Panama November 2017: Waiting

I hate to wait. I expect to be called into my dentist’s office within five minutes of my appointment time. If the lines are long at Met Market, I expect someone to call additional checkers to move customers through faster with our groceries. If I order in a restaurant, I expect my meal to be delivered in a reasonable time, unless the menu has indicated that an entree will take longer than normal to prepare.

What’s more, I feel entitled not to have to wait.

People like Minga wait all the time. She leaves Ita’s house in Filipio at 7am to wait for the bus. Once in the bus, she waits for the choking traffic headed into the city along the Corredor del Sur to clear. She walks from the bus stop to the hospital and then waits for the elevator. When I was there, only one of the two elevators was working — and that one didn’t go up and down in any recognizable fashion. Rather, things were controlled by the elevator lady. If we got on at the lobby floor and had to go to three, the elevator might go directly to nine, where someone in a hospital bed was in transit to another department. We’d get out on nine to make room, and the elevator door would close. Once delivering the patient to his or her floor, the elevator would come back for us. Would we then go directly to three? Maybe. It depended on whether the elevator lady’s radio would crackle with someone whose priority was higher than ours.

Once in the corridor of the dialysis unit, Minga waits for the 10am group to be called. They seemed to take 14 people at a time, so if your number for the day is higher than fourteen, you might wait a whole extra hour while the first people called in are hooked up. Minga was lucky both times; she had low numbers. On Thursday, the first cluster of patients began to go in at 11:30am. On Saturday things moved more quickly; she was number two, and she and the others entered at 10:45am. If you are unlucky enough to have a very high number, you might wait two extra hours while all those before you are connected and their dialysis underway. By then the next group is starting to arrive, so the corridor gets very crowded.

Every patient has to bring someone. We waited in the corridor, on the hard plastic chairs, for our patient to be done. Minga waited three or four hours reclined in her dialysis chair, depending on how long her dialysis was scheduled to run that day, for the process to be over.

Upon leaving the dialysis salon Minga reverses the process: walk to the elevator, wait for it to come, wait to be delivered to the lobby, walk outside — to our waiting car, or to the bus — wait for afternoon traffic to clear, walk home.

She is exhausted upon finishing. The three or four hour treatment actually takes all day.

Minga expects to wait. She does so uncomplainingly. So, it seems, do all the others who are there. They have a kind of camaraderie, the ones who show up for 10am. They trade tips about ways to keep their muscles from wasting: drink Ensure, buy the powder version in large size can [$37], because it’s cheaper than individual serving bottles and goes farther. Mix with oatmeal if you don’t like the taste. They see to it that the patients way up at the end hear the name being called, so no one misses his or her place in the line. They listen to each other’s stories of the difficulties the family is enduring; they commiserate. Uniquely, they understand.

Is it simply that the time of poor people is not seen as valuable? I suppose so, in the end. I suppose it’s as simple as that.

2 thoughts on “Panama November 2017: Waiting

  1. I do agree that health care systems have not respected peoples’ time and more so in clinics. Things have improved somewhat in the US because there are financial incentives to have higher patient satisfaction scores. It really is a philosophy. It seems in most developing countries it is a “favor” to get care, rather than a right. It may be going backwards in our nation depending on what the current administration does. In fact, our current administration doesn’t even want poor people, they are deporting all the Haitians that came as refugees, back to a cholera infested country, to “wait.”

  2. for Katie: I think health care for the poor in Panama is very much viewed as a favor, although there are some in the system who seem kind, like Dr. Felipe. The idea of patient satisfaction simply hasn’t arrived, at least in the free public hospital.

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