I wish I had this worked out better by now. I think, watching the world wrestle with refugees and fear and self-protectionism and welcome and closed borders, that we all wish we had things like this worked out better by now.
Last month a Djiboutian family I know well was struck by a tragic medical crisis. This is a low-income family with two unemployed parents and a few almost-grown children who earn enough money to keep the family fed, clothed, and sheltered.
The crisis involved a newly married young woman, the eldest sibling. She was admitted to the hospital and remained there for over a week. On her third day in the hospital, I received a phone call.
“She needs a urine test right now and she needs money to pay for it.”
Medical care here is different from medical care I am used to in the United States. In Minnesota when my family undergoes surgery or medical tests, the doctor simply orders them and we get the (massive) bills later. Hopefully the insurance company will cover the costs but rarely does it cover everything.
Here, tests are performed and paid for one at a time, in cash and up front, so though the patient might not know why the test is being done and might not be informed of the result, she at least knows how much it costs. Also, supplies must be brought by the family (including food, sheets, pillows, water, soap, etc).
Getting a urine test required that cash, a trip to the pharmacy to get the cup, a trip to the hospital to pick up the urine sample, a trip to the lab to drop off the sample, a return trip to the hospital to deliver lunch (not provided by the hospital), a return trip to the lab to pick up results later in the day, and back to the hospital to try and find a doctor who could, and would, interpret the results.
I felt frustrated with the phone call. My first thought was, “Where is her mother and where is her husband?” I masked my anger and helped take care of this test. I spent hours there, I drove all over the city to find prescription medicine that wasn’t stocked at the hospital (I eventually found some, not at a pharmacy but at a friend’s house). I spent more hours back at the hospital, tracking down doctors and nurses, asking questions, making sure my friend had eaten and washed.
By the time I got home that evening I was completely drenched through my clothing and emotionally and physically exhausted. I canceled a meeting, ordered a pizza, and collapsed in my air-conditioned room.
The next day, again at the hospital, I saw the young woman’s mother, crying. She looked utterly weary, lost, and confused. She told me that the husband had been taking an exam the day before, during the time of the urine test. The exam was to help him get a job, something he needed in order to provide for his wife and soon-to-be-born child. She had been at home caring for several younger children and trying to find someone to watch them so she could come to the hospital today.
I had judged far too quickly.
I had been ignorant of all my advantages.
If the husband left the exam, he would not get that job. He needed a job for the future care of his family. He was trying to do the right thing and had to choose between two impossible things. Staying in that exam was not an easy, selfish thing for him.
If the mother had left her home, in a rough, poor neighborhood far from any kind of police oversight, her house would possibly have been broken into. They don’t have electricity, no refrigerator. She also has to cook meals fresh every day, including a long walk to the market for supplies. Every day. She had to choose: feed several young kids or go to the hospital? Staying at home was not an easy, selfish thing for her.
Me, on the other hand? I had a car, I could zip around from pharmacy to lab to hospital. I had the ability to order a pizza. I had back-up childcare and a secure home that could be left empty. I had power at the hospital, even though I am not a doctor and, as much as I detest it, because of the color of my skin and passport and the money in my wallet.
In other words, I had ease, privilege, and a buffer zone. I had margin.
This family had no margin. They were already living on the edge. They were surviving. They had enough to eat, they had a family support network established, they worked hard to maintain a clean, safe, and stable home. But they had no margin and when disaster struck, disaster requiring money and time, it pushed them right up to and nearly over the edge.
They hadn’t called the foreigner because they were uncaring or selfish. They called me because we have a relationship and because they had little other recourse. They were doing the absolute best they could and asked for almost nothing else beyond this test. Even through weeks of further medical interventions, they scraped together what they could, extended relatives got involved, and other friends rose up to help. With the bit they had, they simply needed a hand to keep them from tipping into the abyss of this crisis and being swallowed whole by it.
I was wrong to be critical. I was selfish, uncaring. Over the weeks that this crisis unfolded I saw family caring for each other in practical, tangible ways. I lent a hand, a car, or a bill, when appropriate. I learned to be much slower to cast judgment and much quicker to serve.
I learned, again, (always learning even after thirteen years as an expatriate) that I need to be less certain and more humble.