We were at our local Kura Reo this January, and I stayed onsite at Wairākewa with my three oldest children. I was woken at midnight in the hot, stuffy tupuna whare by a cough. Initially it intruded into my dreams in which I brusquely told the cough to stop, kaati rā! But as I made my groggy, fogged way out of my dreams, the solid cold lump in my gut told me that constant barking cough was coming from my son. Fear and anger competed for attention and I reached over to him and shook him awake. As he awoke, his sides sucked in for a breath he couldn’t grab and tears welling up in his eyes. In a panic, I picked up my son after a fitful search for his t-shirt and ran to the car. I drove home, windows open, his gasping punctuated by my hopeless and inadequate mantra: “kei te pai, e tama, māku koe i awhi.”

We got home and I ripped the Redipred and Ventolin out of the medicine cabinet. In our silent house, I tried to encourage him to swallow the Redipred or breath in the Ventolin, but he just wept. Enraged by desperation, I swore and then I wept with him. I picked him up and he lay his blue-white cheek against my shoulder and we returned to the car again for the short trip to Tauranga Hospital.

We quickly, quietly crossed the serene, warm night and silent carpark to the Accident and Emergency. The nurse at reception took a considered look at my son, perhaps at me as well, and had us immediately enter triage, from where the maternal older woman politely rolled her eyes at my inability to immediately remember his date of birth and took us through to a bed where our young doctor Connor organised steroids in a nebuliser and then a dose of long acting drugs. As we waited for him to return, an older Māori security guard I had met two years before came over, remembering the white-skinned children who spoke Māori from a previous visit and chatted with us in te reo Māori for twenty minutes. Connor returned and he explained we would need to be in for at least six hours for observation and then handed us over to the pediatrician who had us transferred by a cheery orderly up to the children’s ward. Having rallied considerably thanks to the care and drugs, my son enjoyed the bed ride and giggled at the antics of the orderly. On arriving in the children’s ward, we were put in a room of our own that included a fold-out bed for the parent. I slept fitfully initially, but physical need for rest eventually overcame adrenaline and I awoke at 8am to weetbix and toast for breakfast with a happy, energetic five year old. After a brief visit from the pediatrician, we were formally discharged.

It is only a quirk of fate that we received all of that care, expertise and support. That quirk is that my son and I were born in Aotearoa New Zealand.

According to the World Health Organization there are at least a billion people each year who cannot obtain the health services they need. Each year about 150 million of those who do use health services are subjected to a financial catastrophe, and 100 million are pushed below the poverty line as a result of paying for the services they receive. The WHO estimate that in the next twenty years, 40-50 million new health care workers will need to be trained and deployed to meet the health needs of the global population.

But for this quirk of fate, the conclusion above could have been quite different:

We got home and I ripped the Redipred and Ventolin out of the medicine cabinet. In our silent house, I tried to encourage him to swallow the Redipred or breath in the Ventolin, but he just wept. Enraged by desperation, I swore and then I wept with him. I picked him up and he lay his blue-white cheek against my shoulder. Suspecting the heat to be part of the problem, I woke his mother and we took him out into the cooler night air. We sat on our porch and waited; the nearest hospital was half a day’s drive away, there was nothing more we could do. As the effort to breathe exhausted his small body, he lay listless against his mother. We sung him songs and prayed, wiping his tears and ignoring our own, waiting for the dawn.

Or:

I picked him up and he lay his blue-white cheek against my shoulder and we returned to the car again for the short trip to hospital. I already knew not to call an ambulance; we had no insurance so they wouldn’t come for a sick child. The nurse at the ED reception took a considered look at my son and had us immediately enter triage, where the maternal older woman had me sign forms taking personal liability for the costs after which we were taken through to a bed where our young doctor Connor organised steroids in a nebuliser and then a dose of long acting drugs. He explained we would need to be in for at least six hours for observation and as we didn’t have any insurance, it was best we sat in the waiting room. In the uncomfortable chairs (metal arms had been put in to stop people laying across them) we dozed fitfully until the clock ticked over 8am beneath the buzzing strip lighting. Connor came out, noted the improvement in my son’s condition and handed my an invoice for $2,000 [the average cost for an ED visit in the US is US2,168]. We walked out into another day as a busy city awoke.

We have a remarkable health system in Aotearoa New Zealand. It is accessible for most people, it is responsive to most needs, it has access to high levels of new technology and drugs and it provides an internationally comparable level of care to those of us who are NZ citizens or permanent residents for little or no cost. It is by no means perfect; indeed it has failed people I know and care about in ways that have changed their lives for the worse. However it is still worth celebrating the little quirk of fate that put you and I within an hour of free healthcare from skilled and compassionate people. I’m sure I know one little five year old who would agree.