Dr. Arwa Al-Rabi’: “Low pay is liable to affect the performance of the Yemeni doctor & nurse.” [Archives:1998/22/Interview]
Dr. Arwa Al-Arabi’ is the first female to rise up to the rank of hospital general manager in Yemen. She was appointed by the Minister of Public Health on March 24 to run the Sabeen Hospital in Sanaa. A graduate of Egypt, Dr. Arwa holds a B.Sc. in general medicine and an M.Sc. in gynecology. She is now preparing to start her Ph.D. work.
Dr. Salah Haddash, Yemen Times Managing Editor, talked to Dr. Al-Rabi’ about a number of issues. He filed the following interview. Excerpts:
Q: How do you feel now that you are the first female general manager of a major hospital in Yemen?
A: When I first got the post, I had a mixture of contradictory feelings. This is an administrative job which could take me away from my patients and professional research. But it is a challenge.
Q: Have you formulated any plans to further improve services at the hospital?
A: There are now plans to introduce new departments, especially for maternity and mother and child health care. We also hope to establish a cancer treatment center and fertility center.
In general we will work to raise standards of services at the hospital. Plans have already been formulated, and implementation is due to start in the near future. Also, a modern center for family planning is scheduled to be established at the Sabeen Hospital within the next few months.
Q: What organizations are you cooperating with in implementing your plans?
A: In addition to the Ministry of Health – our principal supporter – there are several international organizations and local philanthropists which provide a lot of aid. These include the WHO, the Habbary family, Mr. Ahmed Al-Daylam and many others.
Q: Could you tell us more about the Sabeen Hospital?
A: The Sabeen Hospital was established in 1988. Just a general practitioner then, I was one of the first doctors to start working there.
The hospital has several main departments: gynecology, maternity, pediatrics, internal medicine, surgery, pediatric orthopedics, ENT, quarantine, and the out-patient department.
There are 296 beds and a staff of 52 specialists, 49 of whom are Yemeni, and 64 general practitioners, only two of them are foreign. There are also 155 nurses, 70 of whom are Yemeni – 65 females and 5 males.
Q: Is there a private section at the hospital?
A: The top floor was built three years ago as a private section, which contains 46 rooms for gynecology, 27 for pediatrics. Each room has two beds, a bathroom, a fridge, and a TV. It costs YR 1,500 per night.
Q: Do you think there are many highly qualified Yemeni women capable of occupying senior positions in public life?
A: If given a good chance to have a proper education, Yemeni women can excel in their professional life. There is the nagging problem of low wages, compared to what expatriate workers get. This is the reason behind many Yemeni females refraining from working as nurses. Nursing is an essential part of the medical profession. Nurses have stay with the patient around the clock, especially after complicated surgery.
Social restrictions prevent the majority of Yemeni female nurses from working on night shifts, a problem which may be rectified by giving them better wages. That is why there is a strong reliance on an expatriate nursing staff.
Q: How are salaries determined?
A: The expatriate staff are paid partly in US dollars and partly in Yemeni riyals, according to the civil service charter. Only specialist expatriate doctors are employed. We intend in the future to employ only the best consultants from abroad.
On average, an expatriate specialist get about $500 a month, in addition to other personal perks such as housing, transport, annual vacation and a return airplane ticket.
Q: What about the salaries paid to the Yemeni staff?
A: Money paid to Yemeni staff is just not enough to cover the needs of a decent life, leaving them constantly on the search for other sources of income to take care of the needs of their families. A Yemeni specialist is paid the equivalent of $100 a month, while, a GP gets only $80.
This affects their performance on the job, by one way or another. The nervous tension created by the worry over the chronic shortage of money is liable to affect the performance of the Yemeni doctor or nurse.
Q: Are medicines available free of charge for the patients?
A: We try our best to provide all the essential drugs, especially for the emergency and surgery departments. Free meals are available for all the hospital inmates.
Q: What procedures are followed for admission into the hospital?
A: Admission procedures are very easily facilitated through the out-patient department, in which the patient’s condition is first assessed and then referred to the hospital department concerned.
Q: What are the working hours at the Sabeen Hospital?
A: We work 24 hours a day.
Q: How many patients visit the hospital every day?
A: The number varies, but it is in the hundreds.
Q: What are the most prevalent diseases?
A: Diseases differ from one area to another and from one education level to another. As far as feminine diseases are concerned, the most prevalent cases are of child bearing and delivery complications.
Children also usually suffer from nutritional deficiencies and diseases caused by lack of hygiene.
Q: What are the main causes of such diseases or complications?
A: The main cause is lack of awareness of the importance of hygiene and the need to go to the doctor during the early stages of an illness. There should be more health education at schools and community centers. Midwives have to be fully trained to do their job properly.
Complications also arise because of the lack of a proper emergency and ambulance system. Cases of hemorrhaging in particular get complicated because the patient is not speedily brought to the hospital. There is an urgent need to provide an efficient ambulance system and a well-stocked blood bank to take care of emergency cases.
Q: How much are patients charged for surgeries?
A: Patients have to pay just the basic cost of the operation. Those who cannot pay get an exemption or a big deduction. A cesarean section at the Sabeen Hospital, for example, now costs YR 5,000 – the same as it did three years ago. Baby delivery costs just YR 1,000.
Q: How can public awareness be raised regarding personal health and hygiene?
A: Primary health care centers and child and mother clinics must be improved and equipped with modern facilities so that illnesses and possible complications are diagnosed or predicted at an early stage.
The other important thing is to conduct national campaigns to raise parents awareness of the necessity to vaccinate their little children against the common childhood diseases.
Q: Do you have good reserves of blood at the hospital?
A: Sufficient blood supplies are hard to come by. Our blood bank contains two small fridges only and the necessary plastic bottles are not enough. Although stocks are replenished by blood donors, the necessary blood tests are not carried out swiftly to make sure that the blood is free of contagions such as the AIDS and hepatitis viruses. The necessary chemical solutions used to do blood tests are quite expensive. We sometimes seek the help of the Central Laboratory in Sanaa to conduct these tests. All this causes numerous delays. We now have plans to expand and develop the blood bank at the Sabeen Hospital. The new pediatrics emergency ward, due to open in July, will be equipped with a full blood bank.
Q: Any last comment?
A: The Sabeen Hospital needs a cancer treatment center and an intensive care unit to be able to provide better services.
There is still a lot to be done in the health-care sector in Yemen. We have already began the process of modernization so the future seems more hopeful.