Medical treatment

Peace Corps Online: Peace Corps News: Headlines: Peace Corps Headlines - 2003: July 2003 Peace Corps Headlines: July 5, 2003 - PCOL Exclusive: A Volunteer's Courage : Medical treatment

By judy brookhiser on Tuesday, July 08, 2003 - 10:03 am: Edit Post

I was medically evacuated from Gambia, Africa August 8, 1974 (the night Nixon resigned). I had been in Africa for one year and been very healthy when had a bout of dysentery in Dakar followed by conjunctivitis and then high fevers. Was in country 2 weeks before medically evacuated to George Washington University Hospital in DC and diagnosed with Reiter's Syndrome. Afte a month at George Washington was transfered to hopsital near home in Iowa.

There were some minor problems while in DC. Peace Corps nurse called and always promised to come, but never appeared and that was ok. When I had opportunity to be released to Iowa, she was supposed to accompany me on trip, but at last minute said she was on vacation and my mother had to return to DC and accompany me home to next hospital.
I was in the hospital over 3 months total and Peace Corps covered all bills. They assured me that bills related to this disease would be covered throughout my lifetime.

I had a few years of remission after recovering from initial onset. However, with arthritis and iritis as the primary ongoing conditions, I have spent 1000s of dollars out-of-pocket, even though I have been covered by health care insurance during most all of the past 30 years, which has paid for a significant portion.

At different times I have tried to file the medical forms required for reimbursement, but even with a doctorate degree I have found these impossible to complete successfully. When I have sent things in there has been an endless barage of more things to do, that has never resulted in successfully filing claims.

Anyway, the Peace Corps did very well with initial illness and recovery, but has not been helpful since that time.

By Rick Rhodes on Tuesday, July 29, 2003 - 4:29 pm: Edit Post

I found the nurses and the rest of the Peace Corps Medical Staff in Washington DC to be outstanding. While I was vacationing back in the States, they probably saved my life with their long distance medical and logistical advice. And while I was recuperating in Washington, care continued to be most conscientious and correct. However once the "medical ball" was passed from Peace Corps/Washington to Federal Workers Compensation Programs (in about 45 days), it is been quite a different and disquieting situation.

After 17 months in Ecuador, I was medically separated in July 2000. Three medical conditions were approved: 1) falciparum malaria; 2) a torn right shoulder rotator cuff tear; and 3) sore knees. The malaria was contracted, in part, to PC Ecuador prescribing choloquine instead of the more potent larium --what the CDC recommended for Ecuador. For a while, I was placed on Federal Worker's Comp. I even voluntarily got off WC to take a lower paid sales job. I've likely fully recovered from the malaria and the torn shoulder rotator cuff. But the knees are another story. In December 2001, a Worker's Comp contract doctor saw me for less than two minutes (and for the three conditions), stated everything was fine, and if I had any knee problems (and I sure as heck did!), they were due four arthoscopic knee surgeries performed 10-to-20 years prior on the right knee. He saw this in an old report...nor did he ever asked me about the current condition of either of my knees.

Since leaving the Peace Corps, I've had four knee operations: scopes on both my right and left knees, a total knee replacement on the right knee, and six months later --an unsuccessful attempt to rectify the painful 28 degree permanent bend in my right knee by the Veteran Administration (VA). The VA is my only health saftey net since nobody would offer me health insurance on account of my post-Peace Corps knees.

To date, I need (and have needed for seven months) either a cane, crutches, or a walker just to get around. I have had extreme difficulty landing employment in this condition. I also need painkillers for the right knee. I have produced solid medical reports by an orthopeadic surgeon who stated my knees were fine before I entered the PC in 1999, and by another orthopeadic surgeon who stated especially the right knee was totally shot after the Peace Corps. Federal Workers Comp, in their four denial letters of my appeals, have hardly acknowledged these profesional medical submissions --and by two doctors who knew my knees quite well (before and after the PC). Instead Federal Workers Comp has taken out of context the statement by one doctor who saw me for less than two minutes. For more than the last year and a half, Federal Workers Comp has denied my appeals to get my knees fixed. Unfortunately, and at my age during this recession, and with my crippling condition, I have been having great difficult re-entering the workforce (and preferably somewhere with group health benefits). And I had held a federal job in Washington for 16 years prior to volunteering as a PCV. I don't know what else to do!

By Hans Lechner on Wednesday, July 30, 2003 - 5:35 pm: Edit Post

I was an environmental education volunteer in Jamaica from 1999 through 2001. I was very active with 4-H school clubs promoting environmental projects and activities. I lived in a small community outside of Mandeville where I was a member of the community club and the local cricket team.

One month before my COS I hyper-extended my knee during a cricket match. The pain was extreme and I had difficulty walking or even supporting my weight. The next day I saw a local doctor who referred me to an orthopedic surgeon. The orthopedic surgeon suspected a torn later meniscus and possible ACL damage and recommended an MRI. I relayed all of this information to the Jamaica PCMO's. The PCMO's decided that it would be in my best interest to finish out my service and wait until my return to the U.S. to have the MRI.

I was reluctant to agree for fear that my case would be shoved aside once my service was complete. The PCMO's assured me that I would be well taken care of as soon as I arrived home.

There was only a little delay in having the MRI after arriving in the states. Prior to my departure from Jamaica the PCMO's had requested and approved a follow-up exam from a family physician. That means that when I got home I had to get another reference from my family doctor in order to go see an orthopedic surgeon who suspected a tear of the lateral meniscus and possible ACL damage and recommended an MRI. The MRI was approved by Peace Corps Washington and performed about two weeks later.

The orthopedic doctor in the states didn't detect and sever damage from looking at the MRI. He felt that a scope might be necessary but wanted to try a vigorous physical therapy regime first. It was after that when everything went to hell.

My case was given to the Department of Labor. While my orthopedic surgeon wanted me to begin P.T. immediately, DOL/OWCP took close to one year before approving any treatment. During that time I made numerous attempts to contact my caseworker at the DOL - whose existence I highly suspect - who NEVER seemed to be in his office and never returned a phone call. Also during that time the insurance coordinator at the orthopedic clinic made numerous attempts to contact my caseworker as well. Her results were the same as mine. I contacted returned volunteer services at PCHQ and was told that there was nothing they could do for me now. Itís a DOL matter now.

Finally, nearly a year after my MRI, I received a letter from the Office of Workers Compensation stating that I was approved for treatment that did not involve surgery. Of course this wasn't quite good enough for the surgeon's office. They wanted some document or more assurance that OWCP was going to pay for treatment. I was now back where I started. My caseworker at the DOL could not be contacted and I was still without therapy.

It's now two years after my COS and the injury to my knee. The only physical therapy I have received is the lifting and swimming I've done on my own. My knee still gives me pain regularly and I have to limit many of my athletic activities. I gave up trying to receive the medical treatment that the Jamaican PCMO's had promised me and that I felt entilted to. I suppose that all the red tape and bureaucracy at the DOL are designed for that purpose. However, seeing all the other stories told by RPCV's gave me some new hope that something may someday improve for volunteers that come home injured.

My Peace Corps experience is the best thing that I have ever done. It's unfortunate that I now have resentment and bitterness toward the organization. Maybe universal health care in the U.S. would help.

By james burmester on Saturday, August 02, 2003 - 8:07 am: Edit Post

I found the medical care of Peace Corps the Gambia to be better than good. When I had Malaria in 1999, I recieved the best care and recovered quickly. My heart and thanks goes to Barbara Bah, who is not only a fantastic doctor, but a wonderful person. She went beyond the duty of the doctor and put many a doctor in the states to shame. Even when I was suspicious of Mephloquin, she provided all the data on the study of Mephloquin, and provided the other options to mephloquin, their benefits and weaknesses. My thanks once again goes to PCTG staff. They have far more bravery, worth and talent than any US soldier. We Peace Corps Volunteers deserve the money and support that is going unfairly to the US military. A military that now only props up the corrupt and greedy. The peace corps was a start, but we need to get our priorities straight in this country

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