The Health of Kuwait – A Wake up Call (Part I)

Health is neither a luxury nor a commodity; it is an unquestionable right of every human being. Governments must strive to provide the best possible care to their people. The public must be informed of advances in health care and have access to a scope of quality services. In an altruistic realm this could probably stand as a moral statement. Truth be told, health must also be looked upon as an investment as a healthier population is a more productive one. Illness impedes on the socioeconomic progress of our nation by reducing productivity through the lack of manpower. This may seem to be a moot point knowing that Kuwait’s economic expansion has been unprecedented in the last couple of years. Thanks to our desirable resource, we have achieved a growth of close to 20% in 2004 alone, continuing to fair well to this day. So, what is the point you may wonder? Well, with health being the third largest budget, you would expect our health services to flourish accordingly. They do not. People in the business will tell you that, in the recent decades, the quality of services has been steadily declining. Can we objectify this? Standard markers of a population’s health such as infant and maternal mortality rates or life expectancy can be deceiving as they do not adequately highlight certain deficiencies in primary, secondary or tertiary prevention throughout life creating a false sense of well-being despite a high prevalence of chronic diseases with worsening courses and trauma-related injuries in the country. The reasonable life expectancy underscores a trend in our disease profile, also seen in the rest of the industrialized world, towards more chronic conditions such as heart disease or diabetes from the more acute, life-limiting infections previously observed in our young and middle-aged populations. A caveat to keep in mind is that devastating infectious disease crises remain plausible if entities such as HIV continue to be neglected and prevention programs for threats like the Avian Flu or, worse, the deadly XDR-TB

No Health without Mental Health

Depression is one of the leading contributors to the global burden of disease in close proximity to ischemic heart disease. It is also a major cause of disability worldwide. Other mental disorders like substance abuse and psychotic disorders have shown to contribute to the global burden of disease in a significant way as well. Despite these well-established facts, mental illness remains marginalized in the majority of developed nations. As opposed to the growth witnessed in funding and resources granted for research in other, more “recognized” diseases, mental illness has suffered a decline in this vital support.

In developing countries, the situation is even worse with long term hospitalizations, infrequent contact with mental health providers, use of old medications with poor safety profiles and few, if any, rehabilitative therapies. The stigma of mental illness extends beyond the public to include health care providers making mental health an undesirable profession exacerbating the poor services.

Lady in White

Upon the increasing awareness of the need for professional unions and consolidating bodies, and with the recent birth of “Kuwait Health United in North America”, the new institution that recently gathered under it’s wing many post graduate physicians and dentists residing in North America, I find it essential to start by pointing out for those who don’t know me, and before they judge me with the contrary, that I’ve historically been and continue to be a furious advocate for women’s rights, and have always favoured the policy of helping our female partner in life help her self rather than the throw of my leftovers for her to pick up and yet expect her to be thrilled about.

Having said that, I believe there is one area that appears to need work most, and that is the Kuwaiti female doctor spirit. I could not help but notice their repeated quantity, or the lack of it, and more importantly quality of contribution that has historically been extremely modest, to say the very least. And here I am referring to the collective quality and quantity of comments by many of our dear lady doctors and sisters and along the years and in many of the other larger e-mail groups that preceded the birth of the new union. And here again I am referring to the quality of intellectual contribution rather than the odd ” GOD bless you for your work”, the “we’re behind you all the way”, and the “add my name brother” e-mails that appeared sporadically here and there. That while keeping an open and watching eye on the rapidly and thrillingly evolving Saudi and rest of Arab Gulf state female doctors and their public and professional engagement I am encountering in this part of the world.

This has also paralleled my general impression of the Kuwaiti woman’s modest political performance in the recently developed political scene in Kuwait, although not necessarily true in the public one, where she has always appeared to have maintained a competitive equal to her man counterpart, which is fine, but in a highly selected female population as in the medical profession in North America, I find her public intellectual absence adverse to her cause, and I honestly don’t see how many are going to survive the professional yet alone political Kuwaiti arena.

Regional Success Stories

After backing the privatization movement, let me begin this post by highlighting one of the region’s most commendable achievements in the public health care sector:

Oman’s hike to the WHO’s 2001 top 10 list of global health care systems.

In the 1970s, Oman’s health care system was struggling with high infant mortality rates, low life expectancies and a poorly-developed vaccination agenda. With the arrival of highly trained and motivated health care leaders who refocused the MOH’s resources into prevention programs, the nation reversed its deficits and now boasts the most efficient health care system in the Middle East, placing Oman at the 8th position on the WHO’s overall best performing systems worldwide. Our neighbors continue today to lead the way in preventative medicine and medical education.

Privatizing Health Care

what holds true of financial or educational institutions holds equally true of the health care sector. the benefits of privatization in reversing the negative effects of a cumbersome public administration, with its complex and, far too often, outdated regulations, lack of incentive or efficient quality assurance measures, have been clearly proven time and again in select nations.

the Saudis, who already operate some of the most advanced health care facilities in the region, have recently announced that in the next year all 200 public hospitals will be turned into for-profit corporations. this is part of the Kingdom’s vision to raise the standard of care and attempt to standardize the quality of care throughout their health care system. click here for more info

following in their footsteps is Dubai’s Department of Health and Medical Services (DOHMS) which plans to privatize its four hospitals to overcome massive losses incurred from years of (dys)functioning as not-for-profit organizations. per the Gulf News report, the hospitals generated revenues covering a mere 20% of their total expenditures. click here for more info

ways governmental agencies can undertake such privatization activities are numerous and include: