Public Hospitals

I received the following and will post it as a guest post.

Dear Don
Here’s my perspective of the public and private hospital systems in David. Your readers may be interested.
Sent live from my bed in Chiriquí Hospital!
Robert Sare

Robert’s experience follows:

Public Medical Care
There is a lot of discussion amongst the Gringos about using the cheaper public hospital system over the private ones. Here are my experiences. Sorry for the length, but the devil is in the details.

I was perfectly healthy until 2 weeks ago. Then, two nights of terrible headaches led me to the Puerto Armuelles Hospital for pain medication. They found my blood pressure to be 80/55, my heart in atrial fibrillation, my liver and kidneys swollen and my abdomen full of fluid. I asked about being sent to Hospital Chiriqui but was told no, the best treatment for whatever tropical disease I had was available at the David Public Hospital. That was a lie.

I was given lots of saline at the public hospital in David and stabilized over a day and a half. The building was bright and new with plenty of staff. The problem was staff were there to run a system, not care for patients. I can make my wants known in Spanish, but the staff treated myself and the Panameno patients as mere bodies. Here are some examples:

I was in a room of about 25 patients and almost as many staff. The bright fluorescent lights stayed on 24 hours a day while the nurses played their music devices loudly at night. After 3 nights of sleep deprivation, I could literally start to feel myself go crazy.

When I first entered the hospital I was told I could have no water. It took 12 hours of pleading to finally get permission from one MD to drink, and then nobody would bring me any. I was desperate with thirst when my wife finally showed up with a water bottle.
My bed was under a huge air conditioner set at 18 degrees. I was shaking with cold, and you could hear patients moaning in distress as they were given a 2 AM cold sponge bath.

My IV regularly clogged. A nurse would draw a bolus of saline then ram it through the tube to clear it. When a long period occurred before the nurse looked at me, my venous blood had travelled back up along the tube. She blasted a bolus of this into me. Instantly, I wanted to defecate, urinate and vomit. I vomited. Then my heart sped up and it felt like a wild animal was trying to break free of my chest. I thought “If you have 1 weak blood vessel in in this body, you are going to be dead in 2 minutes”. Fortunately my heart settled down in 15 minutes.

Mealtimes consisted of 4 styrofoam cups of fluorescent liquids with harsh chemical aftertaste.
By day 4 I thought I would die in the Public Hospital. I signed myself out against their wishes and registered at the Cuidad de David Hotel for a wonderful night’s sleep and real food for breakfast.

I spent 2 days at home in Puerto Armuelles, then a good friend and MD suggested I needed to get checked out at the Puerto Armuelles hospital again where the nursing care was pretty good. I was still in heart failure and fluid retention was getting worse. My friend arranged for me to see an internal medicine specialist and cardiologist at Hospital Chiriqui.

I’ve been here at Hospital Chiriqui a few days now, and it’s obvious my recuperation will take months, including cardioversion in 2 weeks. The staff, from the room cleaner to nurses and doctors go to great lengths to explain my problems and treatment. I have a private, dark room, hot shower, I control the air conditioner temperature, I can order scrambled eggs on whole wheat toast for breakfast and fish fillet with broccoli cheese for supper. This I can live with.

Oh, and my diagnosis? Not a dengue, chikungunya or hepatitis virus. I just got sick.

14 thoughts on “Public Hospitals

  1. Thanks, Robert. This is excellent information for folks without health insurance who may be obliged to seek help at Hospital Regional. (Given your condition, I’m surprised you survived the experience.)

  2. Dear Robert;
    Thanks for sharing your story with all of us. Would you be willing to tell us what the costs were at both hospitals? We’re new here, and my wife will need medical attention and I will not let her go through what you went through at the first public hospital! We live in Volcan and they have a new hospital here, but I don’t know anything about it yet. We also need to know about buying private medical insurance here to avoid your kind of situation.
    Thanks for your honesty and willingness to share your experiences with us!

  3. Robert, it must be painful to have to remember this incident and report on it. Kudos for doing so publically, David, private insurance is available through several outlets, price usually depends on age and existing medical conditions will likely not be covered. If you need more indo email me at johnferguson thirteen oh one at gmail dot com – change the alphas to numeric and miss out the spaces.

  4. Sorry to hear of your torture, as if it is not enough to just be sick….
    I hope they find out what the problem is so that something can be done….

  5. I have had experience at both hospitals, I have been treated for pneumonia at National Hospital, with much care. Another time a friend, who drives a taxi took me to David at 3:00 AM. I was in and out in a very short time after he told the doctor that he didn’t want to leave me alone because of the language problem.I had so much pain in my ankle and foot that I couldn’t put weight on it. Recently my granddaughter who came to Panama needed blood pressure meds. She has been getting them for several months at no charge. I saw a doctor in David for blood pressure meds and also pain meds. I have bone cancer and I needed meds to be able to sleep. He gave me several prescriptions, but as a GP, he was limited as to how many. He suggested a gerontologist. I went to another doctor who gave me a prescription. I filled it at Chiriqui Hospital Pharmacy, It was $156.00. I had paid at the National hospital $ 22.00 for only slightly less pills. It seems that if you don’t have insurance, you are up a creek without a paddle. You can run up a bill you’ll be paying for forever.

  6. if you want to email me I can tell you all about which insurance plan I think is the best especially because of what they offer. I just had 2 serious operations in April. The first one was a spinal fusion ( 7 hour operation by neurosurgeon) and 3 weeks later I had to stents in my arteries. The 2 operations came to around $100,000. My insurance covered 100% of the expenses. My deductible does not apply if you go to either Chiriqui or Punta pacifica.
    I did not spend one penny except the airfare to Panama City for the first operation
    You can email me at gwenmanning49 at gmail dot com

  7. Gwen, WWMA, your insurance and ours, also pays in full at Hospital Mae Lewis.

    David, there is not a hospital in Volcan. The closest hospitals are in David.

    Dee, medications are cheaper at Hospital Regional, but it’s my understanding that they often are out of medications.

    Good medical coverage is expensive if you don’t want to risk an experience like Robert’s. This issue should be fully explored before anyone makes the move to Panama. I hear new horror stories on an almost daily basis about people here who are uninsured or under insured.

  8. Just a quick medical advice, if your atrial fibrillation is new (not happening for months) cardio version should take place when you are fully anti-coagulated since most likely you should have been on blood ” thinners”. Doing it before can risk dislodge of a clot from the heart to the brain and give you a stroke. Please, ask those questions to your doctor.

  9. Just heard on the local news that a Mother who was nursing a new born baby at Hospital Obaldia (the new Children’s Hospital) in David had been given milk with an expiration date of last month, to give to her baby. Luckily, the baby was asleep when the milk arrived and the Mother had time to read the label. You just can’t be too careful in the Hospitals here.


  10. As far as i know if you are full of fluids your water intake is refuced to sl.ost nothing gor a while. I remember i had a roommate at riverdide hodpital who had her belly full of gluifa d dhe begged for water snd drm said NO. then she started a tantrum. Dr said No.

    They stabilized you. Thats first sign you were saved. 25 patients yes the oublic hospital has to save many many lives for same budget they get from contributors who are the work force os panama. It serms it was more about comfort. You are alive. And yes they can listen to music. They did that ay riverside community hosp in california and didnt bother me. There when i was hospitalized could not sleep well either cause even if you turn light off. The hallways are bright and a nurse comes very often and wake you up fir blood drawing shift switch meadure temperature etc.
    My roommate was calling nurse and never came. When they finally arrived she asked to be changed her diaper and the nurse told her assistant to put socks on her feet i was astonished and told the this not what she asked for.
    Those things happen there and here. Dont pretend the us is perfect cause its not. Best advice get insurance and go to private hosp so regional can continue serving the really poor or deal with reality
    You haf the energy to pay attentiin to nurses listening to music and bright lights instead of noticing that they stabilized and when you were transfered to comfort and more pamoering you were saved.
    Sorry if i sound harsh or not sensitive but we should thank god and the staff who stabilized us and let us live.

  11. Don’t make the same mistake those of us who didn’t have medical insurance, to go to a private hospital, made.

    When I first moved here, 13 years ago, I began having debilitating sciatica. I went to Panama City to a neurologist. He happened to be chief of staff of surgery at Santo Tomas Hospital, and was able to immediately book me for extensive tests, and then admitted me in for laminectomy surgery.

    I was in a dorm-style room with 18 women, all being treated for neurological issues. Two were dying of brain tumors, one who had a gun shot wound to the spine area, most who had been in horrible car accidents, and, several of us waiting for surgery.

    I was told that my surgical appointment was in 2 week, and I had to wait there. As I didn’t want to take up a bed for someone with more traumatic problems than I, I told them I would return. No particular reason was given, but they said I had to stay there, and wait.

    Fast forward, a few hours after I came back from recovery I called for help to go to the bathroom. A long time later, I was brought a bed pan, and the nurse left. While I was trying to maneuver myself I happened to burst my drainage bag. When I called again for help, another long time later, a nurse came and bitched me out for making a nasty mess. When I noticed that my I.V. bag was almost empty, I called for someone to come change it. A nurse came in and told me they were on shift change and I would have to wait. I wasn’t too keen to go without antibiotics and pain medication so I decided it was time to bail.

    It was apparent that they weren’t overly eager to help me, because, at that time, I didn’t speak Spanish, and they were over-burned with patients.

    To make a long story short, ten hours after my surgery I dressed myself, packed my suitcase, tucked my drainage bag into my pants, and escaped a virtual nightmare of an experience.

    Needless to say, I now have medical insurance so I can go to a private hospital if the need should arise. And I soon learned to speak Spanish fluently.

  12. I thought after reading Robin’s account on the social security regional hospital system and knowing Robin personaly and knowing the extent he would have gone to not to have been in such scalor that the regional hospital is and has been a free hospital. It is not frequented by the haves and is strictly a venue for those that have no other option. Robin had other options I am sure. He is extremely well versed in the language and has an above average IQ so I am somewhat bewildered as to how he found himself in such a perdicament. He is after all a dr. A dentist but a dr. None the less. His wife is also smart and I cannot imagine how horrific that experience was for the two of them. Here is my experience. I fell twice and both times went to Hospital Chiriqui. First time I took myself after a week of severe head aches. I loved the care, the attention to detail as Robin stated, a lovely semi private room with one lovely room mate, where I did control the air and someone attending to not only my medical needs but it was for sure some of the best food I have eaten. My husband and I have excellent health insurance from the states. Blue Cross and Blue shield PPO and hospital Chiriqui excepts our insurance. We had zero out of pocket expenses and had top notch care. Our insurance even approved rotto cuff surgery to be performed ar hospital Chiriqui. I agree with anyone that suggests health insurance is critical whether you are here or abroad. We believe in good insurance and are truly grateful for the care I recievd at hospital Chiriqui. I recently ran into one of the hospitals founders. He was very clear on the hospital being Private and the drs are hand picked and their mission is to provide exemplary care. He also explaned that they do not take patients with no money and no insurance. After speaking to two nuerologists who suggested spine surgery we decided to go back to the states and get another prospective. It is awesome to have options and we are extremely grateful for the care I received at hospital Chiriqui. Let me also say that during one of my dr. Visits they needed exrays. 9 xrays for 110.00 even that was incredible.. Thanks for allowing me to share and Robin get well soon. Kim

  13. What is the advantage of living in a foreign Central American Countr. The few dollars you save on your monthly living expenses ? Not for me

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