Health Insurance Eases Worries of Senegal's 'Market Women'

This is the VOA Special English Development Report.

In Senegal, some people receive medical coverage from large employers. Some buy their own insurance. But most Senegalese are uninsured, especially the poor -- a common story across Africa and elsewhere. If they get injured or sick, they must somehow pay the costs themselves, or go untreated.

The lack of health insurance is greatest among workers who deal in the informal cash economy. They include what Africans call "market women" -- women who sell produce and other food at local markets.

But a women's cooperative in Senegal is offering low-cost health insurance for market women. The coverage is offered through a credit union, part of what is called the Network of Programs for Urban and Rural Women.

More than twenty thousand women now pay into the insurance program. It pays for care at participating health centers. But it does not pay for conditions that existed before a person was insured, or for cancer, heart disease or H.I.V./AIDS.

Instead, the program is meant to help poor families deal with common health needs without having to borrow money.

The plan can insure as many as fifteen people in a family. Families can also get twenty-five percent off the cost of medicines. And pregnant women can get low-cost care through deals with several public hospitals and clinics.

Oulimatta Tigerre is an independent businesswoman. She sells vegetables and dried fish at a small wooden stand on a dirt road near Dakar, Senegal's capital.

Her husband has been unemployed, and she worried that they could not pay the family's medical bills. Then she joined the credit union. The health insurance costs two dollars a month for her family of five.

She got sick while she was pregnant. The program, she says, paid all her hospital bills. And when her children get malaria, the insurance pays their bills. "This program is very important," she says, "because it saves us from the worry of where to get the money to pay the doctor."

Oulimatta Tigerre has used some of the money she saved from not having to pay hospital bills to expand her business.

But to have such satisfied members, experts say, a health insurance cooperative needs a large group of people. This is known as pooling risk. If the group is small, each member has to pay more, and that would exclude the poorest.

And that's the VOA Special English Development Report, written by Jerilyn Watson, with Scott Stearns in Senegal. I'm Steve Ember.

在塞内加尔，一些为大型公司工作的人可以获得医疗保险。还有一些人自己购买保险。但是大部分塞内加尔人没有保险，尤其是穷人，这在非洲和其他地区都非常普遍。一旦生病，他们必须自己支付医疗费用，或者不进行医治。

缺少健康保险的情况在一些从事非正式的小生意的人中最为普遍。包括非洲人所说的“市场女性”——那些在当地市场出售农产品或其它食品的女性。

但是，塞内加尔一家女性合作社以低廉的成本为市场女性提供健康保险。健康保险通过信贷联盟来支付，信贷联盟是城市和农村妇女网络计划的一部分。

目前，两万多名女性已加入保险计划。这项保险可以支付在加入该项目的医疗中心接受的医疗服务。但是，保险不支付加入保险之前就已经出现的疾病，或者癌症，心脏病或艾滋病等重大疾病。

相反，该项目旨在帮助贫困家庭不需借钱就可以治疗普通疾病。

这项计划最多可以为15个家庭成员提供保险。家庭购买药品还可以享受25%的折扣。孕妇还可以功过与几家公立医院和诊所的合同销售低费用的服务。

Oulimatta Tigerre是一位独立的商业女性。她在塞内加尔首都达喀尔附近一条土路边的小木屋里出售蔬菜和干鱼粉。由于丈夫失业，她很担心不能支付家庭医疗费用。后来她加入了信贷联盟，每月只需为5个家庭成员支付2美元的医疗保险费用。

在她怀孕期间不幸生病了。她说，该保险项目替她尺幅了所有的医疗费用。孩子患了疟疾，也是健康保险帮他支付费用。她说，“这个项目非常重要，因为她免去了我们支付医疗费用的顾虑。”

Oulimatta Tigerre利用医疗费用节省下来的钱来扩大自己的生意。

但是专家说，为了有更多这样满意的人，健康保险合作社需要一大群人的参与。这就是所说的分担风险。如果该组织太小，每个成员要支付的就多，这样就不会顾及到最贫穷的人。