By Adar
This past trip I, somewhat unfortunately, got fairly intimate with the healthcare systems of both Turkey and Bulgaria, directly and through the misfortune of one of my friends.
We all got minor bites by some sort of bug or spider during the first few days in Turkey. I had three on my right hand, and it wasn’t a big deal until on my overnight bus to Bulgaria, my hand became a little irritated and swollen. When we got to Sofia, we stopped at a Pharmacy, and I showed the pharmacist my hand. One of the awesome things about pharmacies in Europe is that the pharmacist has the ability to give prescription medicines, unlike in the US where you have to go through a doctor first. She gave me some anti-allergy cream, which I started applying right away. It didn’t help. My hand continued to swell and became quite hot and itchy. We went through the sites in Sofia, enjoying our time in the beautiful capital of Bulgaria, and in the late afternoon I stopped at a pharmacy again, because my hand had only been getting worse. This pharmacy gave me an anti-allergy pill, which I hoped would kick in soon because my hand at this point was about twice its normal size.
It didn’t.
That night, we were out in Sofia with a couple of locals who had led our tour during the day. I realized that I was feeling a little sick in general, and my hand was becoming the center of my attention. But I still didn’t feel like it was that big a deal, until one of the locals we were with, Anna, looked at my hand and compared it to my normal one. At this point, it was four times the size it was supposed to be, I couldn’t move my fingers and it hurt when anyone touched it. She said I had to go to the hospital, a venture I’m very adverse to in general let alone in other countries where I don’t speak the language. But I got in her car and she took me to the 24 hour emergency clinic at around 2am. We walked in, showed them my hand, and were directed to an office down the hall with a doctor (wearing a bathrobe over his scrubs). He sat me down and examined my hand, asked a few questions, and sent me to toxicology, which did a similar process. They sent me back to the doctor, with a note of their suggestions. The doctor wrapped my hand in a cold compress of iodine and sent me with a prescription to get antibiotics. He then asked about my health insurance, which I didn’t have outside of Israel, nodded, and sent me on my way. As I walked out, I asked my local Bulgarian friend quietly what I had to pay. He looked at me quizzically and said, “It’s the emergency room, it’s free.”
At the GWU hospital, a visit to the emergency room, to the doctor then toxicologist then doctor again, would have taken probably at least six hours and $900. In Bulgaria, it took 30 minutes and cost nothing. Antibiotics in the US? Easily $100. My bill at the end of the night for antibiotics, iodine, gauze and tape was about $6.25. And it worked. The antibiotics cleared up my spider-bite infection in a couple of days, and I wrapped up my hand in iodine for several days to keep the swelling at bay until I was completely healed.
Though I only used a fraction of the bottle of iodine for myself, I had to pull it out again a few days later for my friend Eli. We were in Cappadocia at this point; a desert region in southern Turkey, when my friend cut his bare foot on a sharp rock and had a deep gash in his toe. We hoisted him over to where our tour bus was parked, near several souvenir and snack stands. He was bleeding quite a lot, and our tour guide went completely pale and basically ran away, saying he had no medical knowledge or first aid kid whatsoever. Nor did anyone at the souvenir or snack stands. Suddenly, a group of medics dressed in uniform come over and ask if he wants to go to the hospital. No, none of us thought he needed a hospital, just a good cleaning and wrapping so that it wouldn’t get infected. No hospital? The four medics walked away, leaving him sitting in a chair in the desert with a profusely bleeding toe. I ran over to the bus to get my iodine and gauze, and our friend Noah and I sat there and cleaned and wrapped Eli’s toe, with our lack of supplies or expertise. Our guide thought it would be a good idea to go to the local clinic so that he could get it actually cleaned out. We showed up at this clinic, carried him up the stairs to the entrance, and were met by two nurses who looked at him and said they couldn’t do anything without the doctor’s supervision. Not even wrap a toe? No. Well, where is the doctor? He’s out to lunch, and won’t be back for a while. You should go elsewhere.
To our luck, four of the young travelers on our bus were medical students from Italy, and had a fairly comprehensive first aid kit with them. We sat there on our bus with the door open, parked in front of the clinic with the nurses staring at us, and they managed to get Eli’s foot cleaned and wrapped.
The tour bus had no first aid kit, the guide had no medical knowledge, the medics had no interest in helping Eli if he wasn’t going to the hospital, the nurses at the local clinic couldn’t even clean and wrap a toe, and there was no doctor on call for the one clinic in the region. It was absolutely ridiculous. I immediately longed for Bulgaria and its efficiency and professionalism. Or even Israel, where everybody’s Jewish mother is pushing them to become a doctor, so there’s bound to be one around.
In Israel, we have free health insurance. If someone gets sick, we can call the health insurance and deal with a little bureaucracy, but soon enough get an appointment for that day or the next with a doctor, or even (and this is my favorite) have a doctor show up at our dorm within a couple hours for a free house call. Some of the absolute best medical technology was invented in Israel, and there are specialist doctors for absolutely everything. It’s not quite as good as Bulgaria when it comes to emergency room efficiency, but its health care system is actually quite good. Both Israel’s and Bulgaria’s systems are rooted in socialist principles, which believe in universal health care. It’s not a question. The far far right in politics in Israel still believe in universal health care.
Being able to see Israel’s system, Bulgaria’s and Turkey’s, it’s made me evaluate the US medical system quite a bit. Basically, the US has a ton of work to do until they catch up with Israel, and more until they reach Bulgaria.
Though it’s still better than Turkey.