Saturday, December 11, 2010

Medical Care: Differences From "Home"

(Bundang Cha Hospital, where we received care in Korea)

Moving to a new country, you’re bound to notice differences from “home” just about everywhere.  The language, the food, the social mores… those you expect.  Other differences sneak up on you.

At this point, I’m more familiar with Korea’s medical care than I wish to be.  And, this is where I’ve found some of those differences.  It’s been seven weeks today that my husband and I have been sick.  We’ve been dealing with a cold/bronchitis/laryngitis/sinusitis….who knows what really.  At this point, we’ve heard many diagnoses.  We’ve had highpoints and small recoveries along the way, but no cure.  We’ve each been on four doctor appointments, seen three different doctors – one of those trips to the local hospital.

There are many things to praise about the Korean healthcare system.   As an American, two things truly stand out:  the prices and immediate access to care.

So first, let’s talk about the prices in Korea.  I pay fifty percent of my healthcare premium – and that’s less than $60 a month.  It’s incredibly affordable.  It’s even more amazing when you go the doctor.  I’ve seen a specialist for as little as $2.50.  That’s followed by a visit to the pharmacy where $5 will get me what I need.  How about x-rays…$11 for two people.  When we first arrived, Cameron ended up the ER.  At the time we were uninsured and it cost $160 for care, tests, and drugs.  My previous co-pay in the US was $200 just for showing up at the ER.  The affordable prices are truly shocking.  And, healthcare is certainly more accessible when it’s so affordable.

The second plus of the Korean healthcare system; walk-ins are welcome.  I'm not talking about urgent care facilities, which are available both in the US and Korea.  I mean walking into just about any doctor's office and seeing the doctor that day.  I can’t imagine showing up at a doctor’s office in the US without an appointment.  You’re really out of luck if you’re a new patient.  The doctor can see you in a month or two or three, even though you’re sick right now!  In Korea, you can of course make an appointment.  But, you can also show up and take a number.  So, far the waits have been less than if I did have an appointment in the US.  Fifteen minutes tops.

These two factors immediately had me questioning – why can’t this be done in America?  However, there are two sides to every coin.  That means, there are some things about “home” that I miss dearly:  a thorough examination and antibiotics.

I find the level of examination by the doctors in Korea just isn’t as thorough.  Out of four appointments, only one time did a doctor pull out their stethoscope to listen to my lungs.  And, she asked me if I would like her to – yes!  I’ve been coughing for weeks, please listen to my lungs!  There is no paper gown to change into, no table to lie on, and the doctors barely touch you.  There is no feeling for swollen lymph nodes.  All that I’ve come to recognize as part of a typical exam in the US, has been thrown out the window.   After explaining to doctors on our third and fourth visits about our lengthy illness, there seemed to be little concern.  There were no blood workups, no urine tests, and the doctors didn’t prescribe antibiotics.

So, that brings me to the second thing I miss about home – the medicine.  There’s much debate about the prescription of antibiotics.  There’s a fear that taking them too often will lead to immunity.   Although Korean doctors haven’t expressed that concern to us, we have been told “you don’t need antibiotics.”  Instead, the doctors prescribed over-the-counter medications.  Think going to doctor and leaving with Sudafed and Tylenol.  The doctors’ advice included – dress warm, open up your windows to air out your home, and get some rest.  On our hospital visit, I was overjoyed finally to receive some antibiotics.  But, for whatever reason, the Amoxicillin didn’t do the trick for Cameron or me.  Before even finishing the dosage, our symptoms returned.

In America, I’m certain I would have received antibiotics on my first visit to the doctor.  In fact, for a cold or flu-like illness, I can’t ever remember having to visit a doctor twice.  Frankly, that’s the way I prefer it.  Seven weeks of illness and low energy is just too long.  I’ve written once before about the “Korean cold” and the stories from other foreigners that it lasts for months…but does it have too?   

So, what’s the next step?  I just got a good tip today – there are some international clinics in the Seoul area with American doctors.  We can celebrate the differences each country or culture has to offer – but in this case, I want a little bit of care from “home.”

Thursday, December 9, 2010

Our Trip to Macau

(Looking down on Macau from the ruins of Sao Paulo.  I'm not incognito, it's just really hot)

I’ll be honest here – until I arrived in Korea I had never heard of Macau.  Maybe you haven’t either.  Until recently, the small territory was a Portuguese colony.  However, in 1999 it was handed over to China as a special administration region.  It’s a unique situation.  Right now – both Macau and Hong Kong have similar operating systems under a policy of “one country, two systems.”

So, here’s what that really means.  Currently, China is responsible for Macau’s defense and foreign affairs, while Macau maintains its own legal system, police force, monetary system and customs policy.  That means unlike China – US citizens don’t need a visa to visit Macau.  So, after visiting Hong Kong this summer – we decided to spend a few days in Macau.  We hopped on a jet boat for the 40 mile ride southwest.

What makes Macau so interesting is the mix of east meets west.  The Macau peninsula is on the Chinese boarder, and yet you feel as though you are in Western Europe.  Of course, that can be attributed to centuries of Portuguese rule.  There are more Catholic churches here than temples, although you will find both.  The architecture in the old town is distinctly European, and centered around the “Largo de Senado” or Senate Square.

(Senate Square)

(Are we in Asia?) 

The fountains, cobblestone, elegant colonial buildings, and especially the ruins of the 16th century church, Sao Paulo, will all have you feeling as though you’ve departed Asia.

(Sao Paulo -- only the facade of the church still stands)

Both Cantonese and Portuguese are official languages here, and that’s obvious by the dual signage everywhere.   Food is another example.  You’ll find the Portuguese influence in the popular “natas” or egg custard tarts.  Meanwhile, Chinese food can be found at every corner, and some restaurants specialize in the distinctive Macanese cuisine.  While the culture is a melting pot, the population is not.  Most of the people here are Chinese – either the residents or the Chinese tourists who show up for Macau’s gambling.  Yes, there’s a part of town that feels like a mini-Las Vegas with bright lights and ostentatious casinos.  For such a small territory, Macau certainly has a lot of personality.

(The Grand Lisboa is one of many casinos on the "strip") 

It’s been four months since my visit to Macau – and it’s amazing what being removed from your travel does.  The memories already start to fade into fuzzy feelings and impressions.  What I remember is that Macau was unbearably hot in July.  I did not perspire or glisten – I was sweating, soaking through my shirt.  It was an intense heat that I’ve only felt a few times in my life.  That prompted us to spend one of our days at a public pool situated right on the ocean.  Lounging in that water was blissful.  However, the bus ride getting there was stressful.  We had our eyes glued to a map trying to guess where to get off, as there was no signage or annoucements.

(Heaven in the heat -- we're right on the ocean, getting a nice breeze!)

I remember how small Macau was – it’s incredible and convenient to be able to see all the sights on foot.  I remember vendors hawking almond cookies and cured meats in the square.  They lured you in with free samples.  I remember the beauty of the sights at night.  Under the glow of lights, they had a different aura.  At the ruins of Sao Paulo, many people would just sit on the steps enjoying the evening and the cooler air.

(Macau aglow at night)

I remember the oddity of doing so much travel by jet boat.  At the end of our stay – we checked our baggage at the port and sailed directly to the airport in Hong Kong.  After visiting many temples and feeling like a tourist while others worshipped, I remember feeling at home in Macau’s Catholic churches.

(One of Macau's Catholic churches.)

(The famous A-Ma Temple, which is the oldest place of worship in Macau)

(Prayers written and hanging at the A-Ma Temple)

It was a short stop – we only spent three days in Macau, but I’m glad we took the side trip.  It’s a small place with a lot of personality and certainly worth the visit.  So, if Hong Kong is on your itinerary, make sure Macau is as well.

(I'll end with a few more pictures!)

(Fortaleza do Monte -- canons helped drive back the Dutch in 1622)

(Beautiful building details)

(Beautiful church details)