Lily and her cousin Jennifer made the trek to Aguadulce — a three hour trip from Panama City for Lily — to see if they could get an honest read on whether Minga might find an ambulatory dialysis spot there or in Penonome. Both places are in Cocle province, so the same Seguro Social administers the public health care system and oversees who gets access to ambulatory dialysis.
They were fortunate to find the social worker who helped the Bustavino family when Lily’s other grandmother died. The woman was compassionate and brutally honest. The public health system throughout the country, and especially in Cocle province, is totally overwhelmed by the number of people who need dialysis. There is no spot for Minga in either Aguadulce or Penonome, and won’t be in the foreseeable future. Home dialysis is an option, but it would have to start with a manual process — there is a shortage of dialysis machines, and Minga can’t get one until December at the earliest. The Seguro Social can teach the family to do this manual procedure; it’s the best they can offer.
I have no idea what “manual procedure” means, but it sounds even more daunting than having the machine that goes Beep in the night.
I asked Lily if staying in Panama City and being treated there is a certain option, even if Minga does want to return home. Lily said they won’t know until Minga sees the nephrologist — whoever is on duty when her treatment review is scheduled, not necessarily the kind Dr. Felipe. Apparently, her spot in ambulatory dialysis in Panama City is considered transitional — not a certainty at all — because she is not a resident of the city.
Meanwhile, Minga believes that God will grant her a miracle and that she can return home and leave dialysis behind. Someone told her that a patient sicker than she had just that miracle: kidneys that started working again. Minga believes that God will know all that she has gone through in her life, and be no less kind to her.
This is when faith gets hard for those who really believe.
The options are rapidly narrowing, and the path forward seems more and more perilous.