Joburg Expat: In the Emergency Room

January 15, 2011

In the Emergency Room

How good are South African hospitals? That question is bound to be near the top of your list if you’re considering an expat assignment in South Africa, or any country for that matter.

I don’t consider myself an expert yet, but we are starting to accumulate more data points in this respect. It was barely two days into the New Year that we rushed into Life Fourways Hospital, 3 adults and 7 kids in tow. We had driven three and a half hours straight from Madikwe Game Reserve near the Botswana border, where we were privileged to see the most dangerous animals up close without incurring the slightest scratch. Instead, it was a vicious night stand that came in the way of Sunshine’s forehead when she was jumping on the bed with Jabulani (I should tell you that those two have a history of travel-related injuries, or rather, injuries inflicted on Sunshine by Jabulani right before departure). There was a lot of screaming, the sight wasn’t pretty, and we knew stitches were needed.

We had opted for Life Fourways rather than the Rustenburg Children’s Hospital, because it wasn’t that much farther to drive. After the initial gush of blood, Sunshine seemed to be okay for the moment and we preferred to be closer to home. We didn’t regret it. As was the case when I was there last April for tick bite fever, we waited less than 10 minutes to be taken in. There was a brief debate about trying to find a plastic surgeon, but as it was vacation time and could have taken more than another day to locate one, we opted for the attendant ER physician instead. He did a superb job on Sunshine’s stitches, all the while relegating me to his life story of considering a career in the US and spending several years in Canada instead, part of which I unfortunately missed as I had to take a quick break to lie down. Yet it is I who has to go through these experiences with our kids every single time, as Noisette can stomach them even less and had taken off after barely dropping us off.

Not only was Sunshine stitched up in less than two hours, we also had my nephew looked at for a persistent fever (by the same doctor, who at the same time also attended to a bee sting, drug overdose, dehydrated infant, and broken foot, from what I could gather) and bought the prescribed antibiotics. I don’t think you could have gotten better and certainly not faster care in any American hospital. Sunshine’s stitches were taken out five days later, and now, after two weeks, you can barely even see a scar. Oh, and the cost of her treatment? R1350 or under $200. It would probably pay for us to reduce our health insurance to catastrophic coverage only, at these prices.

Given the recent healthcare debate in the U.S., I cannot help but draw a comparison. If indeed a private South African hospital provides the same level of care as its American counterpart – I admit that much more data is needed for an in-depth analysis and sincerely hope that our family won’t be providing any more of such data – then why is the same treatment so much more expensive there? I suspect there are several causes. The high cost of a U.S. education would be one. Maybe also the cutting-edge medical research, much of which still seems to be spearheaded in the U.S.  But at least a substantial part of the cost difference must be caused by malpractice insurance, which the medical profession in no other country I know of has to deal with to such a degree as in the United States. Stoking death panel fears? Ridiculous and unforgivable. But malpractice reform is a worthy goal that should be part of a streamlined and affordable healthcare system.

Note: I will not even attempt a critique of South African public healthcare, which – judging from the lines you frequently see in front of public clinics and stories you hear of striking personnel and neglected patients – is nothing to be envious of. The above took place in one of the number of private hospitals you will find in all the major population centers, the only type of hospital you’ll ever set foot in as an expat in South Africa.