DALEY’S VIEW: A Health Care Lesson Courtesy of a Clinic in Morocco

Use of emergency rooms is a much-debated part of the U. S. health care system. I recently had the chance to experience what it is like going to one of these places with a medical emergency – and in a place where they did not speak my language.Daley Morocco photo 110

I went with friends on a trip to Portugal and Morocco to take a winter vacation and sample the local cuisine. We spent 10 days in and around Lisbon and then flew to Morocco, destination Marrakesh.

We flew there via an eight-hour layover in Casablanca and found the chance to visit the city irresistible.

We ventured into the produce market where I purchased saffron and fennel seed for a fish soup. There are lots of poor folk in Casablanca and their market is pretty basic. When I was accosted by a man who was coughing, spewing germs, and grabbing the hand of the “generous American” I politely fled in terror to wash up.
However, there was no place to wash up, no hot water, no soap. I suspected I was in trouble.

Two days later, in Marrakesh, I woke with a soreness in my lungs and a mild fever. Ever the intrepid traveler, I pushed on. Yet the apartment was unheated, the desert nights vividly starlit, but bitterly cold, and the meager hot showers provided little relief from the Frigidaire.

I hovered under blankets while my temperature plunged and rose. I have aged into a semi-ambulatory 70 years, but never have I encountered a disease that sucked the energy out of me as this did. I went hunting for the hospital emergency room. Problem. There is no hospital in Marrakesh. There is no emergency room.

The French ran the place for a while but apparently developed no medical infrastructure for the locals. Yves Saint Laurent lived there but seems to have had the wherewithal to attend to his medical needs without a hospital.

The U.S. Embassy web site lists a clinic in Marrakesh where they speak “some” English. I staggered in and mumbled the word “pneumonia,” which I had concluded must be the disease that was pounding at me with such power. The receptionist pointed to the chairs as an invitation to sit.

Four minutes later (no exaggeration) a doctor in traditional Moroccan dress appeared and led me into an office. He was assisted by two women nurses.

They had no x-ray, but they thoroughly investigated the vital signs, took the old guy’s EKG, probed and listened. The only English words I heard in a 45 minute encounter were “sit still,” “asthma,” and “allergies.” I was being told not to move during the EKG, asked if I was prone to asthma or did I have allergic reactions to medications. Whatever else they were saying was in the local Arabic and now seems superfluous.

I filled the proffered prescriptions in a local pharmacy. Not being conversant either with Arabic or French, I have no idea what these medications were. After dosing myself with these mysterious drugs and sleeping four hours, I awoke with the announcement: “I feel better.”

Debilitated by this ordeal I staggered home through a return to Lisbon, a flight to Newark (whew), a hop to D.C., and three days of semi-consciousness.

I have good insurance here in the U.S. but it was irrelevant in Marrakesh, useless and unnecessary. The visit to the doctor cost 120 dirhams – $14.62 – and the prescriptions exactly the same. The whole thing cost me about $30, doctor and prescription.

But the education was worth a fortune.

What would have happened to me had there been no place to go? How many of you know someone who has no place to go?

We have this insipid debate in the U.S. about who gets covered and the cost and who pays. Those who make their living by committing ideological assassination, condemn the use of the emergency room but damn the Affordable Care Act for providing insurance and alternatives that offer the hope of preventive and primary care.

In Marrakesh I met a doctor in 4 minutes, my life was spared from this killer disease for $30.

What if they spoke no English at all? I was like a Somali woman in an emergency room stateside. I think I got much better treatment than she would get and for a fraction of the price.

And I have a lifelong memory from my trip to Morocco. Thanks both for the cure – and for the lesson.