January 19, 2010
Dear Editor,
Last week I wrote a very sad story about the failure of our Healthcare System, and the editor of Amandala was kind enough to print it. The news was also taken up by several other media houses, such as Love FM and KREM. The article finished with several questions to ourselves which I would like to answer now. Before I do that, let me ask them again for the benefit of those who do not remember them.
“Do we need to become violent to be heard? What happens to those who depend solely on public hospitals and clinics because they cannot afford to go to a private doctor or clinic? What happens to those that trust our system simply because they trust that our doctors will do their job properly? Who will answer these questions?”
The answer is simple. We have to answer these questions ourselves. We are the ones that have to demand that our doctors give us the best treatment. We have to educate ourselves as to the prevention of diseases, dealing with our medical conditions and what we must do to remain healthy. This is our duty as patients. There is only so much that doctors can do with the limited resources they have. Our system itself is sadly lacking and only caters to our superficial health needs. What can we do about changing this?
I believe there are many ways to address the issues at hand, but these can be time-consuming for the people who are in a position to create changes in our system. For those of us who must constantly be seeing doctors and accessing this system, changing it for the better is a priority.
Please note that whilst I will be generalizing a lot, the case is not the same with all doctors or medical facilities. There are still a few great ones out there! Case in point is the San Antonio Polyclinic (Toledo), where I was given excellent attention and care last week. My heartfelt thanks go out to the administration and staff of this great facility. Your wonderful work is what inspires us to believe that the system can be bettered and work for us.
Recently, after many years of misdiagnosis, I was finally diagnosed with a chronic disease called Fibromyalgia. Up to the point of diagnosis, I had no idea it even existed. As a youth, I had several bouts of Rheumatic Fever and most of the doctors I visited considered this to be the cause of my pain in the past two years.
The problem was that every time I took the test to determine if it was really this, the results would come back negative. No one could give me an explanation for the debilitating headaches I was getting. An X-ray showed a bit of abnormality, but a CT Scan showed nothing. The recommendation was to do an MRI.
That was way beyond my means, especially since I was out on sick leave for weeks already. All of the doctor visits and testing done were on a private basis, since I could never get the same doctor at the hospital. This was in the months of July and August. The widespread body pain was getting worse by the day, and in the month of December I got to the point where I could not walk again. I could barely take care of myself, much less work.
As a result of routine tests carried out by my gynecologist, we found that I had an elevated ANA (anti-nucleic acid), and he casually mentioned that I probably had Lupus, but that the steroids he was giving me would take care of it. Knowing a bit of human medicine, since I’m a veterinary doctor, I knew this was not true.
At this point in time, my family was worried about me and after doing some research, decided that I should see a rheumatologist in Merida to try to ascertain what the problem was. Why was it decided that I should go to Merida? The answer is simple: I couldn’t find a specialist in Belize.
After making the super-human effort to travel to Merida to see the doctor, I finally had a probable answer to the pain that was ruling my life. The rheumatologist in Merida carried out an extensive amount of testing and after ruling out Brucellosis, was left with an 85% probability of my condition being Fibromyalgia, and 15% possibility of it being Lupus. After more than a year of treatment, my diagnosis is complete. I have Fibromyalgia and must live with it for the rest of my life.
Fibromyalgia is a debilitating condition that is characterized by widespread pain throughout the entire body, disturbed sleep, fatigue in most cases, cognitive dysfunction, exercise difficulties, and other symptoms that vary from person to person. It is a disorder of the nervous system which over-exalts itself. As with all losses, I’ve denied, bargained, been angry, been depressed and have finally come to accept living with a chronic condition.
Upon accepting that this is now my life, I’ve come to realize that I must do something to help those who have found themselves lost when trying to figure out what is medically wrong with them, those who cannot afford to seek private care when they need specialized attention and even those who simply need support, like I do. This is my very personal crusade. The more public one is to lobby for better healthcare for all Belizeans.
For now, I will concentrate mainly on the shortcomings of the Public Healthcare System, looking at it from a patient’s point of view. After being a patient of many doctors in Belize over many years, I can safely say that we are sadly lacking when it comes to many things.
First of all, our doctors are always in a rush. This, unfortunately, cannot be blamed on the doctors. I personally believe it is to be blamed on the Ministry of Health or its policies. Our hospitals and clinics are short-staffed and in the case of most clinics or hospitals, there is a shortage of medications and equipment.
The Ministry of Health has tried to compensate for the shortage in doctors by bringing in volunteer doctors from Cuba. Whilst the intention is good, there is a serious issue when it comes to language. I personally witnessed a break in communication when a doctor who speaks unintelligible English was trying to communicate with an elder who speaks very little English, and mainly Mopan. This kind of situation, I personally believe, can lead to the serious problem of misdiagnosis.
Secondly, I believe our doctors are seriously limited when it comes to professional development. Constant learning and exposure to different situations and scenarios is what equips our doctors to be able to deal with cases that are outside of the box. Not everyone that comes in with hoarseness has a sore throat, but the doctor must approach the situation with an open mind and not limit him/herself to the obvious. To be able to do this, he/she must be equipped with the knowledge that there are other possibilities out there.
Third and lastly, the public’s ignorance of how the complaint system works discourages the improvement of our public healthcare system. Feedback and positive criticism should always be encouraged, since this is the only way we can know our shortcomings and try to make them better. Encouraging people to make positive criticism should be a priority of a system that has failed many.
How do we change these things? The answer is simple, “United we stand, divided we fall.” Let us unite and work together to lobby for changes in the way our healthcare system operates. Let us speak out and ask for people who truly care about us to be installed as primary care providers. Let us give incentives to those people who do their jobs properly.
With this in mind, I would like to call out to concerned citizens who want to work towards a change to contact me at [email protected]. Together we can change things!
(Please note that these are my thoughts and I must apologize if they seem tangled up. This is as a consequence of my Fibromyalgia.)
—Dr. Roxanna Alvarez VM
(Ed. NOTE: Dr. Alvarez, you have our support.)