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[IPk] Pump support in Serbia

Original text in local language published on www.diabeta.net
Website of Diabetes Association of Serbia
May 13th, 2008
It is about Medtronic Minimed rep in Serbia...

What if your insulin pump breaks down in Serbia

Your situation: It took you several years to convince health authorities 
that you need an insulin pump.
First, you needed lot of paperwork:

a) You have to be "ill" based on three conditions (you have to be a 
child, pregnant woman or a person with a kidney disease) and you have to 
prove that with medical reports from last 6 months;
b) You hope that The Committee at your local Health Care Fund is in the 
good mood, as those three conditions sometime are not sufficient;
c) You pray that there are pumps available;
d) Your prays can take couple of days up to several months;
e) You wish that there is vacancy at the clinic, where the pump can be 
implanted and you can learn how to use it.

You are now using your pump. You have programmed your basal rates and 
you've got a grip with boluses and your life has changed for the better. 
You have enough energy for everything. You can eat what you want and 
when you want it. You check your BG levels couple of times per day... 
And the pump works for you around the clock.

And then... one day... around 3 o'clock... AM...
Your pump has stopped working. Whom do you call?

You have to call the supplier, that is the importer of your pump. They 
will answer your call amiably (maybe at 3 AM), and you'll have to brief 
them how your pump has stopped working. Sometimes, you may have to 
convince them that you have not broken it on purpose. The pump costs 
locally around 5,500 EUR, and the supplier does not consider it a cheep 
goods. In Slovenia it costs 2,300 EUR, but this is not Slovenia!

If there are any, supplier will promise you a temporary substitution 
pump. Usually they have old pumps -- "survivors" from the training 
process of medical staff, which were temporarily used in clinics. They 
have the tendency to break down. It is also possible that they currently 
have none. If they do, you will get it within the day. You will be 
thrilled to learn that, even though this model does not have all the 
advantages of your broken pump, it still requires training. The training 
will take several hours.

After your first call, you will reach for the old pen -- if you have it, 
but generally you don't -- or run to the nearest pharmacy to buy a box 
of pens (50-80 EUR per box, depending if it is short-acting or 
long-acting insulin). Or, you may borrow a pen from a friend. Now you 
have to literally catch your endocrinologist in order to get a proper 
dosage on the pens.

If you've got your temporary pump the next day, you are lucky. Just 
continue pumping! But you will have to buy new supplies for this pump, 
because they are not the same as for the model you own. Social security 
will not grant refunding for the new supplies and you will be spending 
200-250 EUR per month.

If you did not get temporary pump, you need to go to your general 
practitioner for prescriptions for insulin analogs and needles, and then 
take those prescriptions back to Social Security.

In the meantime, supplier will send your pump to be repaired in US. It 
takes time. How long? You'll get sick of it. It is supposed to take 6 to 
8 weeks, but actually it takes couple of months, half a year... It's a 
wheel of fortune. Where is the catch?

Pumps from all around the world go back to the States to be repaired. 
Only they know when will your pump get it's turn. If you call them to 
ask for information, they'll refer you to your local supplier. So the 
magic wheel begins, as your supplier simply shrugs, unable to influence 
the schedule of the service.

The moral of the story: If the pump stops working at 3 AM to some John, 
Hans, Merry, Alyosha or Carla... They will get the new one within 24 
hours (even if it is temporary replacement until their pump is 
repaired.) That is called customer support and responsibility. That is 
why repair persons at the US service do not have to work under pressure. 
No one told them that local supplier in Serbia does not provide 
technical support. Maybe the example is not the best, but if you buy a 
new Rowenta cafi-machine, and it breaks down during the warranty period, 
within a day you will get 10 times more advanced model to use until 
your's is being repaired. Warranty for insulin pump is 5 years, 
therefore most of the pumps distributed through Serbian Social Services 
are still within warranty for at least 3 years. Tell this Serbian story 
to any supplier in any other country, and they will not believe that 
this is possible. Unfortunately, it will give you no relief nor will 
level of your sugar be any better.
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