Barney

We adopted a dog in Moshi. His name is Barney. Barney is a mix of a Rhodesian Ridgeback and a Boxer. He’s gentle and fun and BIG. A good dog to have around the house at night. His original owners just returned home to Australia after a 6 year stay in Moshi. A few days after they left, Barney began to look ill. I thought he might be depressed, missing his real parents. He stopped eating and appeared listless. He usually eats anything and is full of life. The local veterinarian made a house call and after a few injections, I was hoping that Barney would be on the mend. He was not eating his usual rice and dried fish dinners so I made a stop at the store to see if I could get him a special treat to perk him up a bit. Looking through the aisles at the store, I noted a host of options for the discerning pet owner. A small store in Moshi, which clearly caters to the expatriot community, had at least 6 forms of dog food. A single can of food was about $2.25. A two weeks’ size bag of dried food cost about $22.00. The average family of four in Tanzania eats for a week for under $10. In the USA, $33,000,000,000 (billion) is spent annually on pet care products, including $14.2 billion on dog food alone. The GDP of Tanzania was about 49 Billion in 2007. The health expenditure per capita in Tanzania is about $50. I spent more on one veterinarian visit and some pet food than the average Tanzanian spends on health care in a full year.

Barney started to look more ill last night. He was panting and could not stand on his own. We lifted him in to the car and drove him to a German veterinarian who lives 17 kilometers away in Machame. The sun was beginning to set as we left Moshi behind. I had promised myself not to stray far from Moshi at night: No street lights, uneven, unmarked pavement, a host of pedestrians and animals on the shoulder and huge trucks with variable safety features. After a ride part way up the foothills of Kilimanjaro, we arrived at the vet’s home and coaxed Barney from the vehicle. He was able to walk to a small clinic down the hill from the doctor’s home. The lab was well equipped with a microscope, hematology and chemistry analyzers and a decent operating table and lights: The envy of many hospitals and health centers in the region. The doctor was efficient and courteous. Not once did he ask how I would pay. It was assumed that I could pay and that I would pay. I thought of the countless patients in hospitals throughout Africa that night who were deprived of testing and treatment because they could not afford to pay. My newly adopted dog was receiving better care than many if not most human patients can get. Was it right to expect treatment for my dog when my patient could not receive the same? Should I allow Barney to languish ill and go pay the hospital bill for the patient in room 25? Would there be some perverse justice in that? This is not a moral dilemma unique to Africa. The 50 million uninsured people in the US can attest to the difficult decisions surrounding healthcare in the richest country in the world. The relative scale of the moral dilemma in Africa, however, is, simply put: HUGE