The other day a guy with a visibly bad leg and hip injury walked into our office. It was clearly difficult and painful for him to move. He was carrying two papers, one with a recommendation text and another one where you could write your name and amount of donation.
It turned out this man was suffering from a severe kidney failure and he needed dialysis treatment (dialysis will never cure your kidney failure but can give you some more years), the cost of which in an Ethiopian hospital can be several thousands, and that is for one dialysis treatment. This man was a shoe shiner so I can estimate he makes a maximum of 50, maybe 100 Ethiopian birr in a day.
In such a situation, my natural reaction was to look at what the locals will do. My colleague agreed that this guy was in a very poor condition – what harm will it do if we give him a few bucks? I decided to give 100 birr, which is roughly 5 euros (in these circumstances, quite a large amount of money). The man left and I will probably never see him again.
Of course I have seen beggars here before. This was the first time, though, that I’ve seen somebody walk into an office and making it into an organized activity. It was like a polished version of begging. A personal Kickstarter campaign for receiving dialysis treatment. For all I know, he could have been a professional con man!
Several thoughts went through my head that morning. The obvious comparison I make is to my own home country, Finland, where a public health care system is accessible for all (definitions vary for ‘all’ – we also have people who are not as well off with regards to access to health care. For example, those without legal status, ‘the paperless’ do not have access to health care. ‘All’ here means legal residens and citizens) at quite a minimal price.
Yet, it is a truly astonishing system which makes it possible for any person, whether rich or poor, to receive the best possible medical treatment, such as surgeries, for his or her sickness. Obviously the system, like any else, has its drawbacks, but it is nevertheless one of the single greatest things in my home country. Worth fighting for.
Universal access to health care so important. It is about dignity and respect. When we start determining people’s access to health care on an income basis, we immediately make part of the population an easy target of pity. Pity is a very effective tool in belittling and paralyzing people.
On the other hand we have the I-have-earned-this-beings. We, the ones better off, have a mental safe place where we like to escape when difficult things become too complicated to overcome. We tell ourselves we have earned what we have in life. We forget life is also about luck, life is not always predictable. The ubiquitous mantra ‘if you just work hard, you can achieve anything in this life’ is unfortunately not universally applicable.
We live in a fallacy if we think universal access to health care doesn’t concern us. One day it might be you, your dad, your wife or your husband who suffers from that severe kidney failure. I don’t think anyone wants them to walk around in offices or in the streets trying to scrap together money for a dialysis treatment, or setting up a crown funding campaign online. Staying alive shouldn’t be a question of affordability.
In Ethiopia, access to health care has improved in the past years. Campaigns have been conducted for maternal health and those have been very effective. Ambulances are now available in many remote places. But yet, when it comes to quality of treatment, and accessibility for advanced treatments, there is a big gap between rich and poor. This is not a problem of Ethiopia only. I have ran into similar health beggars all over the United States.
I heard from my colleague that some years back there was a vivid discussion in Ethiopia about making health care more systematic. Instead of giving random donations to beggars, there was a proposal that people would pay part of their salary to a common fund which would then enable health care access for all. This was finally not approved, partly because people didn’t trust each other, they thought others will cheat and take advantage of the system. This is the common argument we hear in Finland as well.
I’d like to see statistics on how many people actually cheat the health care system versus the benefits it brings when the full development potential of a population is not held back by trivial reasons, such as lacking the finances to have a dialysis treatment.
Health is a priority. Don’t let them fool ya!