The reality of what a weak health system looks like
Friday 9 November 2012
I recently went to Ethiopia where I spent some time in Dessie, seven hours drive from Addis Ababa.
It’s a bustling, fast-growing city with a main road lined with clinics and hospitals, and health workers walking between them.
But these are all private clinics and much too costly for most of the local population, especially the rural poor in the surrounding area.
Making the best
The local public hospital lies below them down a side road and is the tertiary public hospital for up to three and half million people.
We were fortunate enough to visit this public hospital and were shown round by it’s medical director.
An inspiring man, he had worked at this, his local hospital, for twenty years as a dedicated public health professional.
Eschewing the higher salaries available in the private facilities on the main road, he was dedicated to providing the best possible care for as many as possible with limited resources.
With such a large population depending on this sole facility for tertiary care, I had some trepidation on how chaotic the hospital would be.
Yet the facility was run incredibly efficiently with both inpatient and outpatient services maximising the number that could be served in a calm and professional manner.
A different story
During our visit, we were able to see the human side of what the facility can do and also what it’s not yet able to achieve.
The maternity unit had several happy new mothers with their delightful newborn infants. Each mother had a different story on why and how they’d come to the hospital for their delivery, and how difficult that had been.
But in one corner there was a different human story. A young woman was in some distress and was evidently bleeding rather heavily.
Her condition was so severe that she’d lost both her infant and her womb in an emergency operation the previous night.
Indeed her condition was so severe that the medical teams had little more to offer her; even a transfusion of the hospital’s limited blood supplies was thought a waste of a valuable resource by this stage.
Motivation for change
We didn’t discover what happened eventually to this young woman, the staff were inquiring whether any family members were able or willing to provide blood for her, but this in itself wouldn’t necessarily have been enough.
What she needed was a modern intensive care unit – something the hospital did not have.
Dying slowly, in some discomfort, from blood loss following the loss of your infant while surrounded by newborns and dedicated medical staff unable to help you is what a weak health system looks like.
And it’s not pretty.
But it should serve as motivation to us all to redouble our efforts in support of dedicated public health professionals so that they can develop their public health services, making them affordable and available for all, thus ending such needless and preventable deaths.