A dollar here, a dollar there

It has been 11 days since my last post. That’s the longest I’ve gone without posting. In some ways, maybe it’s a sign of the times. The novelty of being here is long gone, routine has set in, evaluations are done, the last project grant at work is all wrapped up, so basically the stuff that I wrote about in earlier months is now stuff that just seems normal/not worth writing about.

I recently read in an article in the globe and mail (yes I still read my Canadian newspapers – the Toronto Start and globe and mail everyday) that talked about healthcare spending in Canada. CIHI estimated that public healthcare spending by governments in Canada reached about $121 billion – and that’s just the public portion (~70% of costs). Add another $50 billion in private costs (mostly drugs and dental care) and the total healthcare spending comes to ~$170 billion. How do you even begin to wrap your head around that number, its around 10% of our GDP. But still, we’re not the highest, or the 2nd highest, or the 3rd highest, (I think we’re 4th or 5th). Anyways, it made me realize (not that I hadn’t realized it yet) the magnitude of difference. Just take the public healthcare spending figure of $121 billion, and lets say in US that comes down around $102 billion (what happened to our loony??). Public healthcare spending in Kenya? Its around $500 million US. And of that, maybe about 30-40% comes from donors so really the government’s budget is around $250-300 million for a population that just slightly higher than Canada.

Why is it so low here? Well, there’s such a small tax base and even then the amount that is collected is minimal. Stir in the corruption factor in and who knows what is actually going into gov’t coffers and what gets spent on healthcare. Add some complacency about the fact that things will never change and a lacking of education about what things can be like and you’ve got your recipe. Ok, I’m sounding cynical, and I’ve already said this before and I want to avoid sounding like a broken record. So I want to throw in another factor here – disease burden. Consider that the top diseases here include malaria, diahorrea, and various respiratory illnesses. Oh yes, and AIDS.

As part of the AKDN, all organizations within have the opportunity to undergo VCT or voluntary counseling and testing for HIV/AIDS. A great idea which will hopefully help raise awareness about this HIV/AIDS. I’ve never been directly tested for AIDS, when I donate blood my blood samples are automatically tested for AIDS, but this is the first time I underwent a direct AIDS test. Simple really, prick your finger with a needle I made absolutely certain was new and sterilized (and which hurts!) and then mix your blood into various things which produce a result – yes in my case, negative. No surprise, and for me I was just more curious about what actually happens in an AIDS test. For a few people here though, I would think that the experience was a lot more nerve wracking and I noticed some people who just refused to do it (emphasize it was voluntary). Think about it, you can go into a room and basically get a death sentence in matter of 10 minutes. How could that not be scary? But whats the alternative? Not knowing until its too late? Not knowing and then passing it onto others? On the other hand, knowing, but then realizing that the treatment you need to survive is too expensive to obtain and it slowly takes you? That is the burden that people here face all too regularly. And that’s if you survive all those other diseases like malaria, tb, and basically make it past the age of 5 (under 5 mortality rate of just over 10%). All this in a $500 million system? somewhere in there, the system has failed