Today, I woke up to the unexpected sight of a red, itchy eyeball that, in my amateur diagnosis, was most certainly pink eye (gross!). My very knowledgeable eye doctor brother agreed with me that my eye ball was indeed gross, but advised me to have an eye doctor take a look at it as he does not do selfie diagnoses. Still being new to the country, I was unsure where to begin so after a few texts with veteran coworkers, I decided to try to nearest hospital and see about their eye clinic.
Outside of my medical tests, which were certainly quite the chaotic event, this was my first trip to a hospital here in Abu Dhabi and I didn’t know what to expect. Based on my experiences in the States, I was bracing myself for long waits, disorganization, and busy, overwhelmed staff who may or may not be kind to me. I knew that the medical costs here are cheaper than the States, but that was about it. Suffice it to say, today’s visit was eye opening in more ways than one.
When I walked into the hospital, I was immediately surprised by how clean and open the facilities were. Perhaps this is just the quality of hospital I came to, but I suspect the standard is relatively high throughout the city. I can’t say for sure. The vibe wasn’t the white washed, sterile feeling I’m accustomed to in the States. It felt peaceful, calm. They even had a little open-air courtyard that I half expected to contain a koi fish pond and some yoga mats (it did not). I asked for the eye clinic, but was told it would be another two hours before it opened. Bummer, but fortunately I came ready with my Nook, phone charger, and a couple bananas. I decided to wait it out. Until I got antsy, that is.
Oh, by the way… This is what the courtyard area looks like:
I walked over to the ER, not because I believed my eye was a real emergency, but because maybe someone was available to give a quick look, prescribe some eye drops, and send me on my way with “sick leave” note. At this point, my eye was already significantly less red than when I woke up and I was contemplating whether I had overreacted by coming at all. Get in, get out, and take a nap. That was my game plan.
Inside of the ER waiting room which, at 7:30 AM, only had about four people, I approached the registration desk. The woman working there asked me what I was there for and informed me that they only had GP’s in the ER (general practitioners). I expected her to be annoyed with me for coming to what was clearly the wrong section of the hospital and send me on my way, remanded to the eye clinic waiting room. She didn’t. Instead, she asked two nurses to speak with me about my eye, how long it had been that way, my symptoms, etc. One of the nurses immediately hopped on the phone and contacted someone who could schedule me an appointment in the eye clinic for 9:30 AM. She was concerned that if I just went over there, I might not be seen as a walk-in and (seemed to) genuinely want me to get my eyeball looked at. She took a look at my name and, realizing that it was not phonetic in a way that is easy for Arabic speakers, politely asked me how to pronounce, as if she really cared about getting it right. She even seemed apologetic (which wasn’t necessary, but I appreciated the sentiment nonetheless).
I was pleasantly surprised, and also a bit shocked. In the urgent care and ER facilities I’ve been in most of my life outside of my hometown in Indiana, the vibe is generally one of minimal patient interaction, massive shuffling, long waits, and little tolerance for patients like me who are a bit lost, do not outwardly appear to be very sick, and also may have names that are not easy to read in the national language. I almost felt as if they were making too much of a fuss, so accustomed am I to getting and witnessing very different levels of patient care in out-patient settings such as this.
I sat inside the waiting room of the eye clinic, enjoying complimentary hot chocolate (seriously, can we get some tea in our hospital waiting rooms back home?!). At 9 AM a nurse came and got me, not because it was my scheduled appointment time, but because she had time and I was there so why not? She did a quick vision test, asked me about my eye, took a look, did a pressure test, and had me wait in another very comfortable waiting area to see the doctor. Within 15 minutes, I was in the doctor’s examination room. She was kind, patient, and very, very concerned about my eye which she revealed through a thorough line of questioning. Apparently, I was right to go to the hospital as my cornea is “severely inflamed.” She examined me for what felt like an eternity, asking questions, trying her best to figure out what happened to my sad, little cornea. She explained to me the possible causes of an inflamed cornea and why my symptoms, or lack thereof, didn’t really fit many of the usual causes. She was baffled. I felt like a patient on House. She wanted to take pictures of my curious little eyeball and get to the bottom of this diagnosis.
The same nurse got me and took me into another examination room to take said photos – many, many photos. I didn’t realize my eyeball had so many potential angles to capture. The entire staff seemed very determined to figure out what exactly was wrong.
After my photo shoot, I waited a little while longer and the doctor saw me again. She asked more questions, had I changed my contact solution, has there been any past trauma to my eye? She asked her colleague to come in from a routine examination to look at my eye to be sure she wasn’t missing something. I was floored, and not just by the fact that I hadn’t realized the extent of my eyeball woes, but that this ophthalmologist was being so diligent in her diagnosis and treatment of me. She wanted to dilate my eyes to make sure there wasn’t additional inflammation in the back.
Throughout this entire process, I never got the sense that she was frazzled by having to spend more time on me than expected. She wasn’t quadruple booked with patients, though the waiting room did fill up a bit, and I certainly wasn’t getting any special treatment – everyone got this same level of care. When I was in her examination room, she gave me her undivided attention. It was nice. I left her office with directions to take three different eye drops and come back the next day. She wanted to see what, if any, progress had been made and would refer me to a specialist if need be. She even wrote me a handwritten letter for my job, as I don’t yet have my ID card, a process that took at least 5 minutes because she wanted it to be legible and clear.
All of this cost me $50 AED, the equivalent of $13 USD.
When I went to the pharmacy to get the cortisone drops, some antibiotic drops, and a topical gel that I am not exactly looking forward to using, the total price without my medical card would’ve been approximately $65 AED, or $17 USD. There was no dropping off the prescription and waiting an hour. She filled it right then and there, not because the pharmacy was empty, but because things like drops and birth control (yes, birth control) and antibiotics are ready to go and be dispensed upon request. With my medical card, I was charged a whopping $7 AED. That’s a little less than $2 US dollars.
My heart sank.
I am admittedly not well-versed on the ins and outs of what keeps our healthcare costs so high in the US, but I can tell you I do know that most other developed nations offer universal healthcare at low costs, much like what I’m receiving here in Abu Dhabi. The medicines I’m prescribed here are the same as the States at a fraction of the cost. I am also aware that pharmaceutical companies in the States operate at obscene profit margins. I came away from the hospital and pharmacy today feeling both blessed and grateful, but also frustrated by the knowledge that I likely would not have received the same care for anywhere near the same price I paid today in my own country. Even with the insurance I had in the States, which I thought was fabulous at the time, my co-pays were 2-3 times more than what I paid today and my prescription costs nearly quadruple in most cases. I would’ve paid approximately $3 USD for something I’d have been charged $200+ in the States without insurance, IF I was even able to see someone.
I won’t feign expertise in the reasons behind the conditions of our healthcare system, but I will say that we have a long way to go and a lot to learn about quality patient care, taking time to actually listen to people when they are unwell, and providing these services at a cost that is affordable for the vast majority of people. Too often we wait until the damage is severe to invest in treatment.
Had I been in the States, I wonder if I would’ve been given a quick glance, some drops for pink eye, and sent on my way, not really knowing that I had another, bigger problem happening. Maybe I would’ve been referred to another doctor, who I would then have to schedule a separate appointment with after my insurance said it was actually okay to see said person, the entire process taking up to a week, not to mention an additional day away from work. I can’t say for sure. I also don’t know who all gets this level of care here in Abu Dhabi, if it’s 100% of people, or just those of us of a certain working class and locals. What I do know is that if you want to come live and work here, you can expect great, affordable healthcare without making a six figure salary. One day, I hope to say the same for my home country.