The term ‘medical tourism’ took on a completely personal meaning in Addis Ababa because of Willie Maire, the surrogate father to Shirley: part of my extended family. Willie and Shirley Papua New Guineans (PNG). Shirley a part of my family but residing in Port Moresby.

My expertise is in corporate social responsibility and engagement, as well as in health. The project I was hired for required me to engage stakeholders, to determine their understanding of medical tourism and how that relates to the strengthening of the health system in Ethiopia. The project required me to discuss and present my reasoning for the medical tourism industry to be established (or not set up). Three weeks into the project WILLIE of PNG became the reality of my work in medical tourism in Ethiopia. And, he became the example of why countries should invest in strengthening their system instead of spending government and private sector money on building a medical tourism industry for others. Willie’s story became a personal example of why medical tourism is not the answer to solve problems of weak health systems.

This is Willie’s story:

Willie was the voice of a country “ GOOD MORNING Port Moresby”. He was the sound of reason; the sound of knowledge, the sound of culture, the sound many tribesmen and women, many communities woke to everyday. But, as he neared his mid century marker of fifty years old, his life dramatically changes without notice of being sick. He finished his radio show ended laughing and returning back into his office and had a stroke. He lay for hours unattended. And, by the time he was discovered collapsed he had irreversible brain damage. His vocal organs changed. His body limp and numbed to paralysis. And, his ability to work stopped dead with disability. For 1.5 years his family raised funds to send him back and forth for physio, occupational, speech therapy and medical treatments, not in his homeland, which is with few if any services, but in the Philippines. The family, their tribe, drained life’s earnings to provide for him the best medical they could afford. This included uplifting their middle daughter, a mature but might I still say 15-year-old child to care for her father in Quezon City, Philippines. She had to leave PNG because her mother had to support financially the family and there was no one else who could go. She had to leave her friends and support system, to go live in a very new, very different, community in a country far from home. And, she had to enter a day school that behaved differently, and maybe even treated her differently. But, she was her father’s daughter, like him, verbal, engaging, smart and brave. And, she cared for him day and night and on weekends between classes. She loved him as he needed but she needed a break. Easter 2015 spring break was her time to visit her mother and sisters hesitantly knowing her father would be alone, but very much needing her own teen time. A lot of responsibility to be put on a child. Her father in agreement. But, this is where life changes for all. Two days later Willie entered a coma and was rushed by his care team to the hospital where he lay alone without family in this foreign country. Whether or not conscious of this, the reality of medical tourism is he was alone with no one there except hospital nurses, no voices of family to whisper their comfort into his ears, no loving wife or daughters to hold his hand. They, devastated with the news, frantic to raise emergency funds from the tribe money needed to get a two thousand dollar flight per person to go to their father, their husband, their brother. But, how does one raise those funds in a few hours. Only a miracle to collect that money for anyone, let alone for people from developing countries on limited income. Yet, it had to be done. And, only enough money for the mother, the wife, was raised in time to put her on the overnight flight from Port Moresby to Manila. She arrived to hold his hand, and tell him she loved him and he died in her arms two hours later. 15 year old daughter at home with her sisters waiting for news on their father, only to be told he had left. A mother then to arrange alone the flight home, to raise more money to for his body to be air freighted for burial a whole country away…

And with his death, my project took another turn. In addition to my long work days on the Medical Hub Private Public Sector Project, I had to spend my wee mornings between 3am and 6am calling medical representatives, family members, and those in government who could help Willie’s wife move the process ahead quicker and easier than if she were alone trying to do this while in shock and grieving her loss. Medical tourism is much more than just stepping on a plane and going for an extended holiday that includes doing executive medical checks, but it can be one of the worst experiences of your life. Death can occur. And, that means family is taken out of their comfort zone where they may have strong emotional support to a place of complete isolation and culture shock. Medical tourism, for all the glamour the idea conjures up in many people’s head, is anything but glamorized when the medical condition turns serious. And, for those left behind wondering, waiting and worrying about their loved one, the stress is something that can bring on hopelessness and the highest frustration of helplessness.

Isn’t it ironic, however, that my contract in Ethiopia to evaluate the idea of medical tourism opportunities for the Government happened at the exact time of Willie’s death in my family. I had to face the issue head on and had to tackle one of the most difficult circumstances in my own life. Feeling totally helpless to do anything. Creating medical tourism hubs is something of a dream for many countries, and in my opinion Ethiopia is not ready to build a hub in 2015. Why? Because its health system is fraught with weakness. Its health system has some secondary level hospitals but no tertiary hospital. Its health system does not include an emergency and disaster system, which in most countries is considered a basic health component. Its health system has not implemented universal health care or a country wide insurance system. And, trust does not exist in the health system by its own
people and even by many of his or her own doctors. When someone who can afford suspects that they are seriously ill, they collect money for a trip and leave to Thailand, or India, or even America. Just as the former Ethiopian President did when he took ill and then died in America.

They don’t stay in the country. Just like WILLIE. They leave. And, until the system is strengthened the people will leave when they can. And, spend their family money seeking services abroad. BUT, the reality is whether it is Papua New Guinea Willie or the Ethiopia Prime Minister; medical tourism does not work when someone dies alone without family and love. It’s a terrible lonely death. And, for me, even my worst enemy I would not wish this story on.

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