allAfrica.com: Rwanda: Medical Services Need Urgent Treatment (Page 1 of 1)

As the report of the auditor general recently indicated, the quality of medical services still leaves a lot to be desired. Towards the end of last year the then state minister in the ministry of health, Dr. Innocent Nyaruhirira, emphasized that the ministry was putting more effort in improving the services in health centers, district hospitals as well as national hospitals such as CHK and King Faycal hospital.

A girl in a hospital; given the poor services in some health centers, it can take you ages to get there.

However, a visit to any health center shows that this objective is far from achieved. Often, patients are ignored and sometimes they end up going home with out seeing a doctor as the nurses keep postponing their consultation.

Maria Nyirabarame, a mother of four children, is one of the many that have experienced the poor services of health centers. After two of her sons caught malaria, she had to face the inevitable: traveling almost 5 kilometers to Kicukiro center find treatment for her sons.

Being unable to afford the motorbike fares, and with no public transport commuting the area, she had to ask a neighbor to escort her and carry one of the sick boys.

But she had to wait four days to get the children treated. "Every morning we went to the hospital as both of my sons' health was deteriorating by the day, but every time we were told that no doctor was available," she says. Nyirabarame, who works in one a supermarket, adds that journeys to the hospital made it impossible for her to go to work, and she feared that she might be fired.

She explains that it was only after a heated exchange between her and the nurse that she finally was able to see the doctor.

According to some of the patients at Kicukiro health center, there is a big problem of lack of proper services and the way the nurses mistreat the patients. They further complain that those who come without a mutuelle cards are often given preferential treatment, as they pay the entire sum immediately.

Private hospitals

However, concerns of poor services in health centers are not confined to Kicukiro alone. According to one Isaac Iyamuremye a resident in Kimironko, proper service and working efficiency still lacks in most centers.

He says that due to this inefficiency, he has opted to go to private clinics which might be more expensive but they have a better service. "Of course I have my mutuelle card, but then the kind of service one receives at the health centers doesn't help a lot," Iyamuremye says.

He recognizes, however, that despite the poor services, the health centers have a role to play, since not everybody can afford the fees charged at private clinics. "There is need to improve on the services offered at the health centers, because now a lot of patients go through hard times before they are treated," Iyamuremye remarks.

He adds that taking a patient to the health center at night is the worst experience of all. He says that most of the time, you will find the nurses asleep or busy discussing private matters instead of attending to the patient.

"It can take an hour or two before you are approached by a nurse, who then proceeds to hurl insults at you for having arrived late or asking why you couldn't come the next day," he says.

Moreover, he remarks that when a patient is to be transferred to another hospital, it seems to take ages before the transfer papers are sorted out - an inefficiency which might lead to health complications of the patient.

Medical ethics

Even though health centers score the worst when it comes to proper and efficient services, the phenomenon is also found in Government hospitals such as CHK, where patients are often overlooked by the nurses, which might lead to serious complications.

"It is a violation of medical ethics not to treat patients properly and ensure that they will be attended to. It really costs nothing to show courtesy to patients," says Ignatius Karimunda an internship doctor student at Kibagabaga Hospital.

Lack of qualified staff is part of the problem of poor services at hospitals and health centers. Although the ministry of health should be commended for its efforts in recruiting graduates in medicine into the health sector, there is still a need for more qualified personnel if the issue of poor services is to be tackled.

However, most of the graduates tend to go for greener pastures in non-governmental organizations to deal with health such as the World Health Organization (WHO), Unicef or Intra health.

During the performance audit report on the implementation of health policies, the report of the auditor general for 2006 showed that apart from poor services, the health sector is also marred by an acute lack of equipment as well as of staff.

The report further indicated that at least 25% of Rwandans have no access treatment facilities they live too far away from the nearest hospital. It was further noted that practices such as family planning are not used, and that most of the people are not aware of the necessity of family planning.

The report pointed out that issues such as religion and segregation were the main hindrance of family planning policy. It also suggested that the quality of health care should be improved.

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