Trading bankruptcy for health
How much poverty would you risk for your health?
Toward the end of grad school, I found myself across a cafeteria table from a Malagasy colleague named Jean Luis. I’d spent the last few months buried in the final chapter of my dissertation, whose entire premise had been prompted by the story of another Malagasy man named Sambany.
In 2015, Sambany, a rice farmer in his 60s, presented to the surgeons on Mercy Ships in Madagascar. He had a tumor larger than his head.
I’ve told Sambany’s story many times before, including in The New York Times, because in his story lies the incarnation of basically every barrier a surgical patient faces. As I wrote in that op-ed,
For [three] decades, he had sought treatment at 10 hospitals, most of which lacked surgeons. He was ostracized, then physically unable to work. His family had to sell a rice field just to pay for the cost of getting to the hospital (the surgery itself was free).
That last line had become the central question in the dissertation chapter I was writing: Was it worth it?
And not because anything went wrong in the surgery—his tumor was successfully removed, and he recovered well. Instead, I’d become fascinated with the decision Sambany and his family made, to sell a source of…
