Everybody’s favorite topic – medical care for nomads!

It’s been two years since Capt. Mike and I have had medical insurance in the USA. Part of our travel plan for 2020 was to fit in a little medical tourism trip to Cancun to get dental work, blood work, and recommended cancer screenings done. But…. it’s 2020….all plans are off! Instead, we spent 6 months in Grenada so we tried our best to find healthcare providers to take care of our needs here.

Although there’s a massive medical school on the island, training America’s future doctors, there’s not really a robust healthcare system or a modern public hospital. There is a small private clinic, St Augustine’s Medical Center, or SAMS, that’s a good option for emergencies. Our friend Cheryl on SV LeefNu had a good experience there treating broken ribs. But I don’t think I’d want to undergo a major surgery here if I had the option to go elsewhere. Many residents, who can afford it, also travel off island for significant medical care.

We started out with the easy stuff – a dental cleaning. Well, I THOUGHT it would be easy! Of the 5 or 6 dentists recommended in my local cruisers FaceBook group, most were taking appointments 4 months out! So I went with the only one I could see within two weeks. I found that the quality of the dental care was….ok. COVID precautions were in place (masks, hand sanitizer, chairs blocked off in the waiting room). A very pleasant young woman dentist, working out of a faded old fashioned office, gave us a thorough exam and a good cleaning. However, no X-rays, and no measurements for gum disease. She pretty much just poked at our typical American teeth and said “everything looks good.” There’s no lab to fabricate crowns on the island, so dentists must order such devices from the US and that takes another three months turnaround. I guess “Replace slowly failing crown” will stay on my to-do list for another year.

Cost for routine dental exam and cleaning = 165 ecd or $61US

Look at those pearly whites!

Up next, annual skin cancer screening. We are two very pale people, living outdoors in the Caribbean, so we make it a priority to get every spot checked out every year. There’s exactly one dermatologist in Grenada, Dr Jenny Issacs. The directions to find her office are “go to the downtown vegetable market, walk up the hill, look for the hand-written sign on the wall next to the used book store.” Again, covid precautions made us feel safe. We even had to bring our certificate from the health ministry stating that we’d passed a covid test and completed quarantine. Dr Issacs has been practicing in Grenada for over 30 years, and she’s licensed as a GP as well as a dermatologist. She’s very kind and thorough, and she listened to all of our concerns and requests for prescriptions to top up the boat first aid kit, writing us prescriptions for antibiotics and my thyroid pills. She examined Mike’s bald head and told him “you have so little melanin in your skin, you should be cruising in Scandinavia”, lol. She wrote him a prescription for Efudix, a cream used to treat pre-cancerous spots. We carefully followed the directions for a two-week treatment, and it seemed to work great! No more rough, red spots! She found one tiny irregular dark spot on my cheek and recommended a biopsy “Out of an abundance of caution”

  • Cost per person for dermatologist appointment = 150ecd or $55US
  • Cost for large tube of Efudix = 460ecd or $170US

Prescriptions are kind of expensive here… But so is everything imported, I suppose! It seems strange to me that prescription meds are priced by the pill, rather than by the month or by the dose. I take a very common generic thyroid medicine, but in the entire time I’ve been in Grenada, I could not find the dose I need in a single pill. Is there a conspiracy in all of Grenada’s pharmacies to make twice the money by selling twice the pills?

Cost of generic thyroid meds = about 55ecd or $20US per month

So that dermatologist appointment led to a biopsy appointment. Sheesh. The spot was so small, I had to point it out to the nurse. The surgeon was very nice – also a sailor who plans to retire and move into a boat in a few years (although he said his wife wouldn’t want to live in one as small as ours). I was nervous about the procedure (after all, it was on my face) but Capt. Mike was there to take care of me, and it really wasn’t bad at all. Three days later and I had the stitches out. Two weeks later, I got the biopsy results – negative – and I could pretend the whole thing never happened. Don’t forget your hat and sunscreen!

Cost for biopsy: including surgeon fees, lab fees, facility fees, initial consultation, and suture removal = 780ecd or $289US.

In addition to these doctors appointments in Grenada, I saw a doctor in Antigua to follow up on my shingles case, and to get routine bloodwork and a cervical cancer screening. So all in all, I got quite a bit of medical care outside the USA this year! If you are used to $20 co-pays and $10 generic prescriptions, these out-of-pocket expenses might sound like a lot. But, when you consider that the premiums alone on my high-deductable ACA plan were over $900 per month, and compare that to the emergency-only international plan that we currently have for about $2600 per year, we can pay for a lot of doctor’s appointments and prescriptions and still come out ahead! Maybe I’ll finally get around to that crown in 2021?

2 thoughts on “Everybody’s favorite topic – medical care for nomads!

  1. I love how thorough you are in your descriptions and assessments. Very reasonable prices in my opinion. Please stay healthy and continue happy sailing. Merry Christmas and Happy New Year to you both! I wanted to send you a Christmas card but didn’t know where to send it. My best to you! – Sharon

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