The Road to Insulin

The cost of providing healthcare in Haiti can be surprisingly high at times.  So we do everything we can think of to reduce expenses.  For instance, road trips are planned to serve as many purposes as possible.  Yesterday was a good example.  Our trip from Port-au-Prince included an airport stop, then a downtown meeting with another NGO, then a rendezvous with our accountant to drop off a tax-check, followed by a stop at a provisioner who had secured some food at a good price, then a quick sandwich which we ate while driving to Leogane to see if we could buy some insulin. 

These days our normal wholesaler is out of insulin more often than not.   So we first stopped at a large hospital to see if they had a good source.  The answer was negative and they explained that they rely on visiting US medical teams to get insulin right now.  After more searching and phone calls, we finally resorted to buying three vials from one pharmacy, and two from another.  The retail price was $18 each.  Not a bad price on the US market, but in Haiti it's more than three-day's pay.  And when you run a clinic where diabetes is not uncommon, and you only charge $1.20 per patient, including exam, lab and meds - it's not hard to see why we work at reducing other expenses. 

During the rest of the drive, I could only reflect on the fact that if you are poor and live in Haiti, it's best not to get diabetes.  If you do, the margin can be very thin between a healthy life and one that is difficult and short.  The margin might just be a 100ml vial, which is located two cities and three paydays away.  Might as well be in Nashville.