Dr. Noreika: Are the patients charged for their care? Is there an insurance system?
Dr. Ebner: Insurance is minimally existent. The people who have insurance are usually government employees.
Insurance is relatively inexpensive, about $15 a month, but small farmers living on a shoestring can’t afford it. I didn’t realize how important the insurance industry was to practicing medicine in the United States until I went to Kenya.
Tenwek Hospital has been able to do fairly well, but it does charge patients. The amount is minimal compared with what you have in the United States, but it’s still a cost.
It’s always kind of a shock to me that people have to pay in order to be treated, especially since I see a lot of trauma cases, and no one plans on having a trauma.
People will come into the emergency room with a broken hip and if they can’t pay for care, they are sent home until they can. I thought that was cold-hearted until I realized that the hospital has to pay its overhead. Patients do not pay a lot but the economic fact is that the hospital has to do this to survive.
I saw a study once that said in Kenya there were about 18 missionary hospitals and only two or three of them charged people for their health care. The rest were financed by U.S. donors.
Almost all the ones who didn’t charge patients went out of business. The ones that were able to make a go of it were the ones that did charge people.
Medical financing was something I never had to deal with in the United States and it’s hard, but you can see why it has to be done.
Dr. Noreika: Is English the primary language in Kenya?
Dr. Ebner: In business it is, but most of the people there do not speak English. They speak either their native language or Swahili, which is kind of a common language up and down the East coast of Africa.
English is spoken in the hospital by most of the doctors and nurses.
Our patients can have maybe four or five different languages from their different tribes. Every tribe has its own language. So I rely upon the nurses or the doctors to translate. I am always amazed at how many languages the staff can speak.