“You can’t start the next chapter if you keep re- reading the last one.”
As a practicing medical officer in a district hospital, I wish to highlight to the Health Ministry some problems that we have been facing almost daily, especially with regard to critical care support.
This refers to patients with good/acceptable outcome requiring critical care support; a functional ventilator machine in a comprehensively monitored setting, meaning intensive care unit or high-dependency unit under supervision of a trained/exposed doctor.
This problem has been encircling for years, arising in each mortality and morbidity meetings and reviews, added with my own personal experience that to my opinion, one shall not sit and dwell any longer and start planning an acceptable, logical rescue strategy.
One must understand that with progressing years, somehow, we are able to reach out to more people for their health care needs. More people are aware of illness and ill loved ones, instead of attributing it to ‘black magic’.
More people are also neglected, especially the elderly, leaving them a in critical state when brought in to hospital, and also more younger people are getting communicable/non-communicable diseases which may bring them into an emergency state out of pure ignorance/ill fate.
Also, 40 is the new young, 70 is the new old, 20 is just a child. People are living longer, exposing themselves to a multitude of degenerative diseases; it is part of wear and tear of our body systems with advancing age. New lands are being explored, urbanisation, migration, industrialisation, foreign imports, all these implies an expected rise in number of hospital visits in a preexisting hospital built 20 years ago, with a vision for 10 years ago.
These are part of the spectrum of patients we are dealing with every day. Many are not for conservative management, after looking at all causes and analysing their recovery potential and their numbers are increasing by the day.
It is horrifying when one had to call across three states to secure a ventilator for a patient and this has been occurring with increasing frequency.
In urgent need of an upgrade
In addition, some states hospitals, especially in the northern region, are in urgent need of an upgrade, urgent need for change of management, urgent need for improvement in training programmes and flexibilities.
Wards are overcrowded, working environment is unfriendly, doctors’ on-call rooms are like store rooms, sanitary system is bad, delivery suites are like a market, outpatient department/clinics are crowded like sardine cans, radiological machines are working overtime resulting in frequent breakdown, why? Because there is only one machine to serve all mankind.
What about issues of brain drain to the private sector? It is alarming that many senior doctors with so much experience is leaving that there is an apparent glaring lack in expertise in a main referral hospital of a state. There are many young specialists in training but they will need time and experience themselves to sit in consultant level.
There should be a statistical study to show why doctors leave. Better opportunities? Better pay? Better life? Escape from stepmotherish like departments? Psychological/psychiatric issues due to all reasons above? Incompetency?
Is it time also for the ministry to consider extra allowances for health staff working in hospitals during public holidays when all other healthcare facilities are closed. The emergency department now caters for daily wound dressing, wound inspection, removal of suture, neonatal jaundice on top of the others with the same amount of staff, probably working in double shifts.
The success of a country depends on the health of its population and the ability of the government to provide a standard and equal and accessible health services. When the need is there, there is no need to sit in meeting after meeting for years to decide on a new building or renovations or equipment. There should be a sense of urgency in health-related events to avoid delays causing disabilities and wastage.
Finally, care for the ill and destitute is not departmentalised, it is everybody’s problem and it is everyone’s responsibility.
