Internationals disappointed in ER
A cough isn’t enough
Door Ingrid Ştefan
By Ingrid Ştefan
Ingrid Ştefan
After two days of throwing up despite not eating or drinking anything, Yeva Nikonenko was desperate. She urgently needed help, she felt, and so the second-year international law student went to the emergency department at the UMCG.
‘I threw up like eight times before a nurse came to me. She said I should know this is only for severe injuries’, she recalls.
After making clear to the nurse her continuous vomiting was pretty serious, Yeva was admitted and spent the next eight hours in a hospital bed with an IV, waiting for her test results. She was diagnosed with a severe form of gastritis, for which she was recommended paracetamol and cola.
‘I was gonna lose my shit at that point’, she says. ‘I had already tried all those basic things, of course. I was there because it didn’t work. There was no point in going to the emergency department. I could have just stayed home and done the same thing.’
Yeva still has to vomit a few times a week, although it isn’t as bad as before. ‘I’m obviously still sick, but I’m letting it be for now because I don’t think I can get help for this in the Netherlands. I’ll just wait to go back to Georgia’, she says.
Gatekeeper
Ask around in Groningen and you’re bound to hear other stories like Yeva’s, of internationals turning to the hospital with a medical situation and feeling like they’re not getting the proper care, or that they aren’t being taken seriously. What is going wrong here?
According to Bas Bens, an emergency physician at the UMCG, one of the problems is that international students are coming to the hospital directly when they should be turning to a GP.
I don’t think I can get help for this in the Netherlands
In the last few years, he has seen a rise in internationals coming to the emergency department. And while in part that is to be expected, since the number of internationals in Groningen has grown, he also feels this has to do with cultural differences. ‘In many countries, the GP doesn’t act as a gatekeeper’, he says. ‘People are used to going to the hospital for a lot of issues.’
Bens doesn’t blame them for doing the same here. ‘For internationals, it can be difficult to understand how the Dutch healthcare system works.’
Even so, he says, many have at least some idea of how things work here, and only turn to the emergency department after they’ve already tried finding a GP. ‘Those often have a waiting list nowadays, which creates difficulties in accessing primary care even for Dutch people. If you haven’t solved that as a country, of course people will just come to emergency care. They’ve tried all kinds of things already and are pretty desperate.’
Peeling skin
That was certainly the case for Ilinca Padurariu, a first-year international relations student, when she started struggling with severe irritation of her facial skin last October. After a consultation via email, StudentArts wrote her a prescription for antibiotics, but by the time she discovered it was a type she was allergic to, the practice was closed for the weekend.
Since it was the middle of the exam period and now both her face and her neck were all itching and peeling off, she decided the hospital was her last resort. She didn’t know yet how exactly emergency healthcare works in the Netherlands.
Of course people will come to emergency care if they can’t find a GP
She got seen by the emergency GP at the Martini Hospital. ‘I told her I thought I had a staphylococcus aureus infection and just from her attitude, I felt she was not taking me seriously. She said it was possible, but that I also might have scarlet fever. She advised me to go back to my GP.’
Although she did eventually agree to give Ilinca a different antibiotic, it turned out to be the wrong one: Ilinca did in fact have a staphylococcus aureus infection, which was resistant to the drug. ‘My face had gotten so bad by that point that a random guy came up to my friend when we were in the library and said that he was going to pray for me.’
Ultimately, Ilinca received the correct diagnosis from StudentArts, but that was after almost a month of trying to navigate the healthcare system.
Chat
While there’s never a guarantee that students will get what they came for, Bens says, they will always at least get a chat at the emergency department, even if it’s a minor problem. ‘We’ll ask about their GP, whether they’ve had issues finding one or getting an appointment, and take it from there. You can’t let them leave empty-handed’, he explains.
What makes things more difficult for internationals is their lack of a network of people to help them, Bens feels. ‘You are alone and worrying yourself sick. Many start looking things up on the internet and usually that doesn’t help.’
That’s why he thinks it’s important to see everyone who comes to the hospital, even though it puts pressure on the emergency system. ‘My idea of an emergency is probably completely different from yours. In general, the public will decide what’s emergency care, whether we like it or not, because they will ring or they will come by and we have to deal with that’, he says.
Even so, for some internationals, it can be hard to get their point across to the emergency staff. ‘There is always a language barrier, which means subtle signals will be lost’, Bens says. ‘Living abroad can be frustrating in these kinds of situations.’
Ambulance
‘Frustrating’ is a mild way to put it, says Raul Robert Nedelcu, a student of international and European law. One night last September, he got a panicked call from a friend. A mutual friend had just collapsed at a shawarma place at the Oosterstraat after consuming a lot of hash and alcohol.
The operator said it was just another student who had too much to drink and smoke
‘When I got there, he was lying slumped over the table with his eyes closed and one hand twitching. He didn’t move or respond to my questions’, Raul recounts. He did the only responsible thing he could think of and called for an ambulance. But the woman on the phone gave him the brush-off. ‘She said it was just another student who had too much to drink and smoke and I should take him home.’
A Dutch passerby who was a medical worker herself came to his rescue. She offered to call the ambulance herself, and this time, they sent one immediately, Raul says. ‘They asked her to check his temperature and his pulse and they actually gave her instructions on what to do.’
Although the evening ended well for Raul’s friend – the ambulance came within ten minutes and he received treatment from the paramedics – Raul lost his trust in the healthcare system. ‘I don’t feel safe here anymore. If I have an emergency, I don’t think I can call the ambulance’, he says.
Recommendations
Things can go wrong sometimes, Bens says, but he stresses that it is important that students do seek help if they need it, first at the GP office and then at emergency care. ‘We see everyone, and we won’t send anyone out without some kind of follow-up.’
While navigating the healthcare system might seem like an impossible mission for many internationals, Bens does have a few recommendations. ‘Find yourself a GP when you arrive here. If you’re healthy, you think you might not need one. But don’t wait until you do’, he says.
And, he adds: ‘If it’s not an acute illness where life or death is at stake, it’s for GP services. They’re there to help, and the system works well generally.’
On the website of the UG you can find more information about healthcare in the Netherlands.