Despite USAID renovation, Amran medical centers still await doctors, equipment [Archives:2008/1174/Health]
By: Jamal Al-Najjar
Medical centers in Amran governorate's Habour Dhulaima and Swair districts still suffer lack of health services and specialized staff, despite recent intervention by the United States Agency for International Development, or USAID.
Residents of the two districts complain about lack of health services and poor access to city hospitals, especially given that these areas have endemic diseases requiring urgent care.
In Habour Dhulaima, located approximately 165 kilometers north of Sana'a, USAID built a residence for Habour Dhulaima medical center's personnel and provided the center basic medical equipment such as an ultrasound machine and an echo-cardiogram (known as an ECG), which measure the heart's electrical pulses. It also provided the center health education equipment and trained local midwives to serve at the center.
According to the center's manager, Yahya Mohammed Al-Ahmar, “More than 45,000 Habour Dhulaima residents – and many from the nearby districts – will benefit from this center, particularly after USAID's recent renovation.”
He notes that the center offers reproductive health services, X-rays, ultrasounds, essential medical checkups, vaccinations and tuberculosis treatment. However, due to lack of specialized doctors and medicine, the center, which was established in 1985, still can't offer district residents proper health services.
As Al-Ahmar explains, “Because we have only one general practitioner, we can't perform any surgeries and while USAID provided us an ECG, no one can use it. We have a delivery room, but we have neither an obstetrics department nor a female surgeon to help those women who require Caesarean sections during childbirth. In such cases, we're forced to transfer them to Sana'a hospitals for surgery there.”
He further notes that because the majority of residents are poor, they can't afford to travel to Sana'a for treatment, as hiring a vehicle to the capital city costs more than YR 20,000. Additionally, the road is unpaved and the conditions upon it are very bad.
“If we had an obstetrics department and a female surgeon, area residents would receive health care here at the center and they wouldn't have to suffer the long trip to Sana'a for treatment,” Al-Ahmar says.
The center's sole general practitioner, Dr. Abdullah Saif Al-Salihi maintains that the facility has witnessed a noticeable increase in the number of patients coming for treatment, but he says the center often can't meet residents' demands because it can't provide the necessary treatment for several diseases specific to the area.
Due to impure drinking water in Habour Dhulaima, bilharzia and renal failure are endemic to the area, according to Al-Salihi, who points out that the center has a shortage of bilharzia medicine and that most bilharzia patients are children. Kidney stones and associated problems are among the area's major complaints due to the salinated water residents drink.
“Kidney stones are common among area residents. You may find three or four patients in the same family with the same disease,” Al-Salihi says, adding that the center can't offer such patients the required treatment due to lack of medicine in its pharmacy.
Ali Ahmed Shuraha, a resident of the town of Habour Dhulaima, says he has suffered renal failure for a long time, but the center can't offer him anything. “I must travel to Sana'a at least twice a week for dialysis [cleansing the blood through a machine],” he explains, “Each trip to Sana'a costs me around YR 15,000. I can't afford to pay all of these costs because I'm poor.”
Al-Ahmar confirms that there are more than 20 renal failure patients just in the town of Habour Dhulaima alone, most of whom are poor. “Despite the fact that they're poor, some are obliged to rent a house in Sana'a in order to better access the hospital where they do dialysis,” he says, noting that even diabetics suffer due to a lack of insulin, which they can only get in Sana'a.
“The number of patients we see is related to the services offered,” Al-Salihi says, adding, “In the past, our center would receive approximately 300 patients per month, but that number now has increased to about 500 due to the recent USAID renovation. Regardless, we transfer most cases to Amran and Sana'a hospitals because we don't have a female surgeon, an obstetrics department or even medicine.”
Additionally, Al-Salihi reveals that the center's pharmacy lacks necessary medicines, adding that the pharmacy sometimes runs out of medicine and waits more than three months for the Amran Health Office to provide more.
“Imagine some patients coming to this center for treatment – we often prescribe them medicine, but unfortunately, they find nothing at the center's pharmacy,” Al-Salihi says. “As a result, they must travel to Amran to purchase medicine at their own expense because there's no private drugstore here in town.”
“No specialists, no female surgeon, no qualified lab technician – how can I depend on such a medical center?” asks Ali Ahmed Jurfan, a Habour Dhulaima town local. “The pharmacy doesn't cover even 10 percent of the required drugs, so even if we receive treatment at the center, we must travel to the city to buy medicine.”
Serving the entire district are 18 USAID-trained midwives, some of whom work at the center while others help deliver in homes, which reduces the pressure upon the center, but also increases the potential for maternal deaths.
The situation at Shaib Medical Center in Swair district, located some 180 kilometers north of Sana'a, is similar to the Habour Dhulaima center, but is worse in terms of essential health services. USAID has provided the center an electric generator, built a residence for staff and established an obstetrics department.
However, because all of the center's personnel are technicians and there isn't even one general practitioner, it can't offer even the minimum level of health services, according to Hind Saleh Qayed, a midwife at the center.
“We don't have any delivery needs such as gloves, disinfectant, oxygen or even gauze. As a result, area residents don't come to the center – especially women, who need family planning. More than 20 percent of women are concerned about family planning, but they don't come here because there are no health services,” Qayed says.
Manager Mahmoud Yahya Abu Helfah points out that the center has only two midwives, a lab technician and four nurses, noting that the center, which serves approximately 12,000 people, desperately needs equipment and a female doctor who can offer prenatal maternal health care.
He adds, “Sometimes, we don't even have paracetamol; thus, the Amran Health Office and Yemen's Health Ministry should consider our center's situation and provide us the essential needs.”