients’ lives.  Willy connected the amputee with a local orthopedic surgeon who has generously donated his services to HHI on multiple occasions.  The surgeon worked to provide quality, financially-feasible debridement surgeries in place of the “wound vac” that was bankrupting this patient’s family.  Meanwhile, HHI helped to fund the purchase of IV antibiotics for the other patient, which HHI physicians determined was safe to be administered at home by intramuscular shots to avoid costly transportation.  “God bless you,” their families would say every time I came to provide wound care and medication.

“God bless you.” It is a phrase that simultaneously warms my heart and sends aWilly & Eric review osteo patient charts chill up my spine–the latter because I realize how easy it is to feel “good” by giving away medication and treatment to people in need.  I am proud to be a part of an organization whose primary focus is not just to give, but also to teach –to empower the people it serves by connecting them with more affordable care and medical education.  There is much more that needs to be done: communities need to continue learning how to communicate with their doctors to better utilize the existing healthcare system.  Local healthcare providers need to be mindful of the social implications of the treatments they recommend.  And foreign aid groups need to continue acknowledging that it takes more than gifts and gratitude to change the world.

Nevertheless, I think we’re off to a good start.

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