Minister of Health to YT: There is no bird flu outbreak in Yemen so far, we are prepared to tackle it [Archives:2006/946/Health]
May 15 2006
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Q: Is it correct that you asked MPs to ask people to eat chicken as the country is free of Bird Flu?
A: No, it is not like that. In one of the parliament sessions, one MP said that the government provided the Ministry of Health with 2 billon YR to fight bird flu. This MP asked the government to pay farmers and poultry's owners as well. I told him that we can compensate farmers only after the spread of the disease. Our view was that if MPs, who are refusing to eat fowls, want to support the farmers then they should buy and eat chickens as well as convincing people in their constituencies to do so as there is no infection of Bird Flu yet, and we have said that many times.
Q: As we know, the monitoring process is the responsibility of the Ministry of Agriculture whereas the Ministry of Health is responsible for watching the infection among humans. How can you confirm that Yemen is completely free of bird flue among human and poultry?
A: There is a constant collaboration between the Ministry of Health and the Ministry of Agriculture. We receive daily reports from the monitoring department in the Ministry of Agriculture which shows that there is no infection among the poultry yet. Some reports mentioned that some fowls perished in some farms, but these reports also indicated that this was due to other diseases like Newcastle disease. I, as a Minister of Health, confirm to you that there is no infection of Bird Flu in Yemen until this moment, whether among people or birds.
Q: Can you tell us what did you do to face such pandemic?
A: The Ministry is following plan and precautions that all Arab countries are adopting to face this disease. This plan was prepared with the cooperation of world Health Organization (WHO). We have also the national plan of Ministry of Health and Population to fight this disease. According to this plan, we are working to equip medical institutions and hospitals with equipments that we will buy such as ventilators, as the disease may lead to failure in respiratory system. We also provided medications such as the Tamiflu – we prepared 250,000 tablets for adults and 4000 bottles for children. We also provided special uniforms for some workers and doctors who received training courses in many medical establishments around the country. Regarding raising the awareness among people, the Ministry is launching an educative flashes and programs in the national TV and radio.
Q: The prime Minister suggested putting the medical collages under the supervision of the Ministry of Health. What is your opinion on such suggestion?
A:Well, this system of putting Medical colleges under the supervision of the Ministry of Health is adopted in some countries such as Iran, which is known by its distinguished medical heath system. However, while this system is not adopted in any Arab country, Yemen may consider following this system in the future if we find it better than others'.
Q: Yemeni authorities have ordered the closure of medical faculties in private universities for failing to meet the minimum education criteria so what about the students who graduated from these universities?
A: The Ministry is not going to deal with any graduate student from a private university except those graduated from the Science and Technology University, which has a recognition from the Ministry of High Education and the Supreme Universities Council. The other students can be moved to public universities according to the council's decision.
Q: Newspapers recently reported many cases related to medical malpractice and doctors' errors. How do you deal with such cases?
A: There is a draft prepared by the Supreme Medical Council. This draft is now in the parliament and the cabinet to adjust it in order to make it a law that defines the penalties and punishments in medical malpractice cases.
However, such issue is related to the existence and need of forensic medicine. We need an authority that examine, improve and define the deficiency sides or malpractices that lead to ambiguous death as an example. Therefore, the Ministry of Health with the cooperation of the Ministry of Interior and the Ministry of Justice are thinking to establish such a forensic authority.
Q: You directed an investigation over the reasons behind the death of an infant in Al-Sabeen hospital (Sana'a). What is new in this case?
A: The Ministry is still investigating the case. The doctor involved in this case is still suspended as it has been found that there was negligence in dealing with the case.
Q: According to the statistics, there is a doctor for 10,000 people in Yemen and doctors are not equally distributed around the country. How do you deal with this matter?
A: In fact we find that most of the doctors are centralizing in three governorates: Sana'a municipality, Aden and Taiz. I can tell you that there is a doctor for 600 people in the city of Sana'a, a doctor for 12,000 people in Dhamar governorate and a doctor for 90,000 people in Otma province. The Ministry is considering a draft law that forces doctors to work in the rural areas. In my last visit to the University of Sana'a, I spoke about this draft with the Faculty of Medicine's students. I also asked influential people not to interfere and try to prevent the implementation of this law.
Q: Does this usually happen?
A:Yes. When I was a deputy in the Ministry of Health, we began at that time to prevent the centralization of doctors in these governorates. We faced lots of pressure from many personalities who tried to affect our decision. I also call female doctors to undertake their humanitarian duties not only in the cities but also in the rural regions. I really wonder why some parents do refuse sending their daughters to work in other governorates while they accept sending them abroad to get their medical degrees. I want also to confirm that there are orders from the Prime Minister to support and encourage the medical staff by recompenses those who work in the rural regions.
Q: Is it right that the Ministry has decided to set a unified price for medical examinations and treatments in private hospitals?
A: The Ministry carried out many investigations in the private hospitals. We found a lot of malpractices and breaches. I ordered to change many mangers and directors of such medical facilities in many governorates. We noted real corruption in these institutions due to the lack of monitoring from the local authorities in these governorates. Thus, in the Ministry we are still studying specifying a unified price for medical treatments in private hospitals. In addition, we are looking at how to classify private hospitals. That is, we will put fees according to the services provided by these hospitals, the cost of the equipments used, the health care quality etc. At the present, the fees are random as every hospital put prices regardless the quality of the medical services it provides.
Q: What are the main obstacles hindering the implementation of your plans?
A: The Ministry of Health undergoes many obstacles. The Ministry is planning for the next years to work on raising the per-capita share of individuals regarding medical services. In Bahrain, for example, the individual share is 100 US Dollars while in Jordon it is 150 US Dollars per person. In Yemen, it is only 3 US Dollars.
There is also unfair distribution of funds to the medical services. The government allocates 5000 YR (approx. 25.5 US Dollars) per bed in Al-kuwait Hospital, 8000 RY (approx. 40.8 US Dollars) per bed in Al-thawra Hospital while one bed in a hospital in Hajja governorate (supported by Saudi Arabia) is allocated 200,000 US Dollars yearly. We hope to raise the budget of the hospitals to improve the medical services. In this regards, I put this issue in one of the cabinet meetings and I can say that I found an understanding. Talking with donor countries also helps us to finance medical projects and programs. For example, the donors support the polio companies and malaria program.
Q: A month ago, newspapers reported that a monitoring medical committee has found two non-Yemeni doctors with a license to practice medicine although they had no medical knowledge. What is your comment about that?
A: Giving licenses is the responsibility of the local authority in the governorates. Local authorities' role is to watch, supervise and change, whereas the role of the Ministry of Health is to evaluate the performance of the medical institutions there. The Ministry gives a primary licence for practicing medicine in the basis of a letter from the General Authority of Investment. Then the Ministry has no authority at all, even the reconstruction of medical institutions became the responsibility of the local authorities. As a Minister of Health, I can't change a director of a hospital because this is the responsibility of the local authority according to the law.
Q: How do you describe Yemen's health condition?
A: Health situation in Yemen is poor and is categorized number 141 amongst 191 countries around the world. There are diseases and non-diseases problems related to health management, health information system and low coverage and accessibility.
The condition is terrible with high infant and maternal mortality rate, Malnutrition, low birth weight, high prevalence of diarrhea disease, acute respiratory infections, Malaria, complication of pregnancy and deliveries. There is also an increase in the prevalence of communicable and non-communicable disease.
Q: What are the areas of cooperation between the Ministry and its partners?
A: Areas for cooperation are many, but as a priority, the Ministry considers the following:
– Increasing reproductive health services at all district hospital and health centers, as 75% of the deliveries take place at the community level not by trained health personnel.
– Increasing coverage and accessibility to Primary Health Care and that will be through providing affordable health care to minimize incidence and prevalence of communicable disease, which will reduce infant morality rate and maternal mortality rate.
We have here a five-year health plan (2006-2010). Any future cooperation should be according to this plan. Programs include health management system, essential service packages with special focus on Primary Health Care, quality Assurance and blood safety and training.
Q: What is your plan concerning Millennium Development Goals?
A: The development process and health should go in line with the government Millennium Development Goals and Poverty Reduction Strategy Plan. In this regard, I suggested to the Yemen Development partners many measures that can be taken such as the provision of free contraceptive pills to rural areas where 75% of the population live. I also pointed at the importance of human rights, which should be respected via providing decent Maternal Child Health Family Planning (MCH/FP) services for woman in general and those living in the rural areas in particular.
I mentioned the social health insurance that will improve the performance of the health system and provide additional resources for funding good quality of health care. It is the essence of health sector reform .I asked for technical and financial support in this area.
As for Health Management, which is the weakest point in the health system at all, I believe more attention must be given to this point. This can be achieved by using different ways and means like training, planning, utilization, decentralization and accreditation.
I also referred to District Health System, which needs to be core for HSR at the district with more emphasis on simplification of financial procedures, community participation, financial sustainability and transparency. Health care provision must be provided integrated in the district level.
To achieve such goals, the Ministry plans to enhance and strengthen donor harmonization and alignment through agreements on specified 5 to 6 priorities with more emphasis on Primary Health Care, Reproductive Health, Health Management and joint health sector review.
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