Two Tier Cake

It’s every new expats biggest dread when plonked into a new country, a sick kid and an unknown health system.    Sixteen weeks into my new expatriation to Abu Dhabi, with two sick kids, I gaze down at “check out doctor / hospital” which was still visible despite the several coffee ring stains on my to-do list.    There it was right between, “get a postal address” and “gas barrel – where to buy?”.  The postal address and the gas barrel were sorted but the health check was overlooked.  I had adopted the long finger approach and it was now biting me on butt.  Ouch!

Emigration is all very well until there’s a hitch and living  thousands of miles from family and friends listening to the cries of sick children begins to drown out the novelty of living abroad and the reality that medical attention is required urgently nag at your conscience like a tap that continues to drip.  Ok things weren’t really that bad, it was tonsillitis and a sore toe, I had to be brave and join the queue in the bottom tier of a Middle Eastern health system.

I had a vague understanding of the health insurance we held, it was compliments of the company and I didn’t hold out much hope.  Having spent my life on the top tier of a two tier system in Ireland, I had grown accustomed to having the advantageous viewpoint of being able to peer down on my peers in the public system.  The growing annual health insurance bill and the complicated claims system along with the large excess all added to my confidence in my position in the Irish healthcare system. I was at the top, paying a fortune and receiving standard care. I had always associated paying high prices with good service so this arrangement suited me.

Nervously, I presumed that as there were no extortionate bills arriving in my new P.O. Box that I was in the bottom tier in the Abu Dhabi health cake.   Walking into the only hospital I knew in Abu Dhabi, I dubiously clutched the insurance card issued by the company only weeks before, I presented myself to the receptionist who pointed me in the direction of the Emergency Room.   Entering the strangely ordered clinic, we sat in line, iPods, pads, touches and phones in hands, ready for the usual mammoth wait associated with the Emergency department.   But guess what,  we were next in line,  this kind of efficiency took me aback a little, but my standing in the waiting room didn’t last long!  The doors burst  open and in walked two armed guards, paranoia crept in as I wondered what I had done, were my shoulders exposed?, had I parked the car in a reserved spot?, they spoke gruffly to the receptionist and signaled to the treatment area, the doors opened again with another two armed guards walking either side of a tall Emirati.  The image of this tall man with his ice white thobe, ironed crisp and equally starched headgear, flanked by two immaculately turned out armed guards, almost hovered past the waiting area and straight into the treatment room, leaving the rest of us Joe Soaps and Josè Esoapsas stare openmouthed in his midst.  I could nearly feel his importance smattering my fitflops, like a Maserati splashing the people in the bus queue.  This was truly the top tier.   

Forty five minutes later, after a consultation with A G.P and a General Surgeon  , talks of x-ray, a visit to the orthopedic department and a call back visit left me feeling weak and my sweating hand stroked my friend, Visa for reassurance, sure that my flimsy health card wouldn’t be able to stand up to these costs.

I shuffled towards the counter, gingerly handing my insurance card as I clenched my back teeth waiting for the teller to break down laughing at the very notion.   “That will be fifty dirham ma’am”,  the equivalent of ten Euros!   I confirmed that this laughable cost was for all the consultations, treatments and prescription, and she confirmed that yes indeed it was and included in that charge of dirham was a free call back to the GP within one week.   Turns out that during the boom years the United Arab Emirates invested over 475 billion in their healthcare system  – what a novel idea.   Leaving Al Noor Hospital , my charges well cared for and the charge low, I decided that this wasn’t the second tier I imagined, it was a different cake altogether.


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