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

Many of you have noticed a number of newly refurbished departments in our hospitals. Their new design may be appealing in some ways but, in most instances, are not in-line with basic patient safety standards. It does not take a health care architect to tell you that slippery marble or granite flooring is hazardous, it is intuitive. When looking more closely at critical areas of a hospital such as emergency departments, where design can dramatically improve or, conversely impede, patient care, we notice that in most of our public facilities patient flow and access to life-saving equipment and medications are hindered by inappropriate architecture thereby defying their purpose. Despite being obvious even to the layperson, hospital administrators, departmental chairpersons and government officials seem to disregard major safety issues when addressing renovations or new constructions. It would only seem natural to involve experts in health care design when engaging in such activities. Furthermore, it is a well-established fact that ergonomics, cost-effectiveness and safety are not priorities when construction contracts are negotiated. Delegated contractors aim at maximizing their commissions by reducing the overall costs. This is often done by minimizing consultancy costs, sacrificing quality for quantity when purchasing hardware and recruiting cheap labor. Such practices are further encouraged by a legal environment that remains overly protective of administrators and health care professionals. Lawsuits are only a theoretical concern that, astonishingly, many physicians will use as an excuse to practice nonsensical medicine. Incidents have occurred and will continue to do so until our leadership decides to put an end to this malpractice.

Another indicator of an ailing system is our recruiting habits. As previously mentioned, there is a trend towards employing unqualified workers. Certain underdeveloped areas have plunged into an employment spree with the unique goal of filling in the gaps. Such areas include psychiatry, emergency medicine, surgical sub-specialties, emergency medical services and nursing. I was astounded to discover that some of our newer recruits have little if any experience in their field. As an anecdote, a colleague recently interacted with an emergency medical technician (EMT) who admitted to being out of practice and, instead, selling vegetables for the past two years prior to arriving in Kuwait. According to a recent report published by the Kuwait Institute for Medical Specialization (KIMS), we will continue to lack experts in various specialties by the year 2020. So, while we train the future leadership needed, we must demand the recruitment of motivated, well-trained clinicians, nurses, researchers and educators from various Western Nations to raise the level of care, if not to that of those nations, at the very least to that of our neighbors.