Insurance for the Insurance!!

Who knew we'd need so much insurance?

We have United Healthcare -- that covers us in the States, and technically, we can submit our medical bills from Ghana to them for 80% reimbursement. However, seeing the types of receipts we get here, it's unlikely that any US health insurance will accept them!

We have International SOS -- this is for medical evacuation in the event that we can't be treated here in Ghana...and basically, even though we are in the capital city of Accra, the likelihood that we could be adequately treated in the case of any real emergency is pretty slim.

So, as of today, we also have the services of WARA (West African Rescue Association). If you come visit, you too, can have there services (they'll charge you for a month, but at $50/month/family...not such a bad deal). What does WARA do? Well, they essentially take the place of all medical emergency services that would normally be provided by local ambulances and emergency rooms. They are a German company and provide German-trained paramedics and German-built ambulances and imported first aid equipment and supplies. And you can only register for their services if you are already insured by someone else!

The key is to bypass, at all costs, the emergency room of even the best hospitals here in Accra (Korle-Bu Teaching Hospital and 37th Military Hospital, in case you were curious). The state of medical treatement in Ghana is a sorry one. Payment comes first -- ALWAYS. Yes, even if you are bleeding to death, or otherwise on your deathbed. So, the paperwork must be completed, your cash must be handed over -- what??? you mean you weren't carrying 5 million cedis (approx. US $550) on you at the time of your unfortunate accident? What a shame! Perhaps you can call someone to go to the bank and get the money for you? Oh, it's after banking hours? That's OK, they can go to the ATM that will allow withdrawals of up to 600,000 cedis each with a max of 4 a day. Oh, wait, that won't cover your bill? I guess you'll just have to bleed to death! Or, call several people who will all be willing to withdraw their own cash for you...

Anyway, so WARA has accounts at all the main hospitals and clinics, so that if you show up in their ambulance with their paramedics, you won't have to deal with that bullshit--the hospital/clinic just gets their money directly from WARA. But the best part is that the WARA paramedics will stabilize you and basically get you prepped to see whatever specialist you need...and they have relationships with all the "best" health providers in the country...and yes, there are some good ones!

If you're out in the boonies of Ghana, they will come get you by helicopter or a "fixed wing". If you need to be med-evaced out of the country, they will work with your insurance provider (International SOS for us) to deal with all that. And, they will bill your insurance provider directly for their services. I was actually in their offices today, getting information and registering when they were mobilizing the helicopter to go get someone that had been in a mining accident. It was terrific to see how quickly they could get their shit together. It was horrifying to learn that the slowdown was actually the local doctor in the boonies who was taking care of the patient..."paperwork" would have to be done before they would release the patient to WARA!!

If you don't have an emergency, but you're feeling ill...they have a 24-hour nurse's line AND they will recommend the appropriate Dr. for you AND facilitate the appointment or house call!!

So, let's say you're driving down the Cape Coast Road for a beach weekend. Your driver is at the wheel and you get sideswiped by a tro-tro (local means of transport) and fall off the side of the road and you are all injured. Someone calls WARA (there are decals all over your car telling them to do so) and the ambulance or helicopter comes to your rescue...what happens to your driver? Is he just left by the side of the road since he isn't technically covered by WARA? Well, their answer is that their paramedics won't just leave them there without any attention. Their paramedics will do what they can there at the scene, but essentially, the driver will not be put on a WARA ambulance or helicopter or fixed wing. WARA will, however, call the local ambulance company to the scene--which sounds lovely, but I'm sure you can imagine how this plays out. I wonder if the local paramedics demand payment before hoisting you up into their ambulance???

WARA realizes that this is a sensitive issue. So, what they are doing, as far as community outreach goes, is training local paramedics and emergency room staff at the local hospitals. I guess with any luck, a local ambulance will come to your driver's rescue carrying WARA-trained paramedics!