It happened just a few meters from the bus station in Puerto Iguazu. My right heel made contact with the concrete, but as the muscles flexed forward towards the ball of my foot, toes met nothing but air for several inches. Encumbered by a front pack and backpack, I was 25 pounds off-balance and sprawled to the ground, ankle twisted, sunglasses flying and my foot still wedged in the hole in the sidewalk. I wrenched it loose and sat up, tears percolating as the pain began registering in my brain. “OUCH!” 

I was as much stunned by the sudden twist of events as by the pain. Seconds ago, we were shaking the fog from our sleepy brains after a 20 hour bus ride from Buenos Aires, preparing to check into our rented flat just a mile away. Now I sat on the dirty ground, fighting tears, embarrassed by the gathering crowd and aware of a creeping realization that this might be a showstopper to our travels. 

“Are you ok? I’m a nurse,” a kind woman offered, obviously on her way to the bus station with suitcases and a companion.

“I’m fine. I just need to sit here a minute.” I tried a reassuring smile and the two women moved on. Caffrey helped me up and over to a stoop and then began clearing the sidewalk of our bags, piling them along a nearby retaining wall.  I was nauseated and fighting a blackout, but quite fascinated by the rapid swelling happening to my foot. My outer ankle bone was the size of a baseball and turning purple. It was clear that I was not just going to shake this off and continue walking. Caffrey signaled a taxi.

The taxi driver patiently waited for Google Translate to process our explanation and instructions. He nodded with kind, sympathetic eyes and drove us to the public health clinic. I was hoisted into a wheel chair and escorted inside. The attendant at the door took one look at my foot and wheeled me straight into an X-ray room. The diagnosis was delivered in less than 10 minutes: fibula fracture. “Solo una pequeña fracture,” the doctor said, emphasizing her point with a hand gesture signifying tiny. “Just a small fracture.” 

My husband bought me a boot and crutches at the pharmacy across the street, USD$100 total. The doctor helped us fit the boot, gave me a shot for pain, and then released us without any paperwork or bill. “Stay off the foot until there is no pain,” she advised. For emergency care, x-rays, doctor analysis, and pain medication, our bill was $0 in this country with nationalized health care. We only had to pay for the crutches and boot.

The average unsubsidized Individual insurance plan costs about $4,000 a year ($10,000 for a family plan). The average price to treat a broken ankle in the United States is $900 to $2500, depending on zip code and treatment facility. Considering that the average deductible under most Individual insurance plans is around $4,000 (almost $8,000 for family plans), treating a broken ankle in the United States would have been an out-of-pocket expense ON TOP OF our annual cost for medical insurance. Insane.

Thank you, Argentina, for the swift, no-hassle, rational medical care you provided me.