John is a 63-year-old retired civil servant living on a pension in his rural village. We follow a conversation that he has over the phone with his daughter who lives in the city.
John: Hello, hello, how are you?
Daughter: Hello Daddy, I’m good, what about you?
John: I am fine. I just came back from the private health clinic.
Daughter: Why, dad? You know there is COVID-19, you should not mix with crowds unnecessarily
John: It’s just that I felt a bit unwell and wanted to get my blood sugar and blood pressure taken. But I had to walk to the clinic, which is 8 km away.
Daughter: But that is far? What about the hospital which is nearer?
John: The main hospital is now focused on COVID-19 and not taking any other patients. And taxi fares have hiked since the lockdown started; so, I decided to walk, because I used the money that I had for my blood pressure medicine, and the other bit that’s left I’m saving for food.
Daughter: But you have your own blood sugar machine – why do you need to go to the clinic for that?
John: Oh yes! The glucose strips that you sent would have served me for a year, but I shared with your uncle Ray – he was also diagnosed with the same problem. I wish they were available here – but even if they were, they are not affordable on our pensions.
Daughter: Oh, sorry dad, I didn’t know the strips were finished, I will send you some through courier since we can’t travel there. I’ll buy for uncle Ray also. They sell 50 strips for $20 here.
John: You know aunty Aggie also retired from nursing, and she helps many people here in the village and at the local dispensary. I was thinking if only she had a blood pressure machine, many people here would not need to make the trips to the clinic or hospital.
Daughter: Oh yes, that actually makes sense… maybe you should talk to your local health authorities or make the suggestion at your next community meeting – who knows, it can become a reality …… anyway Dad I have to go…. I will let you know when I dispatch the parcel.
John: Bye dear, and thanks! We will wait for the blood sugar strips.
What we gather from the conversation:
- Many retired and older persons are home with chronic conditions like hypertension and diabetes that need simple but regular monitoring. COVID-19 puts them at risk in several ways;
- Limited movement has made travel to health facilities difficult for management of chronic conditions,
- Related price hikes for public transport has made travel unaffordable,
- Many older persons are experiencing heightened levels of loneliness and isolation as their loved ones cannot visit them to protect them from further risk and exposure to coronavirus.
- The designated COVID-19 centres are no longer accessible to people whose mobility is limited access.
For me, this is what UHC looks like for older persons:
Empowering older persons to self-care and monitor their health through enabling access to gadgets like blood pressure machines and glucometers. I picture each village equipped with at least one blood pressure machine and a glucometer that patients can access to monitor and manage their conditions and symptoms.
This will avoid unnecessary hospital visits and exposure to other diseases like COVID-19, save the patients money and time, and free up the health facilities to attend to cases that cannot be managed from home.
What does Universal Health Coverage look for you?
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