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By Dr Shakawan Ismaeel:
The Kurdistan health minister announced on Wednesday that an extra 45 billion Iraqi dinar will be spent on heart surgery and on opening additional evening public clinics: 15 billion in Erbil, 22 billion in Sulaymani and 8 billion in Duhok. He also announced that around 100 overseas doctors and nurses will be recruited from India for the expanded services
Although this will make some difference for people who need heart operations or procedures and for those who cannot afford private clinics, one should ask: could this money be better spent developing services that have much greater impact on public health, rather than short-term-funded services that could dry up within a year ?
It is a well known fact or saying that ‘prevention is better than cure’. This does not mean Kurdistan does not need heart treatment centres – on the contrary, if the investment can be sustained, it will be money well spent. However, we need to concentrate on the primary prevention of heart conditions and other diseases, which is the most under-invested sector in the current health system.
The primary care services, or family doctors, are fundamental to the prevention of many conditions and this is by identifying risk factors and treating them before they progress to fatal conditions. Examples of these risk factors are: hypertension, diabetes, smoking, high cholesterol and so on. Once all these are identified and treated then the rate of fatal heart disease will reduce dramatically in the longer term.
What the ministry could have done with this money is to expand primary care services and make them widely available to the public. More people would then benefit from the investment through the early treatment of risk factors for more conditions than just heart diseases.
In my earlier blog post I highlighted that there is a lack of strategic vision to drive the health sector towards a reasonable standard. Wednesday’s announcement could just have proven this point, but I hope to be proven wrong and that there is a long term plan.
