USAID renovation suffers setbacks Al-Qafla Rural Hospital: Well equipped, badly staffed [Archives:2007/1066/Health]
Jamal Al-Najjar
Over $250,000 was provided by the United States Agency for International Development (USAID) to offset renovation and equipment costs for Al-Qafla rural hospital, located in Amran governorate, around 150 km north of Sana'a. Despite this generous allocation of funds, the hospital suffers a lack of health care specialists who can take advantage of the recent facility improvements and offer proper health services to the residents of the area. In addition, the hospital's operational budget is insufficient to cover the health care needs of area patients and improve citizen health services, particularly in the reproductive health unit.
The renovation and equipment enhancement in Al-Qafla District is part of the USAID's Basic Health Services Project (BHS), serving five Yemeni Governorates- Sa'ada, Marib Al-Jawf, Shabwa and Amran. With proper staffing and financing, the hospital in Al-Qafla will be able to offer better services to the citizen population thanks to the recent contribution by USAID.
Dr. Yahya Al-Babili, BHS Project Deputy Director, maintained that BHS is concerned with training doctors and midwives, as well as equipping and renovating health facilities in the five governorates in order to improve available health services in those areas. He further added that all assistance from the BHS projects is provided in collaboration with Yemen's Ministry of Public Health and Population, whose function is to staff facilities and provide the operational budget.
In the past, the hospital in Al-Qafla contained only fifteen rooms wherein residents got simple health services including immunization. Then, USAID built a two-storey building, which contained within it a doctor's residence, delivery room, surgery room, and two additional rooms, one of which is for the hospital and the other for the generator. This building also contained within it most of the medical equipment needed to diagnose and conduct common surgical procedures, especially in the gynecology and obstetric units.
“The hospital now is able to conduct almost all the common surgical operations such as an appendectomy, herniorrhaphy, tonsillectomy, cesarean section and others. But unfortunately, there is not even one specialized doctor in the hospital,” said Mansoor Khameera, Manager of Al-Qafla Hospital, adding, “We are in need of specialized doctors and enough finances in order to run the hospital and offer the required services to people. The hospital's current budget is YR 90.000, which is not enough even to cover water expenses. So, unless we are provided with specialized staff, the hospital can not meet its potential.”
Khameera maintained that the hospital serves more than 42.000 residents in Al-Qafla district in addition to residents from three other neighboring districts (Al-Esha, Al-Madan and Shihara), revealing that due to the hospital's poor services, patients who are in need of any surgical procedures are transferred to Khamir district hospital, around 65 km from Al-Qafla.
He further added that more attention should be paid to reproductive health service, stressing the hospital's need for female staff, including a surgeon in the obstetric unit and midwives. He noted that lack of female doctors is a disservice to residents who need to bring women into the hospital, due to traditions followed in the area.
The hospital now contains only two nurses, two lab technicians and four administrators including the manager who is still GP (General Practitioner). In addition, the hospital lacks a pediatric department.
Al-Qafla Health Office Head, Rajeh Saleh Al-Qudaimi, said that the hospital lacks specialists, especially in the gynecological and obstetric units. According to Al-Qudaimi, ten midwives were trained by the Social Development Fund and six others were trained by USAID (during past health projects of the agency). This trained staff has not been employed despite completion of their training a year ago. In addition, nine nurses were trained by the government to work in the hospital and they have been waiting for two years to be employed but to no avail.
Residents express their hope that they will benefit from the development the hospital recently underwent. However, they don't hide their concerns that the government may not make use of the improvements, as the hospital hasn't been provided with specialists and the required operational budget.
“We are grateful to the USAID for its efforts to support health facilities in the area and we want the agency to follow up with the work in the hospital because we are afraid that it may be subject to negligence,” said Abdulla Saleh Abu Mulook, Head of the district agriculture and irrigation office and an Al-Qafla resident.
Abu Mulook maintained that immunization services are very weak and that the hospital's pharmacy lacks most of the essential medicine needed to fill resident prescriptions. “If the government doesn't provide the hospital with the necessary staff, finances, and medicine, then the agency's efforts to renovate and equip the hospital will not be fruitful,” he commented.
For his part, Dr. Abdulghani Al-Ghuzzi, Head of Amran Health Office, maintained that the Ministry of Public Health and Population is due to employ midwives and increase the hospital's budget. “The Ministry promised that nine midwives will be employed within a month (during July) and that the hospital personnel will be given incentives,” he said, adding, “With regard to the hospital's finances, the Ministry promised to increase the operational budget beginning from July.”
The local district authority received the same promises from both the governorate authority and the Ministry of Public Health, according to Ali Mohammed, head of Al-Qafla district. “When the governor visited the hospital, he told us that he was following up the with the Ministry of Public Health concerning provision of staff. Now, we are still waiting for the Ministry to fulfill its promises.”
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