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Helping needy Malagasy kids to become Jesus’ kids! October 2009 Volume 12, Number 10 "A generous man will himself be blessed, for he shares his food with
the poor." Proverbs
22:9 |
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A Myriad of Questions
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Andry's Dialysis Expenses for 2009 | |
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February (One Week) |
$ 878.78 |
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March |
2,734.92 |
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April |
2,805.55 |
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May |
2,523.17 |
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June |
2,408.76 |
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July |
2,416.94 |
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August |
2,478.83 |
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September |
2,094.74 |
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TOTALS |
18,341.69 |
Betikara has encountered a mass of information concerning the care that
is needed for Andry and his ongoing dialysis treatments. We are finding that the
more we learn, the more questions that there are to be answered. We are also
finding that our initial ideas concerning the quality of care that Andry will be
able to receive in Madagascar are correct. Madagascar is not up to the
task.
Madagascar is barely able to keep up the dialysis treatments, three times
a week, that are needed to maintain Andry at an acceptable level of health. Many
times, we find that there is no medicine and that the necessary expendable items
that are needed for each treatment are not available at the two on-site hospital
pharmacies. This entails that we search around at other hospitals and pharmacies
until we are able to purchase the needed items. This searching for items is
nothing new. Madagascar, as it was in Kenya, has a mindset that whatever an item
might be, if there is still one item on the shelf then you do not need to
concern yourself with ordering more stock. The problem is everyone has the same
mindset. We are finding that when one hospital or pharmacy does not have the
required supplies none of the other hospitals or pharmacies have the needed
supplies. We often spend hours each day searching for the required medicines and
expendable items so that Andry can have his dialysis
treatment.
Our hands are tied. Often we cannot find the needed items locally. The
government will not allow us to have permission to ship in medical supplies for
Andry, and the government will not give us duty free status so that we can get
things into the country inexpensively. We were recently able to get 6 badly
needed dialysis machines shipped into the country. Originally, the government
hospital had 12 machines. Now they are down to 4 working machines. With the
arrival of the 6 new machines the hospital will be able to provide more reliable
care for their current patients. There have been times in the past that Andry
was not able to have three dialysis treatments in a week because of broken
dialysis machines.
T
hings should be better for Andry and his dialysis treatments for a while. Once
the 6 machines start to break down, then we will be back to square one. The
technicians at the hospital cannot seem to keep the machines in good repair.
Often, they complain that there are not enough parts to replace those that are
broken. This is also an ongoing problem in Madagascar. One can always buy
something new off the shelf, but do not expect to be able to find parts or
service for what you have purchased once that item breaks
down.
The doctors told us that the best solution for Andry is for him to have a kidney
transplant operation. We looked into the possibilities and soon realized that an
operation will help Andry by ending the need for dialysis treatments three times
a week, but what will we do for Andry after the operation? There are several
items that need further consideration.
First, one of the biggest obstacles to having a transplant operation is the
needed medication to stop the body from rejecting the new kidney. This medication has to be taken
for the rest of the patient’s life. The medication is expensive, about two
thirds of the monthly cost of dialysis treatments, depending on the dosage of
medicine that is needed.
Second, the doctors informed us that there are no anti-rejection medications in
Madagascar, and that none of the doctors are trained to administer and check on
the levels of the medication in Andry’s blood once he starts to take the
medication. The doctors stated that all of the patients that have gone outside
of Madagascar for kidney transplant operations have never returned to Madagascar
due to the lack of necessary ongoing medical care within the country. Either
they are still living outside Madagascar, or they have died due to complications
from their kidney transplant operations.
If Andry does receive a “new” kidney, where will Andry live? How will Andry earn
an income and be able to care for his medical needs? These are just two of the
many questions that daily plague us. Andry is not educated to the level that he
could live and work outside of Madagascar. In a past newsletter we wrote that
Andry did not complete primary school. So, should Betikara continue to pay for
Andry’s living arrangements in some other country as well as his anti-rejection
medication for the rest of Andry’s life?
By looking at the front page of this newsletter one can easily see how much
Betikara has paid for Andry’s medical expenses. This chart details 8 months of
expenses. However, the expenses for February only cover the last week of
February. So in reality, the chart shows just over seven full months of Andry’s
dialysis costs. This may seem cheaper than costs for dialysis treatments in
another country. However, many of the Malagasy Christians are starting to
question the large outlay of funds, for one child, that could be used to help
the other 40+ children housed at Betikara.
We are faced with many questions. Technically, according to the Betikara
statute, since Andry is no longer in school Andry is supposed to leave Betikara.
We all know what will happen to Andry if he leaves Betikara with his present
medical needs. Andry’s family will not be able to “pick up the ball” and provide
for Andry’s ongoing medical needs. We have already watched 4 different families
that had kidney dialysis patients at the government hospital struggle to come up
with the needed funds for dialysis treatments. One of those four families
approached me about helping them out a while ago. All four of these family have
lost family members due to a lack of funds to pay for the dialysis treatments.
The hospitals do not charge for the use of the dialysis machines, but the
families still have to purchase the needed medications and expendable items for
their family members like we do for every treatment.
The average income for a Malagasy person is about $360.00 per year. The yearly
cost for kidney dialysis treatments is turning out to be around $32,000.00 per
year. A quick calculation shows that the estimated amount required for yearly
dialysis care is 88.9 times more than the average annual income of a Malagasy
person. For this reason the Malagasy people are quick to say, “Why waste all of
that money on one sick person that is going to die anyway?” With that thought in
mind, should Andry also be allowed to die?
As American missionaries to Madagascar we are finding ourselves caught between
the Malagasy mindset and the American mindset. We fully understand how hard it
is for these people to try and maintain a person that is on dialysis due to the
exorbitant costs and the difficulty of finding the necessary medicines and
expendable items. The Malagasy people struggle with daily life and finding
enough medicine to help their families with the common cold and flu. How can we
expect them to be able to cope with something so out of their reach as dialysis
treatments, especially when most Malagasy people do not have medical insurance
like Americans? We are blessed because we have a vehicle to use while searching.
Malagasy people many times go by foot, bus, or taxi. So, we can easily
understand the statement, “Why waste all of that money on one sick person that
is going to die anyway?”
Please give this newsletter a lot of prayerful consideration. Please pray for
Andry and the Betikara Orphanage as we try to minister to Andry’s needs, and as
we try to teach the Malagasy people about their need for a spiritual life since
we cannot count on our physical lives. Feel free to write to us at
barryjrosie@gmail.com if you have any comments, suggestions, or questions
concerning Andry and his ongoing dialysis treatments.
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Indiana Church of Christ “He who is kind to the poor lends to the LORD, and he will reward him
for what he has done.”
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