Pharmacist Carolyn?

As I was trying to decide what I wanted to be when I grew up, a pharmacist was toward the top of the list. Today, I had an opportunity, albeit limited, to see what it was like at Worom Maternity Clinic in Bambur. I typically run away from any medical situations, but the team convinced me that I could be in charge of dispensing meds and collecting charges exclusively, so I agreed and I’m glad I did. I was able to get a small view into the struggle that the clinic workers are experiencing when area residents come to the clinic needing medical help and seemingly unable to pay. Here, the medical professionals were prescribing primarily antacids, ibuprofen, multi-vitamins and acetaminophen, and the total charges for the consultation and multiple medicines often totaled less than US $5. I was counting pills, advising patients about dosage in my limited Hausa, and requesting payment to the dismay of most involved. This experience today was unlike any I’ve experienced before.

Missionaries have provided significant assistance and support to this area for many years. While their contributions were made with love and good intentions, the ramifications of the kind, selfless missionary who served at this clinic for 25+ years now are still felt. She provided the community with greatly subsidized treatment in addition to free medicine in order to raise the level of healthcare in the area. However, when she left more than 12 years ago, the community had become accustomed to unsustainable, free healthcare. Now that we are trying to help the clinic become self-sufficient, the workers are meeting significant resistance from the community to the idea of fee-based healthcare.

Despite the fact that it was announced in many locations and events that a new sustainable model is being implemented and fees will be charged, many arrived at the clinic without money, expecting the white missionaries to cover the bill. Throughout the day, approximately 75 patients were seen, and nearly a quarter of them had to leave their drugs and chart with us and go “find money.” Many of them came back with newly discovered funds; some took a few minutes, others a few hours, others I anticipate tomorrow. It affirmed the fact that money is available in this area for healthcare.

The workers and I constantly reiterated that if the community wants this clinic to exist, fees must be paid. Although I knew charging a modest consultation fee and a small surcharge on the medicine was acting in the best interest of the clinic and in the end the community, it was not easy to implement. Many of the patients complained bitterly. It was especially heart-wrenching to tell a crippled, old woman that she had to bring money to receive her medicine. She told me “ba cudin” (no money) and I mustered all the courage and logic that I could find to tell her that I was sorry, but she would have to go find money to receive her drugs.

It would have been much easier to simply pay her small bill myself. I wouldn’t have noticed the money was gone, but it would not have served her in the long run or the greater good of the community. If the clinic does not become sustainable and the workers don’t get their salaries, the doors of the clinic will be closed indefinitely and that entire area will be void of a healthcare facility for many kilometers. The transition promises to be ugly at first, but the culture will change if the workers hold fast to the ideals of sustainable practice, and the community will be better served by having a clinic that is open and well-stocked with medicines.

Providing assistance through education and empowerment is harder and scarier than simply providing handouts because collaboration is required. Giving the people here the power to succeed or fail based on their response to the information provided is terrifying because I want so much to see them thrive. Of course, there is the chance that the verbal abuse from the community will be more than they can stand, or the timing isn’t right for the change and this new model will fail. However, the triumph Worom Clinic will boast when they are successful will be able to be attributed to God and their diligence and not to outsiders who came in and did it for them.