A million questions..where are the answers?

Another day in the clinic, another day left with questions and confusion.

    I spent the majority of the day in the dressing room watching wounds being cleaned and bandaged.  The nurse, Agnes, was most likely in her mid twenties and was working her first day at Extension 2.  We talked about America and what it is like to live there, and about her applying for her green card.  I never realized the amount of money and work it took to apply for one, and how badly people want to come to the US just to work.  Nurses here make just enough to get by, and most likely work twice as much as nurses in the states.  It costs over P2000, just over 300 USD, to take the English entrance test.  They all have the will and the desire to take the test, but most just don’t have the resources while only making the equivalent of about 2 USD per hour. 

    Not only was this process confusing to me, but their perceptions of Americans were as well.  I’m sure that monetarily, most Americans are rich compared to Batswana, but they assume we are all living such perfect lives.  It was surprising to them when they heard that many people are losing their jobs and can’t find any replacements.  Most are unaware of our economy, health care, and schooling systems.  I could continue for pages on the issues our country is facing.

    Still, every country comes with its unjust issues, and each has its own triumphs.  In Botswana, workers are underpaid yet health care is free.  In the US, health care is remarkably expensive but people have the ability to succeed and advance in their fields.  In the US, education comes at a price but is unbounded.  In Botswana, college is paid for but limited.  The grass is always greener; with some advantages come even more difficulties. 

    I’ve found so far that public health is such a complex field; it is impossible to serve and protect everyone.  Where do you find the resources and political power to enforce public health policies?  With a topic that should be straight forward and simple, keep people safe and healthy, it is completely intertwined with politics, money, and limitations.  I think that no matter where you go, everyone is faced with similar public health issues at varying intensities.  Most health care systems are focused towards curing disease rather than preventing it.  Patients come in when they are sick; why not before?  Most patients don’t follow the rules whether it’s concerning drug adherence or lifestyle choices; who is educating them?  Many hospitals and clinics are congested and most health care workers work too much.

So many issues…how do you fix them?