Pay or Die: The Crisis facing the Medical Industry in Belize By: Aria Lightfoot

pay or dieLike a recurring nightmare, almost every week in the media, victims of  serious medical problems are asking for donations from the Belizean population to assist with medical care. Many need long term life saving surgeries, cancer treatments, kidney treatments, or some major medical intervention. Treatments can cost upward in hundreds of thousands of dollars to a million dollars for effective lifesaving measures to take effect. It plays out as a desperate last ditch attempt from victims to save their lives; and in reality, the public could never realistically sponsor these cases unless of course there is some major overhaul in how we administer medical care to the public.

I recall my mother’s own plight with the Belize medical system. She initially received medical treatment in Houston and Canada because of help of her sisters but when she returned to Belize, I recall Dr. Pott telling my aunt that he would not “waste his time” to treat her (as he had promised the Canadian doctor he would) because she was going to die anyway. My aunt was devastated and in tears desperate for some medical intervention. It was the Belmopan community, her family, friends, church members and nurse Johnson, who helped my mother transition into the next world.

A few years later, my aunt lost her healthy baby boy at the Belize City Hospital, because she did not use the private hospital system.  Her baby had a healthy heart beat at the doctors office however, he did not practice at the public hospital and when she went into labor,  neglectful nurses were not around when her baby began to crown and the doctor who was expected to be there,  was absent. It was a series of unfortunate events.  The baby was perfectly formed except he was blue.  When I was pregnant, my aunt gave me money so that I did not have my son at the public hospital. She did not want a similar fate and treatment for me…my medical care was excellent.

About three years ago, my cousin Albert who was my age, suffered kidney failure. He was retired early from the Government of Belize with limited money; but he needed $4000.00 a month for kidney treatment. More money was needed for his treatment than what he actually made when he was working fulltime. He needed three dialysis treatment a week but managed maybe one and not weekly. When finances ran its course, he died of kidney failure.

Currently I have another cousin undergoing expensive kidney dialyses; she is no longer working and her finances are depleted;  her health continues to decline as she desperately attempts to save her life. I donated some money to her, however it felt like a symbolic act because it will not realistically cover even one needed treatment; she also needs three a week.

Recently Patrick Jones, journalist and long time media personality, is facing a fate of inadequate finances for life saving medical treatment and so he must turn to the public for intervention…I highlight these cases to demonstrate that we need a major overhaul of our medical system and we need to overhaul how we administer life saving medical treatment for all citizens regardless of their immediate ability to pay.

The private hospitals in Belize have found its cash cow and they are pariahs on society. Medical victims are in crisis and desperately in need of major medical intervention and doing everything to stay alive. They borrow, beg and sell all their assets and when they can no longer maintain financially, they die. The private hospitals with life saving technology will not treat anyone who cannot show cash first and foremost. Even more offensive is that tax payers money have played a major role in educating doctors and sponsoring private hospitals

What has the Ministry of Health in Belize done to curb this crisis? The entire  medical system is shameful. I would argue that the practice of treating a patient to the point of bankruptcy and then no more offends the idea of medical care. Should medical care be a profit driven industry ? 

Doctors in Belize seem to have forgotten their Hippocratic oath:

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.

I will not be ashamed to say “I know not,” nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

Months leading up to elections in Belize, the unions showed their strength by demanding pay increases and even Uniform allowances and most were successful in their demands; however none have taken up the task of universal health care or demand that doctors who practice publicly and privately offer the same level of care regardless of ability to pay or place of treatment.

3 thoughts on “Pay or Die: The Crisis facing the Medical Industry in Belize By: Aria Lightfoot

  1. This is a difficult issue as it is literally a matter of life and death. This problem is not unique to Belize and must be looked at in a regional and global context. Cuba has free healthcare and is an amazing leader to the region…but their system is socialized medicine…and the government communist. Yet Cuban healthcare outranks U.S. healthcare in many areas…especially accessibility, efficacy and cost. Canada and England have national health insurance systems. These provide broad access, limit costs but are often associated with long waiting lists for surgery etc. Our latin neighbours have social security hospital safety nets. The care is often substandard compared with private hospital systems.
    We live in a capitalist society in Belize and somebody must pay. Free healthcare is an illusion so our leadership must stop selling this dream. Even if it is free at the point of delivery there is a cost that must be covered.
    I practiced for ten years in primary care piloting Belize’s national health insurance NHI project. We achieved significant progress combining private and public health resources to provide basic medical care to thousands.
    The project was/is a political football and it was never determined how it would be funded in the long term. Healthcare is personal, national and international simultaneously. There are no easy answers.
    It is difficult to remain objective when a loved one is facing life or death due to decades of neglect of our health system
    It is a vexing problem indeed but the solution must be at level of the system…drawing from the best regional and global healthcare successes that exist. Belize is unique,.. and our health system must be optimized for Belize. We can’t just keep pointing fingers as we move from crisis to crisis. The system of healthcare for our children should be better than ours…not getting worse.

  2. Aria, this is a really important article that you wrote and I hope it generate much discussion. when my mother was terminally ill with cancer, my experience with the medical industry was brief , but it didn’t leave me with favorable impression, including the caliber of doctors we have in the country. As my mother got older and after my father passed, I told her she had to leave Belize because she was the only one left there and that she would have needed the kind of medical care Belize couldn’t offer. But while she would come and visit us here she insisted on living in Belize (she was also blind from glaucoma) and a live in domestic helper did chores in the house. Anyway, when she wasn’t feeling well I went back to Belize to she what was going on , and while some of the signs were there we didn’t know she had cancer (it was likely ovarian cancer) , and the doctors were not forthcoming. As for the pay or die situation, I remember she had to do a procedure at Medical Associate and we had paid for the procedure. But I remember before the procedure was done as the nurse was prepping her she held out her hand for me to provide verification that we had paid for the procedure. I found that odd and disturbing. As for her last hours of life, that is too painful for me to talk about (and I have questions about how much more I could have done), but I think what the KHMH practice is a defacto form of euthanasia where some patients are concerned. They are just left to die. I am writing this message because I don’t want to be public on social media with something like this. I do have a favorable view of some of the doctors and nurses in Belize, but Belize has a big a problem. I am looking forward to reading comments about this issue, and hopefully I can make a comment. Again’ thinks for bringing up this issue.

    Oh, where the caliber of doctors are concerned, I think we do have to ask questions about how many are trained at world class institutions. Its okay for some to get trained at institutions like the University of San Carlos in Guatemala and University of Havana, but not 70, 80, or 90 percent. There is something about getting trained at elite institutions that make a difference. But I do understand that the Harvard trained like Dr. Bulwer or Dr. Grinage command higher salaries and have better opportunities abroad. (The writer prefers to remain anonymous but reprinted comment with permission

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