In the past, mothers would sometimes walk two hours to the clinic only to find vaccines out of stock or spoiled.

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At the moment, for example, a straightforward colonoscopy, requiring a couple of hours in a clinic, is priced at two-thirds the rate of a full-scale splenectomy requiring 20 days of post-operative care.

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Many of the clinic's visitors have tramped for hours from villages higher in the hills.

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Sookaina Boudraa had been waiting for three hours at the Alwaha health clinic in Sidi Moumen, an area in northeastern Casablanca known for its slums.

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Medics from Chelsea and Westminster's HIV and sexual health clinic in Soho tested 745 people in eight hours on Saturday, compared with 467 last year.

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If you're living in a country where you have to walk for several hours or even a day to get to a clinic it's extremely unlikely you would bother to make the return trip a week later to get the result of a check-up.

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At present, the state has only one clinic that offers abortions, and that is in Sioux Falls, nearly six hours from Pine Ridge.

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For 48 hours, until Jessica turned up unharmed at a children's clinic five miles away, they watched as police scoured the park pond to see whether she had drowned, and later turned their attention to the whereabouts of a tattooed man whom witnesses had spotted talking to the girl.

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People have gathered long before the clinic actually opens, some have come from outlying communities, and have walked for hours to be here.

BBC: News, River Caguan, Colombia