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Of unending lines at hospital

10 November 2009

I just want to urge people not to compromise your health for the lines in the hospital. It would be very wise to take the pains of being in line but be healthy by being cautious, while we really hope and wait for a time when we have better facilities, better systems, more doctors and other health staff. It is sometimes quite worrying at the disgust some people express on the discussion forums, some even saying that it is better to suffer at home than to go to a hospital.
I wonder if the waiting and the lines in the hospitals will ever get shorter. I have no experience of working in hospitals of the developed countries but with my experience limited to our neighboring countries with big hospitals and large number of doctors, I fear if increase in number of doctors will really shorten the line or the waiting.
In Sri Lanka, there are more than a thousand doctors, especially in the 1500-3000 bedded general hospitals in larger cities. In and around Colombo itself there are about four big hospitals including the National Hospital of Sri Lanka. These hospitals have 1000 to 1500 doctors, 2000 to 2500 nurses and all categories of support staff in each. The general OPDs are run by more than 20 doctors, every specialty has their own clinics with 10-15 doctors each that see new and follow-up patients.
The present hospital I am working/training in is a general hospital. Every morning I see patients in line right from the main road, throughout every available spaces, along the steps and corridors to all rooms. People wait thus in rain and sun with umbrellas till they are lucky to come under some shade.
People come with packed breakfast, packed lunch. Some come in the night itself to be in queue for tomorrow, many sleep in bus stops and train stations to come to the hospital next morning. Every day is like a tshechu gathering.
In the wards, there are patients in closely arranged beds, two patients in one bed, patients on the floor, in the corridor, in the verandah, everywhere. The doctors and nurses have difficulty locating which patient is where and have to shout their names to locate them. All levels of staff complain of the work load and patients complain of the lines and the waitings to see a doctor. And remember, Sri Lanka is said to have the best health care set up among SAARC countries.
At the same time we should remember that there are some tests that can’t be done in minutes or even take days. Also as the specialty field grows you may be required to see more than one doctor (to get a second opinion or to refer to a specialist or super-specialist) thus taking more time. This should not be taken as a delay in the care.
In the cities and even in other places, there are plenty of private clinics. In some areas, almost every second house is a private clinic. And you will see there are constant crowds in every waiting lounge of these clinics.
It is very difficult to get an appointment if you want to see the best doctor. So even with private clinics, the lines are long and it won’t be like going into a shop, buy what you want, pay the money and leave.
So if increasing the number of doctors and other health staff is to contribute to shortening the lines, I would say hospitals here should have the shortest lines, but it is not the case. Because the facilities and specialties are unequally divided, everyone from the remote areas by-passes the peripheral hospitals and come here for treatment thus overloading these hospitals. And this is exactly what is causing crowds in our National Referral hospital.
It calls for equal development and facilities with professional expertise everywhere throughout the country.
Even if we have a thousand doctors in JDWNRH, if we still have no facilities and people in the district hospitals, people will still have to travel all the way to Thimphu and the lines in JDWNRH will never get shorter. At least the regional referral hospitals need to be strengthened in infrastructure and manpower, almost equivalent to the national hospital for shorter lines in JDWNRH.
Individual priority for health needs to improve Because we have no access or because we are ignorant, we never visit a hospital or consult a doctor till we are sick. Does anyone visit a hospital to get a BP check-up or to get a kidney function, liver function test or a lipid profile done? Animals (pets) in the developed countries have better healthcare than people of our region. Those animals have regular appointments and check-ups with their vets.
We carry our habits with us even if we go for long term trainings to a developed country. The only thing we have in mind is finish the study, save some money if possible, visit some places, do some shopping and come home. Going for a health check-up without any illness or even with illness sometimes, is the last thing in our mind, and this needs to improve.
Don’t wait with hypertension till you end up paralyzed with a stroke and with diabetes till you end up with multi-organ damage. Health care is every citizen’s right but to a certain extent you should take things into your hand to live healthy and happy. Make the best use of what we have and whenever luck favors you to go to places with better health care than ours, put them to use

I just want to urge people not to compromise your health for the lines in the hospital. It would be very wise to take the pains of being in line but be healthy by being cautious, while we really hope and wait for a time when we have better facilities, better systems, more doctors and other health staff. It is sometimes quite worrying at the disgust some people express on the discussion forums, some even saying that it is better to suffer at home than to go to a hospital.

I wonder if the waiting and the lines in the hospitals will ever get shorter. I have no experience of working in hospitals of the developed countries but with my experience limited to our neighboring countries with big hospitals and large number of doctors, I fear if increase in number of doctors will really shorten the line or the waiting.

In Sri Lanka, there are more than a thousand doctors, especially in the 1500-3000 bedded general hospitals in larger cities. In and around Colombo itself there are about four big hospitals including the National Hospital of Sri Lanka. These hospitals have 1000 to 1500 doctors, 2000 to 2500 nurses and all categories of support staff in each. The general OPDs are run by more than 20 doctors, every specialty has their own clinics with 10-15 doctors each that see new and follow-up patients.

The present hospital I am working/training in is a general hospital. Every morning I see patients in line right from the main road, throughout every available spaces, along the steps and corridors to all rooms. People wait thus in rain and sun with umbrellas till they are lucky to come under some shade.

People come with packed breakfast, packed lunch. Some come in the night itself to be in queue for tomorrow, many sleep in bus stops and train stations to come to the hospital next morning. Every day is like a tshechu gathering.

In the wards, there are patients in closely arranged beds, two patients in one bed, patients on the floor, in the corridor, in the verandah, everywhere. The doctors and nurses have difficulty locating which patient is where and have to shout their names to locate them. All levels of staff complain of the work load and patients complain of the lines and the waitings to see a doctor. And remember, Sri Lanka is said to have the best health care set up among SAARC countries.

At the same time we should remember that there are some tests that can’t be done in minutes or even take days. Also as the specialty field grows you may be required to see more than one doctor (to get a second opinion or to refer to a specialist or super-specialist) thus taking more time. This should not be taken as a delay in the care.

In the cities and even in other places, there are plenty of private clinics. In some areas, almost every second house is a private clinic. And you will see there are constant crowds in every waiting lounge of these clinics.

It is very difficult to get an appointment if you want to see the best doctor. So even with private clinics, the lines are long and it won’t be like going into a shop, buy what you want, pay the money and leave.

So if increasing the number of doctors and other health staff is to contribute to shortening the lines, I would say hospitals here should have the shortest lines, but it is not the case. Because the facilities and specialties are unequally divided, everyone from the remote areas by-passes the peripheral hospitals and come here for treatment thus overloading these hospitals. And this is exactly what is causing crowds in our National Referral hospital.

It calls for equal development and facilities with professional expertise everywhere throughout the country.

Even if we have a thousand doctors in JDWNRH, if we still have no facilities and people in the district hospitals, people will still have to travel all the way to Thimphu and the lines in JDWNRH will never get shorter. At least the regional referral hospitals need to be strengthened in infrastructure and manpower, almost equivalent to the national hospital for shorter lines in JDWNRH.

Individual priority for health needs to improve Because we have no access or because we are ignorant, we never visit a hospital or consult a doctor till we are sick. Does anyone visit a hospital to get a BP check-up or to get a kidney function, liver function test or a lipid profile done? Animals (pets) in the developed countries have better healthcare than people of our region. Those animals have regular appointments and check-ups with their vets.

We carry our habits with us even if we go for long term trainings to a developed country. The only thing we have in mind is finish the study, save some money if possible, visit some places, do some shopping and come home. Going for a health check-up without any illness or even with illness sometimes, is the last thing in our mind, and this needs to improve.

Don’t wait with hypertension till you end up paralyzed with a stroke and with diabetes till you end up with multi-organ damage. Health care is every citizen’s right but to a certain extent you should take things into your hand to live healthy and happy. Make the best use of what we have and whenever luck favors you to go to places with better health care than ours, put them to use.

Dr Tshokey
Colombo,Sri Lanka

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Comments

One Response to “Of unending lines at hospital”

  1. Kota on November 10th, 2009 9:48 am

    Hoping to see you in JDWNRH or any where in Bhutan with that enthusiasm. Also praying that you won’t become a Roman in Rome once you are back in Bhutan.

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