She thought she could manage it. A retired American nurse with few savings but a small US government pension. Her pension barely kept her above the poverty line in America and she was estranged from her one remaining son, and so she made the choice to move to Thailand alone, where retirement was easy, cheap and the weather was much better. For a while, it was a great move.
As so often happens in "expat" locations, friends moved on, died, moved to Costa Rica and Ecuador. Her world grew smaller.
Slowly the cheap, cheap lifestyle of 15 years ago evaporated as Chiang Mai is rapidly becoming the "Go To" new Asian city. Prices relatively have doubled in the last 10 years while her already small pension has stayed the same. And meanwhile the requirements to remain here have become considerably more restrictive and expensive, forcing her to purchase a "grey" visa where a bit of "tea money" under the table enables a visa to be issued by a mildly corrupt but pragmatic immigration official without the requisite funds being held on deposit in the bank.
She managed to balance it for the 15 years I have known her....
Image by Arek Socha from Pixabay
and then this week it all fell apart.
It started for my now 76 year old friend with what she thought was indigestion; after 3 days the pain became so unbearable she ended up at the emergency room of the cheapest (missionary run) private hospital we have. She had a strangualted bowel and an already very substantial abdominal infection which required major surgery.
She has no health insurance.
The christians put the money issue first, didn't treat her and transferred her to the cheapest Thai government hospital we have: the Nakorn Ping Hospital which has a designated IDP wing for refugee people, displaced people and for people with no money. Here - unlike in the US or the christian missionary hospital - you are still treated first and the bill managed (somehow) later.
It's not a glamourous hospital by any means and she was placed in a large ward of 60 female surgical patients - the beds 1 meter apart, little privacy and a decor reminiscent of 1962. The nursing staff speak little English and my friend had never bothered to learn Thai. But it was clean, her infection was treated immediately with IV drugs and she had major surgery removing 3 feet of damaged bowel.
And then the "fun" started.
- The US Embassy officially doesn't help US citizens staying here, other than arranging repatriation for them to the US with a "low cost" loan which DOES have to be repaid from that still-the-same pension. No where to go back to, and no money to start over with rental deposits etc, not to mention the new repatriation loan repayments? Not their problem - they will asign you a welfare worker. That's it.
- The local US-centric Expat Care Group has a new policy of only assisting those more financally stable people who have a squeaky clean 100% white visa;
- The bill for the surgery and immediate 2 days of post surgical care came to USD $3,200 - a HUGE amount relative to local salaries (equal to 6 months of local median working class wages) and her non-existant ability to repay.
Living only 10 minutes from the hospital which I know well through my refugee work and knowing that this lady doesn't speak Thai, I popped in to see if I could assist. And thus became the official translator, financial negotiator and quasi social worker.
It's been a confronting few days.
I managed to get her discharged from the hospital with only a small percentage of her hospital bill paid (around 30%) with a written contract for monthly repayments;
She (unfortunately and solely for cost containment reasons) chose to be discharged far earlier than I think was wise, and still had seepage from her very large abdominal wound;
Together with a retired lawyer friend of hers who normally also lives here but is currently stranded in the UK, we did an urgent global crowd funding. In 4 days we have raised MORE than the hospital bill - we have enough to cover the daily wound dressing and transport costs to the clinic for that, and a little extra for her follow up xrays and stitch removal.
Tonight, in between blogging and being a solo mom, I'm making barley & vegetable soup for her, and a quiche, since she can barely stand and is needing to eat very bland, not spicy food.
In between it all these last days, I have vascilated between an elated "we got her this time, and she will be OK!!" and a very despondent "oh crap - this is the beginning of a slippery slope towards a less than easy death."
On the way home from the hospital, we spoke frankly about her wishes if she died in the night and how much the cheapest possible funeral here would cost. She knows I can and will arrange it for her. At least I'm clear that she'd be OK to share her cremation with the local deceased dogs and cats if it made the process cheaper. 😆
For now, she has what she needs, mostly. She's in a lot of pain and the take-home pain meds are not as good as the IV morphine, for sure. But she has her cat and her little garden and some sense of a decent, modest life that she has chosen herself.
I can't help but think about SO MANY PEOPLE I know, working "in the system" who think it will all be easy when they stop working becasue they have a pension coming.
I have news for you: it's unlikely to be enough for even a basic life. If you ever get a pension.
We who choose to exit the maze and step of that ratty, wonky treadmill need to be prepared; to have serious contingency plans and also be prepared to go without surgeries and the expected western health treatments. We need to be healthy, strong and working towards alternate social and health care models. We need damn fine friends, and we need to cultivate, treasure and support them. We need community, and care options for people who are frail or sick. Our homes need to be designed with a spare room for an aging auntie or uncle in need. We need to be prepared to give to a seemingly endless stream of incoming crowd funding asks, for people like my friend.
I didn't have cash to support my friend this week, but I translated, cooked, drove, organized and haggled the hospital bill and discharge for her in Thai. I don't count this lady as a particularly close friend - in the last 2 years I have seen her socially only twice. But I am tonight having a renewed sense of what it means to have taken the red pill and what that might mean for so many of us in the years to come.
I can only say this:
- don't rely on the idea of a pension, from anywhere;
- build alternate, autonomous revenue sources that will still deliver when you are much older;
- make your health a serious priority, and not an afterthought;
- build community wherever you can, because you will need it.
Creating space and time to care for someone you're not very close to, and don't even particularly like? It's a commitment to the idea of community, and to the idea of One Love - that we are all fragments of the same whole, and that we are all just walking each other home.
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Oh, such an important question: pension and retirement. It seems like the older you are the more imminent it is, but the younger you are the more questionable it is whether you'll get ANY pension at all, not to mention treatment of any kind. Having savings may seem nice, but no matter how much they are (unless they're in the Gates-Bezos ballpark), a serious situation could eat them up right away.
I think we've mentioned this a few times already: what makes a huge difference is the community. If there are people around, like yourself for this lady, it already alleviates the situation immensely. Sure, the physical pain and financial worries are still there, but by seeing you helping her at least she knows she is not left alone with all this.
I thought that too - that no matter how much we squirrell away, it is unlikely to be enough to PAY in the western hospital system, or for care. I'm becoming increasingly mindful for the need to invest TIME & FEELING into community, and also to be prepared to die. Prolonging life at huge cost is a western idea. I will never forget a Thai uncle who was given 4ish weeks to live with kidney failure. He chose AGAINST dialysis (which would have bankrupted - if there was such an idea in Thailand - his children and grandchildren) and chose instead to use herbs and to allow me to care for him naturally. He lasted for 3 years with little pain, and saw two more gandchildren born. A delightful and generous man, at peace with himself and his eternal spirit.
My daughter's great grandma too, lived at peace with her mortality and expected little. She died at 98, and had farmed actively till 2 weeks before her death, living alone in a rickety bamboo house.
Haha - yes, a much younger me and my daughter receiving the traditional blessing from her many years ago.
Thanks for making me think. It IS all about the community and the love we give.
!ENGAGE 25
The three of you are so beautiful in this picture!
And I love the case of the uncle who chose against dialysis and lived for three more years (with family and community around him). What's also great about this, is that he was given a choice. Imagine if the treatment had been forced on him, while bankrupting his family.
ENGAGEtokens.I'm not sure, but I think I've never had a plan 'B'; not in such a way your post relates to...?!?!? It might be worth considering now that I'm close to your friends age.
I've only thought of ways to make my demise easier on my one child who'll most likely will be handling such an event. Simplifying my lifestyle and divesting of personal property in order to have less time consuming and mind bending clutter for my child to wrestle with.
As for funeral arrangements...my instructions have been: Prop me up on a Park bench with a newspaper tucked under my arm, minus any form of I.D. and let the City worry about the details...
It's a lot cheaper that way😎
I'm gonna be REAL careful sitting next to silent, still looking types on park banches in future 😆 particularly if they have a newspaper rolled under one arm. 😆
The idea that pensions will be adequate for decent living is a fallacy. The economic bloodletting on its way in 2021?? We aint seen nothing yet!
I'm just so mindful that we're stepping out of the system with crypto and social media, and yet for oh so many there is NO thought to sustainable income for older age.
I realy like your idea of divesting and tidying up your life - it's some thing I REALLY believe in and must confess to being a serial declutterer who prefers to travel light. Well done you for making it easier for your child.
!ENGAGE 25
Here in the States...our government overlords don't give a damn about improving the quality of life for "average" citizens, whether young OR old by way of adequate economic distribution/compensation. I suspect that most governments follow the same path, with some far worse than others (unfortunately)
My senses lean towards expecting United Nations, Agenda 21 advocates (of which well over a hundred countries signed onto) to pull out all the stops if able and people will see and experience great hardships globally; far more severe than most ever anticipated. Unless of course...their is a powerful enough opposing force to at least throw a giant monkey wrench into the malevolent machine.
The Malevolent Machine - a GREAT title for a movie - perhaps the first released on the Hive blockchain?? 😊
It is a choice now to choose that place that allows the greatest personal freedom in a world which may soon collapse into economic freefall, as the failed system MUST first come crashing down before something new can rise to replace it.
I chose Thailand quite deliberately - subsistence lifestyle where it would be hard to starve too death, where it's mostly warm and the natural resources are plenty. The alignment with Big China is disturbing but there remains a sense of autonommy and personal freedom under the umbrella (pun intended) of Buddhism.
One day at a time.
!ENGAGE 25
Haha...Malevolent Machine might make for a good movie title.
Some wise considerations you've made above… You've probably had many more happy days there than you would have had in that place escaped from; within the same period of time.
Best wishes to you.
ENGAGEtokens.ENGAGEtokens.I am so sorry to hear about your friend, she is lucky to have you. Community is so important, we really need that support around us as we move away from the system xx
I agree that "community" is so important but so often we take that to mean people we like and choose to be with. People we share values with. In this coming social transition we need to be there for people we barely know, and people who are not like us.
Decentralized is about to get a whole lot more real after April 2021. I just wish and hope that we have more discussion on chain about taking decentralization past only social media and a peer-to-peer currency.
!ENGAGE 15
ENGAGEtokens.That is a familiar story... one of our dear Hive friends had a similar experience. Sadly she is no longer with us.
I'm afraid it's going to become a whole lost more personal and familiar in the next year, as economic systems around the western world start to stagger under the weight of post-Covid debt and inflation.
We need to be proactive and personal - and discuss how we can all make changes to make life easier as we age without all the promised institutional security & care.
I'm sorry about your friend. I'm not sure this lady will be with us for too long either... we shall see. And give what we can, one day at a time.
Appreciated the tweet!! 😍
!ENGAGE 15
ENGAGEtokens.Life is never easy, nevertheless it's important to see the beauty in every situation even though it's difficult.
In that case you are the beauty of this situation!
!ENGAGE 25
What an absolutely lovely thing to say!! 😊 Blush. There ARE bright spots and moments of beauty everywhere. Just 30 mins ago I put out an ask on "that" platform (the one everyone else uses LOL) for someone to donate a walking frame for my friend - it was a long shot. Honestly, had it donated in less than 15 mins and pick it up tomorrow. Free. Given with love & concern.
People ARE awesome when we bring that energy and that invitation for people to step up to be their best selves. But we have to be that first to draw it forward from others. I'm good with that.
Flinging Engage tokens at me?? Feels like sparkly confetti. 😍 Thank you.
!ENGAGE 25 😘
ENGAGEtokens.@tipu curate
Wow - that's a lovely start to the comments on a new post. 😊 Thank you!
Always love to see a new person stopping by whom I've never met before. It's late here in Thailand but i DO look fwd to having a good look-see at your posts and content tomorrow.
!ENGAGE 15
Upvoted 👌 (Mana: 18/27) Liquid rewards.
ENGAGEtokens.ENGAGEtokens.Hi There!
#1 I am "Very, Very Proud" to have met You!
What You have done is "Much More$ than anyone would get from anyone here - I know this...
#2 Proud that You are telling people like it is. I try, many think I am crazy - but the fact of the matter is basically as You state...
You think you got pension, they already figured out how to get that too...
Whole post spoke to "Me", being 62 I've been around long enough to have seen a few things...
I wish "You" a Good Week!
👍🏼😊🌴😊👍🏼
"Don't forget to rest Yourself"!
😊😉😊