Is health a right, a privilege or a responsibility? That’s a pretty hard question to answer. Even with access to the best available health care and the most vigorous self care we may not be able to control our health status. Should I simply be grateful for the privilege of current good health or am I healthy because I live a life of privilege? Are we responsible for our own health? What about our responsibility towards the well being of others? Is a reasonable level of health care a human right? What’s reasonable when we consider the costs of global public health?
I have been thinking lately about health in terms of justice and here in Cambodia there is simply not enough of it.
The inequalities are stark.
In Cambodia it is common for families to sell land, animals or motorbikes or take out high interest loans from unscrupulous money lenders to pay for a family member to have surgery. All bathing, feeding and general nursing care is done by a relative of the patient so the family is going without two incomes. They will often need a family member to continue to be the full time carer when they leave hospital. Not uncommonly a daughter will be removed from school for that purpose. I’ve been seeing stroke patients in a government hospital and they regularly leave to go home well before they can sit up, let alone walk, because they have run out of money. There are too many stories of patients paying for unnecessary and sometimes dangerous combinations of medications with no understanding of their condition. Many people can’t afford the transport cost to a health centre, let alone the treatment, so they wait and wait until their condition is very serious and then often too difficult to treat.
An illness or accident can spell disaster for the whole family. It’s not surprising that anxiety is such a common problem and a contributing factor to ill health.
If you have money, however, most likely you will leave the country when you have a significant health problem in order to receive quality health care elsewhere. Maybe Vietnam or better yet Thailand or Singapore if you can afford it.
We have just done that. Tennyson went to Bangkok for knee surgery because our organization covers our health costs. We are also citizens of a country that has a well functioning, even if imperfect, public health system. When we were back in Australia recently our family had several doctors’ appointments, lots of health tests and a couple of small procedures and just about all of it was covered by Medicare. While I stood in line at the Medicare office contemplating the beauty of a public health system, others around me seemed very put out by the long queue. I was just so thankful that they were going to give me back all that money. It was wonderful to know that having preventative health checks and effective treatment for problems, before they become life threatening, was not going to financially cripple my family. In fact we would hardly notice it.
Bono wrote in a song ‘Where you live should not decide whether you live or whether you die’. Unfortunately it often does.
I’m very grateful for the quality health care we have received but I could do without the nagging discomfort of being one of the privileged few.