Once again I’m helping a member of Minga’s extended family with medical costs. My role is usually to pay to get the person into the private system, where they can then see decent doctors and negotiate for their care. I don’t assume full costs of that care — I can’t, as there are too many of them and the medical problems are widespread and often severe. When Gloria and Luis’ second son, Gabriel, was injured during a soccer game and got a bad infection, his condition was getting worse and worse under the care of a public health medico — actually life threatening. I paid for Gabriel to go to a private clinic near the village, and the doctor there was alarmed enough to send him right into Panama City to a surgeon. Gloria and Luis were asked at the hospital if they could pay $100, and they said yes. I went with Gabriel to the clinic but not on the late-night ride to the hospital. If I’d been there, the fee would have been higher.
We talk a lot about inequality in our country: inequality of opportunity, of wealth distribution, and of access to medical care. But often it’s an abstraction. We’re talking about people with different situations from ours in general, not actual people whose lives are very different from ours and whom we see on a regular basis and about whom we care.
But in my relationships with the Panama family, the issue of inequality is immediate and pressing. They know I have a lot more money than they do. They know that Minga has laid down the law, at least with her clan, that I am not to be asked for money. And yet the crises that befall them do so in a context where there simply is no extra money to be tapped, no savings or access to loans, and no safety net from the government or church or other source. And so on occasion they ask, sometimes with shame, or fear that they will offend and disrupt the relationship. It’s hard for them, and hard for me.
It’s a little like what Doctors without Borders does: address a crisis, but not solve the underlying structural health issues that afflict poor people in developing countries.