Medical Ethics II

 By Amina Shadab and Tara Fatehi:

Whenever you read about South Kurdistan and the Kurdistan Regional Government (KRG), people will tell you about two things: The corruption within the government and the overwhelming, booming economy. With many western and Middle Eastern, multi-million dollar businesses investing in Kurdistan, it is being labeled the next Dubai. It is, however, very disheartening and disappointing that one of the fastest growing economies in the world has had the least improvement in health and education in its region. Billions of dollars are being spent to improve the state of the region. From gigantic malls to sky-scrapers and one of the biggest oil exports in the world you would think the region would give a little bit of attention to the sectors that will give it a firm foundation, namely its health sector and education services. Yet these two sectors are greatly suffering in South Kurdistan. In turn, those who bear the brunt of the suffering are the citizens of the region. Educators and health professionals are under immense pressure to provide the best service they can under the circumstances.

‘Medical Ethics’, an article recently published on KT, highlighted moral and ethical codes broken by doctors in Kurdistan and suggested ways in which this could be improved. The article did not mention any political or governmental stance on the subject, instead it focused on health professionals and the healthcare industry. This caused some unrest among those who live the daily life in Kurdistan, frustrated and fed up with the situation they are in. From almost all feedback we received, citizens blame the government for the situation of healthcare and education in the KRG at this current time.

One junior doctor who has studied and worked in Kurdistan as a health practitioner and has also experienced westernized work environments, explained that, as doctors in Kurdistan, they face many difficulties which most health practitioners do not have to face in normal or standardized situations, which is reflected in their work. The doctor explained that the lack of nursing and paramedic staff is appalling and puts extra stress and pressure on doctors who may have to take on tasks not allocated to their job. He explained that in Slemani, one of the biggest provinces in South Kurdistan, most doctors are forced to work the role of nurses, medical staffing, nutritionists and psychologists etc, due to the lack of availability of those professionals. The doctor emphasizes that nursing staff exist and do their jobs well; they are not to blame and they too have to face all the limitations doctors incur.

“Yesterday I was on call, our team had seen 224 cases in 24 hours, with 5 surgical consults, 2 dialysis cases, having to write Investigations, notes, treatments, imaging tests for all 224 cases then taking the time to speak with all patients about their condition and preparing for them for discharging is not an easy job,” states the doctor.

The doctor goes on to compare the situation to what he saw in the US and UK during his visits: “They only see up to 30 maximum inpatient admissions every day, concentrating on 20 cases of inpatient admissions compared to 220 patients is not comparable.” The doctor argues that, although they agree not enough time is spent with each individual patient, they allocate the time they spend with patients based on the priority of each condition.

The problem seems to be deeply rooted in the healthcare system; the doctor mentioned that he saw 100 reception patients in less than 5 hours of which 80% of cases were colds and flu. These conditions can be seen and treated in primary care rather than emergency hospital wards. The doctor reiterates that it is a largely a problem of the outlook of the community. Due to the corruption and disorganized state of primary healthcare in South Kurdistan, patients with minor cases do not trust it enough to see a medical practitioner but rather go to hospitals where they then take up the time of other patients who are in dire need of emergency care. The doctors cannot ethically refuse them care and then must accommodate for all the patients they see.

Most people who have visited South Kurdistan or currently live in the region vouch that the best public hospitals are in Slemani. In Hewler, the largest province in South Kurdistan, privatized hospitals have been the focus and public ones have been greatly neglected.

All of the reasons mentioned above plus more, much more, impacts on the ethical and moral service which, not only doctors, but all health professionals can provide. Ethical codes of conduct are broken and moral stances overlooked in order to provide basic healthcare to their best abilities. The Kurdistan Regional Government must, as an obligation to its citizens, look into the situation of healthcare and education in the region. Changes must be made in order to improve such basic foundations which will determine the future of Kurdistan.

Although it is easy to point fingers and play the blame game, in order to create a healthcare and education system comparable to that of the west, healthcare professionals, educators and the government must all work together to improve the situation. With such wealth and advanced technology in the region it is hard to understand why the healthcare system is yet to introduce data patient files. Negotiations and talks must start now. The government has too much to answer for and is in debt to society to use its power to improve these services. However, doctors also have room for improvement as highlighted in the ‘Medical Ethics’ article.  With both ends tying the knot in the middle, Kurdistan will be well on its way to providing some of the best healthcare in the Middle East.

Copyright © 2012 Kurdistantribune.com