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October 27, 2011
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Is Revival Possible with No Health?
Kurdishaspect.com - By Helene A. Sairany
I feel hopeless, sad, and depressed to the maximum. As a matter of fact, my eyes are tearing as I type this blog. I feel like disclosing how down and depressed I am due to a shocking episode I witnessed today. I have been going through some difficult times lately. I wake up every morning with a big smile and a hope that my days will get better. I woke up real early today, I dressed, grabbed my camera, planner and pen with the data sheets for this research paper I am working on in the hospitals in Kurdistan. A doctor friend volunteered to accompany me to the Hawler cardiac center and Rizgari, where we are to follow surgical and medical intensive care unit patients (ICU).
A note to myself: I am to never leave the house without a camera, pen, paper, and my planner.
As I was surfing through patient charts, I heard whispers and sensed that perhaps my research topic is simply not possible considering that there is no standardization in the hospitals here, and senior doctors usually don’t abide by the guidelines. Heparin (an anti-coagulant) is given as needed, and not every ICU patient gets it, despite the fact that every bed-ridden post surgery patient is supposed to get some sort of an anticoagulant. Patients simply don’t stay that long, and most of them are rushed by doctors to leave the unit , though they are supposed to stay longer. Despite that, I kept a positive attitude and insisted that I can find patients who are on heparin for a minimum of five days (the type of patients I am targeting for this study of mine).
The staff members I work with for my research paper are simply wonderful. They were helpful to the maximum. I went on rounds with the senior resident the other day at Jumhuri hospital and he filled me in on the daily routine and how the system runs in the cardiac center in the hospital. As we were walking in the hall, I heard a patient complaining. I asked what was the matter with this particular patient. He asked if I would be interested to accompany him to the patient’s room. I was ecstatic to hear his offer and agreed right away. We walked into the room and I wish I never had. The first thing I noticed was the patient's gangrenous feet. The feet were so purple I almost thought it was a purple toe syndrome until I heard the resident say that this patient’s feet need to be amputated as soon as possible or this gangrene will continue growing. I looked at him with tearful eyes. He noticed the paleness on my face and tried to calm me down. I asked why is he in the cardiac unit then? He replied that his chief complaint is heart failure and he is suffering from shortness of breath upon exertion. We looked at the patient’s chart together and I recommended some changes in the drug management. As a clinical pharmacist, I noticed that the patient was supposed to take some meds that he was not currently on. He said that he couldn’t interfere with the seniors' doctors' treatment. “I am simply here to monitor the patient. I will be no where surprised to see this patient get dismissed in a few days because we have a patient over-load at the cardiac unit. We can’t manage keeping the patients for longer than 4-5 days.” He knew what was going to come out of me next, so continued talking, “I know they are medically indicated to stay longer but we have to dismiss them to open new rooms for new patients.”
I left Hawler cardiac center, a bit down from all the discouragement, somewhat shocked. We stopped at a random light. I was busy replying to a text message and all of the sudden I saw my doctor friend rush out of the car. He ran toward a body on the main street. It was the body of a young man who was hit by a car and was severely convulsive and bleeding on the floor. I yelled hard as I saw the scene. I never witnessed a horrific scene like this in my life. I wanted to help, hug, or do something. Have you ever been through a situation where you desperately want to help but you simply cant because of a silly restriction? Well this is exactly how I felt today. There is no such thing as 911-service here. They carried the body, placed him on the back of the car which hit the kid, and there he rushed to Rizgari hospital.
As we were approaching to be done from Rizgari, I had a severe headache, hence made a short-cut and drove home through Gulan streets. As you drive through Gulan, you sense that you are living in a western country. The street is loaded with fancy hotels, houses, coffee shops, etc. Gulan looks nothing like a street in Hawler. Seeing Gulan, you automatically feel that the region is in its way to reach revival. But wait, how can we determine that a country has fully achieved “revival”? You hear that Kurdistan is booming, Kurdistan is going through revival, etc. Now, how can we determine that Kurdistan has achieved or in it way to revival? Well then, let me address this concern in my honest opinion for you. If you want to know whether a revival has been achieved in a certain country or not, look at how greatly it values human beings. I refuse to look at how many building have been built or how many five star hotels are around. To realize the value of human beings, look at the way the sick are treated in that society. By that criteria, you can classify if a country is developed or not. So let me ask, do the current health conditions in Kurdistan enable us to progress? Does the number of hospitals in Kurdistan meet population growth? Our population grows continuously everyday and this will turn into a real disaster if the Kurdish Regional Government, as well as the people, do not provide sufficient services for the growing population. Are the hospitals equipped with the needed medical equipment? Do hospitals perform their roles efficiently? Patients aren’t treated because hospitals are understaffed and lack specialty doctors or medical equipment. The ministry staff indicated numerous times that lack of health, education, financial support, supplies, and research are the main reasons for the increasing rate of morbidity and mortality among the citizens in the region. There are several private hospitals in Kurdistan, yet lower income citizens are incapable of utilizing these services because of their high costs.
In the long run, there should be some modifications in the education system. I like to talk about public service requirements. Public service requirements should be required for completion of a health-related degree. We study to become health care providers. It is therefore very important for our professors in medical and health programs to implant the idea of public service in students’ minds. Students should be required to spend a certain number of hours as a volunteer, and go into communities and teach families about basic health care. Successful completion of a medical degree should not be based on how much anatomy you memorize. Having a medical degree means you are, by all standards, a health care provider. Being a health care provider means you have the passion to prevent a diseased state from progressing. When we examine the medical school system in Kurdistan, we learn that education is based on memory and stuffing the brain with information, with no room for innovation, thinking, or different ideas. The mind of the student becomes like a storage closet.
Knowing this fact, we can state that we have two problems with the current state of health care in Kurdistan: the quantity and the quality of care. The quantity problem can be solved by building more hospitals, but to solve the quality problem, we need to call upon our governments, our health ministries, and the owners of hospitals to set and follow standards. The government should work for the people, managing people’s interests and needs. People should be aware of this fact. Who works for whom? Who is the employer and who is the employee? The people and the government should be aware of this concept. This is the first guarantee. The government should declare facts to whoever is interested, to whoever those facts concern. They should state the number of hospitals being built. They should give complete, serious, and precise facts, and they should announce what has been achieved at the end of each year. The world has changed and we have to reform ourselves
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