Sick in (but not of) Uruguay

Being sick in Uruguay;

Sprained ankle—Emily

Fell off a cliff—Victoria

Cut open Head—Emma

Cut off very end of thumb—Madelena

Cut open chin—Elijah

Pneumonia—Aaron

Various and sundry viruses and colds—Everyone

I only list the major injuries above to prove my knowledge in caring for a family of seven in Uruguay.

So, having a family this big, I expect that illness will be a visitor in our house, but really, it seems like such a much bigger deal when I’m not familiar with the medical system. As a mother of 5 kids, I can pretty much always count on somebody being sick, or someone gearing up to get sick. When we moved down here, we got inoculated against yellow fever, got all of our Hepatitis vaccines, purchased anti-malarial medicine, and thought we were prepared for the big stuff. Well, I guess no one has gotten yellow fever or hepatitis, or malaria, so we're good on that front...

Living in Utah, we were pretty well inoculated for the common viruses going around. Having kids in school guaranteed that we were exposed, and developed immunities to all the bugs floating around. Moving to a foreign country puts you up against a host of new viruses and germs that your body is unprepared for. We've had sniffles and colds for a good part of our time here. I've talked to several doctors, and they all say the same thing: Having all of these little colds and sniffles and viruses is part of the package with moving to a foreign country. Bummer.

Within a month of moving here I fell and sprained my ankle, and we rushed over to the Hospital Brittanico. After an emergency room visit and x-ray, I was pronounced to be just fine, just to rest a lot—this is much easier with a maid, I must admit. I was happy with the short wait in the ER, and didn’t mind paying cash for the service, about $120 US. Basically, it was a good experience.

Later this same month, January, our family went to Buenos Aires for a little vacation. At the Children’s Museum (which we highly recommend) Emma fell into the metal shelves in the grocery store exhibit and cut open her forehead. After cleaning up the copious amounts of blood, it turned out to be a very small cut, but we went to the public hospital, thinking that she might need stitches. We walked in and were seen almost immediately by a pediatrician, who prescribed an antibiotic and made a homemade butterfly bandage using scissors and medical tape. The Dr. was very unconcerned about any scarring, but Emma did end up with a noticeable scar. It seemed like the general thought was that if you are getting free health care, you don’t complain about minor details like a scar. We went to the front desk afterwards to pay for our bill, but surprise! Argentina has free health care and there was no charge.

After returning from Argentina, Aaron took the kids rock climbing and Victoria fell about 10 meters when the cord that was anchoring the line severed. She miraculously twisted in mid-fall so she fell feet first, and Aaron was able to catch her body, even though her heels hit the ground with full force. We had several people watching us, so they called two ambulances to the scene. There was a minor dispute between the ambulance drivers as to who got to be the one to transport her, but after a mere 30 minutes of arguing, we were off to the children’s public hospital. She was taken into the emergency room right away, but they only allowed one person in with her at a time. That was a real problem, I thought. Tori wanted both her mom and dad with her. Tori was speaking English, and one of the nurses went into a diatribe –in Spanish—about all of the stupid gringos who come to Uruguay, and what did they think would happen??? I looked over to her and explained that even though we were from the US, I still spoke Spanish, and that I understood her. Her face blanched, and she quickly left, but when she came back she was much more solicitous about Tori’s care. Tori had x-rays taken and was thoroughly examined. The doctors couldn’t believe that she had escaped the fall with only a few scratches and sore heels. That same day, in the newspaper, there was a story about two construction workers who had fallen from a lesser height, and suffered major injuries. To be sure that all was well, the next week Aaron took her to the Hospital Brittanico (private hospital) for another check, and again, she was just fine. Her heels hurt for a while, but she recovered quickly. The ambulance and care at the public hospital was free, but her checkup with a pediatric bone doctor was about $140.

Aaron had been sick in May, and really pushed himself too hard and developed pneumonia. We joined an emergency healthcare group called Emergencia Uno, that has a clinic and also a mobile Doctor’s unit that makes house calls. Aaron went into the clinic and was told that it might be pneumonia, but that we would need X-rays to be sure. I called our friend, Suki to watch the kids, and I took him to Hospital Brittanico for the x-rays. We figured we’d be gone from home for an hour, max, but once the x-rays were examined, the Dr. determined that he had quite a serious case, and needed to be admitted. As we were not members of the Hospital, the cost for care required a deposit of 50,000 pesos (approximately $2100 US) We had only brought enough to cover x-rays, and weren’t expecting this cost, so Aaron asked to be transferred to the public hospital. It took a long time, and lots of work to convince the Dr. to transfer him, but Aaron succeeded and early the next morning, when an ambulance was available, he was moved to Maciel, a hospital in Ciudad Vieja. The hospital there was past capacity, as there were a lot of people with the same problem. Aaron was then transferred to a private hospital, Impasa, which we were very pleased with. He stayed for 4 days, and received oxygen and breathing treatments and more x-rays. Aaron was nervous about coming home, but has seemed to slowly improve ever since. Several follow-up visits have confirmed his recovery. The hospital was free, and Hospital Brittanico waived their fee (we’re still not sure why), but the check up visit to the pulmonologist was about $40.

Elijah’s injury was a result of 3 year old energy vs. marble stairs in the entryway. He cut open the bottom of his chin, and was given little more than a band-aid when the Dr. came to check on him. Several days later, when we needed a new bandage, we went to the clinic, and were appalled at the lack of knowledge displayed by the nurse when he tried to create a bandage for our boy. He tried to use too-little tape and too-much gauze to cover the wound. He must not have had very much experience patching up small boys. I took off the dressing and created a better covering myself. I also insisted on an antibiotic cream. In this instance, the medical care was very frustrating. It was like I had to insist on what I knew was the right treatment course. Cost covered by our monthly fee for Emergency Uno

Madelena cut open her thumb as she was trying to cut an orange to make orange juice. I could have used a hearing test after the high-pitched wailing, but it turned out to be unnecessary. A sympathetic doctor and lots of gauze healed that situation. Cost covered by our monthly fee for Emergencia Uno.

As for the various and sundry viruses we’ve fought, we’ve had mixed results. There seems to be a general trend for the doctors to prescribe ibuprofen and rest. Lots of times I have felt that we weren’t getting great care. Satisfactory would be a better word. They are filled with lots of sage advice, which sounds distressingly like the stuff of old wives’ tales. Over half of the Doctors that visit blame the weather for our troubles. Sometimes, the doctor doesn’t even bring an otoscope, to check the kids’ ears. We’ve gone though liters of amoxicillin, which is the next most-prescribed drug. I’ve talked to lots of Doctors about it, and there is a consensus that moving to a foreign county, the immune system gets overtaxed, as it is constantly fighting viruses to which it hasn’t built up a resistance. 3 girls in school and 2 boys in preschool equals the introduction of a host of viruses. As you read this, though, you have to realize that I’m in the middle of a virus with a killer headache as the trademark symptom, so I’m not particularly optimistic.

The quality of care has been disappointing, and in spite of all of the complaints I’ve heard recently about the American medical system, I’m all for it. The free system here and quality of care from basic pay-as-you-go doesn’t shine so brightly after one becomes accustomed to American medical care. But, as we’re all alive, despite the odds, it rates a solid “satisfactory” mark.