Kurdistan’s health care system: thwarted medical practice

Dr Rebeen

By Dr. Rebeen Rahim Saeed:

Practicing medicine to treat and save patients is one of the most important careers in the world because, in every aspect, it deals with life and death. A healthcare system is a priority that requires significant funding in every civilized and developed country. Kurdistan is a country with its own health care system; but what kind of health care? I believe it is a tired and collapsing service for both patients and doctors alike.

If you would examine the health care system of some of our neighbor countries and, more so, the health care system in the West, such as in the USA and Europe, you would see young doctors to a great extent enjoying their training and continuing their medical education. You would also see how patients are comfortable in hospital because every facility available to them provides ways to ease their pain and, more importantly, to treat them in the right way. You would also note how other governments’ strategy is to make healthcare a policy priority.

Currently there is propaganda around the parliamentary election in Kurdistan. Some candidates claim that they have a plan to improve the healthcare system but this is fallacious; moreover, none of the parties has a robust strategy for ameliorating the healthcare system or offering a concrete and useful constitution for healthcare.

The purpose of this article is mainly to denounce the deplorable conditions in which young doctors must operate. If you visit Kurdistan’s hospitals, you can observe the exhausted look of every junior trainee’s face, caused by the stress of long and demanding shifts every day. In the emergency rooms (ERs), doctors are dealing with twenty, thirty or even more patients queuing, bizarrely, in front of the consultation room and demanding swift treatment. The overcrowded ERs make people frequenting the hospitals sometimes rude and disrespectful toward the doctors and staff: they blame the doctors for the failure of the healthcare system.

If you visit a hospital, you see doctors admitting lots of patients, giving plenty of instructions to large numbers of them and their families. Voltaire said: “The art of medicine consists of amusing the patient while nature cures the disease”. Because of the sheer numbers of patients, the doctors in Kurdistan – at Slemani General Hospital, for instance – do not have time to amuse and communicate with patients in the proper way.  The task of the doctors in Kurdistan is not easy: they are expected to play the roles of doctor, nurse, psychologist, social worker and dietician. This is because the healthcare system is lacking in other appropriate aspects of healthcare, and the deficiency of many specialties forces doctors to adapt and play other roles to fill the gaps.

Developed countries have lower admission rates compared to Kurdistan. That does not mean they have fewer patients – in fact they may have more – but they have an organized, well-coordinated health care system, with a good number of doctors and medical staff, a satisfactory number of hospitals and they also filter out non-emergency patients, with the common cold for instance, before they come to the ER for unnecessary visits. Kurdistan’s emergency hospitals are always busy in a way that cannot accommodate all the cases, forcing doctors to provide “war-like treatments” to ill people most of the time because doctors and staff are dealing with a disproportionate number of patients. Seeing over 100 patients within six hours in substandard infrastructures makes doctors physically and psychologically exhausted.

I want to assert that my point is not to blame ordinary people, because the doctors are also part of this community and they are the first victims of the current crisis which we find in every corner of this country.

The Ministry of Health should take the problems of the doctors of Kurdistan seriously; it should provide more opportunities for postgraduate training, including training abroad. The Ministry can provide funding for research, establish modern research centers, build and furnish new libraries and promote regular scientific conferences to support doctors for better education and better practice. The healthcare authorities should improve the quality of life of doctors in every aspect and provide doctors annual paid vacation by law, like western hospitals do, which is essential for doctors.

The government should increase public health awareness and improve the nursing care in the hospitals Currently, all patients have chaperones while inside hospitals, otherwise they are at risk of getting lost in the hospitals: this is directly linked to the lack of adequate nursing care. Furthermore, doctors who are practicing in Kurdistan feel frustrated when a necessary treatment is not available in the public hospitals and they end up asking the patients’ family to get it from the private sector: this is one of the points where embarrassment at the failure of the current health care system begins.

Another heinous phenomenon, which can be seen increasingly nowadays in Kurdistan, is unprofessional reporting via the internet and newspapers of events in hospitals and medical centers. Such reports do not convey the news to people exactly as it is; they change stories to give doctors a bad image.  I hope such media change their strategies and report events in a professional way and, most importantly, make certain of the accuracy of any information they receive before publishing it.

In spite of the deplorable situation in the hospitals, there are still lots of energetic, dedicated, knowledgeable, studious and keen doctors, who are still passionately in love with their jobs. Many of them are also interested in conducting research, if they had facilities. There are others who enjoy their clinical practice and learning medicine, either through self-studying or mentorship. Mentorship in medical education in Kurdistan is still not adequate, as compared to western hospitals, although there are some senior consultants who are interested in mentorship and teach the junior trainees passionately.There are ample reasons to create a better healthcare system and better medical education. The authorities and the Ministry of Higher Education should be aware that doctors’ professional passion may decline or disappear if the work of medicine is not fully appreciated in every aspect and if the crisis in healthcare is not handled wisely. A generation may come with no interest in practicing medicine and this will have a negative impact on all of us in one way or another.

Finally, I hope the Kurdish Regional Government and healthcare authorities spend more of the wealth of this country to establish a solid healthcare infrastructure that provides the best service to our community.

Rebeen R. Saeed finished his medical school at University of Sulaimania – College of Medicine; he won the prestigious British Chevening scholarship in 2009-2010 to do a Masters in Medical Science (Nephrology) at the University of Sheffield (UK); he also won a Global Kidney Academy award in 2012; he is currently a board candidate (doctoral) of Internal Medicine working in the General Teaching Hospital of Sulaimania – Department of Medicine.

Copyright © 2013 Kurdistantribune.com

2 Responses to Kurdistan’s health care system: thwarted medical practice
  1. Dr Shakawan Ismaeel
    September 12, 2013 | 19:31

    Very well written and highlighted the very important issue of continuos medical education, I could not agree more , well done kaka Dr

  2. shaheen jeehad
    February 11, 2014 | 19:51

    well done,, we should deal with these issues it is not very difficult but there is no cooperation therefore

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