Health Care in the Bahamas

Windswept IV – 40′ C&C sloop- 6′ draft- February

Subject/Area: Health Care in the Bahamas

Dear SSCA,

On Dec 23rd, 2003 Murray and I set off from West Palm Beach headed for Lucaya, Grand Bahamas. The crossing was straight forward although I was unable to rest while off watch due to a niggling pain in my right side. That pain had bothered me for a day or two but I had just ignored it.

We arrived in Lucaya at first light on the 24th and completed the check-in procedures. The pain in my side intensified and I retired to the boat and medicated myself with some Tylenol 3’s. That worked for a couple of hours and I managed to sleep a little.

At midnight, I woke Murray and said that we needed to head to the hospital. One of the dock staff from Lucayan Village Marina drove us to the Rand Memorial Hospital in Freeport. There we paid the fee to see the physician in Emergency and waited our turn. Eventually I was examined by the doctor, had X-Rays and ultrasound and blood work done. They sent us home at 0600 hrs with prescriptions to fill for pain and antibiotic medication.

Christmas Day found Murray trying to fill the prescription with not much luck. He finally returned to the hospital and persuaded the doctor in Emergency to give him some more pills for me. The pain increased all day and by early evening I had a fever and was vomiting. We returned to the hospital, this time by ambulance. I was eventually admitted with acute cholecystitis (or inflammation of the gall bladder) and given iv antibiotics and injections to control pain. After a 3-day stay, I was released with instructions to follow a fat-free diet, finish a course of antibiotics and stay close to medical aid.

My antibiotics finished on Jan 3rd and I again had a little niggling pain in my right side, which I ignored. The next day we prepared the boat to head further south into the Berry Islands. The dinghy was hauled on deck and tied down. The outboard was stored on the rail and weather checked once again. We were ready to go.

By early evening, I realized that my temperature was climbing again. I searched through my stores of antibiotics looking for something that I could take. It was approaching 2000 hrs and the Maritime Mobile Net was on 14.300. When they called for medical or emergency traffic, I responded. One of the net controllers, who could hear me the clearest, arranged a phone patch with a local doctor. He listened to my recent history and current symptoms before advising that I needed iv antibiotics. When I responded that we would head to the hospital as soon as it was daylight, the doctor advised that we go immediately.

At the hospital, I was examined again by the doctor in Emergency and admitted. IV antibiotics were started immediately and also injections for pain (yes, that had come back as well). After several days of “nothing by mouth”, I was finally given a little food. The doctor only would allow me to leave the hospital if I promised to fly back to Canada as soon as possible to have the gall bladder removed.

I was discharged on Jan 9th and flew to Canada on the 10th. My surgery was done on Feb 3rd and revealed a gangrenous gall bladder, which was removed laproscopically. Recovery was fast and I returned to the boat on Feb 17th.

Why did I not have the surgery done in Freeport? The cost would have been reasonable and they were willing to do it right away. But, they do the surgery the old-fashioned way with a major incision in the abdomen. Trying to maneuver around on a boat, up and down ladders after abdominal surgery did not sound like much fun to me. So I opted to return to Canada were they are using the micro-incision techniques. While there, I filled out the forms for OHIP (Ontario Health Insurance Plan) and they will reimburse us for the total cost.

What is the cost of health care in the islands? The initial visit to emergency cost $535 US, payable before leaving. After the first hospitalization we tried to pay that bill only to find out that the computer system was down and a bill would be sent eventually. The final bill, for both stays, was presented after the second hospitalization and (including X-rays, ultrasounds, iv antibiotics etc) for a total of 7 days was $706.00 US. So for a grand total of $1241 US, I visited emergency three times and was hospitalized for seven days. The medical care was very good and the nursing staff was wonderful. I have no complaints at all about the health care offered here in the Bahamas.

Could things have turned out differently? If we had headed to a remote island instead of one with a hospital, I would have been in serious trouble. Perhaps even needed an airlift to an American center where our costs would have been much higher. If we had managed to head on south when we planned, the infection could have spread and septicemia could have resulted. The contents of my medical kit would have done little to counteract that.

There were a couple of issues that we hadn’ discussed. As we have sold our home, where should I go for medical care? We had retained our family doctor and visit him twice yearly in our hometown. I opted to return to our hometown where friends opened their homes and hearts to me.

The other issue that we had to face was the boat and Murray. Should he stay aboard? Return to Florida, leave the boat in a marina and follow me north by car? I convinced him to stay aboard and to continue to cruise. He single-handed from Lucaya to Nassau where a friend joined him for 10 days. This was the best option although it was very difficult to be separated from each other for that period of time. E-mail aboard and my Pocketmail allowed us to stay in touch several times a day.

Would we do anything different? No, it has worked out for us. The only mistake was not carrying a copy of our cruising permit north with me. That error made it impossible to purchase only a one-way ticket to Nassau. Luckily the return portion was refundable when the cruising permit was produced.

Associates Heather and Murray Rand

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