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Handling Medical Emergencies and Healthcare in Morocco

What’s your worst travel fear? For most people it’s getting sick or having a medical emergency far from home. But, when you choose to make your home in a foreign country understanding and using the medical care system can be even more intimidating and frightening. Many people ask me about healthcare in Morocco.In October of last year I had a medical situation that had me returning to the United States for surgery. We had only been in Morocco for a month when I started getting sick. After arguing about going to the doctor for weeks, MarocBaba finally took me in – and we discovered I had a lot of small gallstones. Because of my previous gastro-surgery and because we still had insurance coverage in the US, I went back to have surgery.

Illness in Morocco

Just a few weeks ago our youngest son was ill for a week and not getting any better. After taking him to the doctor we learned he needed to have his appendix removed. We were left wondering, should we do the surgery here? Should we buy tickets for the next day or two and one of us fly back to the US with him to have it done? What should we do? Ultimately we chose to have the surgery in Morocco. I want to preface the remaining portions of this by saying there are many very skilled, qualified doctors in Morocco. Many have trained in Europe and the United States and there is access to equipment, procedures, and medications that are the same or comparable to what you would find in those countries. But it comes at a price and there can be many hurdles.

I can’t compare what medical service is like in Europe as I’ve never experienced it so my observations are based on my experiences in Marrakech, Morocco and the United States.

Morocco has a two-tiered medical system. There is universal public healthcare as well as a private healthcare system. The public healthcare system is dismal, at best. It may be better than no healthcare but should really not be considered if at all possible. The private system is a pay system. There are some health insurance plans in the country to help with costs and some will accept international insurance plans. By western standards care is very affordable. An office visit can cost between $10-15, medications a few dollars, and an operation $500+.

Healthcare in Morocco

Routine Medical Exams

If you need a check up, are ill, or have a specific concern there are general practice physicians and specialists in any area available. Some doctors only take appointments by appointment, while others take walk ins.  Either way the general procedure for appointments is “do you want a morning appointment or afternoon?” No times. If you have a morning appointment you show up when the office opens (or when you want in the morning) and are taken on a first come, first serve basis. Afternoon appointments work the same way but after lunch hour.

If you need an x-ray or blood work you will leave the office and go to a special location that does this. The doctor will give you the information on where to go. You’ll need to have the work up done, wait for the results (a few hours or maybe the next day) and then bring it back to the doctor to be read. For any prescriptions you’ll be written the order on a paper and can bring it to any pharmacy to be filled.

Pharmacies

Pharmacies are easy to identify in Morocco, they are marked with a green crescent or plus sign. One difference in Morocco is that you can’t buy things like Ibuprofen over the counter, you’ll need to ask for it from the pharmacist. Need some antibiotics? Just go ask! There are lots of medications that a pharmacist can dispense without a prescription so if you know what to ask for you likely will be able to get it without a doctor visit – unless it’s a controlled medication or narcotic drug.  If you are feeling under the weather and it’s not urgent you might try this route first.

Hospitals

Hospital services and care will vary depending on the hospital. In Morocco they’re known as cliniques. If you need to go in for a procedure or operation there were several things I found very different.

  • First, you need to supply almost all of your own things like; a drinking cup, bottled water, towels, kleenex, sheets (yes they have sheets but apparently bringing your own blankets is needed), and pillows. I’m not sure how much this is for comfort vs. required.  This will vary from location to location.
  • Unless you request it, pay extra, and make a big fuss you won’t get a single room, even if you’re with a child. If you’re alone this might not even be an option. When I was considering my surgery I was told my husband would not be permitted to stay overnight with me. A scary prospect when you’re sick, can barely speak the language, and drugged up.  On the other hand when my mom was visiting and ill we went to the same hospital and after making it very clear that one of us was going to spend the night with her they relented and gave us a room that I could stay in with her.
  • You should also be prepared for very different cultural practices in care. For example, you won’t get ice chips -ever. After our sons surgery he wasn’t permitted to drink anything, not even a swab of water in his mouth for almost 16 hours. I found this very strange and can’t say I followed the recommendations.
  • In the US after surgery the nurses and doctor would have you up and walking as soon as possible, here they were more than happy to prolong movement as long as possible. I had to push and push to get help to get our son up and moving around.
  • If you need medications that aren’t given through the IV someone may need to go to the pharmacy to get them for you and bring them to the room.
  • You’re kind of on your own. I found nurses are much less about helping patients, or caring for patients than preforming routine job functions. They’re there to serve some basic purposes but aren’t in the field to care for or comfort patients. Non IV medications were not administered by nurses – we had to give them to him. It is very important and helpful to have someone with you to act as your advocate especially if you are very ill.
  • On the plus side nurses don’t bother you every 2 hours to take your vitals. A bit more restful night of sleep.
  • Recovery time is very pronounced. Our son stayed home from school for two weeks after his appendix surgery. Two weeks!
  • Follow-up care is often included in the hospital bill. We went back to the hospital twice to have his wound cleaned, bandage changed, and doctor to check it. We then had an office visit to have his stitches removed. These were included in the  surgery price. Make sure to ask about this when you pay.
  • Speaking of money. The hospital bill is due at the time of discharge. All of it. There may be some type of payment arrangement system but I’m unaware of  it. Expect to pay cash on the spot.

I have to touch on one other point because it’s something I’ve carried with me after my son’s surgery. If you’re somewhere that your in-laws also live they’re going to be in your business.

This is a very big cultural difference.

My son had surgery later in the evening after a full day of doctors visits and running around. We were stressed out, scared, and worried. The very last thing I wanted was a roomful of people when he came out of surgery. Even though I begged and begged that they stay home, guess what happened? A roomful of people. I’ve learned this is their way of showing they care. But, I felt incredibly disrespected as a person and a parent. My sister in law went with us to the doctors appointments and pre-operative discussions with the doctors. To me, this was frustrating because the doctor and attendants did not include me in any conversations, instead directed the conversation to my husband and sister in law completely excluding me.

I’m sharing this because cultural differences are very real, and when your child is sick (or you’re sick) the last thing you want is surprises. It often feels like as the outsider you’re expected to shoulder the differences and “suck it up” and not the other way. I have no resolution for this experience and it still makes me upset. I don’t feel like I should be expected to just accept things because I’m an outsider, especially when it concerns my child.

While our experience was very different from what I was used to I felt that the doctor was competent and don’t regret having done the surgery here. It would have cost us a small fortune to go back to the United States to have the same procedure done. I know next time I will be more prepared and know what to ask and what to expect.

 

How to Handle a Medical Emergency in Morocco

 

Visiting Morocco and don’t have travel insurance yet? First, check with your local plan to see what it will cover abroad. If you’re not covered, I recommend World Nomads insurance. Get a quote right now and see if it’s a good fit for you.

 

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DL

Monday 30th of August 2021

Here's an update on hospital care I received while in Morocco this month. A few weeks ago, I broke my ankle in Essouira. I was first taken to the public hospital there, which was quite the nightmare. I then moved to the private Akhawayn clinic, where I at least got an X-ray. Unfortunately, the doctor did not inspire much confidence, and seemed to reluctant to do anything other than putting on a splint. He was also a rather unpleasant person. The next day, we decided to get a second opinion and drove up to the Marrakech clinic in Targa. It proved to be an excellent choice. I had a consultation with a surgeon who provided a very full diagnosis and operated on me the same day. I stayed overnight and returned for a checkup two weeks later and then got a brace (boot). The hospital facilities and care are first-rate and of the highest standards. I found the staff to be friendly and professional throughout. In terms of cost, the whole thing cost around 14,000 dirhams. Highly recommended.

Tina

Sunday 12th of September 2021

@DL, i can only second this recommendation of the Marrakech clinic in Targa. My father broke his hip and the surgery was swift and without any complications. This hospital is clean and the staff we interacted with were all competent. Highly recommend.

On another note, can someone please recommend a good doctor/place in Marrakech for laser treatments on the face (to remove dark age spots on the cheeks)?

Ma7moud

Friday 14th of May 2021

Hi Amanda,

Longtime reader, first time commenter.

I am in a desperate situation. I married a Moroccan lady just before the pandemic hit us. Supposedly, as soon as you get married to a foreigner - you lose your health cover. She is also studying so cannot currently work. So she basically has zero healthcare cover.

I am at my wits end on how to support her with healthcare coverage, when I ask an International company they say they only provide Expat cover. Do you know any private healthcare company who we could speak to for Moroccan residents?

I spoke to a company called Sahham and all they do is ask us if she works - which she doesn't. I don't understand their system and am desperate now.

Best regards

Ma7moud

Saturday 15th of May 2021

@Amanda Mouttaki,

Thank you for your kind feedback.

Out of pocket visits are turning into 8-9000MAD every month. Each injection is like 1000MAD. I just paid 3100MAD for just a blood test today in Casablanca.

She's adamant that there's no Private Health Insurance for Moroccan residents unless they're employed, which I find unbelievable. There has to be. Makes no sense to me. If you're paying an Insurance Premium why would employment make any difference. Its bonkers.

I will speak to RMA on Monday but I'm worried its going to be the same conversation I had with Sahham. Thank you.

Amanda Mouttaki

Saturday 15th of May 2021

I'm not sure it has anything to do with marrying a foreign person but she was possibly covered through her parents before and that cancels when you get married. RMA Assurance is one - there are a few others as well though you may want to work out what the cost of premiums is vs out of pocket expenses. Insurance is good for catastrophic things but for general visits etc it may not be.

Helle

Tuesday 31st of December 2019

Clinique International in Marrakesh is the worst hospital I have ever been in! My mother (76) fell on the street in Essaouira, and was sent to Clinique International after one night in the private clinic in Essaouira. In Essaouira, she was the only patient, and got great care. The clinic is small, but personable and new.

In Clinique International in Marrakesh, she has a huge suite with two bathrooms with a large sofa. However it is not clean. The bathroom is distgusting! The guest bathroom has no towels. I asked every day for a werk, before they finally brought a towel for drying hands after washing them. There is a useless nightgown, however. So I have dried my hands on it.

The food sucks, so I bring her fresh salats and olther foods from the Medina.

The first night, they gave her paracetamol intravenous, which was completely unnessesary, since she could have taken pills for pain. They missed the vain, the fluid went into the flesh instead, and it became a big infection. The whole hand swolled up,(under the bandage) and became blue and green halfway up the arm. I insisted a doctor see to it, but the nurse said that a bandage with alcohol would be just fine. The next day the doctor saw it and admitted that it was misplaced. Three days later, the hand is better, but it added injury to injury, and was completely unnessesary.

They love needles here, while in Norway, we are very careful about that and do not appreciate unnesessary breaking of skin in fear of multiresistand bacteria, since some countries use antibiotics on a large scale.

The rooom looks nice, but it is not clean. The nurses do not use gloves or disinfect their hands when entering the room. They keep the door open, and forget to lock it when leaving the room. Mother was for instance peeing in a becquen (hospital bathroom tray), with the door wide open! I have told the nurses 100 times to please close the door.

When called, the nurse may, or may not come. She couldn’t hold it any,ore, when the nurse had not come to see her, 15 mins after ringing the bell, and had to pee in the bed.

They do not help clean her. Not even a washcloth has been offered, so I have bought some in the medina.

She has been in the hospital bed for 8 nights, and yesterday was the first time a nurse helped clean her a little bit on one hand with a washcloth, after my mom asked her to help her.

The nurses come to give medicine, someone else comes with (horrible) food. The orange juice and youghurt is good, everything else is distgusting-looking and tasteless. A great meal in Marocco is very cheap, so they are obviously saving money.

I have had to go look for nurses in the hallways many times. They are too busy and hard to find.

Most of the nurses speak french or arabic, but speak very poor english, if at all. There are major communication-problems. They say yes, when they do notunderstand, so one thinks they have understood, and nothing happens.

My mother has broken her shoulder, her knee and one finger on the other hand. They don’t seem to understand that she is not able to take off theplastic wrap on the food with one hand, or that she is not able to roll the tablefeet/wheels under the bed, so she can have the table in front of her. So she has to watch the food on a table she can not reach!

It goes on and on! We are waiting for a medical team from Norway to help with repatriation/home transport. Our insurance company in Norway are working day and night to arrange the return in a safe manner. The date was set today. However, the nurses and some doctors tell her every day for the last 3-4 days that she is leaving tomorrow or today, manking a lot of extra stress and confution for her, and for me, since I am communicating with the norwegian medical team and insurance about the transport home.

The hospital is noisy. I see a lot of people in the lower floors bringing blankets and pillows. My mom has not been offered any hospital pyjamas, so I have brought some to her.

The doctors are refusing to listen when I beg them to please not use any needles on her. And say they know best. We have friends in Norway who are doctors, some with long experience as doctors/specialists in tropic medicin abroad in countries like Botzwana. They say the most risky thing about her injuries is to get infected with multiresistant bacteria that eill not be cured by antibiotics, and that every minute here increases the chanses of infections. So home aap is what we work for, and finally we have a set date and plan with assistance from a medical team coming from Norway to help her get home.

When they clean the floors, they just splash a little water on the floor, and push it around with a mopper. I assume the same mopper has beenused in other rooms. I see noe clean ones or buckets. They also just clean the middle of the floor, no corners.

In the hallways, there are trays with fresh needles, and buckets with bloody needles on the same toller-tray.

To me, it seems as if they have some or little education and understanding for the importance of sterilization and avoiding bacteria and other patients illness from spreading from patient to patient and room to room. Some nurses use the alcohol liquid by the door when they enter, others do not.

I can not even imagine what is on the door handles to the rooms, the bathrooms, the elevator, and all other things one must touch to get in and out of the rooms bathroom, and hospital.

I am now sooooooo looking forward to getting mom home to a norwegian hospital. This one has been a nightmare!

There are a couple of hospitals in Marrakesh with much higher standars. Marrakesh Clinique is one, and there is one that is better than that again, which do have european standards. This one is really not worth a stay. Go for the top one! Avoid this one, if you can!

I just want to add that I have been to many countries in Africa, and that my parents have lived long periods in the bush in Kenya and Tanzania and in South Africa, so I we are not deer in headlights as to being scared or shocked by dirt or other cultures. But this hospital does not deserve its name. There is NOTHING international about it. Not language/communication, and definately not medical expertise or cleanlyness.

Lulu

Monday 25th of November 2019

ASTHMA - I have asthma and live by Jemaa el Fna in Marrakech.

What should I do/ where should I go if I have a simple asthma attack?

I have had them all over the world but unsure what to do in an emergency.

Usually anywhere with a nebuliser (the oxygen gas gets mixed with medicine) is fine but it would be helpful if there is somewhere in the medina.

I saw they’re building a health clinic in the square.

Liv

Sunday 5th of July 2020

Yes, I too have asthma.

I usually get most of my medicine over the counter at the pharmacy, but did you find out any additional information about nebulisers?

If we were able to use the new clinic built on Jemaa el fna it would be a godsend. Often I don’t need to stay in hospital but a nebuliser is needed.

I know it’s corona time at the moment but if you ever found out that would be helpful!

Take care.

Amanda Mouttaki

Monday 25th of November 2019

You likely want to go to a private clinic. I can't think of one that is directly in the medina, but Ibn Tofail Clinic in Gueliz, Marrakech Clinic in Targa, or the Marrakech International Hospital would all be about 10-15 minutes. I'd make sure to always carry your rescue inhaler. You also may want to make an appointment with a local dr. who can give you the most up to date information and exactly what you should do. Dr. Clare Minejam at Marrakech Clinic speaks English and can see patients on a walk in basis (it's 200-300dh).

Christine

Wednesday 6th of November 2019

Hi, my friends mother have a heart problem and needs surgery immediately. Is there any institution that can help them because they dont have money for the operation?

Amanda Mouttaki

Thursday 7th of November 2019

None that I know of off hand. They may be able to ask at the hospital. Private hospitals may have funds set up for this. Public hospitals also do these surgeries, but there are some costs that would be incurred by the family (though not all).