Wednesday 18 March 2015

Our experience :: living in NC with a disabled child (part 3)


Hello! This is my third post in a series which attempts to lay down some context and tips on our family's personal experience of relocating from suburban Australia to la brousse in northern New Caledonia. My previous posts here and here covered school. This time I'm moving on to therapy and medical care.

The issues of therapy and medical care were top of mind for us when making the decision to come to the middle of the Coral Sea. Our son Jack needs regular physiotherapy to attend to his cerebral palsy. Although Jack has full oral control and communication skills, his condition means he can't walk independently and has poor limb and trunk control. He needs assistance with most activities including toilet and showering, mealtimes, transferring from lying to sitting to standing and in the classroom.

Allor...

Therapy and medical care

We have been extremely fortunate that we were recommended to an excellent kinisitherapeute in the nearly town of Koné. Dom and her holiday replacement Olivier have both developed a great rapport with Jack and their methods of working have helped Jack to develop confidence and strength. 

First day with the new wheelchair in Noumea

For us there has not been much difference in cost of physiotherapy. In Australia we would be covered by the BetterStart system (given the allocated allowance for therapy) for Jack until age 7; here our expat insurance allowance covers most costs as well. The main difference is that we've not been able to get hydrotherapy or group therapy here so we do without and occasionally get into the pool to give Jack a good workout.

Disability equipment, especially paediatric equipment, is not readily available sur le caillou so all specialised equipment we have such as walkers, wheelchairs etc have been sourced from Australia.

Fortunately we've not needed to seek serious medical aid for Jack in New Caledonia. We are lucky that Jack doesn't suffer from complications such as epilepsy or heart problems. However for school vaccinations, chest infections and the like we've visited the local medecin, or general practitioner in our local town of Pouembout. 

The system for most doctors here is first in, first treated. Local GP's don't have small armies of receptionists taking appointments and frowning when you are late; instead, you take a seat (if there's one available) in the waiting room and wait. And wait. And wait. (Take a book. A good one). You take note of who's in the room when you arrive and who comes after you and wait your turn.


Finally (after you've finished your book and read every trashy French magazine available and come to the conclusion that French trashy mags are just as much a waste of time as Australian ones) it will be your turn. You will be rewarded with a relatively cheap but professional appointment. I have never come across a doctor who didn't speak English and I've always been happy with the medical service provided.

Our lovely local doctor charges about 4800f.  Payment is directly to the doctor in cash or cheque (no credit cards, take your cheque book. Nearly every business accepts them and in fact they are extremely commonly used at the supermarkets. Good practice for the tricky spelling of French numbers. The only exception I can think of is service stations - cash or card only). 

The other benefit of the French medical system is that pharmacy medicines seem to be cheaper than those in Australia. When my daughter had a chest infection our local doctor wrote a prescription for paracetamol, a nasal spray, cough suppressant and antibiotic. I was alarmed, thinking the whole lot would probably set me back $80. Imagine my surprise when it all came to less than the equivalent of $20. Again, the service and assistance I've had at every pharmacy I've been to on the island has been excellent.


The only interaction we've had with the hospital system was actually for myself, for the urgent treatment of kidney stones. The doctor I saw was extremely proactive and made a special effort to contact the sonographer in the next town to make sure he was available (only one in the region). She then contacted the private hospital in Noumea to make sure they would be expecting me that evening. I was admitted quickly, immediately connected to an IV and in surgery the next morning. The actual hospital conditions left a little to be desired (another blog post but some funny moments) but the medical care of doctors, specialist, anaesthetist and nurses was efficient.

It's important to note that New Caledonia doesn't have a lot of specialist medical services. For example, I have known many expat women here to have their babies locally but not with the same level of hospital quality they might get in their home country. Those with risky or problem pregnancies have opted to return to their home countries in time to birth their babies to make sure they had adequate medical support.

There is a medical clinic in our neighbouring town of Koné which is also an emergency room. There is a small hospital which also has a maternity section in the small town of Koumac, about an hour and a half to our north. We haven't used either of these services so I can't personally attest to their level of specialist care. The major hospitals, public and private, are in Noumea, over 3 hours to our south. 


We returned to Melbourne for 3 months for the surgery and rehab following Jack's major surgery last year. He had planned double femoral osteotomies which we knew would be sometime during our New Caledonian residency. We have travelled to Australia every 3 to 6 months for regular x-rays and medical and therapy reviews for the duration of our residency here, which is expensive but was always part of our plan. We keep in contact with all Jack's medical and therapy team via email to provide updates or if we need advice. They have all been very supportive and enthusiastic in making our situation workable. We really have been very fortunate.

If you are planning to travel to or live in to New Caledonia it's worth knowing all of this, particularly if you have a pre-existing condition. Pharmacy medicines here have different names and even different formulations so don't expect to easily top up on your own medicine here. For example, one of my medicines is not available in the same formulation here so I top up in Australia when I return, however I find it more convenient to buy medicines such as children's paracetamol here as it's cheaper and available without prescription.

My account can only give an inkling of the therapy and medical care available. The therapists and medical staff we've interacted with have all been excellent which has made our time here so much easier. But certainly each family must make those consideration carefully and with action plans and insurance cover should something go awry. Then you can relax and enjoy the French tropical lifestyle.

My last installment will be about accessibility. À plus tard!




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