At the Repheka clinics, one of our main strategies for keeping our services accessible to all is giving patients medications free of charge. Thus, with only $1.20, which is the fee for a visit, a patient can come to the clinic, see a doctor, and go home with the medications that he needs to get well.
Every time I contemplate charging patients for medications, I have this cringing feeling inside. I’ve seen so many patients with nothing more than the visit fee. I’ve seen parents with multiple kids, all of them sick, but who can only pay for some of them. I’ve seen patients who never buy the medications that they had to purchase outside. Some of them will wait for weeks until we replenish our stock.
Moreover, because we only charge about a third of what other labs charge, patients prefer having their lab tests at the Repheka clinics. Plus it’s more convenient to them. When we have to close the lab because of electricity shortage, some patients will wait for weeks until we are able to run their tests. This week, for example, as our brand new generator just broke down, many patients will delay going to other labs.
According to the World Bank, the gross national income per capita in Haiti is $650 per year, and (just for comparison) $47,140 in the United States. With $650 a year, the purchasing power of most Haitians is dismal, which explains why they cannot afford paying more for their health care needs.
Keeping the fees charged to patients as low as possible makes our services accessible to even the very poor. But we need to get sufficient funding to maintain such strategy, which is not easy. Currently in Haiti, only a handful of organizations provide services free of charge or at very low costs. Most of them are international organizations with legion of individual donors and huge institutional grants.
How long can we keep on providing medications free of charge and lab tests at nominal cost? Today, we have the funding that allows us to do so, what about tomorrow?