When you plan an overseas trip, you look forward to all the exciting things you are going to see and do. Few people think about what would happen in a medical emergency or when they fall ill. For most tourists, I suppose the answer would be international travel insurance*, so that you are covered in a medical emergency. It is a bit different when you emigrate to a new country. Then you have to figure out how their medical system works and how you get access to their basic medical services or day-to-day medical services.
My experience of trying to obtain access to basic medical services for my daughter has been frustrating, stressful and emotionally exhausting. When we arrived in Canada, my daughter had a touch of flu. So we actually needed a doctor within the first week of arriving here, because exposure to the extreme cold , resulted in her getting very sick in a very short space of time.
British Columbia’s public health system requires that you obtain a BC Medical Services Care (MSC) card that allows you access to all medical services and doctors. This card is your golden ticket into the health system. Without this card, you have no chance of obtaining medical help when you need it. Unfortunately, when you arrive as an immigrant, you first have to apply for the card and then you have to wait three months before you are covered by the public health system and can use the card. So basically if you get sick in the first three months after arrival you have a problem.
So when our daughter got sick, we started asking around to find out where we could go to see a doctor. We went from clinic to clinic and they all turned us away. We soon learned that in order to see a doctor, you first need to register with a particular physician as your family doctor. Once you have a family doctor, you are only allowed to see that doctor. But only by appointment, which can be made online, but which has to be made well in advance BEFORE you actually get sick. So if you plan to live in Canada, you should also try to enhance your clairvoyance, since you need to predict when you will be ill to ensure you have made a timely appointment to see a doctor.
So what happens if you don’t have a family doctor and you don’t have a MSC card? You can go to a walk-in clinic. Walk-in clinics operate in most malls and shopping centres. There is one in Walmart, for example. However, they only treat minor ailments, so if you are seriously ill, they still need to refer you to a family doctor or send you to hospital. I am not sure what the actual purpose of these walk-in-clinics are because they charge you $125 so you can see a doctor, but then the doctor does a quick check to ensure you are not dying and sends you home. No medicine, nothing.
We took Emma to a walk-in clinic where we had to wait 1 hour and 40 minutes to see a doctor. The doctor looked at her and confirmed that she had a sore throat and the onset of an ear infection – her ears were red and swollen – but because she did not have any puss in her ears yet, the doctor sent us home. I asked what I could do to treat the pain and fever, and the doctor recommended I buy Advil from Walmart.
So my daughter needed antibiotics but had to settle for Advil, because she wasn’t sick enough. On top of that, the doctor ensured us that all three of us would probably be sick for the next two years while our immune systems try to adjust to the foreign viruses and bacteria we are exposed to here. She reckons she sees it all the time. Foreigners come here and are exposed to so many foreign entities that their bodies simply cannot cope and they end up having continuous flu for two years. Joy. Just before we left her office, she also took it upon herself to tell us that perhaps we should consider going “back to South Africa“, or “rather go to Australia or New Zealand” since we will probably not cope with the lack of sunshine. “You people love your sun too much” we were told; which is probably true, but I was’t sure I was happy about the fact that she felt she had the liberty to decide on our behalf what we could cope with and what not, or advise us on our immigration choices.
A week of Advil, and other medicines brought from home, and with the advice of my sister-in-law, who is a doctor in South Africa, we managed to get Emma through the worst. Or so we thought…She started getting better for a few days and then got sick all over again. As we were approaching her 15-month mark, I realised we were going to have another problem, since she needs a Measles, Mumps and Rubella shot at 15 months.
Being an Ennea 6, of course I anticipated this risk and did the research BEFORE we left South Africa. Nothing I read or heard was encouraging. We were told about the MSC card and the three-month waiting period. But Amazon reassured us that we would be covered under a private medical health that they would provide for the first three months. I asked our new “friends” in Canada about vaccinations and they did not provide us with any real answers or suggestions. I could not fathom their lack of response and nonchalant attitude to my series of questions around vaccinations until I tried to book a vaccination for Emma. Then it all started to make sense.
I figured I needed to secure a family doctor before we would be able to get help for Emma. So I started the process…
Step 1: Find a doctor in our area that is willing to accept new patients
In South Africa, you have one of two options, you can go to a public medical clinic, open a file and wait in line to see a doctor or you can book an appointment with a doctor in private practice. Either way, if you arrive to see a doctor, the doctor is obligated to see you and to treat you. In Canada, if you arrive at a clinic or doctor’s rooms without an appointment, the receptionist (read “bodyguard”) requests that you leave and informs you that the doctor only sees his registered patients. If you are not registered with the doctor, you cannot see the doctor. Even if you are registered with the doctor, you cannot see the doctor without making an online appointment and waiting for an allocated appointment date and time.
So how do you register with a family doctor? Here is Google’s advice: “Let those around you know that you are looking for a new family doctor, and take to social media, too. It’s often a reference from a family member or friend that gets you into the doctor’s office and onto the radar of a doctor accepting new patients.” So, that means we are screwed since we have NO family or friends in Canada.
First you have to find the name and contact details of a doctor that is willing to accept new patients. For that they have this “nifty” service called College of Physicians and Surgeons British Columbia. It is an online database of all the registered physicians and surgeons in British Columbia with a list of their qualifications and an indication of whether they are actively practicing and willing to accept new patients or not.
Step 2: Contact available doctors and make an appointment to see a doctor
Next you do a search to find out which doctors are in your area and then you start phoning. Simple right? Not really. I was on hold for four and a half hours just to be informed that the doctor is no longer accepting new patients, because he has reached his quota. I was told to phone back in a few month’s time.
I insisted that receptionist at least gives me some advice, since I don’t have a few months to wait before Emma can get her vaccination. She explained that I need to register with the Public Health Unit. Every area in British Columbia has one Public Health Unit that serves that particular area and that is basically like a clinic where you go to have your child vaccinated. However, they only help you if you have a MSC card. Great! So I don’t have the card yet. So I ask if I can take Emma to a walk-in clinic to get her vaccinated. No, unfortunately they do not vaccinate. She inquires about Emma’s age and then tells me that they do not vaccinate babies at 15 months, only at 12 months and 18 months. I explain that I am from South Africa and according to my clinic card and vaccination plan, my daughter is due for a vaccination at 15 months. She declines to help me further.
My frustration sets in and I start fuming. The vaccination debate has been a hot topic over the last few years. Those who are in the know are often furious with irresponsible moms who refuse to vaccinate. But I AM a responsible mom who has ensured that my daughter got every single vaccination she was supposed to get, only to have her be put at risk by a system that simply refuses to help me do the right thing!
Step 3: Register with the Public Health Unit
I phone the Public Health Unit to inquire about the process. I have to go to their offices and submit Emma’s passport and medical records and then wait for them to evaluate her records. They then inform me when I can come and book an appointment for Emma to see a nurse. For the appointment with the nurse, I will need the magic MSC card.
Step 4: Phone the doctor and beg for a private consultation
So I phone the doctor’s offices again and explain that I need the doctor to have a look at my daughter’s vaccination records and advise whether she needs to be vaccinated now or not. I tell her we have private medical cover through Amazon, only to be informed that they do not accept private medical cover. So I beg the doctor’s receptionist to allow us to see him without the BC MSC card and pay for the visit privately, because we need to register with them in any case so that we have a family doctor for future medical situations. I am informed that it will be $80 per person for a meet and greet. What is a meet and greet you may ask?
A meet and greet is an opportunity to meet the doctor so that he can assess whether he wants to treat you as his patient. In South Africa, a doctor is obligated to treat you. In Canada, a doctor can refuse to treat you and simply indicate that he/she is not accepting any new patients. Finally, I get why so many South African doctors want to work in Canada! You retain your title and work level when you move here despite having to redo their exams. And if you open a family practice, you can decide how many patients you want to treat and also WHICH patients you want to treat…
Lessons learned:
South Africa’s public health system is battling. They do not always have the facilities and the resources they need, but they have good, passionate doctors who care and who treat every single patient with compassion, irrespective of background or situation. Unfortunately, theses poor doctors are pushed to their limits. I don’t think we appreciate our public health doctors enough. We don’t always realise the immense strain they work under and the horrific things they have to deal with. On one day, the average public health doctor in South Africa could deal with knife-wounds, gun shots, drunken bottle fight injuries, women going into labour and rushing to a rural clinic with no resources and the list goes on… Of course you get much better facilities in the private health sector, but sometimes you have to deal with a doctor who doesn’t care as much for their patients as they care for the lifestyle it affords them as doctor in private health.
I have had the privilege to encounter some of the best doctors in South Africa in the five years that we lived in Randburg – doctors with heart and passion, doctors who care, and doctors who demonstrate expertise and skill that measure up any where in the world. I would even wager that South Africa has some of the best doctors in the world. My experience in Canada has left a lot to be desired. It is the absolute irony that you would trade poor infrastructure, a struggling economy and out-of-control crime for a place where there is proper infrastructure, the economy is strong, they have a firm legal system etc. and yet, they have a confusing and misguided health care system with doctors who seem to lack the compassion to actually care about the health and wellbeing of their patients.
*We had travel insurance by the way, but they were unwilling to cover our medical expenses since we could not provide evidence of a return ticket home. Make sure you read the fine print when you take out travel insurance to emigrate. Travel insurance only works when you travel for leisure, otherwise it is money wasted.