Field Notes

Laissez-Faire

“Comment va le chômage?” (How is the unemployment?) was 2016 most popular greeting at Ngatt’s Health Center.

Dry season had returned, but the patients had not.

Why?

As I discovered this past week, my village is currently boycotting the health center because they believe prices are too high. Instead, they have been traveling to Danfili (~30 minute car ride, 500 CFA) or to Tibati (~45 minute car ride, 1000 CFA) whenever they need treatment.

How did this happen?

There is a lot of “he said, she said,” but I have been asking around and have a few theories.

Theory A (gleaned from talking to a guy who was telling me there are prices that are twice as high as elsewhere and the fact that HIV tests cost twice as much as they should, a cost that varies depending on who I ask at the health center): Disgruntled Health Workers.

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However, another friend has told me prices have been bad since January, which suggests inflation.

But there also is some confusion as to how the prices are set. My health center is private and is a small branch under the Ngaoubela center (~35 minute car ride, 1000 CFA), which is under the bigger hospital up in Ngaoundèrè (9-10 hour bus ride, 4000-5000 CFA). Some even believe, Dr. Nier, the Austrian doctor who has worked at Ngaoubela for years, sets the price (which knowing her, is very unlikely-she barely has time to sleep, being so busy treating people). Being a private hospital there is an even greater pressure to make a profit then at a public, government-funded center, which would explain why the cost of treatment is more expensive.

However, the health center is claiming it is the transporting of supplies to Ngatt from Ngaoubela that is raising the price. (This, I discredit. The medicine travels in bulk and thus the price should be spread out amongst the entire lot, which would only raise the price 100 CFA (at most), as opposed to the 1000+ CFA). As the COSA president (the COSA is a board that meets a few times a year to manage community/health center relations) attempted to explain it too me: You buy a bag of onions and then add 50 CFA to each in order to cover the cost of transport, to which I replied that I understood, but there still exists no obligation for me to buy those onions if I can find cheaper elsewhere. That is the free market. (It has also come to my attention that I have been over paying for onions.)

So what now?

To be honest, I am a bit unsure. This was not exactly covered in training.

Since my role at the health center was giving presentations on health subjects (something that requires an audience), I now see very little reason to go to the health center-I can read just as easily at home. Additionally, I am actually proud of my community’s ability to mobilize themselves (I would estimate 95-99% participation) and staying away from the health center is a way to support them without getting involved. (Would I love to help organize them a write a list of demands? Yes. Would l love to mediate? Yes. But no one has asked me and honestly, they have been doing well so far-my help could just be superfluous.)

So instead, I have been making coffee to bring to my neighbors for “coffee dates” and otherwise, just hanging out. I still have my gardening group and I am hoping after the holiday season Grassroots will pick up again, but until then, I’ll be focusing on spending more time with my community, something I always felt too tired to do after sitting at the health center during the day.

Who knows? Maybe this could be the best thing that has happened yet.

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