Visiting Karang’s Post de Santé

On Thursday May 22^nd, I made a trip to Karang to visit the Post de Santé. The staff there was very welcoming. They showed me around and answered my many questions. These conversations have helped me get a better sense of how the health care system functions in Senegal.

I had initially thought that patients bought medicine as prescribed from nearby Pharmacies. Actually, it turns out that those pharmacies are privately owned, and that they therefore exist independently from the Post de Santé. I’m told that the Post de Santé could never obtain medication from pharmacies, because it would be far too expensive. Furthermore, the Post de Santé isn’t allowed to distribute strong medicines, like those available at the pharmacies. Instead the Post de Santé obtains its medication from another health structure in Sokone. Medication received by the Post de Santé is distributed—not sold—to from the Depot des Medicaments.

From my interactions with 4 staff members, including the Infermier Chef de Post adjoin and the Sage femme, I gather that each consultation and subsequently prescribed medication have a fixed price of 2,000 CFA. In order to give birth at the Post de Santé, women have to pay 5,000 CFA. As of November 2013, children under 5 years of age do not pay medical fees whatsoever. The government has promised to pick up the tab for this age group, but has of yet failed to deliver, putting significant financial strain on the Post de Santé. The Post de Santé’s finances are managed by a Committé de Santé, which in responsible for both medical costs and employee pay. In essence, the Post de Santé relies largely on patients’ financial contributions; the State is pretty much absent here.

Like Alassane at the Case de Santé, the Sage Femme and ICP adjoin see an overwhelming amount of patients each week. They are well educated and hold prestigious jobs, yet they too struggle to make ends meet. They have been nominated to this specific Post de Santé by the State, so their extended families usually live far away. They are technically entitled to housing on Post de Santé grounds, but right now the Sage Femme has to live in the city, because there is not enough money to build her a place to stay at the Post de Santé. She was tired the day we spoke. The night before, the guard had come knocking at her door around 3 am—a patient needed to see her.