Wednesday, June 11, 2008

Discovering Health Care in Natal

We were racing into town at 5:00am with both of our groggy children to find a hospital emergency room to treat Andy.  He had been up all night complaining about pain in his ears. Not wanting to overreact, we gave him Tylenol every four hours and decided to ride it out.  By sunrise, his pain had not subsided and he was vomiting.  We loaded up the car and went on the hunt for a hospital - any hospital other than the one we had been to for my asthma attack.
Among the first things we did when we arrived in Natal was sign up for medical insurance, because we knew we would have to wait a month before we could use it.  It seemed as soon as the month was up we needed it, and "finding doctors" was pushed to the top of the list which, as we soon found out, can be very difficult in a foreign country. 

I have asthma but haven't had any major episodes for over a year.  I carry an emergency inhaler but have not taken daily medicine for some time - mostly because it costs almost $200 each month.  Last month while my brother was visiting, I started having trouble breathing.  (A buggy ride through the sand dunes isn't the best thing for an asthmatic.)  I used my inhaler three times but to no avail.  We went to the nearest emergency room at a hospital called Promater to seek help.  I waited in a packed waiting room for almost two hours to see a doctor.  When I was finally admitted, John and I walked into a small room where a young man was sitting behind a desk.  I say "man" because I'm not at all convinced he was a real doctor.

When I told him my problem he looked baffled, so I helped him out by telling him about the medicines I have taken in the past.  He had never heard of them so he looked them up in a medical catalog of sorts.  He pointed to something and asked if I thought that was what I had taken.  I wasn't sure but he wrote me two prescriptions anyway.   Then he sent me across the hall to a room lined with chairs and spigots.  A nurse entered and mixed the medicine that was written on the order I handed her.  She attached a mask and hose to one of the spigots and handed it to me on her way out the door.  "Wait a minute," I said.  "How long should I do this?"  She told me about fifteen minutes and asked if I had a watch.  I didn't but John took out his cell phone and timed what seemed to be a nebulizer treatment on that.  

 I did not fill the prescriptions because my intuition told me otherwise but, thanks to God and good insurance, was able to seek out a competent pulmonologist who took a chest x-ray and a breathing test the very next day.  She assured me that I am healthy and, if I can avoid certain irritants like chemicals, mildew, and sand dunes, I probably won't need daily medicine because the air quality is so good in Natal.  She said it was a wise decision not to take the medicines the Promater doctor prescribed and gave me others to fill instead to get through the crisis.  She gave me her cell phone number and said to call with any concerns.  She also suggested that we avoid that hospital in the future.  I am breathing fine now and Andy, who also has asthma, has not had any problems breathing.

His problem that morning was something else.  We pulled into the parking lot at the hospital where I visited the pulmonologist.  They told us at the reception desk that they don't see children.  They recommended Promater - the one I swore never to visit again.  We drove through the city and found another ER.  John ran in and right back out.  Bad news.  They only see adults here.  By that time Andy was throwing up again and we headed straight back to Promater. 
 We waited for about forty-five minutes.  The "pediatrician" mumbled something about a green thing in his ear.  I told her it was tubes we had put there because he had so many ear infections.  She was visibly relieved to know what it was.  The fact that she had never seen tubes in a kid's ears didn't earn my confidence.  Then she said he had a double ear infection and started to write him a prescription. She stopped short and said she should probably know how much he weighed.  She sat there and waited for us to go find a scale.  Before we finally walked out of her office with the suspicious prescription in hand, she stopped us saying she forgot to listen to his heart and that would probably be a good idea.

We gave him the medicine only because we knew what it was.  The next day we found a reputable pediatrician for a second opinion.  He changed the dosage of the antibiotic, saying it was a bit much for a three year old.  As it turns out, Andy had the beginnings of a respiratory infection with a lot of congestion.  The medicine cleared it right up and he is well.  We were both very thankful that this was not a grave emergency and have since done much research to find competent pediatricians and hospitals for our family.   


  1. Just thought I would write a quick note to say we are glad you and the kids are now fine.

    Also to request that you think a few times before writing what will cause foreigners to have a very negative attitude about Brazil. There are very competent doctors and hospitals here. I am sure you are going through culture shock because of your recent return to Brazil, and to another part of it at that. Your area is much different to the southeast where you lived before.

    Please do not feel put down by this letter. I do not mean it that way. I just do not want foreigners to Brazil to think that it is a very backward, uneducated, primitive place, because it is not.

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  3. Glad the Andy is Okay! I have shared your blog with Sally at RIP. The first thing she saifd was, "There's squekers". Do you remember the shoes he wore while you were here? Anyway, just want to let you know that you, John, Jonah and Andy are always in our prayers!


  4. Hi Samantha,
    I'm glad Andy is okay. It's scary when things happen in the middle of the night and you don't know who to call or where to go. I don't think people will have negative reactions to Brazil because of your experience. That kind of thing can happen anywhere. Have a good day. It's warm and windy here in good ol' Texas.