Healthcare in Panama

Invoices from Clinic visit. Note the charge for the “consultation”, $5 to see the doctor.

We’ve had more occasion to check out the Panamanian healthcare system in our travels than we would have preferred. First Dan had allergies or a virus and saw a local doctor who was raised in the USA but got her medical training in Panama. I saw her to see if she had any different suggestions for the chronic insomnia that I have (some help).

Then last week when we went to Bocas Del Toro on the Caribbean coast I got “amoeba”. The water in Bocas is notorious but from what I can tell, the incubation period for amoeba is 1-2 weeks so I can’t blame it on Bocas. Amoeba seems to be the underlying problem causing dysentery. Gross bloody mucus stools, intense cramping. It came on quickly and I went to the Bocas clinic the next morning.

The clinic is in a large old building. Staff was professional but not overly friendly. The wait for care wasn’t long. I saw a doctor with a face mask on who asked me about symptoms and allergies. She ordered basic blood work, two IV antibiotics, and medications to take home.

It is obvious that sanitation is not a very high priority in this area. While we didn’t encounter mosquitoes in spite of some standing water in some ditches and the doctor wearing the mask, the rest was cursory. Not a single restroom was fully functioning with paper, soap, and flushing toilets. There was some combination of those things in the various restrooms but the only soap was in the treatment room.

The prep of my arm prior to the blood draw or IV insertion was a very quick swipe with a piece of cotton that had alcohol on it. It must have been adequate though.

I went home with two oral antibiotics, antacid, and probiotics. I was shocked (and grateful) that the doctor ordered the probiotics. The IV antibiotics started working within a couple of hours and I am now back to normal.

The entire cost of my test and treatment? $37 which included the medications. I would have gladly paid more to have more sanitary conditions but I know many of the locals couldn’t have afforded that.

Aside from these “adventures”, Dan has seen a skin doctor and will see her again this coming week. The office visit was $40 and the skin biopsies will be about $150 each. I plan to see a dentist locally in the next week or two for cleaning. My understanding is that the dentist himself/herself does the cleaning and that the cost is in the neighborhood of $50.

And in case you are wondering, I really have no idea how I got the amoeba. We have been really careful and use the reverse osmosis water to drink, brush our teeth, rinse many of the dishes, wash veggies/fruits. I had gotten a little lax and drank water in a restaurant in David but so did Dan and he didn’t get sick. We have gotten stricter again, just to be sure.

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