"Bien grande!"

That's what my dentist kept saying this afternoon but I couldn't open any wider. LOL Despite what some say about the size of my mouth, for dental purposes it could apparently stand to be a little bigger. Each Friday for the next three weeks this is what I have to look forward to -- my sweet dentist saying "Bien grande, Kim, bien grande!"

BTW, my dentist back in the U.S. had a small army working for him. There were dental hygienists, lab techs, dental assistants, a receptionist, bookkeeper... He always had an assistant right by his side, handing him tools and mixing up concoctions. My dentist here is a one-woman show. She answers the phones, handles the paperwork, does all the dental work BY HERSELF. Her entire office would fit into one room in my old dentist's facility. There are 4 chairs in a "waiting area", a not-very-big desk with two chairs in the "office", and one dental chair with accoutrements in the room where she actually practices dentistry. Maybe it's because she's young and just starting out. But if she chooses not to expand, I don't think that's a bad thing. What she's doing, and how she's doing it, works for her.

Anyway...

While I was at the dentist, Ivan was at a clinic having out-patient surgery on his knee. He's had problems since a bad fall while doing construction work in November of 2007, and it was getting worse. Sorta looked like he had two knees on one leg. LOL Sorry, hon, but you gotta admit, it did look a little funny.

Anyway, he went to the doctor two months ago and they aspirated the cyst that had developed but it immediately filled back up again. So today they removed the cyst. Which, contrary to the sonogram, was not just on the surface but had burrowed into a tendon, requiring much cutting and scraping today. Not an image I like to think about.

Nor is Ivan's description of the operating room. Dangling wires obviously repaired with electrical tape, old --and RUSTY -- equipment, and although we're assuming the room was clean, it had a rather dingy appearance. Welcome to nationalized healthcare.

The room is no reflection on the doctor though; Ivan's very pleased with his work.

It's been interesting to note some differences in medical care since we arrived. I want to preface this by saying: it's not necessarily BAD, just DIFFERENT.

Even though there is nationalized health care, many people have an auxiliary insurance so they can go to "private" clinics -- where the doctors might actually have tongue depressors and cotton swabs.

The process goes like this: you have to physically go and pay your monthly health insurance premium -- no sending in a payment by mail -- and then each time you have anything done, you have to take the doctor's order to the same office where you pay the premiums and get it approved and pay your percentage of it, then take that slip with you to the doctor or hospital. If it's just a regular doctor visit, you don't have to have a doctor's order; you just go to the office and tell them you need to see the doctor and pay your part (approximately $4 for a regular visit).

Yes, prices are much, much lower. What we paid for Ivan's out-patient surgery is less than we'd pay for an office visit to the specialist in the U.S. (And remember, for that price we get the dangling wires and old, rusty equipment.)

While facilities and supplies might be lacking, doctors and nurses here are well trained and very professional. We've been extremely happy with the quality of care. Not that I want to spend any more time than necessary with them.

And what we have is so much more than a lot of others have in less developed parts of the world. I was reminded of that this week when the daughter forwarded a link about the ministry that "Uncle" Francis has in Uganda. [This brought to mind the hospital in Uganda that was, by Ugandan standards, quite nice but lacked certain amenities that Americans were used to...like windows (or even screens) in the window openings, running water and indoor bathrooms...]

Francis was interviewed last year by Daryn Kagan for the work he's doing: helping others acquire wheelchairs. We know Francis; he was also on staff at Kasana Children's Center the year we were there. He's got a big, tender heart and I just know you'll enjoy "meeting" him!