Mission Issues

Thinking and re-thinking missionary issues

Health care in Africa

An article was recently published in Christianity Today which lamented the poor health coverage which a great many people in the USA are getting. In one case mentioned someone had spent five months in intensive care after which he had to pay $1.2 million. When he referred this to his health insurer, he was told that they had already paid $1.5 million and that he had reached his lifetime cap. This is terrible! The article calls on changes which need to be made to rectify the situation where many people are not getting any health insurance whatsoever and sees this specifically as a challenge for evangelicals.
When I first read the article I did not really know what to think about it. We have a saying in our country that one shouldn’t complain with a white bread under the arm (traditionally white bread was more expensive than brown bread and it was considered that only the privileged could eat white bread.) I re-read the article and then realised that there is no difference between myself and those people about whom the article is written. I have excellent health insurance. If I should need to go to hospital, I only have to make a single (toll-free!) phone call and I can enter the hospital of my choice. Obviously health insurance costs money, but I can afford it (or rather, I cannot afford to be without it.)
But what is the situation in Swaziland? Hospitals are run by the government with an extremely restricted budget. A person who is sick has to go to the nearest clinic (run by a couple of nurses and possibly one midwife) or travel to a hospital which may (or may not) have a few doctors. There the person has to fall in line and await his turn to be seen by the doctor – anything up to four or five hours of waiting. In most cases the patient will leave with a few paracetamol tablets and the instruction to return in a few days time if, whatever had caused the illness, had not cleared up. On his return, the process starts afresh, falling in line, waiting for four or five hours….
On some occasions people will be hospitalised. The smell in the hospital wards are sometimes absolutely appalling. I have been in hospital rooms made for two where four patients share the room: two on beds and two on the floor. If you want to see the inside of one of the (more decent) hospital wards in Swaziland, click here (and yes, that’s me visiting a patient in Hlatikhulu hospital in Swaziland). If a person is too sick to feed himself and he has no family to care for him while in hospital, he will probably eventually die. All the hospitals are totally short-staffed which means that no nurses can be spared to feed someone. People entering hospitals due to having full-blown AIDS may be cared for for a few days, but after having been on an IV drip for a few days, will probably be sent home (to die) in order for a new patient to be able to occupy the bed.
We (including myself) complain about high medical costs and health insurance which doesn’t cover all expenses. But at least we still have a choice. To have no choice is to be stripped off all dignity.


Thursday, February 14, 2008 - Posted by | Africa, Cross-cultural experiences, Culture Shock, Death, Evangelicals, Health, HIV & AIDS, Mission, Poverty, Swaziland, Theology


  1. Happy Valentine’s Day! I have passed on an “Excellent Blog” award to your blog. Stop by my blog at http://www.ukrainestreetchildren.blogspot.com to pick it up on the Feb 14th post.

    Comment by Michelle | Thursday, February 14, 2008 | Reply

  2. Thanks so much! What an honour! I’ll do my best to keep up to your expectations.

    Comment by Arnau van Wyngaard | Thursday, February 14, 2008 | Reply

  3. Nice way of expressing things.


    Comment by Anish | Friday, February 15, 2008 | Reply

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