sympathy and healing for a sick system

I sympathised with Dr. Ian Clarke last Sunday as I read his article on private health care and the progress made by the International Hospital Kampala and International Medical Group since their inception.

But I sympathised more for Remie Nakintu Wamala and thousands of others who die every day in hospitals and health centres in Uganda, public and private, because of corruption, neglect, laziness, ineptness or sheer stupidity across the chain of health care.

Whenever someone dies under medical care, everybody becomes an expert; a lay pathologist of sorts, with clear explanations of cause of death, and perfect hindsight as to what could have been done to prevent death.

It’s uncanny how accurate our views normally are when they don’t really matter and emotions are high.

Most frequently, the targets of blame and wrath are the medical professionals who were “negligent”, “inept”, “incompetent”, “rude”, “cruel”, “unkind” and, ultimately, “killed (him/her)”.

In the case of Remie Wamala, the International Hospital Kampala is the target, and this is not a position that is new to the hospital.

It is a more painful position, for some of us who knew her, because Remie Wamala worked extremely hard for the cause of preventing needless maternal deaths in Uganda. I first met her last year while working on the Everyone Is Me project with Save The Children, from which organisation she had been seconded to the Parliament of Uganda to work as Coordinator of the Uganda Parliamentary Forum for Children.

She smiled all through our discussions and meetings, and had a gusto for this cause that warmed me so much so that she was on my list of special New Year’s messages this year – and she was my second work meeting of 2013.

The manner in which she passed on still sends chills down my spine at the memory of a harrowing four hours spent reviving someone very close to me who was in exactly the same position as Remie a day after giving birth.

I still swear that the nurses were to blame, in my case, for not having administered the right medicine at the right time even though the doctor had specifically told them to do so and we had reminded them a couple of times thereafter.

By the Grace of God, we did not end up at a graveside, and moved on pretty quickly but not without giving the hospital a heavy feedback session, and memorising the face of the nurse in question so we never get served even a glass of water by her if she eventually justly ends up as a waitress.

But this can’t be the conclusion all the time – moving on till the next death or close shave.

And neither can blaming the hospitals and doctors. Again, I sympathise with Dr. Ian Clarke and other hospital owners and health centre owners and managers. They normally hear of these cases and despair as much as we, the victims, do.

In most cases they are extremely sympathetic, apologetic and quite genuinely helpless, but in some cases, they come off as uncaring and arrogant – as IHK’s General Manager, Alex Alexander, did last week in an email to a lay complainant:

“I implore you to react based on facts and not propaganda…here are some facts for you to mull over (insert, unbelievably, press release content re: ISO certification and other successes of IHK). Rest assured ANY death at our facility is looked into and scrutinized from all perspectives. Please do not discourage us from doing our jobs, but rather support us, by not indulging in baseless stories.”

The person he emailed had lost his mother there just a month ago and is still fighting to come to terms with how it had happened, so the doubly-named Alex Alex struck the wrong tone in his over-assured, non-apologetic, unsympathetic email.

Alex Alexander aside – very far aside –I sympathise with ordinary health workers most of all. As we discussed many a time in the project Remie worked on, health workers, not Alexander, are often over-worked, under-paid and very, very under-appreciated – and this makes it easy for them to err. 

The analysis of this problem is much lengthier and deeper, yet the solutions are simple. They certainly don’t lie, as Ian says, in attacking private hospitals who are filling a gap that should rightly be filled by a public sector which chooses to focus its facilitation, recruitment and wage or salary allocations on administrators, legislators and technocrats.


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