Transcript waiting for health - Universal Health Coverage Day

WAITING FOR HEALTH
Too many people are still waiting.
Photographers around the world tell their stories
WA I T I N G F O R H E A LT H . O R G
GUINEA
Nana Camara, 48, waits to see the nurse at La Clinic Cabinet Medical in the Nongo neighbourhood of Guinea’s
capital, Conakry. Camara has been suffering from malaria for four days, but had been unable to come to the
clinic sooner due to lack of funds.
Instead, she endured the fever at home, relying only on Paracetamol from her local pharmacy, until one of her
nine children was able to borrow enough money from his employer to cover the medical costs.
Many Guineans simply cannot afford to pay for medicines or treatment, as well as the costs of transportation
to access their local clinics, leaving many of the country’s health centers largely empty most of the time.
It is a problem Camara understands all too well. Just two months ago she lost her husband to a heart attack,
after doctors at one of the city’s main hospitals refused to treat him without being first paid a sum of money
the family could never afford.
The clinic is also struggling in the aftermath of the Ebola outbreak. In particular, malaria symptoms like
Camara's are very similar to Ebola symptoms. One patient at this clinic didn't respond to malaria treatment and
later tested positive for Ebola. The clinic never had full protective gear.
MYANMAR
Muzammil, 37, is comforted from his pains by his stepmother while waiting outside a pharmacy for
the pharmacist to arrive. Incredibly poor sanitation in the area make deaths from diarrhea and
stomach infections all too common.
Others watch them, early in the morning in an internally displaced persons camp for Rohingya people
on the outskirts of Sittwe, Rakhine State, Myanmar. With virtually no doctors around, pharmacists are
the only people treating diseases and injuries. There is a government-run hospital, but it is semioperational and the Rohingya don't trust it.
NEPAL
A young girl waits in one of several seemingly endless queues at a clinic in Sindhuli district in Nepal.
This specific clinic, set up by an international NGO for the day, was one of many of its kind operational
after April 25th’s devastating earthquake in the country.
After a long walk to the clinic the queuing starts; first to register and receive their patient form, then
to see the doctor, then to get any medication prescribed. The outing can last a full day, and despite
tarps being erected to shade the crowds, the excessive heat still took its toll. These were the lucky
few.
Patients are meant to keep their form for future doctor's visits, which theoretically would help the
doctors to see the patient's history and track progress. In reality, without duplicate copies of
patients' forms on file, the system doesn't always work.
Especially since the earthquake, people in Nepal wait incredible amounts of time for healthcare,
which often comes in the form of volunteer doctors. Villages routinely wait for medical care for days,
because of how difficult it is to get there by road.
BURUNDI
Mama Fidès sits beside her son, who is 11 months old and suffering from high fever and anemia
caused by severe malaria. The child needs a blood transfusion that is not currently available at
Kirundo Hospital. Mama Fidès waits and hopes it will come soon enough.
In this case, they were lucky: the blood transfusion arrived during the night. The following day, the
doctors told Mama Fidès that her son was almost ready to go home.
Many other children are not as lucky, either because they arrive too late to the hospital or because
the blood never arrives, whether from lack of fuel in the ambulance or lack of cold bags to carry it.
JAPAN
A woman takes care of her mother, who is waiting to enter a nursing home.
She is not alone. Approximately 520,000 seniors are on waiting lists for nursing homes in Japan. As
the country's elderly population continues to grow (people aged 65+ currently represent 25% of
population) and as the government continues to scale back funding for nursing homes and its staff,
working-age children are increasingly feeling the pressure.
Many women and men must give up their careers to take care of their parents, and with people living
longer, "young" senior citizens must even act as caregivers for their parents.
By 2025, Japan will need 2.5 million caregivers. By 2060, senior citizens will represent 40% of the
population.
CHINA
After collapsing twice in one day, Chinese gold miner He Quangui is struggling to breathe, gripping the bed and his
son He Jinbo's thigh while his wife Mi Shixiu holds him, crying. He eventually recovers his breath. But in the early
hours of the next morning, he attempted suicide to end the suffering.
For 10 years, Mr. He battled silicosis: a irreversible but preventable disease he contracted from years of work in
small, unregulated gold mines in the Henan province of central China. This illness is a type of pneumoconiosis (or
"black lung" disease), which is China's most prevalent occupational disease, afflicting millions. Silica dust sucked into
the lungs during years of blasting rock causes the miner's lungs to harden and eventually fail.
Workers who have access to good health care and are able to remove themselves from these harmful
environments—particularly those who worked for state mines—can live a normal lifespan. But most of the growing
number of victims in China today are migrant workers like Mr. He, with no insurance, no good health care and no
legal recourse. They often live in the most remote parts of inland China where medical facilities are far away.
To get to the nearest reasonably-equipped hospital, Mr. He had to travel approximately four hours by
van. Otherwise, all he could do was wait in his farmhouse for the minimally-trained staff member from the small
local clinic who had access to only basic medicines.
Mr. He died 1 August 2015.
INDONESIA
Gilang holds an x-ray of his right lung, damaged as a result of Bronchiectasis—a condition when airways are
so damaged they no longer clear out bacteria, often leading to repeated and serious lung infections.
In Indonesia, Bronchiectasis is often not diagnosed or treated in a timely manner. Gilang waited through
four medical examinations before his Bronchiectasis was identified, along with its likely source: an
extended and untreated Tuberculosis infection.
Antibiotic therapy and physiotherapy brought no help for young Gilang. Six months after this photo was
taken, his right lung collapsed. To prevent infection from spreading to his left lung, his right lung was
surgically removed.
Sadly, his battle came to an end three days later.
Indonesia reports the fifth-largest number of Tuberculosis cases in the world after India, China, South
Africa and Nigeria. Unfortunately, this means there is a good chance that Gilang’s story will repeat itself.
NORWAY
More than 30, 000 refugees have so far crossed the Norwegian border in 2015. Asylum centers across the
country are now overcrowded.
Wahid Mohammad Mustafa Alkarami (45) and his children Mohammed (17), Haitham (15), Oday (13) and
Taghred (9) fled from their home in Benghazi and the civil war in Libya last year. Wahid lost his job as an
engineer when his workplace was bombed in 2011. In April 2013, his wife, Nejla Elsatsai, was diagnosed with
aggressive liver cancer. Due to shortage of medical institutions in Libya, Wahid took his wife to treatment in
Tunisia every other week for nine months. Sadly, Nejla passed away at the end of 2013.
Hoping for a better and more stable life for his children, Wahid started the long process of seeking asylum in
Europe. The family came to Norway on 28 October 2014, and after more than a year, recently got a permit to
stay. On 14 December 2015, they will move into their new home.
But the wait for health continues. The proportion of refugee children and adolescents in Norway with mental
health needs is alarming. While everyone in Norway is entitled to health care, the wait for services—
especially mental health care—can be long. Although the children have experienced several traumatic events
during the war, they say they have not been offered any psychological help.
INDIA
Early in the morning outside a primary health care center in Bihar, patients queue up to receive a
token from the attendant. The center, which serves around 200,000 patients in the region, has only
one doctor and two junior doctors. Everything depends on whether the doctors actually show up—
and for the patients, arriving early rarely makes any difference.
Once inside, the conditions of the primary health care center is poor. Used syringes are disposed of in
the sink.
BRAZIL
A mother and her one-year old baby with skin ulcers wait for medical care in a public hospital in the
rural area of Palmares city in Pernambuco State, northeastern Brazil.
In the 1970s, Brazil had a segregated health system: the rich and salaried workers had access to
private hospitals in urban settings, whereas limited public services existed for the poor and
unemployed.
Now, health is a constitutional right in Brazil. The country established a unified health system for all
citizens in 1988, with the principles of universalism, equity, integration, and democracy.
But promising health for all is not the same as achieving it. While health outcomes have improved
across the population since the unified health system was adopted, persistent corruption and
inequity mean that the poorest communities still face tremendous barriers to accessing the same
quality health services as the rich.
USA / MEXICO
American seniors seeking more affordable healthcare in Mexico.
The high cost of medical care in the U.S. is a growing concern to millions of Americans, especially
seniors. U.S. Customs estimates that 10 million Americans bring home medications from across the
border each year either from Mexico or Canada.
During the peak winter season when seniors and retirees flock to Arizona by the thousands, many
also make the short trek across the border to Mexico for cheaper pharmaceuticals and significantly
less expensive medical care.
Los Algodones is a small Mexican town on the USA/Mexico border. It caters to the market-driven
north-south migration of American seniors seeking relief from the high cost of medical services and
rising prescription drug prices. Los Algodones was once a tiny single industry town, relying solely on
its cotton yields. Today, it is a boomtown with more than 200 doctors, dentists and pharmacies all
catering to their neighbors from the north.
CAMBODIA
In the rural province of Siem Reap, a woman waits with two children for a routine prenatal visit under
a joint scheme between the local government health centers and an NGO-funded hospital.
The fact that visits to the doctor can be "routine" is a sign of Cambodia's progress toward universal
health coverage—reaching everyone with essential health services without causing financial
hardship.
However, many people in Cambodia are not so lucky. For example, there is only one hospital in the
country that offers any form of mental health service.
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