Healthcare Among Friends (Part 1)

A few months ago, I (Jennings) noticed a sore on my face that wouldn't heal, and I began to be suspicious of it. Back home in the U.S., I would call or email my dermatologist to make an appointment; the spot would be removed (if needed); and the insurance company would have sorted out how much I owed (perhaps a hundred dollars or more).

Here, it works differently. Here, you use the friend network.

First, I ran into a doctor friend, Dana, while we were both exercising at the United Nations gym. I hate to impose on her by asking her medical questions when she's not on the job (such as, when she's exercising at the gym). But she is used to doing impromptu exams and consults, and is very gracious about it. So I showed her the spot, and she said it needed to come off immediately. "Call Philip," she said. "He can do it."

Philip is another friend, a surgeon, who lived here for many years and had returned to Bunia to work at CME hospital for a few months. But he was leaving town soon to return to Canada, and I wasn't sure he'd have time. So I emailed *yet another* surgeon that we know, who works in a hospital in Nyankunde, a couple of hours outside of town. He said he could remove the spot, and that if I needed to spend the night, I could stay with him and his wife. (How often does a surgeon in the U.S. offer to *put you up at his house* before surgery?) 

So here was a surgeon willing to do it, and to put me up at his house. But rather than travel out of town, I decided to try Philip first. I texted his wife, Nancy (also a physician), and she called me right back. She said Philip was working up until the day before he left, and that could remove the spot the next day. "Be at the CME operating room tomorrow at 9 AM," she said. (Try scheduling next-day surgery that way in the U.S., by calling the surgeon and talking with his wife, who is also a physician.)

So I went to the hospital at 9, and Philip met me in his scrubs and a pink cap. Half an hour later, I walked out, with a bandage on my face and the removed skin preserved in a container. I was about to get a motorcycle taxi home when I realized that I had not paid anything. I went back and found my surgeon, and he thought about and said I should go to the cashier and pay $10. 

Cost of having a potential skin cancer removed from my face in Congo: $10.

Time delay between having a skin problem "diagnosed" (at the gym) and having it removed: about 16 hours.

Now the removed skin needed to be analyzed. As it happened, our friend Dana has a brother -- another doctor -- who has a lab in the U.S. and could analyze it, if we could just find a way to get it there. Philip offered to take it, but he was flying to Canada, and apparently there can be tricky rules about shipping body parts across international borders. Go figure. 

Dana's husband, a theology professor, thought of a colleague who had come to Bunia to teach for a few weeks and was about to travel back to the U.S. This visiting professor and I had never met, but he's an old friend of Douglas's. Could he help us? Sure enough, he was willing to take my "sample" with him and mail it to the lab! I had a check sent to Dana's brother, and the results came back within a week to say that the spot had been completely excised and posed no further risk.

Healthcare in Congo: a community affair.

PS. There are several photos on the link, which was posted by another Canadian surgeon who recently visited Bunia. There is a good picture there of Philip, seen with the other Canadian and four Congolese CME colleagues and a piece of equipment. Philip is third from the left. There is also an aerial photo of Bunia. We live inside the loop near the middle of that picture.