photo: Eddy van Wessel


Saturday, September 22, 2012

Of bags of blood and health care tourism

'My mother was finally operated on in Iran', says my young Kurdish friend. 'And there were a lot of other Kurds in the same hospital for treatment'.

I need to return in this entry to the bad healthcare in Iraqi Kurdistan, as I have some new stories to share and some new insights. The mother of the friend I just mentioned had planned to have the operation done in Erbil. But when she arrived for the occasion, she was sent away because she did not bring the blood needed for the transfusion. Yet when she made the arrangements a short time before, the surgeon had said no blood was needed.

The family lost trust in the clinic and took the patient to Iran, where health care is better and she was operated on successfully. I am even told that the care is cheaper there. So it is not so strange that, even though Iran is suffering under a strict embargo, many Iraqi Kurds go there for medical treatment.

The issue of the blood is also an interesting one. The mother of another friend needed an urgent heart operation last week. Before she could be admitted, the family had to provide the clinic with five bags of blood of the right blood group. It took some organizing, but the family members donated the blood that was then used in the operation.

For westerners, this is a strange practice. We have blood banks, where blood is donated by volunteers and carefully screened for diseases. The blood is almost a hundred percent safe. What happens to this blood family members of the patients donate - is it screened as carefully? Is there enough time for that, if the operation, as in this case, is an urgent one?

There is another side to this story. The woman went to the local hospital with complaints a few weeks earlier. As she arrived there before the morning shift started, she was put on medication. Even though her arteries needed to be catheterized, she was refused the treatment because of the time of arrival. That time ruled out anything but a treatment with oral medication, after which she spent over a week at home with daily recurring small heart attacks until the family decided to take her to a clinic out of town to get the operation done.

Another recent story. A pregnant doctor from the West went for a check up on the baby and had an echo-cardiogram. In a waiting room full of patients, the secretary asked her when was the last day of her period, and had she ever miscarried. The whole room was listening, and so it also heard the girl before her answer that she had a miscarriage the day before. Private information, that is involuntarily shared with a group of people who can do with it what ever they like - which will be mainly gossiping.

When the pregnant doctor was led into the room for the echo, she found there were two other women already there. The doctor was unkind and impolite, and told her to keep her head still when she tried to steal a look at the monitor. Only when she told him she was a medical doctor herself, his behaviour changed. And while the others were sent away with the gel for the echo still on their stomachs, she was handed a Kleenex.

Now, after all these stories, I want to share with you a reaction that reached me about an earlier entry where I looked for the reasons behind the bad health care in Iraq, and put the blame partly with the doctors and partly with the system.

I  used to be a doctor in Iraq, I worked as an intern for almost 2 years but then had to flee the country and I live in the Netherlands now as an asylum seeker with a 5-years permit.
I completely agree with you about how bad the health system is, but I felt really offended when you blamed the doctors only and pictured the Iraqi doctor as a butcher who slays the patients for money with no mercy at all... 

Iraq is full of corruptions and doctors are humans and there is always a bad human and a good human, but like everything else in Iraq the bad one is in the power position. I met doctors (specialists) forced to work in a hospital (or that is what it should be) in a village 7 days a week living in a (sorry) dumpster called the doctor resident and getting humiliated every day if not by the patients, by the Department of Health.

Well you can't expect a human feeling betrayed, feeling he worked so hard his whole life just to be humiliated every day to give all he can and to keep updating himself. I would love if you would investigate - as a journalist - the life of a doctor in Iraq; a junior doctor and write an article about it. Only then you'll know what is going wrong in the health system of Iraq...

I understand what the doctor is saying, but still I do not agree with him. It can be very good for young doctors to get their first working experience in a local clinic. This is where they will have to learn, because at the Iraqi universities they hardly learned anything about diagnostics or treatment in a real situation. It might be hard not to be respected, but I am afraid when the young doctors are older, they do the same to the younger ones again. It is the system that needs to be changed. And that starts with not only allowing those with top grades to become doctors, but also those that show the necessary passion for the job.

Passionate doctors will want the best for their patients. And for that reason, they are polite, gentle and caring - not only when they find they are treating a colleague. They want to find more information about illnesses and new treatment, because they want their patients to recuperate. They want to improve themselves for the improvement of their patients.

I hope Iraq still has doctors like this, tucked away somewhere. But I doubt it, because of the many stories that I hear. It is high time for the medical practice and the authorities to sit down together, discuss and find ways to improve the situation. We do not want to continue the medical tourism to Iran, Turkey and even India. People who are ill, are entitled to be cared for as good as possible. With their family members at their bedside, and not in a strange country of which they hardly speak the language.

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