Health Under Way By Stephanie J Martin

The Caribbean Treatment

A nasty infection leads an American couple to appreciate the quality and cost of care far from home

When Tom Lane, my husband, and I decided to sell our business and home to sail our 50-foot Gulfstar, Mima, to the Caribbean, health care was one of our top concerns. All my life I'd been told that the United states had the best health care in the world. We thought getting sick outside the country would necessitate a quick plane ride stateside for proper treatment. A medical emergency we had in a faraway place, however, caused us to rethink everything that we took for granted.

While we were in Trinidad, Tom was helping a friend work on his engine and got a small— but deep—cut from a hose clamp. our tetanus shots were up to date, so we didn't worry. A week later, though, he woke up delirious and with a high fever, his leg swollen and bright red. I called another cruiser who was a nurse, and she insisted that we go immediately to the emergency room.

When we arrived, we found a small, clean room filled with people, and it was freezing cold, just like the ERs at home. We were asked to pay an upfront deposit of TT$400 (about US$62), and the receptionist assured us that we'd get money back if our bill was less. The paperwork was minimal, and then it was off to see the admitting nurse.

Just half an hour later, we

were called to see the doctor. Tom was given a thorough examination, and a nurse was sent in to reopen and clean his wound. The doctor returned in about 20 minutes to tell us he'd called in a specialist, who had to come from home, since this was Sunday. To our amazement, he arrived just a few minutes later and promptly ordered X rays, blood tests, a urinalysis, and an electrocardiogram (EKG). When the test results came back in under an hour, he diagnosed Tom with a particularly tenacious case of celluli-tis, an infection of the blood vessels and skin.

When we left, I took a deep breath, stopped at the desk, and braced myself for the bill. Instead of owing more, I was given back TT$23 (about US$5). The emergency room, all of the lab work, the X rays and tests, two doctors, bandages, dressings, and three medications came to US$57. This wasn't a co-payment. This was the entire bill—quite a surprise, and a good one at that!

Accessible Professionals

The ER doctors had told Tom to see his regular physician the next day. Since we didn't have one, we got a referral from local friends. Unable to reach the doctor on a Sunday, I left a message on his office answering machine asking for an appointment as soon as possible. Imagine my surprise when at 7 o'clock that same evening I got a call from Dr. Sinannon himself, and we set an appointment for the next morning.

The doctor spent a lot of time talking to Tom about his

A trip to the dentist is never fun, but the author found herself in good hands with Ricardo Acosta. Best of all, the price wasn't hard to swallow.

lifestyle and history. Compassion and competence walked hand in hand at this office. This was to be the beginning of a six-week course of weekly visits that each cost about TT$100 (US$16) and eventually led to Tom's recovery.

Use Your Networks

If you don't have local contacts, get in touch with your fellow cruisers through the various radio nets. The Dominican Republic, St. Martin, Antigua, Grenada, Trinidad and Tobago, and Venezuela have morning VHF nets for sailors that allow time for

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