One thing foreign travelers fear the most is a travel emergency that will land them in a local hospital. Language and cultural barriers are the last thing you want to deal with when you need medical attention abroad. Or perhaps you don’t trust the competence of the doctors? The fear alone is enough to cause many people just to stay at home. Well, last week, it happened to us. My wife had an acute bladder infection in rural Bolivia, and ended up two nights in a Bolivian hospital.
Now that she is healthy again (yay!), and our anxieties have soothed, we can reflect on the whole experience from the perspective of a medical consumer. Turns out, it wasn’t that bad! I learned that my fears of receiving emergency medical treatment down here are largely unfounded. In some ways, we found it to be far better than a hospital stay in the United States. And in other ways, not so much. Here’s what it was like:
A Remote Travel Emergency
It really sucks to have an acute disease in a remote location. Here in our town in rural Bolivia, we are hours away from the closest doctor. When my wife started having severe pains and decided she needed help, she couldn’t just drive down to the local emergency room. She couldn’t even call a 24-hour hotline. She had to wait overnight before she could catch a ride to the nearest city. Then, once she got a ride, it took her nearly three hours to get into the city where she could get medical attention.
There was no thought of going back to the United States – that would have taken days. But whether you’re in rural Michigan or a small town in the Southern Bolivian Andes, the reality of being in a remote location is the same – it can take a long time to get to medical attention.
Then, once she finally arrived in the city, my wife then had to choose a doctor.
A Choice of Doctors
In the U.S., your choice of doctors is heavily limited by your insurance. In a country like Bolivia, where health insurance doesn’t exist, neither do those limitations on your choice of doctors. The only limitation a patient has is how much money they can spend. There are nearly-free public clinics and hospitals, primarily used by the poor. And there are more expensive private clinics used by people with more means.
As you can imagine, the public clinics don’t have the best reputation for their quality or speed of care. If you can afford it, it is certainly advisable to go to one of the private clinics. But, even among the private clinics, there is a range of choices and a range of quality. Like so many other things in life, you get what you pay for.
So, as a foreigner with a travel emergency, how do you choose a doctor? Typically, travelers place their trust in a local who can make that decision – perhaps the hotel where they are staying or a tour guide. In my wife’s case, she has relatives here in Bolivia who chose a clinic for her.
Thanks to a little a little wealth through FX magic, along with the stunningly low cost of medical care in Bolivia, we were very easily able to afford one of the top clinics in town.
Here’s a picture of it. Private clinics like this offer a range of emergency treatments with a limited number of hospital beds. They can’t perform more complicated procedures, but for most travel emergencies, they have what you need.
This is one area where the U.S. healthcare system outshines. The steps required to diagnose my wife’s condition were not complicated – just some lab work on blood and urine samples, and a few other routine tests. In the U.S., it would have been diagnosed quickly, in-house, same-day. Or at most, one day. The lab coordinates closely with the doctor. Information is shared. Everything is expedited. Go Teamwork!
Here in Bolivia, it took our doctor two full days to diagnose my wife’s condition. I can’t really blame it on the doctor or the clinic so much as on the realities of life in Bolivia. Everything takes longer here.
The lab is a separate business, which requires an appointment. And they don’t share information with the doctor – you have to go pick up your results yourself, and deliver them to the doctor. Each step takes time. Add in the fact that business hours are limited (typical business hours are 9 am – 12pm, and 3pm to 6pm), and you can see how the diagnosis just takes longer here.
Nevertheless, after two more painful days, the results were in. The doctor diagnosed my wife’s condition and ordered her to check in for two nights into the clinic.
Had this all happened in the U.S., we probably would not have checked into a hospital. They would have diagnosed the condition faster, given my wife some drugs, and told her to come back in a couple of days. Hospital beds are too expensive for anything that can be treated at home.
Undoubtedly the delays in traveling to the city and waiting for a diagnosis worsened my wife’s condition. It was nearly three days from the time she decided she needed medical attention to the time she checked into the hospital and they gave her some of those really good drugs.
Once she checked-in, things started getting much better. Here’s where the Bolivian healthcare system outshines the American. From the minute we checked-in, we noticed a higher level of service from what you might find in a typical American hospital.
She had a private room with a BED FOR GUESTS and a private bathroom with a hot shower. Plus her own cable TV and free Wi-fi access! All this for about the same cost per night as a hotel room! In the U.S., most people would need to sell their first born to afford a hospital room like this! My wife and I were joking that we might prefer to stay in the clinic again next time we’re in town!
Here’s a picture of the room:
I remember when my first son was born, trying to sleep in my wife’s hospital room in Virginia in a little chair that didn’t even recline. Bolivian hospital rooms are WAY better.
Oh, and did I mention the food? Her first lunch was grilled chicken breast with quinoa, fresh green beans, and homemade vegetable soup. I asked the nurse if I could order one for myself! Unfortunately, she said no.
Hospital food in the U.S. is sad and pathetic, at least in my experience. You would think a place that charges thousands of dollars per night would have better food. Here’s proof that it is possible!
I’m certainly no medical professional, nor do I play one on TV. But, in my amateur opinion, the urologist who treated my wife was top-notch. He was professional and accessible, he explained things well, and I’ll be damned if he wasn’t the most charismatic urologist I’ve ever met! He didn’t speak any English, but my wife and I are both fluent in Spanish, so there were no language barriers. And, most importantly, he cured my wife and made the pain go away.
In fact, all the medical staff at the clinic was superb. The clinic was well staffed and they were always helpful and attentive to my wife’s needs. They didn’t seem overly stressed, rushed, or stretched thin like the staff in most U.S. hospitals. I would have no hesitation going back to the same clinic for medical treatment. And when you hear how much it cost, your jaw is going to drop wide open.
The total cost? Two nights in a pimped-out hospital room with real 24-hour nurse attention, some lab work and other tests, an IV with a bunch of antibiotics and some really good drugs to make the pain go away, plus several consultations with an very charismatic urologist – it all together cost a little under $600. No, I didn’t forget a zero. That’s $600 American dollars.
Plus… and this is really going to blow your mind…. The hospital bill was simple, transparent, and easy to understand! It’s all so… reasonable! It’s like some kind of fantasy world down here!
Here’s the breakdown:
|Hospital Bed (2 nights)||$101|
|Nurse Attention (48 hours)||$29|
|Lab Work & Other Tests||$83|
We actually bought some travel insurance from travel insurance from World Nomads before this trip. It cost us about $900 to cover the whole family for six months of travelling. Since this was a qualifying travel emergency, we will make a claim and get our money back.
I’m often not a big fan of insurance. Insurance should only be used to cover the risk of catastrophic losses. Otherwise, it tends to be a waste of money. And $582 is not a catastrophic loss by any stretch. But, since we already have the insurance, I’ll make the claim anyway and take the money! I guess it was a good choice!
Now we’re all happy and safe back home in our rural Bolivian pueblo. My wife is still taking some antibiotics, but feels perfectly normal (Yay!).
The last thing most travelers want is the anxiety and uncertainty that accompany a travel emergency in a foreign country. But, from our experience, those fears are unfounded. There can be both advantages and disadvantages to receiving medical attention abroad in a country like Bolivia. Things may take longer, and you may have to deal with language or cultural barriers. But, for routine medical conditions, you probably won’t have to sacrifice quality of care – in fact, you may receive even better care than you would in the U.S. And you can be treated for just pennies on the dollar compared to the U.S.
You’ve got to wonder if all the outrageous costs in the U.S. healthcare system are worth it! Are we getting what we pay for? Maybe not.
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