I plan to go with Minga for her dialysis appointments when I’m in Panama next week — Thursday and Saturday, for about four hours each. I want to see firsthand what she is experiencing. And I want to be with her through what sounds like an exhausting ordeal.
My sister Wendy found an article online about ambulatory dialysis here in the U.S. — turns out servicing the poor and being reimbursed by the federal government is a lucrative big biz.
I imagine Minga’s experience is not too far from what is described in the article, dialed down several levels to reflect that Panama is a poorer country with less ability to make ambulatory centers attractive, and to include that Minga has to come and go from her appointments on the bus. Lily says there is a long walk from the ambulatory center to a location where Minga can get a bus that goes to and from Filipio.
Transplant is unlikely for Minga — it probably would be for her here too because of her age and generally complicated health. But this article makes me think about Raoul, Gloria’s eldest son, who suffered kidney damage when he was born prematurely and Gloria and her mother fed him weak tea to keep him alive when Gloria couldn’t nurse. He’s a young man, in his 20’s, and has no more than 25% kidney function now. If anyone should be on a transplant list, Raoul should. I’m not sure transplant is an option for the poor in Panama at all, but when I get more deeply into the weeds of the medical options there, I plan to find out.