Why flying people to the US for medical care isn't always a great idea
When you bring someone to the US, you take them out of their entire social support system. Assuming the medical care is donated, you still need to pay for their plane flights, housing, and food. For a long period, since they will need to stay in the US for all necessary follow-up appointments. Considering how much your mental state affects the healing process and your ability to adhere to treatment protocols, loneliness and isolation makes a difference.
The patient will need translators so they can talk to doctors. They’ll need a lot of help with understanding what is going on, and giving informed consent to risky procedures. And pretty much anything you have to travel for is risky. Sometimes, at the end of it, the patient doesn’t want to go home but there is rarely any (legal) way for them to stay.
Assume the medical treatment is successful, assume everyone goes home happy. What happens to the next person with the same problem? If she’s lucky, the same effort that was generated for the last patient. Expensive transport, a long time away from home and family, frightening and unfamiliar doctors who don’t speak her language. If she’s not so lucky, nothing. The next person with the same problem probably won’t get as much media attention because it’s not a novelty. There will be donor fatigue – finding donated care will be harder. Probably she is stuck in her home country with medical care she may or may not survive.
How do we do it better? It’s not very realistic to argue that you should just ignore seriously ill people and spend the money on public health interventions. No human can do that. As Isaac Holeman pointed out, you can’t ignore emotional responses. On a practical basis, you probably have people willing to donate money for that one compelling story. You can’t ethically just take that cash and save fifty children from malaria or helminthes. But you can fly in a team of specialists or oncologists. You can most likely talk them into donating their time for the chance to help someone in a faraway location.
Team up your foreign doctors with local specialists. They can train the local physicians in how to treat the illness or perform the necessary surgery. They can train local doctors in how to provide the follow-up care. You may have to bring the sick person to the capital where facilities are available, but he is still in his own culture, speaking his own language. His relatives visit him. You’ll need translators for the foreign doctors, food and housing, but that’s still a lot less than sending people the other way. Yes, there are lots of complications; you may need to purchase, or find donated equipment and drugs.
But now consider the next person. She’s received a scary and terrible diagnosis, which requires sophisticated treatment. She travels no further than her own capital for care. She is treated by doctors who’ve been trained by American specialists, and her doctors can contact those American colleagues if they have questions. She can go home right after her treatment, and come back as needed for follow-up visits. Isn’t that a better picture?
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