By Tareq Neman
We visited a public hospital in Damascus and found that the main problem is not the unqualified doctors of old equipment. The real problem was the terrible services, which some officials say is the result of the large number of patients who come from all over Syria. But what about hospitals in Damascus Countryside? The Ministry of Health mentioned that the occupancy rate of these hospitals was around 68 percent for the first half of the year 2010. There were 41,000 patients admitted to hospitals and 956,352 services rendered, huge numbers for only six months. Did these patients find the necessary services in the hospitals spread all over Damascus Countryside (Dumma, Qalamoun, Dayr Atyeh, Yabroud, Qarra, Zabadany, Harasta, Jayroud, Daraya). The Directorate of Health in Damascus Countryside shows that the medical team in those hospitals carried out 14,106 surgical operations, including 2,160 caesarean surgeries, 978 famine surgeries, 2,178 IR patients and 8,784 natural births. Outpatient clinics provide services to 187,268 patients and the laboratories carry out about 586,068 tests, 108,372 x-rays, 4,416 CT, 37,386 ECO, 7,590 kidney machine sessions, 1,140 gastrointestinal endoscopies and 774 lithotripsies. Ahmad al-Doura, Associate Director of the Directorate of Health in Damascus Countryside said that the directorate is trying to expand the scope of its health services by building more hospitals in Dayer al-Assafyer, Yabroud, Almeleha, Daraya, Qtana, Erbyn, Jourjaneah, Kessweh and Qutayfa. They are also considering transferring the hospital in Ayn Afeygeh to Basymeh, renovating the existing hospitals, transforming the health center in al-Nashabeyah into a hospital and building clinics in Addra in addition to two public clinics in Halboun and Ras al-Maara. Yabroud Hospital Everyone who knows Yabroud Hospital calls it the slaughterhouse. Everyone admits that the staff in the hospital is qualified. The problem, as we were told by the ER doctor, is that any doctor joining the staff will be disgusted by the services provided and therefore, will not feel motivated to work as hard as he could. Some doctors will direct the patients to private clinics, while others simply leave. The doctors see the hospital as a form of punishments. Doctors clean floors without sterilizing them and don’t bother cleaning the beds. Sterilization is a luxury reserved for the surgery room. A student from the medical faculty said that once while in the hospital, he saw the head nurse instructing students on how to perform injections. The nurse touch the tip of the needle with his finger then injected it into the student’s hands without sterilizing either the needle or the student’s hand. This is just one example of the health hazards at Yabroud hospital, which pushes medical students and doctors to take up positions in al-Nabek Hospital or Barer Ateh Hospitals, while the remaining doctors are less skilled. The administration of Yabroud is chaos. All employees and doctors seem to put more time into gossip and their personal lives than with the patients. No one has taken control of the situation. Some ER doctors called the front desk to announce that a female patient needed a transfusion. After joking around with the secretary and asking how her family was doing, the secretary hung up and called the doctor in charge of transfusions. After chatting and asking about his family, she asked him to report to the ER room to receive a patient in bad condition. Finally, an alternate doctor arrived 30 minutes later. Fix the machine, I will hold the heart A tragic example of negligence in Yabroud hospital occurred when a patient died in the surgery room. The patient was suffering aoritc arch dissection. The doctors told the parents to take him to al-Assad hospital because Yabroud is not equipped for such surgeries and if the patients chose to have the surgery done in Yanroud, which does not have the necessary equipment, they must accept full responsibility if things went wrong. Doctors started the surgery even though they didn’t have the appropriate equipment. The heart stopped after they failed to find the defibrillator. They asked to use the defibrillator in the emergency room, but the device was broken. They began repairing the machine as the patient lay on the table with his chest opened up. The patient died before the machine was fixed. Why would the doctors perform the surgery knowing it would not be successful? The defibrillator is not the only thing in the hospital that doesn’t work. Many of the devices are in disrepair. The problem is due to neglect. The equipment is not maintained and if it is broken it is put aside and forgotten until it is needed. How can a hospital function with no repair crew as the other hospitals have. Inspections by the Ministry of Health are not at all strict and resemble a family reunion more than an inspection. Al-Nabek and Dayer Ateyah hospital The conditions in these hospitals are much better than those in Yabroud Hospital. Al-Nabek hospital is not financially supported by the Ministry of Health, but is financed by local residents and other private citizens. Even so, the hospital still needs much support and attention because of the strain on an insufficient staff and a shortage of beds. Dumma and Daraia Hospitals The most obvious problems at Dumma Hospital are the dirt and cockroaches. In spite of complaints published in official newspapers, the situation continues to worsen. Dumma Hospital is one of the most crowded hospitals in Damascus country side. The reason for the dirty conditions, according to the director of the hospital, is not the cleaners but the patients and their families, who leave food waste in the cupboard next to the patients bed or they may set on the floor and to eat or even they cook in the garden. They visit the patient as if attending a party. They urinate in the garden. This behaviours attracts insects and vermin to the hospital. The Ministry of Health assures that they are preparing to construct a multi-story building to replace the old Dumma Hospital because insects easily penetrate the building. Dumma hospital is equipped with modern medical equipment and an expert medical staff. The surgery rooms are large and equipped to receive large numbers of patients at the same time. The main problem is sanitation and the tight financial budget Every time we talked to any director of any public hospital in Damascus Countryside they assured us that their budget was sufficient. If the budget is enough, then perhaps poor organization and use of the funds is the problem. We as Syrian citizens should work together to change the conditions in the public hospitals and work to keep the facilities clean and new. We will all need these hospitals one day or another.