Late one evening, Dixon Chibanda, a psychiatrist in Harare, Zimbabwe, received a call from a doctor in an emergency room. A 26-year-old woman named Erica who Chibanda had treated months before had attempted suicide. The doctor said he needed Chibanda’s help to make sure Erica didn’t try it again.
Erica was at a hospital more than 100 miles (160km) away, however, so Chibanda and her mother came up with a plan by phone. As soon as Erica was released from the hospital she and her mother would come see Chibanda to reevaluate her treatment plan.
A week passed, and then two more, with no word from Erica. Finally, Chibanda received a call from her mother. Erica, she told him, had killed herself three days before.
“Why didn’t you come to Harare?” Chibanda asked. “We had agreed that as soon as she’s released, you will come to me!”
“We didn’t have the $15 bus fare to come to Harare,” her mother replied.
The response left him speechless. In the months that followed, Chibanda found himself haunted by the case. He also knew that Erica’s inability to access care due to distance and cost was not exceptional but, in many countries, in fact was the norm.